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DS-DE 84 Zachary M. Eisner 2017 • OFFICE USE ONLY STATEMENT OF ti. __ CANDIDATE ZOO FEB -9 P 1 2: 09 (Section 106.023, F.S.) CITY CLip,;. S uJFi= ICE (Please print or type) I, Zachary Eisner candidate for the office of Miami Beach City Commissioner Group 2 have been provided access to read and understand the requirements of Chapter 106, Florida Statutes. X 404 fei 7 ?of-7 Signature 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)