Qualifying documents - Meruelo CANDIDATE OATH -
01 i SAP : - E '
9 P� 1 V 2i) .
NONPARTISAN OFFICE • 3 0
(Not for use by Judicial or CITY L �' OFF I C
School Board Candidates)
OFFICE USE ONLY
OATH OF CAN DI DATE
(Section 99.021, Florida Statutes)
Mar /c€
(PLEASE PRINT NAME AS YOU WISH IT TO APPEAR ON THE BALLOT * — NAME MAY NOT BE CHANGED AFTER THE END OF QUAUFYING)
am a candidate for the nonpartisan office of Oh/MISS 1 on ' e Ili 4 N/A
(office) (district #
N/A (RILL
; I am a qualified
r elector of /1 Count / � C County, Florida; ,
(circuit #) (group or seat in
lam a qualified elector of the City of Miami Beach, Florida, residing within the q at least one year before qualifying for City of Miami Beach
elected office, with my legal residence being: .5727 riht 7 l 1� pr. , Miami Beach, Florida. I am qualified under the ordinances
and Charter of said City and under the Constitution and the Laws of Florida to hold the 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; and I will support the Constitution of
the United States and the Constitutio of the State of Florida.
G3 0 iL,estl
x Signature of Candidate Telephone Number
5 PI pirai he. e e , 32/4/D
Address City ■ State ZIP Code
Candidate's Florida Voter Registration Number (located on your voter information card): MAU-9N
* Please print name phonetically on the line below as you wish it to be pronounced on the audio ballot for persons
with disabilities (see instructions on page 2 of this form):
e o m . a rr e a <4r4te) -fli e ct rr ee ell n
� e yy h
STATE OF FLORIDA min COUNTY OF � P ,T DC
l
Sworn to (or affirmed) and subscribed before me this q14 of � , 20 6 da
(/ NOTARY PUBLIC OF FLORIDA
Personally Known: or ''''''''' t.
R o L �-r� E . Parcher
Comr nssjo i #DD896080 Signature of Notary Public
Produced Identification: '''' Expirti: JUNE 03, 2013 Print, Type, or Stamp Commissioned Name of Notary Public
BONDED THRU ATLANTIC BONDING CO., INC.
Type of Identification Produced:
DS -DE 25 (Rev. 5111)
Rule 18-2.0001, F.A.C.
FORM 1 STATEMENT OF 2010
Please print or type your name, mailing FINANCIAL INTERESTS [------------
address, agency name, and position below:
LAST NAME -- FIRST NAME -- MIDDLE NAME : ,,nn t4erae1o Mv &- (?avm€, USE ONL E O i , d
"� �" D
MAILING ADDRESS
3 7 L7 ?� A 2011 SEP -9 Ply 2 30
ID Code
/ Paek iffill:tage-
ejli �/ CITY CLERK'S OFFICE
CITY : / ZIP : COUNTY :
ID No.
NAME AIF 9F AGENCY r
( 0 Mi in i ilegarek Conf. Code
NAME OF OF ICE OR POSITION HELD OR SOUGHT : P. Req. Code
£o rniii r C%Z,
You are not limited to the space on the lines on this form. Attach additional sheets, if necessary.
CHECK ONLY IF X CANDIDATE OR fJ 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 FISCAL f EAR. PLEASE STATE BELOW WHETHER THIS STATEMENT IS FOR THE PRECEDING TAX YEAR ENDING EITHER (must check one):
DECEMBER 31, 2010 OR 0 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
inst ctions for further details). PLEASE STATE BELOW WHETHER THIS STATEMENT REFLECTS EITHER (must check one):
COMPARATIVE (PERCENTAGE) THRESHOLDS OR ❑ DOLLAR VALUE THRESHOLDS
PART A -- PRIMARY SOURCES OF INCOME [Major sources of income !to the reporting person]
(If you have nothing to report, you must write "none" or "flla ")
NAME OF SOURCE OURCE'S DESCRIPTION OF THE SOURCE'S
OF INCOME ADDRESS PRINCIPAL BUSINESS ACTIVITY
/1W- ,
i
PART B -- SECONDARY SOURCES OF INCOME [Major customers, clients, and other sources of income to businesses owned by the reporting r
y p g pe son]
(If you have nothing to report , you must write "none" or "n /a ")
NAME OF NAME OF MAJOR SOURCES ADDRESS PRINCIPAL BUSINESS
BUSINESS ENTITY OF BUSINESS' INCOME OF SOURCE ACTIVITY OF SOURCE
_ ∎"
PART C -- REAL PROPERTY [Land, buildings owned by the reporting person] FILING INSTRUCTIONS for
(If you have nothing to report, you must write "none" or "n /a ")
when and where to file this form
are located at the bottom of page 2.
1/1/911X2 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 - Effective: January 1, 2011 Refer to Rule 34 -8 202(1), F.A.C.
y (Continued on reverse side) PAGE 1
K PACE i 0 — INTANGIBLE PERSONAL PROPERTY [Stocks, bonds, certificates of deposit, etc.]
(If you have nothing to report, you must write "none" or "n/a")
TYPE OF INTANGIBLE BUSINESS ENTITY TO WHICH THE PROPERTY RELATES
‘
PART E — LIABILITIES [Major debts]
(If you have nothing to report, you must write "none" or "n /a ")
NAME OF CREDITOR ADDRESS OF CREDITOR
PART F -- INTERESTS IN SPECIFIED BUSINESSES [Ownership or positions in certain types of businesses]
(If you have nothing to report, you must write "none" or "n /a; ")
BUSINESS ENTITY # 1 BUSINESS ENTITY # 2 BUSINESS ENTITY # 3
NAME OF BUSINESS ENTITY '1(\ildriAiLY
ADDRESS OF BUSINESS ENTITY
PRINCIPAL BUSINESS ACTIVITY
POSITION HELD WITH ENTITY
I OWN MORE THAN A 5%
INTEREST IN THE BUSINESS
NATURE OF MY
OWNERSHIP INTEREST
IF ANY OF PARTS A THROUGH F ARE CONTINU = D �, A SEPARATE SHEET, PLEASE CHECK HERE ❑
SIGNATURE (requir DATE SIGNED (required): 4';1/
A(/
FILING INSTRUCTIONS:
WHAT TO FILE: WHERE TO FILE: WHEN TO FILE:
After completing all parts of this form, including If you were mailed the form by the Commission Initially, each local officer /employee, state
signing and dating it, send back only the first on Ethics or a County Supervisor of Elections for officer, and specified state employee must
sheet (pages 1 and 2) for filing. your annual disclosure filing, return the form to file within 30 days of the date of his or her
that location. appointment or of the beginning of employ -
If you have nothing to report in a particular Local officers /employees file with the Supervisor ment. Appointees who must be confirmed by
section, you must write "none" or "n /a" in that the Senate must file prior to confirmation, even
of Elections of the county in which they perma-
section(s). nently reside. (If ypu do not permanently reside if that is Tess than 30 days from the date of their
in Florida, file with the Supervisor of the county appointment.
Facsimiles will not be accepted. where your agency has its headquarters.) Candidates for publicly - elected local office
NOTE: State officers or specified state employees must file at the same time they file their
MULTIPLE FILING UNNECESSARY: file with the Commission on Ethics, P.O. Drawer qualifying papers.
Generally, a person who has filed Form 1 for a 15709, Tallahassee, FL 32317 -5709; physical Thereafter, local officers /employees, state
calendar or fiscal year is not required to file a address: 3600 Malclay Boulevard, South, Suite officers, and specified state employees are
second Form 1 for the same year. However, a 201, Tallahassee, FL 32312. required to file by July 1st following each
candidate who previously filed Form 1 because Candidates file t -is form together with their calendar year in which they hold their posi-
of another public position must at least file a copy qualifying papers. tions.
of his or her original Form 1 when qualifying. Finally, at the end of office or employment,
To determine what category your position
falls under, see the "Who Must File" Instructions each local officer/employee, state officer, and
on page 3. specified state employee is required to file a
final disclosure form (Form 1 F) within 60 days
of leaving office or employment.
CE FORM 1 - Effective January 1, 2011. Refer to Rule 34 -8.202 (1), F.A.C. PAGE 2
Form 9 QUARTERLY IFT DISCLOSURE
(GIFTS OVER $100) RECF1 /
LAST NAME -- FIRST NAME -- MIDDLE NAME: NAME OF AGENCY: �I SEP �9 •
r ne(o Yv1atei'el Ca/'m fl'1mI P m 2: � 30
MAILING ADDRESS: OFFICE OR POSITION D: CITY
5 7a 7 Pin/ 1 -I A , 1 64 — MfrelWi*ei 6,1
CITY: ZIP: COUNTY: FOR QUARTER ENDING (CHECK ONE): Y AR
fll /a»i i v f3 V `l 'a', � 03 %0 / J/ ❑MARCH ❑JUNE ❑SEPTEMBER ❑ DECEMBER 20
v
PART A — STATEMENT OF GIFTS
Please list below each gift, the value of which you believe to exceed $100, accepted by you during the calendar quarter for which this statement is
being filed. You are required to describe the gift and state the monetary value of the gift, the name and address of the person making the gift, and the
date(s) the gift was received. If any of these facts, other than the gift description, are unknown or not applicable, you should so state on the form. As
explained more fully in the instructions on the reverse side of the form, you are not required to disclose gifts from relatives or certain other gifts. You
are not required to file this statement for any calendar quarter during which you did not receive a reportable gift.
DATE DESCRIPTION MONETARY NAME OF PERSON ADDRESS OF PERSON
RECEIVED OF GIFT VALUE MAKING THE GIFT MAKING THE GIFT
i '.
1 '
❑ CHECK HERE IF CONTINUED ON SEPARATE SHEET
PART B — RECEIPT PROVIDED BY PERSON MAKING THE GIFT
If any receipt for a gift listed above was provided to you by the person making the gift, you are required to attach a copy of that receipt to this
form. You may attach an explanation of any differences between the information disclosed on this form and the information on the receipt.
❑ CHECK HERE IF A RECEIPT IS ATTACHED TO THIS FORM
PARTC —OATH
I, the person whose name appears at the beginning of this form, do STATE OF FLORIDA
COUNTY OF 4 1 ‘"4.4e_....
depose on oath or affirmation and say that the information disclosed Sworpto or affirmed) and su crib d be fore me this
day of , 20 i i
herein and on any attachments made by me constitutes a true accurate, �
by !`"`C. r 1 CA- `-01 r IY\213 0.e, ( 0
and total listing of all gifts required to be reported by Section 112.3148, (S - • � 00%l 11/00
Florida Statutes. / f 1 /
'
. ; ,_ �
ignature of otar qi� •a
I
."'-'1 /4biA ' , . / , , er . (Print, Type, or Stamp sian d;Name cat Notary Pu�ilic-
I GNATURE OF • E • ORTING • ICIAL Personally Known Co Co OR Wadded ded l tit on : o f
Type of Identification Produced 1: ..%?..*. , m ay:
` PART D — FILING INSTRUCTIONS " ® %i �g ti c i 50.:\ \.e°�
This form, when duly signed and notarized, must be filed with the Commission on Ethics, P.O. Drawer 15709, Tallahassee, Florida 32317 -5709; physi-
cal address: 3600 Maclay Blvd. South, Suite 201, Tallahassee, Florida 32312. The form must be filed no later than the last day of the calendar quarter
that follows the calendar quarter for which this form is filed (For example, if a gift is received in March, it should be disclosed by June 30.)
CE FORM 9 - EFF. 1/2007 (See reverse side for instructions)
MARIA MERUELO CAMPAIGN ACCT 08-11 1146- ( °--5- 7 101
5727 PINETREE DR
MIAMI BEACH, FL 33140 _19 63 313
Date
Pay to the / „ ,
Order of $
do t
14 11 did 4 ./P._ Dollars
Back
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