Qualifying documents~;;
LOYALTY OATH
CANDIDATES WITH NO PARTY AFFILIATION R . ~. ~ ~ ~ F
(Sections 976.05-x76.10. FIO-ida Statutes)
2001 S P -S PM 4~ 3b
I,
STATE OF FLORIDA
OFFICE USE ONLY
CITY CLEt~H`S OFD IC~vtiarni-Dade COUNTY
PLEASE PRINT /~,
1/l!
First Names Middle NamsAnitlal Last Name
a citizen of the State of Florida and of the United States of America, ... and a candidate for public office ... do
hereby solen-~~~!y sh-aar or affir~„ -~ tat 1 will support the Constitution of the United States and of the State of Florida.
OATH OF CANDIDATE
• (Section 99.021. Florida Statutes)
I,
(PLEASE PRINT NAME AS VOU 1MSN IT TO A-PE'R ON
am a candidate for the office of
wA NlA
(o. ~) ,, (dhtrict) tclrcult)
. 1 am a qualified elector of t ,x/77/ ~iy'~dF County, Florida.
(firoup)
1 am a qual~ed elector of the City of Miami Beach, Fkxida, residing within the C~~it,,YY at least one ear bef~p quarifyirq
for City of Miami Beach elected once, with my legal residence being: / ~5`v~ ~G_,~f~.~il~/5`~~
Miami Besch, 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 tae nominated or elected. I have qualified for no other public ofllce
in the state. the term of which office or any part thereof runs concurrent with the office 1 seek; and 1 have resgned from
sfnv efrce from whir_h I am rerniireri In resign pursuant t0 Section 99.012. Florida Statutes.
UN E f T 0 P 1 IJIRE THAT 1 HAVE READ THE FOREGOING LOYALTY OATH AND OATH OF
C ~ r TEO IN EACH ARE TRUE.
~~~ ~'I~t~olafyptbMC ~ ~hbt0.~ SWORN TO AND SUBSCRIBED before me this ''~ day .
~~ ~ ~ ~, dt DD 876299 of 4,9.T~1007, Notary Name: ~i II~,~, ~. ~a~ ~
,,,~ tlottdsd t~laNortdNo~aryAtEn. Notary Public, State of Florida
Commission Expires: ill del D 9 Personally Known:
Prnrturtori In• TVDE3:
SIGN HERE
~ ~ X85 ~' -
Mallinp Address Oay PAOne T-
State
- NAME N1AV NOT ~ CNANGEO AFTER THE END OF OUAIIFYtNti)
'~/~
Zip Code
Fax Number
°~--d~
Date Signed
OS-OE 21B (Rev. 08103)
FORM l STATEMENT OF 2006
ddrbs ag n~y~ameua
"dpos~~onibel
FINANCIAL INT'EREST'S
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ow:
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LA NAME --FIRST NAME -- MIDDLE NAM FOR OFFICE
r / ~ USE ONLY:
MAILI G ADDRE55 . t'7 0
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NAME OF A ENCY :
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NAME O 0 1 E O POSITIO LO OR SOUGHT :
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Vou an not limited t he space on the lines on this form. Attach additional sheets, if necessary.
CHECK ONLY IF ~ CANDIDATE
PDF 2006
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 (check one):
DECEMBER 31, 2006 QF3 ^ 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 EITHF_R (check one):
COMPARATIVE (PERCENTAGE) THRESHOLDS QB ~ DOLLAR VALUE THRESHOLDS
PART A -PRIMARY 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 ACTIVITY
. ~®O ~ d L L ~ss~..
~ ~ ~
6A~ ~
PART B -SECONDARY SOURCES OF INCOME [Major customers, Gients, and other sources of income to businesses owned by the reporting person]
NAME OF NAME OF MAJOR SOURCES ADDRESS PRINCIPAL BUSINESS
BUSINESS ENTITY OF BUSINESS' INCOME OF SOURCE ACTIVITY OF SOURCE
PART C -REAL PROPERTY (Land, buildings owned by the reporting person] FILING INSTRUCTIONS for when
and wher
t
fft
thi
e
o
e
s form are locat-
ed at the bottom of page 2.
fNSTRUCTIONS on who must file
this form and how to fill it out begin
on page 3.
OTHER FORMS you ma
ne
d t
..~ .- y
e
o
file ars described on page ti.
..~. ~ .+.~~.~ ~ - u~. vcuu~ (l.OrillnYe4 00 reVerSe 81de} PAGE 1
I PART D -INTANGIBLE PERSONAL PROPERTY iStocks, bonds. certificates of deposit. etc.] I
TYPE OF INTANGIBLE ( BUSINESS ENTITY TO NVHICH THE PROPERTY RE LF.TES
PART E -LIABILITIES (Major debts]
NAME OF CREDITOR
PART F --INTERESTS IN SPECIFIED BUSINESSES- (Ownership or positions in certain types of businesses]
BU5INESS 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
ADDRESS OF CREDITOR
DATE SIGNED
WHAT TO FILE:
After completing all parts Hof this form, induding
signing and dating it, send back only the first
sheet (pages 1 and 2) for filing.
It you have 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:
Generally, a person who has filed Form 1 for a
calendar or fiscal year is not required to file a
second Form 1 for the same year. However, a
candidate who previously filed Form 1 because
of another public position must at least file a copy
of his or her original Form 1 when qualifying.
FILING INSTRUCTIONS:
WHERE TO FILE:
If you ware mailed the Iorm by the Commission
on Ethit~ or a County Supervisor of Elections for
your annual distdosure tiring, return the form to
that bcsUon.
Local of-lcers/ernployeeafile wRhthe Supervisor
of Elections of the county in which they perma-
nently reside. (If you do not permanently reside
in Florida, file with the Supervisor of the county
where your agency has its headquarters.)
State otNcers or speciFred state employees
fife with the Commission an Ethics, P.O. Drawer
15709, TaNahassee, FL 32317-5709; physical
address: 3600 Maday Boulevard, South, Suite
201, Tallahassee, FL 323t2.
Candidates file this form Eogether with their
qualifying papers.
To determine what category your position
facts under, see the "Who Must File" lnstrudions
on page 3.
n .r
WHEN TO FILE:
Initially, each local officer/employee, state
officer, and specified state employee must
fife within d0 days of the date of his or her
appokttment or of the beginning of employ-
ment. Appointees who must be confirmed by
the Senate must file prior to Confirmation, even
if that is less than 30 days from the date of their
appointment.
Candidates for publicly-elected local office
must file at the same time they file their
qualifying papers.
Thereafter, local officerslemployees, state
officers, and specified state employees are
required to fire by July 1st following each
calendar year in which they hold their posi-
tions.
Finally, at the end of office or employment,
each local oltcerlemployee, state o~cer, and
spedfied state employee is required to file a
final disclosure form (Form 1 F) within 60 days
of leaving oflce or em0lovrnent_
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