Qualilfying Documents FernandezLOYALTY OATH OFFICE USE ONLY
CANDIDATES WITH NO PARTY AFFILIATION ~" ~ "' ~ °!:~ ~- ~~
(Sections 876.05-876.10, Florida Statutes)
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STATE OF FLORIDA
,COUNTY
Please Print
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First Name Middle Name/Initial Last Name
a citizen of the State of Florida and of the United States of America, ... and a candidate for public office ... do
hereby solemnly swear or affirm that I will support the Constitution of the United States and of the State of Florida.
OATH OF CANDIDATE
(Section 99.021, Florida Statutes)
T TO APPEAR ON THE BALLOT -NAME MAY NOT BE CHANGED AFTER THE END OF QUALIFYING)
(PLEASE PRINT NAME AS YOU WI
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am a candidate for the office of ( :~~7J
01I1~Zl~~fd'~'~ N/A N/A
(office) ''~~ (district) (circuit)
. I am a qualified elector of /y l~ri, ~~ / 1.9-eQ~ ~ County, Florida.
(group)
I am a qualified elector of the City of Miami Beach, Fla., residing within the City at least one year before quality-
ing for the City of Miami Beach elected office, with my legal residence being: ~ ~ i _
Miami Beach, Fla. I am qualified under the ordinances and Charter of said City and under the Constitution and
the Laws of Florida to hold office to which I desire to be nominated or elected. I have qualified for no other
public office in the state, the term of which office or any part thereof runs concurrent with the office I seek; and
I have resigned from any office from which I am required to resign pursuant to Section 99.012, Florida Statutes.
Signa ure of C (date Telephone Number Email Add
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Aaaress city state zIP code
Sworn to (or affirmed) and subscribed before me this ~~~day of~~~~200~.
Personally Known: ~~ or
Produced Identification: \,~~t!!1!lIINI/~/~
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Type of Identification Produced:
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DS-DE 246 (Rev. 05/08)
FOI~:M 1 STATEMENT OF
2008
Please pHnt or type your name, mailing FINANCIAL
INTERESTS
,
address, agency name, and position below:
g~'~yy
LAST NAME -- FIRST NAME --MIDDLE NAME : C~i rl"" ~ M° ~ ~~ '~ ~.}
FOR OFFICE
USE ONLY:p
MAIL~INy,G ADDRESS : 2~U~ S~P ~ j ~~~ «' ~ S
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~~ ~DYCbde~--ili.`r~ Uy. t Ii. i_
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CITY : ZIP : COUNTY
ID No.
NAM OF AGENCY:
Gonf. Code
0
NA E OF FFICE OR POSITION HELD OR SOUGHT : P. Req. Code
You are not limited to the space on the li on this form. Attach additional sheets, if necessary.
CHECK ONLY IF (~ANDiDATE OR ~ NEW EMPLOYEE OR APPOINTEE
""BOTH PARTS OF THIS SECTION MUST BE COMPLETED'""
DISCLOSURE PERIOD:
THIS STATEMENT REFLECTS YOUR FINANCIAL INTERESTS FOR THE PRECEDING TAX YEAR, WHETHER BASED ON A CALENDAR YEAR OR ON
A FISCA
R. PLEASE STATE BELOW WHETHER THIS STATEMENT IS FOR THE PRECEDING TAX YEAR ENDING EITHER (check one):
~
DECEMBER 31, 200$ ~ ^ SPECIFY TAX YEAR IF OTHER THAN THE CALENDAR YEAR:
MANNER OF CALCULATING REPORTABLE INTERESTS:
THE LEGISLATURE ALLOWS FILERS THE OPTION OF USING REPORTING THRESHOLDS THAT ARE ABSOLUTE DOLLAR VALUES, WHICH
REQUIRES FEWER CALCULATIONS, OR USING COMPARATIVE THRESHOLDS, WHICH ARE USUALLY BASED ON PERCENTAGE VALUES (see
instructions for further details). PLEASE STATE BELOW WHETHER THIS STATEMENT REFLECTS EITHER (check one):
^ COMPARATNE (PERCENTAGE} THRESHOLDS 4B ^ DOLLAR VALUE THRESHOLDS
PART A -- PRIMARY SOURCES OF INCOME [Major sources of income to the reporting person]
NAME OF SOURCE SOURCE'S DESCRIPTION OF THE SOURCE'S
OF INCOME ADDRESS PRINCIPAL BUSINESS ACTIVITY
eC.. I , ~' ~ i~t ? ~ ~1 ~-
~- 1
PART B --SECONDARY 30URCES OF INCOME [Major customers, clients, and other sources. of income to businesses owned by the reporting person]
NAME OF NAME OF MAJOR SOURCES ADDRESS PRINCIPAL BUSINESS
BUSINESS ENTITY OF BUSINESS' INCOME OF SOURCE ACTIVITY OF SOURCE
l ~ r ~ ~~ E
PART C -- REAL PROPERTY [Land, buildings owned by the reporting person] FILING INSTRUCTIONS for when
and where to file this form are l
t
oca
-
~ ed at the bottom of page 2.
INSTRUCTIONS on who must file
this form and how to fill it out begin
on page 3.
OTHER FORMS you may need to
file are described on page 6.
cE FORM 1 - Eff. 1/2009 (Continued on reverse side) PAGE 1
PART D -INTANGIBLE PERSONAL PROPERTY [Stocks, bonds, certificates of deposit, etc.)
TYPE OF INTANGIBLE BUSINESS ENTITY TO WHICH THE PROPERTY RELATES
PART E -LIABILITIES [Major debts)
NAME OF CREDITOR ADDRESS OF CREDITOR
PART F -INTERESTS IN SPECIFIED BUStNESSES [Ownership or positions in certain types of businesses]
BUSINESS ENTITY # 1 BUSINESS ENTITY # 2 BUSINESS ENTITY # 3
NAME OF
BUSINESS ENTITY .~
1
ADDRESS OF
BUSINESS ENTITY
ACTtUtITY BUSINESS ~ ~ ~
POSITION HELD
WITH ENTITY
C~
I OWN MORE THAN A 5%
INTEREST IN THE BUSINESS
~ ~U ~ o
NATURE OF MY
OWNERSHIP INTEREST
fF ANY OF PARTS A THROUGH F ARE CONTINUED ON A SEPARATE SHEET, PLEASE CHECK HERE ^
StGNA
TE
WHAT TO FILE:
After completing all parts of this form, including
signing and dating it, send back only the first
sheet (pages 1 and 2) for filing.
If you have nothing to report in a particular
section, you must write "none" or "n/a" in that
section{s).
Facsimiles will not be accepted.
NOTE:
MULTIPLE FILING UNNECESSARY:
Generally, a person who has filed Form 1 for a
calendar or fiscal year is not required to file a
second Form 1 for the same year. However, a
candidate who previously filed Form 1 because
of another public position must at least file a copy
of his or her original Form 1 when qualifying.
WHERE TO FILE:
if you were mailed the form by the Commission
on Ethics or a County Supervisor of Elections for
your annual disclosure filing, return the form to
that location.
Local otTicerslemployees file with the Supervisor
of Elections of the county in which they perma-
nently reside. (If you do not permanently reside
in Florida, file with the Supervisor of the county
where your agency has its headquarters.)
State ofircers or specified state emplayees
file with the Cammission on Ethics, P.O. Drawer
15709, Tallahassee, FL 32317-5709; physical
address: 3600 Maciay Boulevard, South, Suite
201, Tallahassee, FL 32312.
Candidates file this form together with their
qualifying papers.
To determine what category your position
falls under, see the "Who Must File" Instructions
on page 3.
WHEN TO FILE:
Initially, each local officer/employee, state
offrcer, and specfied state employee must
file within 30 days of the date of his or her
appointment or of the beginning of employ-
ment. Appointees who must be confirmed by
the Senate must file prior to confirmation, even
if that is less than 30 days from the date of their
appointment.
Candidates far publicly-elected local office
must file at the same time they fib their
qualifying papers.
Thereafter, local officers/employees, state
officers, and specified state employees are
required to file by July 1st following each
calendar year in which they hold their posi-
tions.
Finally, at the end of office or employment,
each local officerlempioyee, state officer, and
specified state employee is required to file a
final disclosure form (Form 1F) within 60 days
of leaving office or emolovment.
CE FORM 1 - Eff. 112009 PAGE 2
SUNAMERICAN BANK
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