10 DS-DE 84 Statement of Candidate S. Roberts OFFICE USE ONLY
STATEMENT of
CANDIDATE =. CFIVFF)
(Section 106.023, F.S.) 2012 MAR 21 Phi 1: 59
(Please print or type) C I T Y C L'r_-R'K'S C F F I C F
1, Sherry Roberts
candidate for the office of Moami Beach Commissioner Group 4
have been provided access to read and understand the requirements of
Chapter 106, Florida Statutes.
X 2,0 4� March 91 , 9 1
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(05111)