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Gelber, Dan - September 27, 2021S U B M IT S IG N E D C O P Y TO E LE C T IO N S A T C A M P A IG N S @ M IA M ID A D E .G O V M U N IC IP A L O FFIC IA LS A N D C A N D ID A T E S : S U B M IT FO R M TO C IT Y C LE R K ...M9 è±fii iii MIAMI-DADE COUNTY ELECTIONS DEPARTMENT Reset Form REPORTING OF SOLICITATION OF CONTRIBUTIONS FOR POLITICAL COMMITTEES, ELECTIONEERING COMMUNICATIONS ORGANIZATIONS, 501(c)(4) ORGANIZATIONS AND POLITICAL PARTIES OFFICE USE ONLY Elected Official's or Candidate's Name Mayor Dan Gelber o .3 ·r 2 ·mcc 3 Address (number and street) -- - -- 5445 LaGorce Drive r1-« o 70 >o c3 fr rr; od le I o City, State, Zip Code r:-- - rr rn7» 3. - Miami Beach, FL 33140 -- I» « -U r -rr Tr1 J> 9 o DJ CHECK IF ADDRESS HAS CHANGED r»" rr - 0 5 €.o Filing as: ~lected Official Office: Miami Beach Mayor Dan Gelber D Miami-Dade County Candidate Office: D Municipal Candidate (Name of Municipality) Office: CERTIFICATION It is a first degree misdemeanor for any person to falsify a public record (ss. 839.13, F.S.) I certify that I have examined this report and it is true, I certify that I have examined this report and it is true, correct, and complete. (SECTION APPLICABLE TO correct, and complete. (FOR BOTH ELECTED CANDIDATES ONLY) OFFICIALS AND CANDIDATES) Mayor Dan Gelber (Type name) O Treasurer D Deputy Treasurer (Type name) El Elected Official [lcanatdate X ~----~ Signature Signature 09/27/2021 Date Date MD-ED 28 (Rev. 3/1/17) R E P O R T IN G O F S O LI C IT A T IO N O F C O N T R IB U T IO N S F O R ".IAM•D PomcAL coMMrrrs, ELECTIONEERING COMMUNICAToNs oRa,a[}?}kj,ge 501(C)(4) ORGANIZATIONS AND POLITICAL PARTIES This report must be filed by Miami-Dade County and Municipal Elected Officers and Candidates to publicly disclose their fundraising activities for Political Committees, Electioneering Communications Organizations, 501(C)(4) Organizations and Political Parties within five days (includes weekends and holidays) of commencing solicitation activities, either directly or indirectly, on behalf of said organization(s). (1) Elected Official's or coo · Mari each ayo Dan@ele .wormer Name (Only for County Candidates) (2 ) Page 1 2 _____ of _ (3) (4) (5) (6) (7) Row \ Name of PC, ECO, PC, ECO, Description of Relationship between Date Number 501 (c)(4) Organization 501(c)(4) Candidate/Officer and solicitation or Political Party Organization or PC, ECO, 501(c)(4) Organization or activities Political Party Political Party started 1 YES for A Safer Miami Beach PC Support 9/27/21 2 New Leadership for Florida P C Support 9/27/21 2 • SEE REVERSE FOR INSTRUCTIONS AND CODE VALUES MD-ED 28 (Rev. 3/29/18)