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Levine DS-DE 84 �.,. -•OFFICE LJSE ONLY STATEMENT OF CANDIDATE 2f15 AUG 28 17,1; 9: 46 (Section 106.023, F.S.) C J '� t, (Please print or type) 1, Philip Levine candidate for the office of Mayor of Miami Beach - 2015 have been provided access to read and understand the requirements of Chapter 106, Florida Statutes. Adoe , 08/28/2015 •e 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)