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HomeMy WebLinkAboutLori Lewellen - Form 12023 Form 1 - Statement of Financial Interests Filed with COE: 08/16/2024 General Information Ms Lori Brooke LewellenName: County: Address:4541 Sw 27th Ter, Dania Beach, FL 33312 Broward AGENCY INFORMATION Organization Suborganization Title Dania Beach Community Redevelopment Agency Board Vice Chair Dania Beach Mayor And City Commission PID 265673 Name of Source of Income Source's Address Description of the Source's Principal Business Activity Billing Cochran Lyles Mauro & Ramsay 515 East Las Olas Blvd Fort Lauderdale FL 33301 Law Firm LaCava Jacobson & Goodis 4901 NW 17th Way #606 Fort Lauderdale FL 33309 Law Firm City of Dania Beach 100 W. Dania Beach Blvd Dania Beach FL 33004 City Government 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”) Primary Sources of Income THIS STATEMENT REFLECTS YOUR FINANCIAL INTERESTS FOR CALENDAR YEAR ENDING DECEMBER 31, 2023. Disclosure Period Printed from the Florida EFDMS System Page 1 of 4 2023 Form 1 - Statement of Financial Interests Filed with COE: 08/16/2024 Name of Business Entity Name of Major Sources of Business' Income Address of Source Principal Business Activity of Source N/A SECONDARY SOURCES OF INCOME (Major customers, clients, and other sources of income to businesses owned by the reporting person) (If you have nothing to report, write “none” or “n/a”) Secondary Sources of Income REAL PROPERTY (Land, buildings owned by the reporting person) (If you have nothing to report, write “none” or “n/a”) Location/Description N/A Real Property Intangible 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 FRS Investment Plan City of Dania Beach 401 K LaCava Jacobson Goodis Printed from the Florida EFDMS System Page 2 of 4 2023 Form 1 - Statement of Financial Interests Filed with COE: 08/16/2024 Name of Creditor Address of Creditor Bank of America PO BOX 31785 Tampa FL 33631-3785 LIABILITIES (Major debts valued over $10,000): (If you have nothing to report, write “none” or “n/a”) Liabilities Interests in Specified Businesses Business Entity # 1 Name of Business Entity JLW Concepts LLC dba Artesano Cafe Address of Business Entity 6 South Federal Hwy Dania Beach FL 33004 Principal Business Activity Food and Beverage/Restaurant Postion Held with Entity Managing Member I own more than a 5% Interest in the Business Yes Nature of my Ownership Interest Managing Member INTERESTS IN SPECIFIED BUSINESSES (Ownership or positions in certain types of businesses) (If you have nothing to report, write “none” or “n/a”) Printed from the Florida EFDMS System Page 3 of 4 2023 Form 1 - Statement of Financial Interests Filed with COE: 08/16/2024 Digitally signed: 08/16/2024 Signature of Filer Filed with COE: 08/16/2024 Lori Brooke Lewellen þ I certify that I have completed the required training under Section 112.3142, F.S. o Required training under Section 112.3142, F.S., not applicable to filer for this form year. Training This section applies only to an appointed school superintendent, an elected municipal officer, or a commissioner of a community redevelopment agency created under Part III, Chapter 163, each of whom are required to complete annual ethics training pursuant to Section 112.3142, F.S. Printed from the Florida EFDMS System Page 4 of 4