Better Miami Beach DS-DE 103 i
ELECTIONEERING COMMUNICATION 2013 JAN' 23 PN 3: 02
STATEMENT OF ORGANIZATION C17'Y CLc f,K'S F F 1C;7-
(PLEASE TYPE)
OFFICE USE ONLY
1. Full Name of Organization Telephone
A%
Mailing Address (include city, state and zip code)
5-0 Pf(-b nf-o a 1'70 ;t- M (Am d ec-14 S31 3 9
Street Address (include city, state and zip code)
2. Affiliated or Connected Organizations
Name of Affiliated or Mailing Address Relationship
Connected Organization
3. Area, Scope and Jurisdiction of the Organization
4. Identify by Name, Address and Position,the Custodian of Books and Accounts for the Organization
Full Name Mailing Address Street Address . Title or Position
qS'O A(-6,n k-41?OJ
Form DS-DE 103(Rev. 10/12)-page 1 of 2 (continued on reverse)