Qualifying Documents Redfern
LOYALTY OATH °~'~•"~~"`~~~
CANDIDATES WITH NO PARTY AFFILIATION ~~~~ s~~ ~ ~
(Sections 878.05-878.10, Florida Statutes) ~~~~ ~a~ ~~
STATE OF FLORIDA r ;
I~~~G""_'' COUNTY
Please Print
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Flret Narrw MIddN NamaAnltial L~ Narrw
a citizen of the State of Florida and of the Untied States of America, ... and a candidate for public office ... do
hereby solemnly swear or affirm that 1 will support the Constitution of the United States and of the State of Florida.
OATH OF CANDIDATE
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(nLEASE wBNr NAME As YOU wIBII 1T TO APPEAR ON THE BALLOT -NAME MAY NOT BE CWtNOED AF/ER TIE: END of QUALB°YING)
am a ca idate for the office oY~~M~.~~~~-~ N/A N/A
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. I am a qualified elector of ~~~~~~ f1~ County, Florida.
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I am a qualified elector of the City of Miami Beach, Fla., residing within the City at least one year before qualify-
ing for the City of Miami Beach elected office, with my legal residence being:~~-i-~-l-~~ ~Y!J av
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 resign from any office from which 1 am required to resign pursuant to Section 99.012, Florida Statutes.
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Sworn to (or affirmed) and subscribed before me this .~ day of s~ - . 200.
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Produced Identification:
Type of Iderdification Produced:
nature otary Public - 8ta
Print, Type Stamp Commissioned Name of otary Public
,o ~:~. °~~;• KEFHY H[RNANDEZ
=:~ *= MY CQMMISSION N DD 626373
~o EXPIRES
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Banded Thru Notary Public Undanvniers
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FORM 1 STATEMENT OF 2008
PleasepriMwtypeyourn.m.,malang FINANCIAL INTERESTS
addreee, agency Warw. and pesitfon twlow:
LAST NAME - FlRST~ MIO NAME
FOR OFFICE
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USE ONLY: ~--~ ~'~..
MAILING DRESS:'°.~~v
ID Code ,~ '~ .'A.~"
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Y 1
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CI ZIP : COUNTY
ID No. '~'
NAME OF AGENCY: G ~? ~~
.,
Cont. Code •~• ~
c~?
ME OF OFFICE POSITION HELD OR SOUGHT : P. Req. Code
You an not 1 mibd t<i tM epaee ee t!w three this fbrm. Al6aeh additiooat eheete, H necessary.
CHECK ONLY IF DIOATE OR ^ NEW EMPLOYEE OR APPOINTEE
"'BOTH PARTS OF THIS SECTION MUST BE COMPLETED"
DISCLOSURE PERIOD:
THIS STATEMENT REFLECTS Y011R FINANCIAL. INTERESTS FOR THE PRECEDING TAX YEAR, WHETHER BASED ON A CALENDAR YEAR OR ON
A FIS~AL„YfAR. PLEASE STATE BELOW WHETHER THIS STATEMENT IS FOR THE PRECEDING TAX YEAR ENDING EITHER (dtedc one):
\F~+ DECEMBER 31, 2008 Qg ^ SPECIFY TAX YEAR IF OTHER THAN THE CALENDAR YEAR:
MANNER OF CALCULATING REPORTA$LE INTERESTS:
THE LEGISLATURE ALLOWS FILERS THE OPTION OF USING REPORTING THRESHOLDS THAT ARE ABSOLUTE OOLlAR VALUES
WHICH
,
REQUIRES FEWER CALCULATIONS, OR USING COMPARATIVE THRESHOLDS, WHICH ARE USUALLY BASEO ON PERCENTAGE VALUES (see
instructions for further detaib}. PLEASE STATE BELOW WHETHER THIS STATEMENT REFLECTS EITHER (d'bck orte):
^ COMPARATNE (PERCENTAGE) THRESHOLDS Qj3 ^ DOLLAR VALUE THRESHOLDS
PART A -PRIMARY SOINRCES ~ INCOME (Major souroes of income to the reporting peroonj
NAME OF SOURCE SOURCE'S DESCRIPTION OF THE SOURCE'S
OF INCOME ADDRESS PRINCIPAL BUSINESS ACTIVITY
v lt,~~ of~~.
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PART B -SECONDARY SOURCES OF INCOME [Ms~r cuatomera, dLerNs, and cther sour~oes of income to businesses owned by the reporting psrson)
NAME OF NAME OF MAJOR SOURCES ADDRESS PRINCIPAL BUSINESS
BUSINESS ENTITY OF BUSINESS' INCOME OF S
OURCE ACTIVITY OF SOURCE
PART C -REAL PROPERTY [Land buildings owned by the reporting person) FILING INSTRUCTIONS for when
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an
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en to fl!e thb form an loeat-
ed at the bottom of page 2.
fl INSTRUCTIONS on who must file
this form and how to fill it out begin
• on page 3.
OTHER FORMS
you may need to
ffie are described on page 6.
CF FnRM 1 _ Fw ~ nnne
ra.vrmnueo on reverse swe) PAGE 1
PART 0 - INTAN(31B1.E PERSONAL PROPERTY [Stocks, bonds, certificates ~ deposit, etc]
PART E -LIABILITIES [Major debts]
NAME OF GREDITOR
ADDRESS OF CREDITOR
PART F -INTERESTS IN SPECIFIED BUSINE88E8 (gip or positions ~ certain types of twsinessesJ
BUSINESS ENTITY * 1 ~ BUSINESS ENTITY #~ 2 ~ BUSINESS ENTITY ~ 3
THE
OWNERSHIP INTEREST
I ~ IF ~P1NY OF PARTS A THROUGH F ARE CONTINUED ON A SEPARATE SHEET PLEASE CHECK HERE ^
31(iNATURE (nqufred):
WHAT TO FILE:
After completing aB parts of this form, including
signing and dat~tg it, send balk only the first
sheet {pages 1 and 2) for fling.
M you have nothing to rapoet in a particular
section, you must write "none" or "n/a" In that
section{s).
Facslmilea will not be accepted.
NOTE:
MULTIPLE FILING UNNECESSARY:
GensraHy, a person who hss fNed Form 1 for a
calendar or fitcpl year is not requ&ed to fife a
second ~FOm1 1 for the sane year. However, a
candidaM who previously filed Form 1 bspuse
of another public positlon must at least ifie a copy
of his or her original Form 1 when quakfying.
~c cnou , ra .........,
DATE 31CaNED (requtrod): I ~/Q.~ 7
I •
WHERE TO FILE:
If you wero maibd the form by the Commission
on Ethics or a County Supervisor of Ebdiona for
your annual disclosure filing, return the form to
that location.
LocNollygrsAsr»p/pyees fib wfihthe Supervisor
of Ebdions of the county in which they pem~a-
nently reside. (If you do not permanently ride
in Florida, file with the Supervisor of the k~unty
where your agency has iM headquarters.)
State offices or apee/Aad stet+e en~rloyeea
file with the Commission on Ethics, P.O. Drawer
15704, Taflahassee, FL 32317-5709; physical
address: 3600 Maclay Boubvarcl, South, Suite
201; Tallahassee, Ft 32312.
Candidates fib this form together with their
qualifying papers.
To determine whdt category your position
falls under, see the "IM1fho Must Fib" Instructions
on page 3.
WHEN TO FILE:
InlgaUy, each local officer/empbyee, state
officer, and specified state employee rr~st
fib wtldNn 30 dtya of the dace of his or her
appointment or of the beginning of employ-
merrt. Appointees who must be confirmed by
the Senate must ffie prior to oonflrrnatan, even
if that is bss than 30 days from the date of they
appointment.
Canc[dates for publicly-elected local otFce
must fib at the same time they fib their
qualifying papers.
Thereafter, local olficerslempbyees, state
officers, and spscfisd state employees are
required to file by Ju~r 1st following each
caendar year in which they hold their posi-
tions.
Finally, at the end of oRkx or empbyment,
each local officerlempbyes, state officer, and
specified state empbyee is required to fib a
final disclosure form (Form 1F) within 60 days
of having office or emolovmant_
PAGE 2
4
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