Filing Papers
STATE OF FLORIDA
APPOINTMENT OF CAMPAIGN TREASURER
AND DESIGNATION OF CAMPAIGN
DEPOSITORY FOR CANDIDATES
(Section 106.021(1), F.S.)
C" c'j
) e--
~O JAN - 4 PH 4: , 4
(PLEASE TYPE)
CHECK APPROPRIATE BOX:
gJ Original Appointment
Name of Candidate
o Deputy Treasurer
o Reappointment of Treasurer
'B 'r~t:..Vl k, E
Telephone (optional)
1. Address (include post office box or street, city, state, zip code)
'l't N.c., qtk I\ve.
0...(' S 'Be> n -tCY1 o.ck FL 33 35
2. Party (Partisan candidates only) 3. Office (add district, circuit, group number)
I have appointed the fOllowing person to act as my ~ Campaign Treasurer
4. Name of Treasurer or Deputy Treasurer
~ -I . ().. . Ed U-
s. Mailing Address (If post office box or drawer add street address)
A>vtP. .
B. County
9. State
F C'r~ J~ 33'Y
~ Primary Depository D Secondary Depository
12. Street Address
31 . \=ect
15. State . Zip Code
1~9
I have designated the following named bank as my
11. Name of Bank
E:)IJn Ti\j +-
f
33Y
Date
va.IIl...q....
20/0
I,
Campaign Treasurer's Acceptance of Appointment
8 r~o-., K. Ed WQrd;)
(Please Print or Type)
, do hereby accept the appointment as
~ Campaign Treasurer D Deputy Treasurer for the campaign of B (' la.V\. k. Ed uJa...rc1 S
who is seeking nomination or election as a
candidate to the office of
~Dr .
UNDER PEN LTIES OF PERJURY, I DECLARE THAT I HAVE READ THE FOREGOING CAMPAIGN TREASURER'S
ACCEPTANCE OF APPOINTMENT AND THAT THE FACTS STATED ARE TRUE.
X yj~,~ t:~J
Signature of Campaign Treasurer or Deputy Treasurer
(Party)
~O) ()
OS-DE 9 (Rev. 01/08)
RESIDENCY REQUIREMENTS
I, !3f'('ClV1 k, E d w 0... f1d S-
(Print Name)
m!:!::!::.f!dY
(Mayor/Corrlrt.issioner - District #)
, candidate for
of the City
Beach, have received, read and understand the
residency requirements of Article II of the Charter of
the City of Boynton Beach.
~~;( ~~
(Signature of Candidate)
7ct '1. 1/ Q. r~ 1~ c:2 0/ ()
(Dater r
8/18/2009 5:43 PM
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88-002801 EDWARDS, BRIAN K
OEM
4030 629 NE 9TH AVE
APT 125
BOYNTON BEACH FL
33435
4/20/1915 W M
6/23/2004
Miscellaneous Cash Receipt
CITY OF BOYNTON BEACH
No.
56771
Account No. 001-0000-369-10-00
CODE W4
Received of
BRIAN EDWARDS
$ 275.82
~UUtt'dl' .20llL
Address 629 NE 9th Ave., Boynton Beach. FL 33435
1% State Assessment Fee for Filinq ~?~ Ma~or in General
\]p€>;. ,ACKSOtL
General Election on March 9, 2010 Date: 2/01/11 0: r,e:-el)t [';:!: 12!~;)b
For
Dept.
City Clerk's Office
$'-/:;.82
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Miscellaneo"s Cash Receipt
CITY OF BOYNTON BEACH
~'"TY 0".
III Jx
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"'''''ON ~~
No.
56773
Account No. 001-0000-369-10-00
CODE W4
Received of
Brian Edwards
$ 25.00
~.~K
.20~
Address
629 HE 9th Ave., Bovnton Beach. FL 33435
For Filing Fee to the City of Boynton Rpi'I(!h -fnr Mayor in
Ope'r: JACKSOHZ
in the General Election on M Dat. !. 1/10 01 ReceIPt 00: 1270&7
Dept. City Clerk I s Office
Total payment
LJ& '_
$2~,. 0e!
By
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FORM 1
STATEMENT OF
FINANCIAL INTERESTS
2009
Please print or type your name, mailing
address, agency name, and position below:
FOR OFFICE
USE ONLY:
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10 Code
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CITY:
10 No.
Conf. Code
NAME OF OFFICE OR POSITION HELD OR SOUGHT:
P. Req. Code
You are not limited to the space on the lines on this form. Attach additional sheets, if necessary.
CHECK ONLY IF Ikt1SANDIDATE OR
o NEW EMPLOYEE OR APPOINTEE
**BOTH PARTS OF THIS SECTION MUST BECOMPLETED**
DISCLOSURE PERIOD:
THIS STATEMENT REFLECTS YOUR FINANCIAL INTERESTS FOR THE PRECEDING TAX YEAR, WHETHER BASED ON A CALENDAR YEAR OR ON
A FISCAL YEAR. PLEASE STATE BELOW WHETHER THIS STATEMENT IS FOR THE PRECEDING TAX YEAR ENDING EITHER (check one):
B" DECEMBER 31, 2009 OR 0 SPECIFY TAX YEAR IF OTHER THAN 'THE CALENDAR YEAR:
- ;
MANNER OF CALCULATING REPORTABLE INTERESTS:
THE LEGISLATURE ALLOWS FILERS THE OPTION OF USING REPORTING THRESHOLDS THAT ARE ABSOLUTE DOLLAR VALUES, WHICH
REQUIRES FEWER CALCULATIONS, OR USING COMPARATIVE THRESHOLDS. WHICH ARE USUALLY BASED ON PERCENTAGE VALUES (see
instructions for further details). PLEASE STATE BELOW WHETHER THIS STATEMENT REFLECTS EITHER (check one):
o COMPARATIVE (PERCENTAGE) THRESHOLDS OR ~ DOLLAR VALUE THRESHOLDS
PART A - PRIMARY SOURCES OF INCOME [Major sources of income to the reporting person]
(If you have nothing to report, you must write "none" or "n/a")
DESCRIPTION OF THE SOURCE'S
PRINCIPAL BUSINESS ACTIVITY
Golfe~
Ke f{,t:te..
. ,
PART B - 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, you must write "none" or "n/a")
NAME OF NAME OF MAJOR SOURCES ADDRESS PRINCIPAL BUSINESS
BUSINESS ENTITY OF BUSINESS' INCOME OF SOURCE ACTIVITY OF SOURCE
PART C - REAL PROPERTY [Land, buildings owned by the reporting person]
(If you have nothing to report, you must write "none" or "n/a")
A
FILING INSTRUCTIONS for
when and where to file this form
are located at the bottom of page 2.
INSTRUCTIONS on who must
file this form and how to fill it out
begin on page 3.
OTHER FORMS you may need
to file are described on page 6.
CE FORM 1 - Eft. 1/2010
(Continued on reverse side)
PAGE 1
PART D - INTANGIBLE PERSONAL PROPEP' . [Stocks, bonds, certificates of deposit, etc.]
(If you have nothing to report, YOl .lst write "none" or "n/a")
TYPE OF INTANGIBLE BUSINESS ENTITY TO WHICH THE PROPERTY RELATES
J.JJA
.
,
. ..." . . .
PART E - LIABilITIES [Major debts]
(If you have nothing to report, you must write "none" or "n/a") .,
, , ., . .
NAME OF CREDITOR ADDRESS OF CREDITOR
N1A
-,
PART F - INTERESTS IN SPECIFIED BUSINESSES [Ownership or positions in certain types of businesses]
(If you have nothing to report, you must write "none" or "n/a")
BUSINESS ENTITY # 1 BUSINESS ENTITY # 2 BUSINESS ENTITY # 3
NAME OF BUSINESS ENTITY N/A
ADDRESS OF BUSINESS ENTITY
PRINCIPAL BUSINESS ACTIVITY
POSITION HELD WITH ENTITY
I OWN MORE THAN A 5%
INTEREST IN THE BUSINESS
NATURE OF MY
OWNERSHIP INTEREST
IF ANY OF PARTS A THROUGH F ARECONTINUED,ON'ASEP.~RATE SHEET, PLEASE ,CHECK HERE 0 .
SIGNATURE (requir"d); ~ '~A.I~;(. f'L~ . ' '. DAT~ Slq.NED ("quired):. .~. . h . . ,'. , , .
'. .; .2c9 I b
FILING INSTRUCTIONS:
WHAT TO FILE: WHERE TO FILE: WHEN TO FILE:
After completing all parts of this form, including If you were mailed the form by the Commission Initially, each local officer/employee, state
signing and dating it, send back only the first on Ethics or a County Supervisor of Elections for officer, and specified state employee must
sheet (pages 1 and 2) for filing. your annual disclosure filing, retum the form to file within 30 days of the date of his or her
that location. appointment or of the beginning of employ-
If you have nothing to report in a particular Local officers/employees file with the Supervisor ment. Appointees who must be confirmed by
section, you must write "none" or "n/a" in that of Elections of the county in which they perma- the Senate must file prior to confirmation, even
section(s). nently reside. (If you do not permanently reside if that is less than 30 days from the date of their
in Florida, file with the Supervisor of the county appointment.
Facsimiles will not be accepted. where your agency has its headquarters.) Candidates for publicly-elected local office
NOTE: State officers or specified state employees must file at the same time they file their
MULTIPLE FILING UNNECESSARY: file with the Commission on Ethics, P.O. Drawer qualifying papers.
Generally, a person who has filed Form 1 for a 15709, Tallahassee, FL 32317-5709; physical Thereafter, local officers/employees, state
calendar or fiscal year is not required to file a address: 3600 Maclay Boulevard, South, Suite officers, and specified state employees are
second Form 1 for the same year. However, a 201, Tallahassee, FL 32312. required to file by July 1st following each
candidate who previously filed Form 1 because Candidates file this form together with their calendar year in which they hold their posi-
of another public position must at least file a copy qualifying papers. tions.
of his or her original Form 1 when qualifying. To determine what category your position Finally, at the end of office or employment,
falls under, see the "Who Must File" Instructions each local officer/employee, state officer, and
on page 3. specified state employee is required to file a
final disclosure form (Form 1 F) within 60 days
of leaving office or employment.
CE FORM 1 - Eff. 1/2010
PAGE 2
LOYALTY OATH
OFFICE USE ONLY
(Sections 876.05-876.10, Florida Statutes)
NON-PARTISAN OFFICE
STATE OF FLORIDA
COUNTY OF ?c>..\'M eea..c~
I, I
"B-r ~a.V\
First Name
l<e.~+h
Middle Name/lnitial
e.~~Q.~dS
Last Name
a citizen of the State of Florida and of the United States of America, and being [a candidate for public office] do
hereby solemnly swear or affirm that I will support the Constitution of the United States and of the State of Florida.
Important: If elected, a candidate must retake the loyalty oath as specified in s. 876.05, Florida Statutes, and that oath shall be
filed with the records of the governing official or employing governmental agency prior to the approval of payment of salary,
expenses, or other compensation.
OATH OF CANDIDATE
(Section 99.021, Florida Statutes)
I,
':B <' ~ C1v~ E., d.'-V 0.,. d.s
(PLEASE PRINT NAME AS YOU WISH IT TO APPEAR ON THE BALLOT NAME MAY NOT BE CHANGED AFTER THE END OF QUALIFYING)
am a candidate for the non-partisan office of m ~r
U (office)
; i am a qualified elector of 'Ya.\M -ee'c:::.~
I.J030
(district)
County, Florida;
(circuit) (group)
I am qualified under the Constitution and the Laws of Florida to hold the office to which I desire to be nominated or
elected; by executing this form, I have taken the oath required by ss. 876.05-876.10, Florida Statutes; 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. -'/./
x~:-L ~ (5<.1) '73-8tl/lf b~w()e"j,".a..c",....
Signature of Candidate Telephone Number Email Address
'1. r~,j,-
State
jyYJS-
ZIP Code
Personally Known: /' or
Sworn to (or affirmed) and subscribed before me this ~~
Produced Identification:
Type of Identification Produced:
NOTARY PUBUC.STATE OF FLORIDA
l'i"" Janet M. Prainito
\, ) Con:-mission # DD592173
"I,,,,.." Expires: SEP. OS, 2010
BONDED THRU ATlA.\l1C BONDiNG CO., iNC.
OS-DE 25 (Rev. 11/09)
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The City of Boynton Beach
City Clerk's Office
100 E BOYNTON BEACH BLVD
BOYNTON BEACH FL 33435
(561) 742-6060
FAX: (561) 742-6090
www,boynton-beach.org
PUBLIC NOTICE
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TO:
CANDIDATES, POLITICAL PARTIES AND OTHERS
NOTICE IS HEREBY GIVEN that the Logic & Accuracy (L&A) testing of the
voting equipment to be used in the March 9, 2010 General Election will be
held:
Friday, February 19, 2010 at 3:00 p.m.
Supervisor of Elections Office
240 South Military Trail
West Palm Beach, FL 33415
RECEIPT of this notice is hereby documented:
-/3~ ~. Uw~
Signature
/ /ZS/ZOIO
Date Received
-----------------------------------------------------
-----------------------------------------------------
(Detach)
IF YOU AND/OR YOUR REPRESENTATIVE(S) plan(s) to attend the logic & Accuracy
(l&A) testing on Friday, February 19, 2010, please detach and return the lower portion
of this notice to the City Clerk.
Signature
Number Attending
9/9/2009 9:06 AM
jmp
S:\CC\WP\ELECTION\year 2DIO\PUBNOTE - L&A TESTING NOTICE FOR CANDIDATE SIGNATURES-l.doc
Palm Beach County
SUSAN BUCHER
Supervisor of Elections
240 SOUTH MILITARY TRAIL
WEST PALM BEACH. FL 33415
POST OFFICE BOX 22308
WEST PALM BEACH, FL 33416
TELEPHONE: (561) 856-8200
FAX NUMBER: (581) 858-8287
WEBSITE: www.pbcelections.org
CERTIFICATION
I, SUSAN BUCHER, SUPERVISOR OF ELECTIONS, for Palm Beach County, Florida, do
hereby certify that the 27 signatures on the Nominating Petition for MAYOR of BRIAN K.
EDWARDS are registered electors within the municipal limits of the City of Boynton
Beach, according to the registration records on file in this office.
This is to further certify that BRIAN K. EDWARDS is a registered voter in Precinct 4030, in
the City of Boynton Beach, Florida.
Signed, this the 25th day of January, 2010.
~~
SUSAN Bl)CHER
SUPERVISOR. OF ELECTIONS
PALM BEACH 'COUNTY
(SEAL)
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NOMINATING PETITION
c;:() - It l ~?-'
We the undersigned, duly qualified voters of the CITY OF BOYNTON BEACH, do
hereby nominate:
<3 Y'LC\.n k. Edwa.rcls
C")
G,2 q N,e.. g-rh Ave., 1ejfl+M Geo.c~ FL ;:: ~:;!
/ 33~3S- 5; ~~
to be a candidate for MAYOR, City of Boynton Beach, Palm Beach Coun~ ~~
Florida, for the term: ~ ~
-0 en--4
:II: 00
MARCH 2010 to MARCH 2013 ca ~~
c.n -rTl
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pursuant to the Charter and Ordinances of said City. :::t:
ADDRESS
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I, the undersigned,
i3r^taV1 EJ~q,V'd~
, do solemnly swear
(or affirm) that I am duly qualified to hold office under the Charter and Ordinances of the
City of Boynton Beach, Florida, and I do hereby accept the foregoing nomination as a
candidate for the office of City Commissioner for the City of Boynton Beach, Florida.
~:.. :f $-L
Sworn to and subscribed before me at Boynton Beach, Florida, this .!JIB El:L.
daY~
A.D.20ID
~Yn.P~
Received at the City
~'Vrg-
Hall in
20,0
,
Boynton Beach
at ..3 : 45
1:./...l
c!J. 8 day
of
this
~
P.M.
tn. p~
Janet M. Prainito, CMC
City Clerk
SICCIWPIELECTIONIYear 2010lMayorlPETITION - Nominating Petition - MAYOR doc
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