Wieder Qualifying Documents CANDIDATE OATH
NONPARTISAN OFFICE
2x15 SEA' I I Pti 12: 35
(Not for use by Judicial or C, j',` `; ; i i=► l i -
School Board Candidates)
OFFICE USE ONLY
OATH OF CANDIDATE
'(Section 99.021, Florida.Statutes)
I, -v∎0 5-
(PLEASE.PRINT NAME AS you WISH IT TO-APPEAR ON THE BALLOT*- NAME MAY.NOT BE CHANGED AFTER THE END OF QUALIFYING)
am.a candidate for the nOnpartisan:office of '1& c CAC M I I rv"1 ) �"� 1° N/A
(office) (district#)
N/A 1 :; I am a.qualified elector of — Des County, Florida:;
'(circuit'# (group or seat#)
I erne.qualified elector of the City of Miami B achh,Florida,residi g within the City at least one year.before qualifying for City of Miami Beach
• elected office,with my legal residence being:/ o r fl, . ,L18//7i/2(H rii Beach, Florida. I am qualified under the ordinances
and Charter of said City and under the Constitution and the Laws of Florida to hold the office to which I desire to be nominated or elected; I have
qualified for no other public office the state, the term of which office or any part thereof runs concurrent with the office I seek; and I have
resigned from an = ice from w . '4 am required to resign pursuant to Section 99.012, Florida.Statutes; and I will support the Constitution of
the United St- -s.an.• the Co ion of the State of Florida.
1 '.
1I -111 C ci��
'i nat- of Can s i•ate TeIe hone Number aU Address
X ny0 e.Cain
Address City State ZIP Code
Candidate's Florida Voter Registration Number(located on your voter information card):. ■0(6C1G1 443(
* Please print name phonetically on the line below as you wish it to be pronounced on the audio.ballot for persons
with disabilities(see instructions on page 2 of this form):
DA\/ V i 1
STATE:OF FLORIDA.
•
COUNTY OF Ll: ' u�- P
Sworn to(or affirmed) and subscribed before me this /i day of , 20 /(.
Personally Known: or NA//rV egini
'4ra ure of Notary Public
Produced Identification: / `=,;or Stamp Commissioned Name of Notary Public
"r 1,<, LIIJAM R.HATFIELD
•i;, *? MY COMMISSION#EE 844865
Type of Identification Produced 'b L, :.. 15E EXPIRES:February 18,2017 ,. u,
d;:•' Bonded Thru Flaky Public Underwriters V P 1 1 �11 .
DS-DE 25(Revs 5111) Rule 1S-2.0001,F.A.C.
s ® ® 40 —, _ I r,:
® 1:—, t , a .
1915•70151' 12:
NAIAMIBEACH
CITY OF MIAMI BEACH OATH/AFFIRMATION
STATE OF FLORIDA
COUNTY OF MIAMI-DADE
Before me, an officer authorized to administer oaths, personally appeared
PA i 1 b 1&i)6a„ to me well known who, being
sworn, says that he/she is a candidate for the office o Mayor sr City Commissioner, Group No.
!J [,4- , for the City of Miami Beach, Florida; that he/she is a qualified elector of said City
residing within the City at least one year before qualifying for City of Miami Beach elected office; that
4 _�
L
his/her legal residence is: 3'0 V ' iv- Q. (A i ---.:' ")4, -_ ) 1
Miami Beach, Miami-Dade County, Florida; that he/she is qualified under the ordinances (including
Miami Beach City Code Chapter 38 governing "Elections") and Charter of said City to hold such office;
and that he/she has paid the required qualification fee or filed with the City Clerk a petition approving
his/her candidacy signed by sufficient qualified and registered voters to constitute not less than two
percent (2%) of this number of such voters as the same shall be on the date sixty (60) days prior to
the firs ,. of quali '►• as a candidate for office.
leaf- pi//,
, .. A . _......._ ,,
Signa"re of ^rn•ate
Sworn to (or affirmed) and subscribed before me this (1 day of cj , 2015, by
-David S a)i Q.d W .
yficanyvit,Ca'
% / SEP3112015
`� -State of Florida (NOTARY SEAL
Signature of Notary u ( SEAL)
4:4 t o f. u ,:
1�t�I'r1 ;*: i i ;4';, MYMMINSIASINHI X4866865 4,
Name of Notary Typ d Printed or Stamped aii°t; ' „ 1e
Personally Known OR Produced Identification
Type of Identification Produced `1 "L__
,,may,,,,,,- LIUAM R.HATFIELD
t: MY COMMISSION#EE 844865
.r"—o;: EXPIRES:February 18,2017
�,'R d$' Bonded Thru Notary Public Underwriters
FORM 1 STATEMENT OF 2014
Please print or type your name,mailing FINANCIAL INTERESTS I FOR OFFICE USE ONLY:
address,agency name,and position below:
LAST NAME--FIRST NAME--MIDDLE NAME: a a 3
P'r\f1D IiiWrz. 2[U5 Sofa i I �gi 1 e'
MAILING ADDRESS : 35
\3q0 Phi IMP_A 06 • CITY OFF la
Pil i iA1vl 1 B+� GA-N .33141 NI I Ate
CITY: ZIP: COUNTY:
CA-1- Cry M I Ivy►
NAME OF AGENCY:
M rc4d-
NAME OF OFFICE OR P SI ION HEW OR SOUGHT:
Ply
You are not limited to the space the lines on this form.Attach additional sheets,if necessary.
CHECK ONLY IF ICANDIDATE OR ® NEW EMPLOYEE OR APPOINTEE
**** BOTH PARTS OF THIS SECTION MUST BE COMPLETED ****
DISCLOSURE PERIOD:
THIS STATEMENT REFLECTS YOUR FINANCIAL INTERESTS FOR THE PRECEDING TAX YEAR, WHETHER BASED ON A CALENDAR
YEAR OR ON A FISCAL YEAR. PLEASE STATE BELOW WHETHER THIS STATEMENT IS FOR THE PRECEDING TAX YEAR ENDING
EITHER(m t check one):
DECEMBER 31, 2014 OR ❑ SPECIFY TAX YEAR IF OTHER THAN THE CALENDAR YEAR:
MANNER OF CALCULATING REPORTABLE INTERESTS:
FILERS HAVE THE OPTION OF USING REPORTING THRESHOLDS THAT ARE ABSOLUTE DOLLAR VALUES,WHICH REQUIRES FEWER
CALCULATIONS, OR USING COMPARATIVE THRESHOLDS, WHICH ARE USUALLY BASED ON PERCENTAGE VALUES (see instructions
for further v .1 tails). CHECK THE ONE YOU ARE USING:
COMPARATIVE (PERCENTAGE)THRESHOLDS OR ❑ DOLLAR VALUE THRESHOLDS
PART A--PRIMARY SOURCES OF INCOME [Major sources of income to the reporting person-See instructions]
(If you have nothing to report,write"none"or"n/a")
NAME OF SOURCE SOURCE'S DESCRIPTION OF THE SOURCE'S
OF INCOME ADDRESS PRINCIPAL BUSINESS ACTIVITY
I�ArvrTh 5,, P�i� 3o0 i1 s i NIlttl�l # ,.�� //t4C.flC
PART B-- SECONDARY SOURCES OF INCOME
[Major customers,clients,and other sources of income to businesses owned by the reporting person-See instructions]
(If you have nothing to report,write"none"or"n/a")
NAME OF NAME OF MAJOR SOURCES ADDRESS PRINCIPAL BUSINESS
BUSINESS ENTITY OF BUSINESS'INCOME OF SOURCE ACTIVITY OF SOURCE
6coat, it U5 &our-
iddttim
v/5`1(- tIg
PART C--REAL PROPERTY [Land, buildings owned by the reporting person-See instructions]
(If you have nothing to report,write"none"or"n/a") FILING INSTRUCTIONS for when
and where to file this form are
located at the bottom of page 2.
V3Ct0 Ve-1 v1E I1l I 1 TVAL.14 .3x11-1 INSTRUCTIONS on who must file
this form and how to fill it out
begin on page 3.
CE FORM 1-Effective:January 1,2015 (Continued on reverse side) PAGE 1
Adopted by reference in Rule 34-8.202(1),F.A.C.
PART D—INTANGIBLE PERSONAL PROPERTY[Stocks, bonds, certificates of deposit,etc.-See instructions]
(If you have nothing to report,write"none"or"n/a") 1
TYPE OF INTANGIBLE BUSINESS ENTITY TO WHICH THE PROPERTY RELATES
A —kR/
PART E—LIABILITIES [Major debts-See instructions]
(If you have nothing to report,write"none"or"n/a")
NAME OF CREDITOR ADDRESS OF CREDITOR
• 4 — q(oco Col-Li v 5 L- 1-44c590 , ft -3.3%54
Su+..v -s-- VIC T 13-I OW --l1"►4 1k 41 RH 1 .x.31 -7
PART F—INTERESTS IN SPECIFIED BUSINESSES [Ownership or positions in certain types of businesses-See instructions]
(If you have nothing to report,write"none"or"n/a")
BUST SS ENTITY#1 BUSINESS ENTITY#2
NAME OF BUSINESS ENTITY
ADDRESS OF BUSINESS ENTITY
PRINCIPAL BUSINESS ACTIVITY
f ry
POSITION HELD WITH ENTITY =.1 -
I OWN MORE THAN A 5%INTEREST IN THE BUSINESS . v
NATURE OF MY OWNERSHIP INTEREST _
IF ANY OF PARTS A THROUGH F ARE CONTINUED ON A SEPARATE SHEET, PLEASE CHECK HERE :®
SIGNATURE OF FILER: CPA or ATTORNEY SIGNATURE ONLY
If a certified public accountant licensed underhapter 473, or
Signature: attorney in good standing with the Florida Bar'�prepared this
' , form for you, he or she must complete M e folfr ving statement:
f /
I, prepared
the CE Form 1 in accordance with Section 112.3145, Florida
Statutes, and the instructions to the form. Upon my reasonable
knowledge and belief, the disclosure herein is true and correct.
Date Signed:
9/ 1 ( lis CPA/Attorney Signature:
Date Signed:
FILING INSTRUCTIONS:
WHAT TO FILE: WHERE TO FILE: WHEN TO FILE:
After completing all parts of this form, including If you were mailed the form by the Commission Initially,each local officer/employee,state officer,
signing and dating it,send back only the first on Ethics or a County Supervisor of Elections for and specified state employee must file within
sheet(pages 1 and 2)for filing. your annual disclosure filing, return the form to 30 days of the date of his or her appointment
that location. or of the beginning of employment. Appoints
If you have nothing to report in a particular Local officers/employees file with the who must be confirmed by the Senate must file
section, you must write "none" or "n/a" in that Supervisor of Elections of the county in which they prior to confirmation, even if that is less than
section(s). permanently reside. (If you do not permanently 30 days from the date of their appointment.
reside in Florida, file with the Supervisor of the Candidates for publicly-elected local office must
NOTE: county where your agency has its headquarters.) file at the same time they file their qualifying
MULTIPLE FILING UNNECESSARY: papers.
State officers or specified state employees
A candidate who previously filed Form 1 because file with the Commission on Ethics. P.O. Drawer Thereafter, local officers/employees, state
of another public position must at least file a copy 15709, Tallahassee, FL 32317-5709; physical officers, and specified state employees are
of his or her original Form 1 when qualifying. A address: 325 John Knox Road. Building E, Suite required to file by July 1st following each calendar
candidate who files a Form 1 with a qualifying 200,Tallahassee, FL 32303. year in which they hold their positions.
officer is not required to file with the Commission Finally,at the end of office or employment,each
or Supervisor of Elections. Candidates file this form together with their local officer/employee,state officer,and specified
qualifying papers. state employee is required to file a final disclosure
To determine what category your position falls form(Form 1F)within 60 days of leaving office or
under, see the "Who Must File" Instructions on employment.However,filing a CE Form 1F(Final
page 3. Statement of Financial Interests)does not relieve
the filer of filing a CE Form 1 if he or she was in
Facsimiles will not be accepted. their position on December 31;2014.,
CE FORM 1-Effective:January 1,2015. PAGE 2
Adopted by reference in Rule 34-8.202(1),F.A.C.
•
Form 9 QUARTERLY GIFT DISCLOSURE
(GIFTS OVER $100)
LAST NA - IR T NAM MIDDLE ME: NAM r:AGE_ NCY:
(A)
Vi/q41/P
el A 0444/ 13/ A-6e-/-
M LING ADDRESS: OFFICE OR POSITION HELD:
`)/ S S � 5jj,JC M4 L'/2/ i rl
CITY: lZIP: COUNTY: !� f4AijOR MARCH T'JUNE ENDING
❑SEP EMBER N❑DECEMBER 20A�_
PART A—STATEMENT OF GIFTS
Please list below each gift.the value of which you believe to exceed$100,accepted by you during the calendar quarter for which this statement is
being filed.You are required to describe the gift and state the monetary value of the gift,the name and address of the person making the gift,and the
date(s)the gift was received. If any of these facts,other than the gift description,are unknown or not applicable,you should so state on the form.As
explained more fully in the instructions on the reverse side of the form,you are not required to disclose gifts from relatives or certain other gifts.You
are not required to file this statement for any calendar quarter during which you did not receive a reportable gift.
DATE DESCRIPTION MONETARY NAME OF PERSON ADDRESS OF PERSON
RECEIVED OF GIFT VALUE MAKING THE GIFT MAKING THE GIFT
e■
rrl
CHECK HERE IF CONTINUED ON SEPARATE SHEET
Tt N
PART B—RECEIPT PROVIDED BY PERSON MAKING THE GIFT
(.71
If any receipt for a gift listed above was provided to you by the person making the gift,you are required to attach a copy of that receipt to this
form.You may attach an explanation of any differences between the information disclosed on this form and the information on the receipt.
❑ CHECK HERE IF A RECEIPT IS ATTACHED TO THIS FORM
PART C—OATH
I,the person whose name appears at the beginning of this form,do STATE OF FLORIDA
COUNTY Olayx,C.
depose on oath or affirmation and say that the information disclosed Sworn to(or a armed)and subscribed before me this
day of 20 /c
herein and on any attachments made by me constitutes a true accurate, ;� d
/-
by /Jav/i G�
and total listing of all gifts r- ..fired to be reported by Section 112.3148.
(Signature of Notary Public-State of Florida)
CA • (Print,Type,or Stamp Commissioned Name of Notary Public)
SIGNATURE OF • PORTING OFFICIAL Personally Known OR Produced Identification
SEP 11 2015 Type of Identification Produced
IJLIAM R.HATFIELD
Y �
MY COMMISSION k EE 844865 1
PART D—FILING INSTRUCTIONS '
;,� �� EXPIRES:February 18,2017 !s.
This form,when duly signed and notarized,must be filed with the Commission on Ethics,P.O.Drawer as ee, on a 317-5709;physi-
cal address:325 John Knox Road,Building E,Suite 200,Tallahassee,Florida 32303.The form must be filed no later than the last day of the calendar
quarter that follows the calendar quarter for which this form is filed(For example,if a gift is received in March,it should be disclosed by June 30.)
CE FORM 9-EFF.1/2007(Refer to Rule 34-7.010(1)(g),F.A.C.)(Rev.9/2013) (See reverse side for instructions)` +
M AM BEAC H
NOTICE OF TESTING OF THE TABULATING EQUIPMENT
(LOGIC AND ACCURACY TEST)
AND CANVASSING BOARD SCHEDULE
FOR THE CITY OF MIAMI BEACH RUN-OFF ELECTION (IF NECESSARY)
NOVEMBER 17, 2015
Pursuant to Florida Statute §101.5612, notice is hereby given of the time and location of the public
preelection test of the automatic tabulating equipment (Logic and Accuracy Test) for the November
17, 2015 Miami Beach Run-Off Election (if necessary).
Pursuant to Florida Statute §102.141, notice is hereby given of the time and place during which the
City of Miami Beach Canvassing Board for the November 17, 2015 Miami Beach Run-Off Election
(if necessary) will meet to canvass the absentee electors' ballots and provisional ballots.
The City of Miami Beach Canvassing Board will convene at the Office of the Supervisor of
Elections, 2700 NW 87 Avenue, Miami, Florida. The Canvassing Board is convening on these dates
in preparation to conduct the Miami Beach Run-Off Election to be held on November 17, 2015 (if
necessary).
DATE/TIME ACTIVITY ATTENDANCE
Thursday, 11/12/15 1. Logic and Accuracy Test of the touch All Canvassing Board
10:00 a.m. screen and optical scan voting systems to Members or
be used for absentee, early voting, and one designated
precinct ballots Canvassing Board Member
Friday, 11/13/15 1. Pre-count Logic and Accuracy Test of the All Canvassing Board
10:00 a.m. through optical scan system used for absentee and Members or
Tuesday, 11/17/15 provisional ballots one designated
2. Absentee ballot opening and processing Canvassing Board Member
(as needed)
3. Duplication of ballots (as needed)
Tuesday, 11/17/15 1. Absentee ballot opening and processing All Canvassing Board
(as needed) Members
2. Duplication of ballots (as needed)
Canvassing: 3. Canvassing of presumed invalid absentee
5:00 p.m. to completion ballots and provisional ballots
4. Tabulation of results J o
5. Unofficial Results provided by the ;0
Supervisor of Elections _ rn
Friday, 11/20/15 1. Canvassing of provisional ballots All Canvassing Board_
11:30 a.m. to completion (if needed) Members -- 4
2. Certification of Official Results, including -v
provisionals, by the Supervisor of Elections
3. Post-count Logic and Accuracy Test of the -n N
optical scan system used for absentee and W _:
provisional ballots
4. Race and precinct(s) selection for manual
post-election audit
5. Audit process starts to completion Majority of the Canvassing
Board Members or
designees
l
/4 //4/4_ 6/ i/dr
All proceedings will be open to the public. To request this material in alternate format, sign
language interpreter (five-day notice required), information on access for persons with disabilities,
and/or any accommodation to review any document or participate in any City-sponsored
proceedings, call 305.604.2489 and select 1 for English or 2 for Spanish, then option 6; TTY users
may call via 711 (Florida Relay Service).
In accordance with Florida Statute §286.0105, a person who appeals any decision by the
Canvassing Board with respect to any matter considered at a meeting, he or she will need a record
of the proceedings and therefore will need to ensure that a verbatim record of the proceedings is
made.
Please note that the Canvassing Board Schedule is subject to change, if needed. Please
contact the Office of the City Clerk at 305.673.7411 if you have any questions.
The County Canvassing Board Members are TBD - County Judge, Chairperson; Rafael E.
Granado, City Clerk; and TBD— Miami Beach Resident.
AM BEA H
NOTICE OF TESTING OF THE TABULATING EQUIPMENT
(LOGIC AND ACCURACY TEST)
AND CANVASSING BOARD SCHEDULE
FOR THE CITY OF MIAMI BEACH GENERAL AND SPECIAL ELECTIONS
NOVEMBER 3, 2015
Pursuant to Florida Statute §101.5612, notice is hereby given of the time and location of the public
preelection test of the automatic tabulating equipment (Logic and Accuracy Test) for the November
3, 2015 Miami Beach General and Special Elections.
Pursuant to Florida Statute §102.141, notice is hereby given of the time and place during which the
City of Miami Beach Canvassing Board for the November 3, 2015 Miami Beach General and
Special Elections will meet to canvass the absentee electors' ballots and provisional ballots.
The City of Miami Beach Canvassing Board will convene at the Office of the Supervisor of
Elections, 2700 NW 87 Avenue, Miami, Florida. The Canvassing Board is convening on these dates
in preparation to conduct the Miami Beach General and Special Elections to be held on November
3, 2015.
DATE/TIME ACTIVITY ATTENDANCE
Thursday, 10/15/15 1. Logic and Accuracy Test of the touch All Canvassing Board
10:00 a.m. screen and optical scan voting systems to Members or
be used for absentee, early voting, and one designated
precinct ballots Canvassing Board Member
Friday, 10/30/15 1. Pre-count Logic and Accuracy Test of the All Canvassing Board
1:00 p.m. through optical scan system used for absentee and Members or
Tuesday, 11/3/15 provisional ballots one designated
2. Absentee ballot opening and processing Canvassing Board Member
(as needed)
3. Duplication of ballots (as needed)
Tuesday, 11/3/15 1. Absentee ballot opening and processing All Canvassing Board
(as needed) Members
2. Duplication of ballots (as needed)
Canvassing: 3. Canvassing of presumed invalid absentee
5:00 p.m. to completion ballots and provisional ballots -C N
4. Tabulation of results (-) rn
5. Unofficial Results provided by the r-
Supervisor of Elections ---
Friday, 11/6/15 1. Canvassing of provisional ballots All Canvassing Board
1:30 p.m. to completion (if needed) Members
2. Certification of Official Results, including
•
provisionals, by the Supervisor of Elections W
3. Post-count Logic and Accuracy Test of the rn C
optical scan system used for absentee and
provisional ballots
4. Race and precinct(s) selection for manual
post-election audit
5. Audit process starts to completion Majority of the Canvassing
Board Members or
designees
A1.90
/ 1
All proceedings will be open to the public. To request this material in alternate format, sign
language interpreter (five-day notice required), information on access for persons with disabilities,
and/or any accommodation to review any document or participate in any City-sponsored
proceedings, call 305.604.2489 and select 1 for English or 2 for Spanish, then option 6; TTY users
may call via 711 (Florida Relay Service).
In accordance with Florida Statute §286.0105, a person who appeals any decision by the
Canvassing Board with respect to any matter considered at a meeting, he or she will need a record
of the proceedings and therefore will need to ensure that a verbatim record of the proceedings is
made.
Please note that the Canvassing Board Schedule is subject to change, if needed. Please
contact the Office of the City Clerk at 305.673.7411 if you have any questions.
The County Canvassing Board Members are TBD - County Judge, Chairperson; Rafael E.
Granado, City Clerk; and TBD — Miami Beach Resident.