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Arriola Qualifying Document CANDIDATE OATH - . ,,7.7 Y ,;T I NONPARTISAN OFFICE 20I5 SEP E I PH 3: 26 I T aI Cf.�i(1','�.% OFFICE. (Not for use by Judicial or �V School Board Candidates) OFFICE USE ONLY OATH OF CANDIDATE. (Section 99.021,Florida Statutes) Ricky Arriola (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 Miami Beach City Commissioner , NIA. (office) (district# N/A. 5 Miami-Dade I am a qualified elector of County; Florida; '(circuit#) (group orseat#). I am a qualified elector of the City of Miami Beach,Florida,residing within the City at least one year before-qualifying'for City of Miami Beach elected office,with my legal residence being: 140 Jefferson Ave APT 14010,Miami 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 in the state,,the term of which office or any part thereof runs concurrent with the office I seek;and I have resigned from any office from which I am required to resign pursuant to Section 99.012, Florida Statutes;and I will support the Constitution of the United States and the Constitution of the State of Florida. 305-523-1115 rickymb2015 @gmail.com X ig ature of Candidate Telephone Number Email Address 140 Jefferson Ave APT 14010 Miami Beach Florida 33139 Address City State. ZIP Code • Candidate's Florida Voter Registration Number(located on your voter information card): 109494447 *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): RIK ee ah ree OH lah STATE OF FLORIDA COUNTY OF Miami-Dade Sworn to(or affirmed)and subscribed before me this. / / day of-S-PP Yri t-Q " ,20 /5 Personally Known: or /, ,1 ..1 , /OOP Sig ature of Notary Public 1 Produced Identification: Print,Type,or Stamp Commissioned Name of Notary Public Type of Identification Produced: e' DOREEN A FERNANDEZ .r MY COMMISSION#EE218812 ••• DS-DE'25(Rev.5111) Jon�o�s3 F ede senIIRMI1 c n001,duly 23.1010 = O molimmimmmmmmmmimm % f. A i o- , , • d _, 1915•2015 MIAMIBEACH 7,015 SEP, 1 PH 3: 26 CITY CL..: i 0'S OFFICE CITY OF MIAMI BEACH OATH/AFFIRMATION STATE OF FLORIDA COUNTY OF MIAMI-DADE Before me, an officer authorized to administer oaths, personally appeared Jose Ricky Arriola to me well known who, being sworn, says that he/she is a candidate for the office of Mayor or City Commissioner, Group No. 5 , 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 his/her legal residence is: 140 Jefferson Ave, APT 14010, Miami Beach FL, 33139 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 first day of qualifying as a candidate for office. Sig a.tur of Candidate Sworn to (or affirmed) and subscribed before me this 1 1 day of Se Pkerr , 2015, by J osx_ 11.t'ol y /)'r o k . J / FERNANDEZ 1 DOREEN A FE •'= MY COMMISSION#EE218812 I / f G� �� , '�-r. EXPIRES July 23,2016 �/ ( 398-0153 r-torlaallomrySerikcoom Signature of Notary Public-State o lorida (NOTARY SEAL) ix,e490 A, k40-f7 z Name of Notary Typed, Printed or Stamped Personally Known v OR Produced Identification Type of Identification Produced 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: Arriola Jose Ricky MAILING ADDRESS: 1413 Sunset Harbor Dr#211 CITY: ZIP: COUNTY: ---' s Miami Beach Florida Dade , ''.-'i NAME OF AGENCY: ,`j • r_. . . NAME OF OFFICE OR POSITION HELD OR SOUGHT Miami Beach City Commission ,e,fto u n 6" - " =; .- You are not limited to the space on the Ones on this form.Attach additional sheets,if necessary. (—, -4 CHECK ONLY IF g CANDIDATE OR ❑ NEW EMPLOYEE OR APPOINTEE -11 GO 1 **** BOTH PARTS OF THIS SECTION MUST BE COMPLETED**** H 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 - mus e« one: - l' DECEMBER 31,2014 QR ❑ 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 details). CHECK THE ONE YOU ARE USING: i 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"nla") .NAME OF SOURCE SOURCE'S DESCRIPTION OF THE SOURCE'S OF INCOME ADDRESS PRINCIPAL BUSINESS ACTIVITY Inktel Holdings Corp 8200 NW 33rd,suite 100,Miami,FL 33122 Business Process Outsourcing 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 Inktel Holdings Corp Wal Mart Inc 702 SW 8th St,Bentonville,AK Retailer PART C–REAL PROPERTY [Land,buildings owned by the reporting person-See instructions] FILING INSTRUCTIONS for when (If you have nothing to report,write"none"or"n/a") and where to file this form are located at the bottom of page 2. 1413 Sunset Harbor Dr#211,Miami Beach,FL 33139 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 Adapted by reference in Rule 34.8.202(1).FA.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") TYPE OF INTANGIBLE BUSINESS ENTITY TO WHICH THE PROPERTY RELATES SEE ATTACHED SHEET PART E—LIABILITIES (Major debts-See instructions] (If you have nothing to report,write"none"or"n/a") NAME OF CREDITOR ADDRESS OF CREDITOR SEE ATTACHED SHEET c) 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") —4 cr' 7' BUSINESS ENTITY#1 BUSINESS ENTITY#.2: � C . NAME OF BUSINESS ENTITY Apollo Bank . ADDRESS OF BUSINESS ENTITY 1150 South Miami Ave Miami FL --- PRINCIPAL BUSINESS ACTIVITY Bank ..--. " • POSITION HELD.WITH ENTITY NA ; I OWN MORE THAN A 5%INTEREST IN THE BUSINESS NA c,'"? • = - - -... —Investor --:::: l - - IF ANY OF PARTS A THROUGH F ARE CONTINUED ON A SEPARATE SHEET,PLEASE CHECK HERE D SIGNATURE OF FILER: CPA or ATTORNEY SIGNATURE ONLY If a certified public accountant licensed under Chapter 473,or Signature: attorney in good standing with the Florida Bar prepared this form for ou,he or she must complete the following statement: I 8 ELA 7Ra° , prepared c? 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 di • r-iiii - rue and correct. Date Signed: ∎► CPA/Attorney Signature: `•' //( I i I Date 9 Signed: —// !2-0 15" g 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 its send back only the first on cs or a rq, 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. Appointees who must be confirmed by the Senate must file If you have nothing to report in a particular Local officers/employees file with the prior to confirmation, even if that is less than section,you must write"none"or"n/a° in that Supervisor of Elections of the county in which they 30 days from the date of their appointment. section(s). permanently reside. (If you do not permanently Candidates for publicly-elected local office must reside In Florida,file with the Supervisor of the file at the same time they file their qualifying NOTE: county where your agency has its headquarters.) pars. MULTIPLE FILING UNNECESSARY: State officers or specified state employees 7herea local officers/employees, scale A candidate who previously filed Form 1 because file with the Commission on Ethics,P.O.Drawer off erea and specified state employees are of another public position must at least file a copy 15709, Tallahassee, FL 32317-5709; physical required to file by July 1 st following each calendar of his or her original Form 1 when qualifying.A address:325 John Knox Road,Building E,Suite year in which they hold their positions. candidate who files a Form 1 with'a qualifying 200,Tallahassee,FL 32303. Rnal/y,at the end of office or employment,each officer Is not required to file with the Commission Candidates file this form together with their local officer/employee,state officer,and specified or Supervisor of Elections. 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 Ale"instructions on employment.However,fifing a CE Form 1F(Final page 3. Statement of Financial Interests)does Dot 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. PAGE 2 CE FORM 1-Effective:January 1.2015. Adopted by reference in Rule 34.8.202(1).F.A.C. • Ricky Arriola CE Form I—Separate Sheet PART D—INTANGIBLE PERSONAL PROPERTY (CONTINUATION) TYPE OF INTANGIBLE BUSINESS ENTITY TO WHICH THE PROPERTY RELATES ISHARES MSCI EMRG MKT FD - ETF ISHARES MSCI JPN ETF SPDRS&P500ETFTR FACEBOOK, INC. —Common Stock CITIBANK—Checking Account 8750 Doral Blvd Miami FL 33178 PART E—LIABILITIES (CONTINUATION) NAME OF CREDITOR ADDRESS OF CREDITOR BANK UNITED PO Box 02603, Miami FL 33012 US BANK PO Box 3427, Oshkosh, WI 54903 CITIBANK PO Box 6062, Sioux Falls, SD.57117 SABADELL UNITED PO Box 5460 Hialeah FL 33014 Cr) ti ,g 00 — N.) v Form 9 QUARTERLY GIFT DISCLOSURE (GIFTS OVER $100) LAST NAME--FIRST NAME--MIDDLE NAME: NAME OF AGENCY: Arriola, Jose Ricky Miami Beach City Commission MAILING ADDRESS: OFFICE OR POSITION HELD: 8200 NW 33rd Street,Suite 100 City Commissioner, Group 5 CITY: ZIP: COUNTY: FOR QUARTER ENDING(CHECK ONE): YEAR UMARCH LIJUNE ❑SEPTEMBER ❑DECEMBER 2015 Miami, 33122 Miami-Dade 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 n/a n/a n/a n/a n/a c_?. c . 3 ❑ CHECK HERE IF CONTINUED ON SEPARATE SHEET ,, PART B—RECEIPT PROVIDED BY PERSON MAKING THE GIFT 4._. 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 tills 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 OF (Y I c Uh I — 06161,6 depose on oath or affirmation and say that the information disclosed Sworn to(or affirmed)and subscribed beforg me this 1 day of L -1-4✓)1100-C---- ,20 15 herein and on any attachments made by me constitutes a true accurate, -- .y o_5-e 24C,I6," A Kip' , and total listing of all gifts required to be reported by Section 112.3148 Iffilla Iffifffiry,-.. Florida Statutes. - (Signatur-o'Iotary Publ';:State of Florida) (Print,Type,or Stamp Commi ioned Name of Notary Public) SIGN UR OF REPORTING OFFICIAL Personally Known OR Produced Identification Type of Identification Produced PART D—FILING INSTRUCTIONS This form,when duly signed and notarized,must be filed with the Commission on Ethics,P.O.Drawer 15709,Tallahassee,Florida 32317-5709;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) 0''"��tif„ DOREEN A FERNANDEZ '• .``' .,'c MY COMMISSION#EE218812 '' EXPIRES July 23,2016 (407)398-0183 FlorldallotarySeMoe.00m ,-----. \ — -ci > m > El •ci o I -91 ......, 0 0 0 c e ,# 441 c SD 0 0 :1 ..e. 2 a CI. U) M ‘,. 0 = =Is SU 1.dgc 1 0 ,- 3 0 Or■I m ■J . . A -% tr 73 > CD ' 4 M m= 1 1 II rrl 0 DO NJ 0 . ,,r- —i 0 . 3 , — CD MOO C 03 V) 1 i 1 ■ _uND 7. - _.... 5 1.2 /c.--. 0. '7 1 1 I r^.-.. 0 > 7 • z ,.._ 0 1 a si) o 0 Do c ,--..., -) -, I U) Q. 1 i .'- , 1/4.-- \ ( `' V-) Pa . i :7. "' r- ., 1—171 0 • >'m --,• ____ r-L__ cr; m 0 D ; , 1 I= , ''i ...---I • r-z • ) \ .1 0 \ CD 1 cl LLC CO CO ci O — r 0 csi" ors■ ...... 0 a) -a . •-•\ 4 0 ✓ -1\ . G 0. , . i . _ it'. c.,.,-- 0 rn g ,---, —I .....\ * d % m 0 C- "e• ' ."'' Ir' ; , , _....\ 0 ' 0 > ' 1 0 a • -1 0 1\ 1 ---, •• --f-' ( .--- , u -.1 . ..,, ...‹ ® = a- 0 0 , . ... 3 i_ ii., , ..._ 7, '.. .... , i ..........„_____, ,-- ."---„CsT zo"—::-\,_r_ ..-- I ;4 i N../ ,,,, c if,' ,.. 0 • ,f....„ 1 i -,_ 1 IN 11 ' cp i •, 1 m = zi ) 1 , --.3 = 0 o a -... 2 2. --' 3‘)'-') c)— .. -,.. .....,..-_ I , , - ..i.. i i 1 1--- , c I I , ii. o c....; r •••• c■ I 0 u...i , t % . ,,-- - !.. .,_,.., cz 2 x 1--1 -■_,...„. 0 .. I—n,6., 1 ( cn 75, 4:■,, ct ....._ ..,:-.- -•..i---.:,--., n I., 1 _ AIM BEACH 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 rn �R- 5. Unofficial Results provided by the '"o Supervisor of Elections Friday, 11/20/15 1. Canvassing of provisional ballots All Canvassing Board 11:30 a.m. to completion (if needed) Members 2. Certification of Official Results, including r, W provisionals, by the Supervisor of Elections ?' 3. Post-count Logic and Accuracy Test of the 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 9V i/ii/js 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. IV\ A/V\1 BEAC 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 Canvassingoarr (as needed) Members to 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 ....o 5. Unofficial Results provided by the Supervisor of Elections �t Friday, 11/6/15 1. Canvassing of provisional ballots All Canvassing Board 1:30 p.m. to completion (if needed) Members a' 2. Certification of Official Results including provisionals, by the Supervisor of Elections 3. Post-count Logic and Accuracy Test of the 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 Q c/1 /11J '.C-- 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.