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Gustavo Blachman - Registration Documents RECEIVED OFFICE OF THE CITY CLERK APPOINTMENT OF CAMPAIGN TREASURER AND DESIGNATION OF CAMPAIGN MAR - 6 2023 DEPOSITORY FOR CANDIDATES (Section 106.021(1), F.S.) (PLEASE PRINT OR TYPE) CITY OF AVENTURA NOTE: This form must be on file with the qualifying officer before opening the campaign account. OFFICE USE ONLY 1.CHECK APPROPRIATE BOX(ES): X❑ 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 GUSTAVO BLACHMAN code) 3136 NE 212TH ST, AVENTURA, FL 33180 4. Telephone 5. E-mail address (786 ) 229-8009 GUSTAVOBLACHMAN@G6 6. Office sought(include district, circuit, group number) 7. If a candidate for a nonpartisan office,check if AVENTURA COMMISIONER SEAT 1 applicable: ❑ 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 X❑ No Party Affiliation ® Party candidate. 9. 1 have appointed the following person to act as my ❑X Campaign Treasurer ❑ Deputy Treasurer 10. Name of Treasurer or Deputy Treasurer MARINA C BLACHMAN 11. Mailing Address 12. Telephone 3136 NE 212TH ST, ( 305 ) 439-9909 13. City 14. County 15. State 16.Zip Code 17. E-mail address AVENTURA MIAMI DADE FL 33180 marinablachman@hotmail.com 18. 1 have designated the following bank as my ❑X Primary Depository ❑ Secondary Depository 19. Name of Bank 20.Address BANK UNITED 19125 BISCAYNE BLVD 21. City 22. County 23. State 24. Zip Code AVENTURA MIAMI DADE IFL 33180 UNDER PENALTIES OF PERJURY,I DECLARE THAT I HAVE READ THE FOREGOING FORM FOR POI TMENT OF CAMPAIGN TREASURER AND DESIGNATION OF CAMPAIGN DEPOSITORY AND THAT T E FACTS ATED IT ARE TRUE. 25. Date 26. t re of C did MARCH 06, 2023 X 27. Treasurer's Acceptance of Appointment(fill in the ks a d check�*`opriate block) MARINA C. BLACHMAN do hereby accept the appointment (Please Print or Type Name) designated above as: 0 Campaign Treasurer ❑ Dfwuty Treasurer. MARCH 06, 2023 X C"1120�lyn Date kignature of Campaign Treasurer or Deputy Treasurer DS-DE 9(Rev. 1 Oil 0) Rule 1S-2.0001, F.A.C. RECEIVED APPOINTMENT OF CAMPAIGN TREASURER OFFICE OF THE CITY CLERK AND DESIGNATION OF CAMPAIGN DEPOSITORY FOR CANDIDATES LIAR - 6 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): 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 <� J S"7 A ,l z (-. L. P WrV1kN code) 3136 Ns21Z �� S � 4. Telephone 5. E-mail address PL 3 3 I RO ( �1$b et-4vwl � � Air,�M L/� I 22981,09 • L-D-LA 6. Office sought(include district, circuit, group number) 7. If a candidate for a nonpartisan office, check if applicable: d -f�I�i4 4r�1 1SS/�f�/ S3�°s-j /1 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 G 0 s 7 A,J o �3 L AA-e t->• ,*O 11. Mailing Address 12.Telephone 3134:) ,Ja 2-1 Z 7H S7 22- (foE) 13. City 14. County 15. State 16.Zip Code 17. E-mail address N ew-T oak DA(,g 18. 1 have designated the following bank as my Primary Depository Secondary Depository 19. Name of Bank 20.Address 21. City 22. County 23. State 24. Zip Code 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 ST I ARE TRUE. 25. Date 26. Si natur of Ca' idat X :� 27. Treasurer's Acceptance of Appointment(fill in the bl ks and the a appropriate block) I, US 74,10 5L aC01a4 A-- , do hereby accept the appointment (Please Print or Type Name) designated above as: Campaign Treasurer ® Deputy Trea u r. o 2oZ X Date Sig I r or Deputy Trea urer DS-DE 9 (Rev. 10/10) Rule 1S-2.0001, F.A.C. F.1VC�NLY STATEMENT OF CANDIDATE OFFICE OF THE CITY CLERK (Section 106.023, F.S.) MAR - 2023 (Please print or type) CITY OF AVENTURA 1, GUSTAVO BLACHMAN , candidate for the office of AVENTURA COMMISIONER SEAT 1 ; have been provided access to read and understand the requirements of Chapter 106, Florida Statutes. MARCH 06, 9023 %natui!eXKC didate 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(05111) City ®f RECEIV`D Aventura OFFICE OF THE CITY CLERK 2024 Municipal Election CITY OF AVENTURA Access to the Candidate and Campaign Treasurer Handbook and The Election Laws of the State of Florida i� Candidate: G Q S7 ► S\J L lA CXi"M (Print Name) Office Sought: Commissioner Seat 1 Commissioner Seat 3 ❑ 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.citvofaventura.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; Frequ tly Asked Questions; and Common Reporting Compliance Errors; as well as website links a Miami-Dade County Elections Department and State of Florida Division of EI Acknowledged by: Signatur101 to Date: 03 06 2 0 2 3 Primary Telephone Number: 9 6 2 2- C� -R O7 Alternate Telephone Number: E-mail address: G Q S 13 L igCtjlM A L PHONE: 305-466-8901 9 Fax: 305-466-8919 www.cityofaventura.com APPOINTMENT F CAMPAIGN TREASURER AND DESIGNATION CAMPAIGN DEPOSITORY FOR CANDIDATES Office of the City Clerk (Section 106.021(1), F.S.) RECEIVED 3/7/2023 (PLEASE PRINT OR TYPE) SM NOTE: This form must be on file with the qualifying officer before opening the campaign account. OFFICE USE ONLY 1.CHECK APPROPRIATE BO (ES): 21 Initial Filing of Form Re-filing to Change: F1 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 GUSTAVO BLACHMAN code) 3136 NE 212TH ST, AVENTURA, FL 3310 4. Telephone 5. E-mail address (786 ) 229-8009 GUSTAVOLACHMAN G 6. Office sought(include district, circuit, group number) 7. If a candidate for a nonpartisan office,check if AVENTURA COISIOER SEAT 1 applicable: ® y 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 X 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 MARINA C BLACHMAN 11. Mailing Address 12. Telephone 3136 NE 212TH ST, ( 305 ) 439-9909 13. City 14. County 15. State 16. Zip Code 17. E-mail address AVENTURA MIAMI DADE FL 33180 marinablachman@hotmaii.com 18. 1 have designated the following bank as my X Primary Depository Secondary Depository 19. Name of Bank 20.Address BANK UNITED 121155 BISCAYE BLVD 21. City 22. County 23. State 24. Zip Code AVENTURA MIAMI DADE FL 33180 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 F CTS STATED IN IT ARE TRUE. 25. Date 26. Signature f Candida MARCH 06, 2023 27. Treasurer's Acceptance of Appointment(fill in the blanlu and check the a opriate block) I MARINA C. LACHMAN , do her y accept the appointment (Please Print or Type Name) designated above as: X Campaign Treasurer Deputy Treasurer. MARCH 06, 2023 Date Si r or Deputy Treasurer DS- E 9(Rev. 1 Oil 0) Rule 15-2.0001, F.A.C. APPOINTMENT OF CAMPAIGN TREASURER AND DESIGNATIONCAMPAIGN DEPOSITORY FOR CANDIDATES (Section 106,021(1), F.&) (PLEASE PRINT OR TYPE) RECEIVED 3/8/2023 NOTE: This form must be on file with the qualifying officer before opening the campaign account. OFFICE USE ONLY 1.CHECK APPROPRIATE O ( S): X Initial Filing of Form ReAling to Change: Treasurer/Deputy Depository 0 Office Party 2. Name of Candidate(in this order: First, Middle, Last) 3-Address(include post office box or street, city, state, zip GUSTAVO BLACHMAN code) 3136 NE 212TH ST, AVENTURA, FL 33180 4. Telephone 5. E-mail address (76 ) 229-8009 GUSTAVOBLACH A G 6. Office sought(include district, circuit, group number) 7. If a candidate for a nonpartisan office,check if AVENTURA COMMISIONER SEAT 1 applicable: My intent is to run as a Write-In candidate. 8. If a candidate fora partisan office, check block and fill in name of party as applicable: My intent is to run as a Write-In Z 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 GUSTAVO BLACH AN 11. Mailing Address 12. Telephone 3136 NE 212TH ST, ( 305 ) 439-9909 13. City 14. County 15. State 16. Zip Code 17, E-mail address AVENTURA MIA MI DADE FL 3310 gustavoblachman@hotmaii.com 18. 1 have designated the following bank as my X Primary Depository ❑ Secondary Depository 19. Name of Bank 20.Address BANK UNITED 121155 BISCAYNE BLVD 21. City 22. County 23. State 24. Zip Code AVENTURA MIA MI DADE IFL 33180 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 T E FACTS TA,7$b IN IT ARE TRUE. 25. Date 26. Signatu a of Ca ate MARCH 06, 2023 27. Treasurer's Acceptance of Appointment(fill in the bl4dks an ch he appropriate block) I GUSTAVO LACHAN hereby ccept the appointment (Please Prink or Type Name) designated above as: ® Campaign Treasurer jX Depu Treasurer. MARCH 06, 2023 Date Signature of Ca p ign Trea r Wuty Treasurer DS-DE 9(Rev. 10/10) Rule 1S-2.0001, F.A.C.