Wieder DS-DE 84 ■
OFFICE USE ONLY
STATEMENT OF
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CANDIDATE +
215 UG26 PM 12: 5
, 1- (Section.106.023, F.S.) - - _ - • _ -
' (Please print or aype) MY-: 1 E R, '.' OFF ICE
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David-S. 'Wieder
1 candidate for the office of ,
Miami Beach Mayor
'have been provided access to read and understand the requirements of
Chapter 106, Florida-Statutes:
Ad ':'S', ' ': . _,
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8/24/2015
• Si 2 n. ure of Candidate Date
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Each candidate must file a- statement 'withtle qualifying officer within 10 days after the
Appointment o_ f Campaign Treasurer and Designation of Campaign,De osito is filed--.` Willful
f
,Depository
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). 1
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• DS-DE 84(05/11).' ,
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