Levy, Josh - March 7, 2017x
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MIAMFDADE
MUNIC,IPAI ()I )-inIAI f-; MAO ( ;ANOVA' flit II iN11 I ( )1 qv; ) :I I :1.1 I COUNTY
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
Name
Josh Levy
Address (number and street)
5033 N. Bay Road
City, State, Zip Code
Miami Beach, FL 33140
al CHECK IF ADDRESS HAS CHANGED
Filing as:
Elected Official
Office:
Miami-Dade County Candidate
Office:
Cs Municipal Candidate Miami Beach
(Name of Municipality)
Office: Miami Beach Commissioner, Group 2
CERTIF 'CATION
It is a first degree misdemeanor for any pers
I certify that I have examined this report and it is true,
correct, and complete.
on to falsify a public record (ss. 839.13, F.S.)
I certify that I have examined this report and it is true,
correct, and complete.
Mark Herron
(Type name) C easurer 0 Deputy Treasurer
ate
Josh Levy
(Typo name) C Elected Official 10 Candidate
ii\AL filiZ/
Sign ure
3///1/
Date
MD-ED 28 (Rev. 115117)
I.D. Number 1) Name Josh Levy
(3)
Row
Number
(4)
Name of PC, ECO,
501(c)(4) Organization
or Political Party
REPORTING OF SOLICITATION OF CONTRIBUTIONS FOR
POLITICAL COMMITTEES, ELECTIONEERING COMMUNICATIONS ORGANIZATIONS,
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 of commencing solicitation activities, either directly or indirectly, on behalf of said organization(s).
(Only for County Candidates)
(2) Page of
(5)
PC, ECO,
501(c)(4)
Organization or
Political Party
I PC
(6) (7)
Description of Relationship between Date
Candidate/Officer and solicitation
PC, ECO, 501(c)(4) Organization or activities
Political Party started
Friend/Supporter 3/7117 I Protecting Coastal Communities
SEE REVERSE FOR INSTRUCTIONS AND CODE VALUES
MD-ED 28 (Rev. 115117)
INSTRUCTIONS FOR REPORTING OF SOLICITATION OF CONTRIBUTIONS FOR
POLITICAL COMMITTEES, ELECTIONEERING COMMUNICATIONS ORGANIZATIONS,
501(C)(4) ORGANIZATIONS AND POLITICAL PARTIES
In accordance with Ordinance No. 16-46 and 16-75, codified in Sections 12-14.2 and 12-14.2.1 of the Code of Miami-Dade
County, Florida, respectively, Miami-Dade County and Municipal Elected Officers and Candidates must file this form to publicly
disclose their fundraising activities for Political Committees or Electioneering Communications Organizations.
Sec. 12-14.2. County and Municipal Elected Officer and Candidate Reporting Requirements for Political Committee and
Electioneering Communication Organization Solicitations.
(1) Effective January 1, 2017, each candidate for County or municipal office in Miami-Dade County shall insure that their
designated campaign treasurer shall, within five (5) days of commencing solicitation activities, either directly or indirectly, on
behalf of a political committee or electioneering communications organization, file a one-time report with the Supervisor of
Elections or other applicable filing officer indicating that the candidate is undertaking solicitation activities on behalf of such
political committee or electioneering communications organization. The report shall identify the name of the political
committee or electioneering communications organization on behalf of whom such funds are being solicited and a description
of the relationship between the candidate and the political committee or electioneering communications organization. The
report shall be filed on a form created by the Supervisor of Elections for such purpose.
(2) Effective January 1, 2017, upon commencement of any solicitation activities undertaken on behalf of any political committee
or electioneering communications organization, each County or municipal elected officer in Miami-Dade County who is not
also a candidate for another County or municipal office shall, within five (5) days of commencing solicitation activities, either
directly or indirectly, on behalf of a political committee or electioneering communications organization, file a one-time report
with the Supervisor of Elections or other applicable filing officer indicating that the officer is undertaking solicitation activities
on behalf of such political committee or electioneering communications organization. The report shall identify the name of the
political committee or electioneering communications organization on behalf of whom such funds are being solicited and a
description of the relationship between the officer and the political committee or electioneering communications organization.
The report shall be filed on a form created by the Supervisor of Elections for such purpose.
(3) Any County or municipal elected officer or candidate who fails to file a report as required by this section on the designated
due date shall, for the first violation, be sent a letter of reprimand and instruction regarding the provisions of this Section, and
for each subsequent violation, be subject to a fine of $50 per day for the first three (3) days and, thereafter, $500 per day for
each day late not to exceed $5,000. Such fine shall not be an allowable campaign expense and shall be paid only from the
personal funds of the candidate or officer. Any candidate or officer may appeal or dispute the fine to the Miami-Dade County
Commission on Ethics and Public Trust based upon, but not limited to, unusual circumstances surrounding the failure to file
on the designated due date, and may request, and shall be entitled to, a hearing before the Commission on Ethics and Public
Trust, which shall have the authority to waive the fine in whole or in part. Any such appeal or dispute shall be made within
twenty (20) days after receipt of notice from the Supervisor of Elections that payment is due or such appeal or dispute shall
be waived.
FILING OUT ALL THE REQUIRED FIELDS:
(1) Type name and I.D.# of candidate. The I.D.# only applies to Miami-Dade County candidates.
(2) Type page numbers (e.g., 1 of 3).
(3) Type the row number. Each detail line shall have a row number assigned to it.
(4) Type name of Political Committee, Electioneering Communications Organization, 501(c)(4) Organization or Political Party.
(5) Select the type of organization from the drop-down menu.
(6) Describe the relationship between the Candidate or Official and the organization.
(7) Enter the date solicitation activities commenced.
Once form is completed, print it, sign it, and submit an electronic copy to the appropriate office. County Officials/Candidates are
to submit completed forms to the Miami-Dade County Elections Department via email at campaigns _miamidade.gclv.
Municipal Officials/Candidates are to submit completed forms to their municipal clerk.
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