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DS-DE 5 Statement of Organization LET MIAMI BEACH DECIDE STATEMENT OF ORGANIZATION OFFICE USE ONLY S2 4 _o OF POLITICAL COMMITTEE r � (PLEASE TYPE) cn t 1. Full Name of Committee Teleptronery 7-1 cm Let Miami Beach Decide 305-593C2644 Mailing Address (include city, state and zip code) 1602 Alton Road, #382, Miami Beach, FL 33139 Street Address (include city, state and zip code) 1602 Alton Road, #382, Miami Beach, FL 33139 2. Affiliated or Connected Organizations (includes other committees of continuous existence and political committees) Name of Affiliated or Connected Organization Mailing Address Relationship N/A r 3. Area, Scope and Jurisdiction of the Committee Sponsoring and Supporting Amendment to Miami Beach Charter 4. Nature of Organization or Organization's Special Interest(e.g., medical, legal, education, etc.) Miami Beach Charter Amendment 5. Identify by Name, Address and Position, the Custodian of Books and Accounts (include treasurer's name) Full Name Mailing Address Committee Title or Position Carlos M. Trueba 1985 NW 88th Ct Suite 101 Treasurer and Custodian of Doral, FL 33172 Books and Accounts DS-DE 5 (Rev. 05/06) (continued on reverse side) 6. List by Name, Address and Position, Other Principal Officers, Including Officers and Members of the Finance Committee, If Any (include chairman's name) Full Name Mailing Address Committee Title or Position Jonah Wolfson 1602 Alton Road, #382, Miami Beach, Chairman - - FL.33139-- 7. List by Name, Address, Office Sought and Party Affiliation Each Candidate or Other Individual that this Committee is Supporting (if none, please indicate) Full Name Mailing Address Office Sought Party 8. List Any Issues this Committee is Supporting: Amendment to Miami Beach Charter List Any Issues this Committee is Opposing: N/A 9. If this Committee is Supporting the Entire Ticket of a Party, Give Name of Party N/A 10. In the Event of Dissolution, What Disposition will be Made of Residual Funds? Returned pro-rata to contributors or given to 501 c3 charitable organization 11. List all Banks, Safety Deposit Boxes, or Other Depositories Used for Committee Funds Name of Bank or Depository &Account Number Mailing Address 750 Arthur Godfrey Road Wells Fargo Bank N.A. Miami Beach, FL 33140 12. List all Reports Required to be Filed by this Committee with Federal Officials and the Names, Addresses and Positions of Such Officials, If Any Report Title Dates Required to be Filed Name& Position of Official Mailing Address N/A STATE OF Florida Miami-Dade COUNTY Jonah Wolfson I, certify that the information in this Statement of Organization is comp te, tr and correct. X 1 3 Signature o airman of Political Committee Date 1