DS-DE 84 Mark Weithorn j ; :OFFICE.USE"ONLY
STATEMENT OF
CANDIDATE 2015 JA Q6 Ari 8: 142
(Section 106.023, F.S.) r '� �. 1_ : ! °; U H= l C r
(Please print or type)
1, Mark Weithorn
candidate for the office of Miami Beach Commission, Group 5 ;
have been provided access to read and understand the requirements of
Chapter 106, Florida Statutes.
January 6, 2015
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) •