Simon Cruz - 1997,~
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FORM 1 STATEMENT OF FINANCIAL INTERSTS 1996
THIS STATEMENT REFLECTS MY FINANCIAL INTERESTS FOR THE
PRECEDING TAX YEAR ENDING: NAME OF YOUR AGENCY: n ' ~ , ~ ~~ ~`~
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DECEMBER 31,T 1996 ~HAN THE CALENDAR YEAORHER CHECK QjV~ OF THE FOLLOWING CATE~~~~:
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^ LOCAL O ^ STATE OFFICER CANDIDATE
LAST NAME -FIRST NAME -MIDDLE NAME:
U Z S ~ p !J
D SPECIFIED STATE EMPLOYEE
MAILING ADDRESS:
SoZ- 3 G cL. Cr- c re.G C r,
LIST OFFICE OR POSITION HELD OR SOUGHT:
CITY: ZIP: COUNTY:
j}l ~ ~t-~-t i e ~1 c 3 3 b D r4 c
NOTICE: Under provisions of Sec. 112.317, Flori
closure constitutes grounds for and maybe pun
fication from being on the ballot, impeachment,
ment, demotion, reduction in Sala , re remand, da Statutes, a failure to make any required dis-
ished by one or more of the following: disquali-
removal or suspension from office or employ-
or a civil ena/t not exceedin $10,000.
PART A -PRIMARY SOURCES OF INCOME [Sources exceeding 5% of gross income]
NAME OF SOURCE SOURCE'S DESCRIPTION OF THE SOURCE'S
OF INCOME ADDRESS PRINCIPAL BUSINESS ACTIVITY
L• v,V's~ Ld ~.c~ S it/L . .Z 3 a.. e-Y-a ~"'~. ~ . a i r o ~
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PART 8 -SOURCES OF INCOME TO BUSINESS ES OWNED BY THE REPORTING PERSON (Maj or customers, diems, etc.]
NAME OF SOURCE OF
BUSINESS ENTITY'S INCOME SOURCE'S
ADDRESS DESCRIPTION OF THE SOURCE'S
PRINCIPAL BUSINESS ACTIVITY
J
PART C -REAL PROPERTY [Land, buildings] FILING INSTRUCTIONS ror when
and where to file this form are located at the bot•
s tom of page 2.
`~ ~ INSTRUCTIONS on who must file tt-is
form and how to flii it out begin on page 3 of this
packet.
'' OTHER FORMS you may need to flee
are described on page 6.
(Continued on p2] ~
PAGE
CE FORM 1 -REV. 1/'97
i
A
PART D -INTANGIBLE PERSONAL PROPERTY [Stocks, bonds, certificates BUSINESS ENTITY TO WHICH THE PROPERTY RELATES
TYPE OF INTANGIBLE
S ~ ~ ~ v- ~ -. J~ v e u c- t 1 S
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PART E -LIABILITIES IN EXCESS OF NET WORTH [Major debts]
PART F -INTERESTS IN SPECIFIED BUSINESSES [Ownership or positions in certain types of businesses]
BUSINESS ENTITY # 1
NAME OF S' R ~ G -
ADDRESS OF /O 0 S~ d-~ ~ ~$T',
~, rc o
PRINCIPAL BUSINESS -S U Y'
ACTIVITY
POSITION HELD i N ~'eS
WITH ENTITY
1 OWN MORE THAN A 5%
INTEREST IN THE BUSINESS
NATURE OF MY
OWNERSHIP INTEREST
BUSINESS ENTITY # 2
IF ANY PARTS OF A THROUGH F ARE CONTINUED ON A SEPARATE SHEET, PLEASE CHECK HERE
• ~7
FILING INSRUCTIONS FOR FORM 1
WHAT TO FILE: After completing
all parts of this form, including signing and
dating it, send back only the first sheet
(pages 1 and 2) for filing. Note: You also
may be required to file Form 10, which is
the last page of this packet. Please see that
form for detailed instructions.
NOTE: MULTIPLE FILING
UNNECESSARY: Generally, a per-
son 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 can-
didate 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.
WHERE TO FILE: Local offi-
cers file with the Supervisor of Elections
of the county in which you permanently
reside. (If you do not permanently reside
in Florida, file with the Supervisor of the
county where your agency has its head-
quarters.) State officers or specifled
state employees file with the Department
of State, Room 1802, The Capitol,
Tallahassee, Florida 32399-0250.
Candidates file this form together with
your qualifying papers. To determine
what category your position falls under,
see the "Who Must File" Instructions on
page 3. If you were mailed the form by
the Secretary of State or a County
Supervisor of Elections for your annual
disclosure filing, return the form to that
location.
BUSINESS ENTITY # 3
WHEN TO FILE: Initially, each..
local officer, state officer, and specified
state employee must file within 30 days of
the date of his or her appointment or of the
beginning of employment. 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 appoint-
ment. Thereafter, local offlcers, state ofR-
cers, and specified state employees are
required to file by July 1st following each
calendar year they hold their positions.
Candidates for publicly-elected., state or
local office must file at the same time they
file their qualitying papers.. -
(Continued on p.3)~;
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CE FORM 1 -REV. 1/97