Qualifying documentsLOYALTY OATH R ~ ~
CANDIDATES WITH NO PARTY AFFtL1ATiON
lse~«~ e~s.os-a~s.,o. F~-io~ st=we~~r 20~~ ~~P
STATE OF FLORIDA
CITY CL
OFFICE USE ONLY
~I~F
5 PM ~: 20
'S OAF (C~ Miami bade
COUNTv
PLEASE PRINT
S 1 t~(o ~ ~ [~' u Z-
I,
First Nsms
MiddN Namrnnl~iau
use na-s.e
s citiaen of the State of Forida and of the United States of America.... and a candidate for public office ... do
hereby aoler:-rr~ls sv~~aar or affu~~ u'1at t wig support the Constitution 0f the United States and Of that Mate of Ftortda.
OATH CAF CANDIDATE
• (section 8!!.021. Frorida Statwrs)
p~wse r~uar a~ ~s rou wNSN ~ ~ ~ele a~,IE rbc,wr- wtt~E Wtr NoT ~ c~uwGeu NfYER lrlat eau Oi riu~usrMwei
tetlA
~__ _. _ _ =v_.
tu'n s candidate tar the of'hce of Ill `~ C`~ ~ WA
toMleej tdlstrtctf toireuk~
. 1 arrl a qu~ified etet~ of tM t ~ ~- r/ iJ D ~ County, Florida.
Itt-ewPf
t sm s qua~ied elector of the City of Miami Beach. Florida. within the City at (east one year befimt quai~ykrjt
fix CSy ~ Miami Beach elected otfOe. witl, rrry kf{a! residence : S~3 Z d t~'•~c-~ Tree Dr: ~, ~ __ .
ttAieeeti Baach, Fiorkia. tam eSealiRed render >tle s and Charter of sad City and under then Consetitutior- and the
Laeas of Florida to hold the office to which i desire b be rtoeti~ted ar elersted. i have t~uaiified for rw other F+ aoMice
Mrs 11te s~ste. the term at which office a arty Fart thereof rt~ens oortexxrent with the office l seek; and i have ret~reed t~nm
_..., - ~ .............E. ~ ~.....,....:~,.~ ~, .,a~:.~..,~~.mnt i~ Ssrliaolt l3e.Of2. Florida Statutes.
IJNOER PENAtTtES OF t~'ERJURY. t DECLNRE THAT t HAVE REND Tt~ FQltECsClit~ LC3YAt_TY E'fATH ANO OATH OF
CANaDATE AND THAT Tt~ FACTS STATED tN EACH ARE TRtiE.
SVVE?RN TCI Ate SUBSCRIBED before me this ,~~ day
uw~w s~uctir+leP of ~~D~ 20f17, Notary game: ~, ll ~'~,,~ ~~-.~'~
MY CAMMISSION N DD 530416 P[ptary Pubiic~ State of Florida
{ 7:~;<: EXPIRES: April29, 2oto C~mi~~ E~~~ ~,-~2c, /o Personalty Known:
~!Rf ~Rh~r`,, Sorbed TMu NMery Prdrlc Urberndbre
Produced iD: Type:
SIGN HERE
J~I~iZ-S ~t~ l?'e~ b~ey~ ~ _ ~'a5~ ~~0~~~8.Z/
Ma11inQ Add-ess ~9t P'IFOtre Fs: lluta~lt~
~~ ~K~ (3~~c~ ~L _3 3 [ y- ~
Cky State zip cads
9~ s' o ~
o:a siQaed
as-oE ~t~e tR•v. os,o~!
>lPlgnat~ere ~ ~~~
.
.
FORM 1 STATEMENT CAF
2006
~ ~ ~
~ ~ ~ ~
~
„~~ ~~y ~m~"Antl ~~on mow: FINANCIAL INTEI~EST
~ EP `5 PM 2~ 20
LAST NAME -- FIRST NAME -MIDDLE NAME : FOR F
~
~
~
'
~
111
Y
CLF~~i
S 01
FICF
C. ~ t~ Z S ~~? o usE
MAILING ADDRESS
~~ ~ f i/! c° T~~° e ~r~ U ~.
ID Cade
,,~~ /~ /- L~ f~
CITY : ZIP : COUNTY
tD Na.
NAME OF AGENCY : _ '~
C _ ~ ~ (. ~ ~L ` J t~ vQ C Canf. Code
NAME OF
OFFICE OR POSITION HELD OR SOUGHT : P. Req. Code
Q
~/
You an not Nmked to the apses on the Nnes on this form. Atgeh sdditionai sheets, If netessary.
CHECK ONLY IF ~ CANDIDATE OR ®NEW EMPLOYEE OR APPOINTEE ~~~ 20t'~
."'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 ENDfNG EITHER (chtrrGc one):
DECEMBER 31, 2006 ¢$ ~ SPECIFY TAX YEAR IF OTHER THAN THE CALENDAR YEAR:
MANNER OF CALCULATING REPORTABLE INTERESTS:
THE LEGISLATURE ALLOWS FILERS 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). PLEASE STATE BELOW WHETHER THIS STATEMENT REFLECTS EITHER (check one):
COMPARATIVE (PERCENTAGE) THRESHOLDS Q$ Q DOLLAR VALUE THRESHOLDS
PART A - PR{MARY SOURCES OF INCOME [Major sources of income to the reporting person]
NAME OF SOURCE SOURCE'S DESCRIPTION OF THE SOURCE'S
OF INCOME ADDRESS PRINCIPAL BUSINESS ACTNfTY
1UT6NR~(lIDI~r4~ i>ftQ ~bo~o `(3rticlte(f U~ Ktt~etL~ ~(. ~1 G
PART B -SECONDARY SOURCES OF INCOME [Major wstamers, Giants, and other sources of income to businesses awned by the reporting person]
NAME OF NAME OF MAJOR SOURCES ADDRESS PRINCIPAL BUSINESS
BUSINESS ENTITY OF BUSINESS' WGOME OF SOURCE AGTIYITY OF SOURCE
<~
PART C -REAL PROPERTY (Land, buildings owned by the reporting person] FILING INSTRUCTfONS for when
and where to file this form are locat-
ed at the bottom of page 2.
lNSTRUCTIQN5 on who must file
this farm and how to fill it out begin
an page 3.
E3THER F63R~lIS you may need to
file are dascrlbad on page 6.
CE FORM 1 - Etf. 1/2007 (Continued on reverse skN} PAGE t
PART D -INTANGIBLE PERSONAL PROPERTY (Stocks, bonds, certificates of deposit, etc.]
TYPE OF INTANGIBLE BUSINESS ENTITY Td WHICH THE PROPERTY RELATES
L.1= ~= s7-aG-k s G~-~
~ ~ s -~ ~ ~~ tR~ C
J lu" rr C ~ ~T ~ vl ~U'~
PART E - LIABILITIES [Major debts]
NAME OF CREDITOR ~ ADDRESS OF CREf3iTdR
PART F -INTERESTS IN SPECIFIED BUSINESSES [Ownership or positkrns in ceRain types of businesses]
BUSINESS ENTITY # 1 I BUSINESS ENTITY # 2 [ BUSINESS ENTITY # 3
ENTITY
INTEREST
IF ANY OF PARTS A THROUGH F ARE CONTINUED ON A SEPARATE SHEET, PLEASE CHECK HERE
SIt3NATURE (raqutnsd}:
WHAT TO FILE:
After completing all parts of this form, inducting
sigMng and dating b, send back only the first
sheet (pages 1 and 2) for fiFng.
N you haw nothing to report in a particular
section, you must write "none" or "n!a" in that
section(s).
Facsimiles will not be accepted.
NOTE:
MULTIPLE FILING UNNECESSARY:
GenereNy, a person who has filed Form 1 for a
calendar or fiscal year is not required to fi~ a
serxmd Fonn 1 for the same year. However, a
candidate who previously filed Form 1 because
of another public position must at feast fde a copy
of his or her original Form 1 when qualifying.
DATE SIGNt'eD (r+squlrsci). ¢, ~! D
WHERE TO FILE:
tf you were mated the farm by the Commission
on Ethics a a County Supensor of Elections for
your annual disclosure fifing, return the farm to
that bcation,
Local ofBcers/srnpfoyeesfiIe with the Supervisor
of Elections of the county in which they perma-
nently reside. (tf you do not permanently reside
in Florida, file with the Supervisor of the county
where your agency has its headquarters.}
State olffcers or specHfed state employees
file with the Commission an Ethics, P.d. Drawer
157(}9, Tallahassee, FL 32317-5709; physical
address: 3600 Maciay Boulevard. South, Suite
201, Tallahassee, FL 32312.
Cano~tes fife this form together with their
qualifying Papers.
Ta determine what category year position
falls under, see the "tMto Must Fse' Irestrur~ions
an page 3.
WHEN TO FILE:
fnltlally, each local officedempinyee, state
officer, and spud state emp~yee must
tfie wilYtirt 3ti days of the date of his o- her
appointment ar of the beginning of empksy-
menL Appointees who must be confimted by
the Senate must file prior to confinnaGon, even
if that is teas than 30 days from the date of their
appointment.
Carrdidstea for pulsNdy-eieded ioca! ofice
must 81e at the same time they file their
qualifying papers.
Thereafter, local officersJemployees, state
offers, and specified state employees are
required to file by July 1st following each
calendar year in which they hold their pos6-
tksns.
Fly, at the end of office or employment,
each local offrcerfempioyee, state officer. and
specified state employee is required to file a
final disclosure form (Form 1 F) within fat} days
of waving otfroe or employment.
CE FORM 1 - Eff. 1/2007 PAGE 2
~55
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CITY OF AAfANR BEACH
No.
^ cash ^ c~a~t ca~a check # /~' ~ ~ ~i 3 ~ ~
~ t~ ?off
R~w«i of G~
(THIS INFORMATION MUST BE COMPLETED)
Account N ~ ' ~ ~ ~- ~
Prpanr: ~ a
Director
B3'
EXT: ~> l`
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