ReformMB.com DS-DE 5 STATEMENT OF ORGANIZATION OFFICE USE ONLY
OF POLITICAL COMMITTEE a
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1. Full Name of Committee Telephone ... <
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ReformMB.com, Inc. 305 - 8614197
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Mailing Address (include city, state and zip code)
7455 Collins Avenue, Suite 212, Miami Beach, Florida 33141
Street Address (include city, state and zip code)
7455 Collins Avenue, Suite 212, Miami Beach, Florida 33141
2. Affiliated or Connected Organizations (includes other committees of continuous existence and political
committees)
Name of Affiliated or
Connected Organization Mailing Address Relationship
Communications 7455 Collins Avenue, Suite 212 Sponsoring Organization
Workers of America Miami Beach, Florida 33141
Local Union Number
3178
3. Area, Scope and Jurisdiction of the Committee
City of Miami Beach - Ballot Initiatives
4. Nature of Organization or Organization's Special Interest (e.g., medical, legal, education, etc.)
Labor
5. Identify by Name, Address and Position, the Custodian of Books and Accounts (include treasurer's name)
Full Name Mailing Address Committee Title or Position
Richard McKinnon 7455 Collins Avenue, Suite 212 Treasurer
Miami Beach, Florida 33141
DS -DE 5 (Rev. 05/06) (continued on reverse side)