Materials Enclosed - Meruelo APPOINTMENT OF CAMPAIGN TREASURER RFCPVFn
AND DESIGNATION OF CAMPAIGN
DEPOSITORY FOR CANDIDATES 2011 AUG 19 PM 1: 49
(Section 106.021(1), F.S.)
CITY CL. J K'S OFF ICI:_
(PLEASE PRINT OR TYPE)
NOTE: This form must be on file with the qualifying
officer before o • enin • the cam • ai • n account. OFFICE USE ONLY
1. CHECK APPROPRIATE BOX(ES):
!XI Initial Filing of Form Re- filing to Change: ` Treasurer /Deputy L: J Depository j Office [ Party
2. Name of Candidate (in this order: First, Middle, Last) 3. Address (include post office box or street, city, state, zip
01 A s i a C A( IN12 Y) 1M 42 e (A-e_.1 t7 code)
.5"7-2, A54-to
4. Telephone 5. E -mail address r
(305) 3)i /311 Wle(U -e�
o Q.o 1 .how► �`��G�'�?�l /`1`��ll.��� �� �
6. Office sought (include district, circuit, group number) 7. If a candidate for a nonpartisan office, check if
to W1 ( l 0 applicable:
My intent is to run as a Write -In candidate.
8. If a candidate for a partisan office, check block and fill in name of party as applicable: My intent is to run as a
il l Write -In j ! No Party Affiliation j Nk Party candidate.
9. I have appointed the following person to act as my XJ Campaign Treasurer 7 1 Deputy Treasurer
10. Name of Treasurer or Deputy Treasurer
Isaac Rosenblum
11. Mailing Address 12. Telephone
4045 Sheridan Ave., #123 ( 305 ) 434 -2376
13. City 14. County 15. State 16. Zip Code 17. E -mail address
Miami Beach Miami -Dade FL 33140
18. I have designated the following bank as my Primary Depository l Secondary Depository
19. Name of Bank 20. Address
7Tb i K A
21. C / 22. Coun 23. State 24. Zip Cod
,a i 4,eit._ % Gil / - , L-- I>
UNDER PENALTIES OF PERJURY, I DECLARE THAT I HAVE READ THE FOREGOING FORM FOR APPOINTMENT OF CAMPAIGN TREASURER AND
DESIGNATION OF CAMPAIGN DEPOSITORY AND THAT THE FACTS STATED IN IT ARE TRUE.
25. Date 26. of Candida
0,9 // X 0/a
•
27. Treasurer's Acceptance of Appointment (fill in the blanks and check the appropriate block)
Isaac Rosenblum , do hereby accept the appointment
(Please Print or Type Name)
designated above as: X Campaign Treasurer - Depu Treasurer.
)/1(( X rt,(A,_
Date Signature of Campaign Treasurer or Deputy Treasurer
DS -DE 9 (Rev. 10/10) Rule 1S- 2.0001, F.A.C.
OFFICE USE ONLY
STATEMENT OF
CANDIDATE`` ' x
(Section 106.023, F.S.) 11 AUG 19 PM I.4 9
(Please print or type) CITY CIA iWS OF I Mi-
1,
I/i//a//1 /
candidate for the office of / ,( -
have been provided access to read and understand the requirements of
Chapter 106, Florida Statutes.
i
X �(/C
Signature of Candidate Date
Each candidate must file a statement with the qualifying officer within 10 days after the
Appointment of Campaign Treasurer and Designation of Campaign Depository is filed. Willful
failure to file this form is a first degree misdemeanor and a civil violation of the Campaign
Financing Act which may result in a fine of up to $1,000, (ss. 106.19(1)(c), 106.265(1), Florida
Statutes).
DS -DE 84 (05/11)
F-
1
CA ;• \ E Is °,uaw'
City of Miami Beach, 1700 Convention Center Drive, Miami Beach, Florida 33139,
www.miamibeachfl.gov
CITY CLERKS Office
Tel: 305.673.7411 Fax: 305 -673 -7254 Email: CityClerk(7miamibeachfl.gov
HAND DELIVERED
August ,, 2011 c rn
Dear Candidate,
RE: November 1, 2011 General Election Qualifying Information _ 71
••
The candidate qualifying period for the November 1, 2011 General Election begins TtieSdaX
September 6, at 8:30 a.m., and ends at 5:00 p.m., on Friday, September 9, 2011. Tri
preparation for the candidate qualifying process, the City Clerk's Office has prepared the
enclosed information and materials to assist you:
✓ November 1, 2011 City of Miami Beach — General Municipal Election Information
✓ November 1, 2011 City of Miami Beach - General Election Campaign Reporting Dates
✓ Loyalty Oath and Oath of Candidate form (blue paper). Note: Candidates for commissioner must
enter a group number. The Loyalty Oath form requires the candidate signature be notarized.
The City Clerk's Office must notarize the form..
✓ Form 1: Statement of Financial Interests 2010
• Form 9: Quarterly Gift Disclosure
✓ Letter from the Department of Code Compliance pertaining to the placement of political signs
✓ City Code sections regarding election signs
✓ Florida State Statute Sec. (106.08(3)(a) regarding last day to accept campaign contribution
✓ Miami -Dade County Absentee Ballot Request
✓ Early Voting Information
✓ Miami -Dade County Poll Watcher Designation Instructions and Form
✓ The City Commission approved the Miami Beach Candidate Presentation Guidelines with
Rehearsal and Live Taping schedule to be sent sometime after candidate qualifying.
✓ Miami -Dade County Elections Department — Certificate of active registered voters as of 07/08/11.
✓ Position Number Information will be issued on Tuesday, September 13, 2011
Note: Pursuant to City Charter Section 6.03, a candidate qualifying must have been
photographed and fingerprinted by the Identification Bureau of the Police Department of the City
of Miami Beach as a requirement for qualifying. As a candidate, your name has been submitted to
the Police Records Unit. You may call 305.673.7100 to make arrangements to be fingerprinted
and photographed.
The information contained in this letter should simplify the qualifying process. If you have any
questions, or require additional information, please do not hesitate to contact me at anytime.
Sincerely,
.
Robert Parcher :,E �..>
City Clerk
Enclosures
F:\CLER\CLER\ELECTION12011 General Election \Qualifying materials\Qualifying paperwork letter 2011.doc
tA' e are committed to pn,vidinc excellent public seirace and rafery'to rift who live work, G011 play in our vibrant;, tropical, historic
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