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DS-DE 125 Parker DESIGNATION OF POLL WATCHERS FOR: M B COMM RUNOFF GRP 4 (Specify Applicable Election) Pursuant to Section 101.131,Florida Statutes,I request that the following persons(none of whom is a candidate or a sheriff,deputy sheriff,police office or other law enforcement officer), who are qualified and registered voters of the county in which they will serve, be approved as poll watchers for(check only one): E' EARLY VOTING ELECTION DAY 1. Printed Name: MELISSA PARKER Date of Birth (mm/dd/yy): 09/21/1971 Address: 560 w 51ST ST,MIAMI BEACH,FL33140 Location of Polling Room or Early Voting Site: MIAMI BEACH CITY HALL,NORTH SHORE LIBRARY 2. Printed Name: NIEVES R FENICHEL Date of Birth (mm/dd/yy): 08/05/1954 Address: 1568 WASHINGTON AVE.MIAMI BEACH,FL 33139 Location of Polling Room or Early Voting Site: MIAMI BEACH CITY HALL,NORTH SHORE LIBRARY 3. Printed Name: ENRIQUE MECHULAN Date of Birth(mm/dd/yy): 06/14/56 Address: 550 W 51ST STREET,MIAMI BEACH,FL 33140 Location of Polling Room or Early Voting Site: MIAMI BEACH CITY HALL,NORTH SHORE LIBRABRY 4. Printed Name: SANDRA GOTMAN MECHULAN Date of Birth(mm/dd/yy): 06/04/1959 Address: 550 W 51ST STREET,MIAMI BEACH,FL 33140 Location of Polling Room or Early Voting Site: MIAMI BEACH CITY HALL,NORTH SHORE LIBRARY NOTE: If more lines are needed to poll designate oll watchers, use DS-DE 125 continuation page(s) and attach to g this page. Only sign this top form, but the page count entry must be completed on the bottom of this page. ***************************************************************************************** Check applicable box and fill in the blank lines: I am a candidate for MIAMI BEACH CITY COMMISSION GROUP 4 in this election. IT I am the chair of the County Executive Committee of the Party. FT I am the chair of Political Committee. / JONATHAN H.PARKER 10/30/15 s Printed Name Signature Dates 3921 ALTON RD#471,MIAMI BEACH,FL 33140 305-865— 888 r Address V Phone Attention: This form is due to the Supervisor of Elections: • For Early Voting, no later than noon of the 14th day before early voting begins. • For Election Day, before noon of the second Tuesday preceding the election. - (This form becomes a public record when submitted to the Supervisor of Elections.) Page 1 of 2 pages. DS-DE 125 (rev.05/2011) DESIGNATION OF POLL WATCHERS — Continuation Page (Enter Page Number on Bottom of Page) This form becomes a public record when submitted to the Supervisor of Elections. 1. Printed Name: GINA DANZIGER Date of Birth(mm/dd/yy): 12/09/1956 Address: 8311 SW 157TH AVE#707 MIAMI BEACH,FL 33186 Location of Polling Room or Early Voting Site: MIAMI BEACH CITY HALL,NORTH SHORE LIBRARY 2. Printed Name: MICHAEL W.KESTI Date of Birth(mm/dd/yy): 08/26/1961 Address: 8161 SW 170TH STREET,PALMETTO BAY,FL 33157 Location of Polling Room or Early Voting Site: MIAMI BEACH CITY HALL,NORTH SHORE LIBRARY 3. Printed Name: MARIA C.KESTI Date of Birth (mm/dd/yy): 08/26/1957 Address: 8161 SW 170TH STREET,PALMETTO BAY,FL 33157 Location of Polling Room or Early Voting Site: MIAMI BEACH CITY HALL,NORTH SHORE LIBRARY 4. Printed Name: IVY BAUTISTA Date of Birth (mm/dd/yy): 05/17/1995 Address: 560 W 51ST STREET,MIAMI BEACH,FL 33140 Location of Polling Room or Early Voting Site: MIAMI BEACH CITY HALL,NORTH SHORE LIBRARY 5. Printed Name: JULIAN BAUTISTA Date of Birth(mm/dd/yy): 06/22/1991 Address: 1553 JEFFERSON AVE,MIAMI BEACH,FL 33139 Location of Polling Room or Early Voting Site: MIAMI BEACH CITY HALL,NORTH SHORE LIBRARY 6. Printed Name: DAVID ANDERSON Date of Birth (mm/dd/yy): 07/24/1956 Address: 10101 E.BAY HARBOR DR#706,BAY HARBOR,FL 33154 Location of Polling Room or Early Voting Site: MIAMI BEACH CITY HALL,NORTH SHORE LIBRARY ,-_, 7. Printed Name: CORI MOSS Date of Birth(mm/dd/yy): 04/14/198x". Address: 1553 JEFFERSON AVE,MIAMI BEACH,FL 33139 Location of Polling Room or Early Voting Site: MIAMI BEACH CITY HALL,NORTH SHORE LIBRARY 8. Printed Name: Date of Birth (mm/dd/yy): -::� Address: Location of Polling Room or Early Voting Site: 9. Printed Name: Date of Birth (mm/dd/yy): Address: Location of Polling Room or Early Voting Site: DS-DE 125—continuation page(rev.05/2011) Page 2(Yid DESIGNATION OF POLL WATCHERS FOR: M B COMM RUNOFF EARLY VOTING GRP 4 (Specify Applicable Election) Pursuant to Section 101.131, Florida Statutes, I request that the following persons(none of whom is a candidate or a sheriff,deputy sheriff,police office or other law enforcement officer), who are qualified and registered voters of the county in which they will serve, be approved as poll watchers for(check only one): EARLY VOTING E ELECTION DAY 1. Printed Name: MELISSA PARKER Date of Birth (mm/dd/yy): 09/21/1971 Address: 560 w 51ST ST,MIAMI BEACH,FL33140 Location of Polling Room or Early Voting Site: MIAMI BEACH CITY HALL,NORTH SHORE LIBRARY 2. Printed Name: NIEVES R FENICHEL Date of Birth(mm/dd/yy): 08/05/1954 Address: 1568 WASHINGTON AVE.MIAMI BEACH,FL 33139 Location of Polling Room or Early Voting Site: MIAMI BEACH CITY HALL,NORTH SHORE LIBRARY 3. Printed Name: ENRIQUE MECHULAN Date of Birth(mm/dd/yy): 06/14/56 Address: 550 W 51ST STREET,MIAMI BEACH,FL 33140 Location of Polling Room or Early Voting Site: MIAMI BEACH CITY HALL,NORTH SHORE LIBRABRY 4. Printed Name: SANDRA GOTMAN MECHULAN Date of Birth (mm/dd/yy): 06/04/1959 Address: 550 W 51ST STREET,MIAMI BEACH,FL 33140 Location of Polling Room or Early Voting Site: MIAMI BEACH CITY HALL,NORTH SHORE LIBRARY NOTE: If more lines are needed to designate poll watchers, use DS-DE 125 continuation page(s)and attach to this page. Only sign this top form, but the page count entry must be completed on the bottom of this page. ***************************************************************************************** Check applicable box and fill in the blank lines: E I am a candidate for MIAMI BEACH CITY COMMISSION GROUP 4 in this election. fl I am the chair of the County Executive Committee of the Party. D I am the chair of Political Committee. JALJONATHAN H.PARKER 10/30/15 Printed Name n ignature Date. 3921 ALTON RD#471,MIAMI BEACH,FL 33140 305-865-6888 Address Phone Attention: This form is due to the Supervisor of Elections: • For Early Voting, no later than noon of the 14th day before early voting begins. • For Election Day, before noon of the second Tuesday preceding the election. (This form becomes a public record when submitted to the Supervisor of Elections.) Page 1 of 2 pages. DS-DE 125 (rev.05/2011) DESIGNATION OF POLL WATCHERS — Continuation Page (Enter Page Number on Bottom of Page) This form becomes a public record when submitted to the Supervisor of Elections. 1. Printed Name: GINA DANZIGER Date of Birth(mm/dd/yy): 12/09/1956 Address: 8311 SW 157TH AVE#707 MIAMI BEACH,FL 33186 Location of Polling Room or Early Voting Site: MIAMI BEACH CITY HALL,NORTH SHORE LIBRARY 2. Printed Name: MICHAEL W.KESTI Date of Birth(mm/dd/yy): 08/26/1961 Address: 8161 SW 170TH STREET,PALMETTO BAY,FL 33157 Location of Polling Room or Early Voting Site: MIAMI BEACH CITY HALL,NORTH SHORE LIBRARY 3. Printed Name: MARIA C.KESTI Date of Birth(mm/dd/yy): 08/26/1957 Address: 8161 SW 170TH STREET,PALMETTO BAY,FL 33157 Location of Polling Room or Early Voting Site: MIAMI BEACH CITY HALL,NORTH SHORE LIBRARY 4. Printed Name: IVY BAUTISTA Date of Birth(mm/dd/yy): 05/17/1995 Address: 560 W 51ST STREET,MIAMI BEACH,FL 33140 Location of Polling Room or Early Voting Site: MIAMI BEACH CITY HALL,NORTH SHORE LIBRARY 5. Printed Name: JULIAN BAUTISTA Date of Birth (mm/dd/yy): 06/22/1991 Address: 1553 JEFFERSON AVE,MIAMI BEACH,FL 33139 Location of Polling Room or Early Voting Site: MIAMI BEACH CITY HALL,NORTH SHORE LIBRARY 6. Printed Name: DAVID ANDERSON Date of Birth (mm/dd/yy): 07/24/1956 Address: 10101 E.BAY HARBOR DR#706,BAY HARBOR,FL 33154 Location of Polling Room or Early Voting Site: MIAMI BEACH CITY HALL,NORTH SHORE LIBRARY 7. Printed Name: CORI MOSS Date of Birth (mm/dd/yy): 04/14/198k, Address: 1553 JEFFERSON AVE,MIAMI BEACH,FL 33139 r-� Location of Polling Room or Early Voting Site: MIAMI BEACH CITY HALL,NORTH SHORE LIBRARY c-" 8. Printed Name: Date of Birth(mm/dd/yy): Address: e�a� Location of Polling Room or Early Voting Site: 9. Printed Name: Date of Birth(mm/dd/yy): Address: Location of Polling Room or Early Voting Site: Page 2 O DS-DE 125—continuation page(rev.05/2011) F