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Clifford B. Ain - Qualifying Documents RECEIVED OFFICE OF THE CITY CLERK APPOINTMENT OF CAMPAIGN TREASURER AND DESIGNATION OF CAMPAIGN DEPOSITORY FOR CANDIDATES 0CT 3 0 2023 (Section 106.021(1), F.S.) (PLEASE PRINT OR TYPE) CITY OF "ENTURA NOTE: This form must be on file with the qualifying officer before opening the campaign account. OFFICE USE ONLY 1. CHECK APPROPRIATE BOX(ES): ,M Initial Filing of Form Re-filing to Change: ❑ Treasurer/Deputy Depository Office Party 2. Name of Candidate (in this order: First, Middle, Last) 3. Address (include post office box or street, city, state, zip C C( P F 0ju )�I d code) Z a� ZT C 67a xZ- V-'-D 4. Telephone 5. E-mail address". A3 6. Office sought(include district, circuit, group number) 7. If a candidate for a nonpartisan office, check if applicable: C'J jT/ 3 My intent is to run as a Write-In candidate. 8. If a candidate for a partisan office, check block and fill in name of party as applicable: My intent is to run as a Write-In No Party Affiliation Party candidate. 9. 1 have appointed the following person to act as my Campaign Treasurer Deputy Treasurer 10. Name of Treasurer or Deputy Treasurer CLIFF-aRll) 'B I 49 ! 11. Mailing Address 12.Telephone SL v__,� 1 /J3 (3(J-1- ) 1,Y4 -- v?DI/ 13. City 14. County 15. State 16. Zip Code 17. E-mail address AV rwvylr fXW41- Apr Pt 331Co (�5910 a HC ' I 18. 1 have designated the following bank as my Primary Depository Secondary Depository 19. Name of Bank 0 20. AddressLo gT-D ,$1i-�c&gq F 21. City 22. County 23. State 24. Zip Code PV CgTV0 rt 1641I.-, _�bopF, Ft 1 3340 UNDER PENALTIES OF PERJURY,I DECLARE THAT I HAVE READ THE FOREGOING FORM FOR APPOINTMENT OF CAMPAIGN TREASURER AND DESIGNATION OF CAMPAIGN DEPOSITORY AND THAT THE FACTS STATED IN IT ARE TRUE. 25. Date 26. Signature of Candidate (D vF /vo il-3 X 7 , Q , 27. Treasurer's Acceptance of Appointment (fill in the blanks and check the appropriate block) I, C C ( F-F03 1,J 7. A 7 j , do hereby accept the appointment (Please Print or Type Name) designated above as: Campaign Treasurer Deputy Treasurer. Date Sign a of Campaign Treasurer or Deputy Treasurer DS-DE 9 (Rev. 10/10) Rule 1S-2.0001, F.A.C. OFFICE USE ONLY S TAT E M E N T OF RECEIVED CANDIDATE OFFICE OF THE CITY CLERK (Section 106.023, F.S.) 0 CT 3 0 2023 (Please print or type) CITY OF "ENTURA candidate for the office of _f F01- 3 ; have been provided access to read and understand the requirements of Chapter 106, Florida Statutes. x " 3 . <:z - 1614113 Signature of Candidate Date Each candidate must file a statement with the qualifying officer within 10 days after the Appointment of Campaign Treasurer and Designation of Campaign Depository is filed. Willful failure to file this form is a first degree misdemeanor and a civil violation of the Campaign Financing Act which may result in a fine of up to $1,000, (ss. 106.19(1)(c), 106.265(1), Florida Statutes). DS-DE 84(05/11) City of RECEIVED n OFFICE OF THE CITY CLERK e A ura 2024 Municipal Election OCT 3 0 2023 CITY OF AVENTURA Access to the Candidate and Campaign Treasurer Handbook and The Election Laws of the State of Florida Candidate: !911i (Print Name) Office Sought: Commissioner Seat 1 ❑ Commissioner Seat 3 9 Commissioner Seat 5 ❑ I acknowledge that it is my responsibility to read, understand and follow the requirements described in the City of Aventura Municipal Candidate Election resources available on the City of Aventura Website (www cityofaventura com), including but not limited to: Candidate and Campaign Treasurer Handbook; Compilation of the Election Laws of the State of Florida; City of Aventura Charter and Code of Ordinances; City of Aventura Political Sign Code; List of City Vendors; Voter Registration Guide; Items for Sale from Miami-Dade County Elections Department; Campaign Financing Forms; Frequently Asked Questions; and Common Reporting Compliance Errors; as well as website links to the Miami-Dade County Elections Department and State of Florida Division of Elections. Acknowledged by: R Sign re of Candidate Date: I o 11VS 43 Primary Telephone Number: 3 _v J Alternate Telephone Number: ? - IN — )33 E-mail address: PHONE: 305-466-8901 FAX: 305-466-8919 www.cityofaventura.com . .._., City of RECEIVED OFFICE OF THE CITY CLERK Aventura 2024 Municipal Election Notice of Candidacy I, I (the undersigned), an elector of the City of Aventura, who has resided continuously in the City for at least one (1)year preceding the date of filing of this Notice of Candidacy, whose residence in the City of Aventura is xsL V.W Fc,efj 4 V qf jz 31 ' hereby announce my candidacy for the office of: Commissioner Seat 1 ❑ Commissioner Seat 3 Commissioner Seat 5 ❑ to be voted for at the election to be held on the 5th day of November, 2024, and I hereby agree to serve if elected. i Signature of Candidate Date and hour of filing: Received by: Ellisa L. Horvath, MMC City Clerk/Supervisor of Elections [City Code Sec,26-31] PHONE: 305-466-8901 9 FAX: 305-466-8919 www.cityofaventura.com CANDIDATE OATH NONPARTISAN OFFICE OFFICE OF THE CITY CLERK (Do not use this form if a Judicial or School Board Candidate) Check box only if you are seeking to qualify as a write-in A U G 1 4 2024 candidate: ❑Write-in candidate ICE USE ONLY Candidate Oath Name to appear on ballot: <a . T 'P7/ Check box if two last names without hyphen. ❑ (Name cannot be changed after qualifying.) Check box if name includes nickname. ❑ (For use of a nickname,you must complete the Nickname Affidavit on reverse side.) swear or affirm that I am a candidate for the nonpartisan office of / p 1 0 (Office) (District#) I am a qualified elector of o" 1 County, Florida (Circuit#) (Group or Seat#) I am a qualified elector under the Constitution and the Laws of Florida to hold the office to which I desire to be nominated or elected; I have qualified for no other public office in the state,the term of which office or any part thereof runs concurrent with the office I seek; and I have resigned from any office from which I am required to resign pursuant to Section 99.012, Florida Statutes; and I will support the Constitution of the United States and the Constitution of the State of Florida. Statement of Outstanding Fines, Fees, or Penalties I owe outstanding fines,fees,or penalties,that cumulatively exceed$250,for ethics or campaign finance violations(s. 99.021(1)(d), F.S.). YES, 1 Do NO,I Do Not , If you do,you must also specify the amount owed and each entity that levied the same on the reverse side. Signature drCandidate Telephone Number Email Address - ,6J J 'sZr,6,J. 3f.10 i(ol t'v�j 1 JVt 3/(0 Address of Legal Residence City State ZIP Code STATE OF FLORIDA COUNTY OF k Signature of Notary PubWc Print,Type,or Stamp Commissioned Name of Notary Public below: Sworn to(or affirmed)and subscribed before me by means of online notarization ❑ OR physical presence this 14 day of A L) A,U , 20 ''. ELLISA L HORVATH '* *= W COMMISSION S HH 3017M Personally KnownEl OR Produced Identification ❑ % o��; IRM usti7 2025 T4aFtev9 e Type of Identification Produced' DS-DE 302NP('Eff. 1012023) Rule 1S-2.0001, F.A.C. onet�c r. p 'in,, �o araie Phonetic spelling for the audio ballot(not required for qualifying purposes): Print the name phonetically on the line below as you wish it to be pronounced on the audio ballot as may be used by persons with disabilities(see instructions on page 3 of this form): Staternenf®f Outstanding Fine$, Fees or;Renalttes Pursuant to Section 99.021(1)(d), F.S., each candidate, whether a.party candidate, a candidate with no party affiliation, or a write-in candidate,shall,at the time of subscribing to the oath or affirmation,state in writing whether he or she owes any outstanding fines,fees, or penalties that cumulatively exceed$250 for any violations of s.8,Art. II of the State Constitution,the Code of Ethics for Public Officers and Employees under part III of chapter 112,any local ethics ordinance governing standards of conduct and disclosure requirements,or chapter 106. 77-7-777777-7777-77 Afficlavif of:;t�lckname (Only required if using ntCkname fc�r the ballot) My legal name is . I am over the age of eighteen (18)and the contents of this affidavit are true and correct. My nickname is . I am generally known by this nickname or have used it as part of my legal name. I have not created the nickname to mislead voters. My nickname does not imply I am some other person,constitute a political slogan or otherwise associate me with a cause or issue,or that is obscene or profane. Signature of Candidate: STATE OF FLORIDA COUNTY OF Signature of Notary Public Print,Type,or Stamp Commissioned Name of Notary Public below: Sworn to(or affirmed)and subscribed before me by means of online notarization ❑ OR physical presence ❑ this day of ,20 Personally Known ❑ OR Produced Identification ❑ Type of Identification Produced: DS-DE 302NP(Eff. 10/2023) Rule 1S-2.0001, F.A.C. DECLARATION AND FIRST AMENDMENT WAIVER RECEIVED FOR CANDIDATES WHO AGREE TO COMPLY WIT OFFICE I THE VOLUNTARY STATEMENT OF FAIR CAMPAIGN PRACTICES VOLUNTARY STATEMENT OF FAIR CAMPAIGN PRACTICeSI As a candidate for public office in Miami-Dade County, I believe that political issues can be freely debated without appealing to racial, ethnic, religious, sexual, or other prejudices. I recognize that such negative appeals serve only to divide this community and create long-term moral, social, and economic problems. Therefore, CITY OF "ENTURA I. I shall not make my race, religion, national origin, gender, physical disability, or sexual orientation an issue in my campaign. 2. 1 shall not make my opponent's race, religion, national origin, gender, physical disability, or sexual orientation an issue in my campaign. 3. 1 will condemn any appeal to prejudice based on race, creed, national origin, religion, gender, physical disability, or sexual orientation. 4. 1 shall not, without just cause, attack or question my opponent's patriotism. S. I shall not publish, display, or circulate any anonymous campaign literature or political advertisement. b. 1 shall not tolerate my supporters engaging in these activities that I condemn, nor shall I accept their continued support if they engage in such activities. I will not permit any member of my campaign organization to engage in these activities and will immediately and publicly repudiate the support of any other individual or group that resorts to the methods and tactics I condemn. 1. 1 shall run a positive campaign emphasizing my qualifications for office and positions on issues of public concern. 8. 1 will limit my attacks on an opponent to legitimate challenges to that person's record, qualifications, and positions, 9. 1 will neither use nor permit the use of malicious untruths or innuendoes about an opponent's personal life, nor will I make or condone unfounded accusations discrediting that person's credibility. 10. 1 will take personal responsibility for approving or disavowing the substance of attacks on my opponent that may come from third parties supporting my candidacy. I[. I will not use or permit the use of campaign material that falsifies, distorts, or misrepresents facts. BY SIGNING THIS DECLARATION AND FIRST AMENDMENT WAIVER,I AGREE TO ABIDE BY THE VOLUNTARY STATEMENT OF FAIR CAMPAIGN PRACTICES, SUBMIT TO THE COMPULSORY JURISDICTION OF THE ETHICS COMMISSION,AND WAIVE MY FIRST AMENDMENT RIGHTS. IC L( 6 -1 P 0 a candidate for the office of please print your name elective office sought county,municipality,or other jurisdiction agree to abide by the voluntary Statement of Fair Campaign Practices as provided in Section 2-11.1.1(D)(1) of the Code of Miami-Dade County,Florida, and to recognize as compulsory the jurisdiction of the Ethics Commission. I further agree that the Ethics Commission will have the authority to decide whether I have violated the voluntary Statement of Fair Campaign Practices and,if a violation is found,the Ethics Commission has the authority to impose the appropriate penalty,if any, which may include an admonition or public reprimand. I recognize that I have the right before signing this DECLARATION AND FIRST AMENDMENT WAIVER to consult my own legal counsel and to request and receive from the Ethics Commission an advisory opinion as to whether my planned campaign activities are likely to violate the voluntary Statement of Fair Campaign Practices.I also recognize that after signing this agreement,I will continue to have the right to request and receive from the Ethics Commission an advisory opinion regarding any future campaign activities that I may be considering. I hereby proclaim(1)that my agreement to abide by the Statement of Fair Campaign Practices is voluntary,knowing, and intelligent; (2) that I have not been forced,pressured, or otherwise coerced into making this agreement; and(3) that I am aware of the voluntary nature of this agreement. I recognize that there is no penalty for refusing to agree to abide by the voluntary Statement of Fair Campaign Practices.I also recognize that in signing this agreement,I will be forfeiting rights to which I would otherwise be entitled under the First Amendment to the U.S. Constitution and Article 1, Section 4, of the Constitution of the State of Florida. Once the DECLARATION AND FIRST AMENDMENT WAIVER is signed,it is deemed irrevocable for the duration of the campaign. Signature Date COE,revised 5/2010 2 of 2 RECEIVED 2023 For 1 ® Statement of Financial Interests OFFICE Genrallnformation Name: Mr CLIFFORD B AIN CPA CITY OF "ENTURA Address: 2600 ISLAND BLVD APT 1103,AVENTURA, FL 33160 County: Miami-Dade Cfrganiatfon .: , , ' �: Su�torgar�t'�ation Tide N/A CANDIDATE FOR Fnsition, ;: Agency Name Pos�t�on sought a hefcf .: City,Town or Village(Commission or AVENTURA COMMISSIONER SEAT 3 Council),Governing Board-Form 1 n ,f (Effective 6/10/2024) Diselosure;Pe'riod ; THIS STATEMENT REFLECTS YOUR FINANCIAL NTERESTS FOR CAl ENDAR,YEAR ENDING DECEMBER 31, 2023 . Printed from the Florida EFDMS System Page 1 of 4 2023 For - Statement of Financial Interests 71 Primary Sources of ncame, PRIMARY SOURCE OF INCOME(Over$2,500) (Major sources of income to the reporting person) (If you have nothing to report,write"none"or"n/a") .Description of the Source"s Name of Source of Income Source's Address Prtncipal Business Activity H&CO GLOBAL CPA FIRM 19495 BISCAYNE BLVD,STE 702, ACCOUNTING&CONSULTING AVENTURA, FL 33160 WELLS FARGO 2801 MARKET ST,ST LOUIS,MO 63103 INVSTS-STOCKS&BONQS. VANGUARD PO BOX 3009, MONROE,WI 53S66 INVSTS-STOCKS 2851 JOHN ST,STE ONE, MARKHAM,ON I VST-RE NADG NNN PROPERTY FUND LPT L3R 5R7 KEITH DIAMOND PA TRUST A/C 3440 HOLLYWOOD BLVD,STE 415, INVSTS "MORTGAGES .: HOLLYWOOD, FL 33021 2600 ISLAND BLVD,APT1- 3,AU,ENTURA, RE A ESTATE CBA REALTY LLC FL 33160 CBA FINANCIAL SERVICES INC 2600 ISLAND BLVDAP1103,AVENTURA' CONSULTING FL 33160 :Secondary Sources of income SECONDARY SOURCES OF INCOME(Major customers cifents,and other sources of income to businesses owned by the reporting person)(1f (have,,,,,'notftirig to report,write `n©ne or'. (a } �. oI osourcesName of IU ai fAcdressof"S'ouce Name of BusthessEntity>: , RrinctpalBus►ness Bustnesslncome:.; Acttvttyof. aurce: CBA FINANCIALS£RVICES INC "CONSULTING 2600 ISLAND BLVD,APT 1103, CONSULTING AVENTURA, FL 33160 CBA REALTY LLC REAL ESTATE INVSTS 2600 ISLAND BLVD,APT 1103, REAL ESTATE AVENTURA, FL 33160 Printed from the Florida EFDMS System Page 2 of 4 2023 Fermi I - Statement of Financial Interests Real Proffer#y REAL PROPERTY(Land,buildings owned by the reporting person) (If you have nothing to report,write"none"or"n/a") Location/Description 3550 GALT OCEAN DR,APT 407, FT LAUDERDALE, FL 33308 Intangiole Personal Property INTANGIBLE PERSONAL PROPERTY(Stocks, bonds,certificates of deposit,etc.over$10,000);. (If you have nothing to report,write"none"or"n/a") Type of Intangible Business Entity to Which the Property Relates CASH CBA FINANCIAL SER�?lICES'INC Liabilities LIABILITIES.,(Majordi btswaluedr°over$10,000): (If you have nothing to report,write"none"or Narn �of Cre�titor "' Adtlress of Creiiitor N/A Printed from the Florida EFDMS System Page 3 of 4 2023 For 1 ® Statement of Financial Interests 1nteress in Specifiedustnesses INTERESTS IN SPECIFIED BUSINESSES(Ownership or positions in certain types of businesses) (If you have nothing to report,write"none"or"n/a") Business Entity#1= N/A Signature,of Filer,, CLIFFORD 8 A1N CPk Digitally signed:06/27/2024 Printed from the Florida EFDMS System Page 4 of 4