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The Afterparty DS-DE 103 RFCFLVED ELECTIONEERING COMMUNICATION 2011 MAR -1 PM 4: 28 STATEMENT OF ORGANIZATION CITY CLERK'S OFF ICE (PLEASE TYPE) OFFICE USE ONLY 1. Full Name of Organization Telephone The Afterparty 317 409 6056 Mailing Address (include city, state and zip code) 600 NE 36 St. #1718, Miami, FL 33137 Street Address (include city, state and zip code) 600 NE 36 St. #1718, Miami, FL 33137 2. Affiliated or Connected Organizations Name of Affiliated or Mailing Address Relationship Connected Organization N/A 3. Area Scope and Jurisdiction of the Organization Municipal election for Mayor of Miami Beach 4. Identify by Name, Address & Position, the Custodian of Books & Accounts for the Organization Full Name Mailing Address Street Address Title or Position Ronald Malone 600 NE 36 St. #1718, 600 NE 36 St. #1718, Registered Agent, Treasurer Miami, FL 33137 Miami, FL 33137 5. This Organization was formed (check applicable box): (Calendar quarters end the last day of March, June, September, and December.) ❑ As a newly created organization during the current calendar quarter. ❑ From an organization existing prior to the current calendar quarter. Form DS -DE 103 (Rev. 08/10) (continued on reverse) r 6. List By Name, Mailing and Street Address, & Position, Other Principal Officers, including the treasurer and deputy treasurer, if any. Include the top- ranking officer's (e.g., chairperson) name and information. Full Name Mailing Address Street Address Title or Position Ronald Malone 600 NE 36 St. #1718, 600 NE 36 St. #1718, Miami, Chairman Miami, FL 33137 FL 33137 7. In the Event of Dissolution, What Disposition will be Made of the Residual Funds? Any residual funds will be placed with a qualified organization, as per U.S. Federal law and Florida State law requirements. 8. List All Banks, Safety Deposit Boxes, or Other Depositories Used by this Organization for Electioneering Communications Name of Bank or Depository Mailing Address Chase Bank 940 Ives Dairy Road, Miami, FL 33179 9. List All Reports Required to be Filed by this Organization with Federal Officials, & the Names, Addresses, & Positions of Such Officials, If Any Report Title Dates Required to be Filed Name & Position of Official Mailing Address N/A STATE OF Florid Miami -Dade COUNTY Ronald Malone , certify that the information in this Statement of Organization is complete, true, and correct. r X - G 7- /7 Signature of Top- ranking Principal Officer of Organization Date Form DS -DE 103 (Rev. 08/10) — page 2 of 2 Note: If necessary, continuation sheets should be used to complete the form.