Filing Papers
RESIDENCY REQUIREMENTS
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(Print Name)
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, candidate for
of the City
Commissioner - District #)
Beach, have received, read and understand the
residency requirements of Article II of the Charter of
the City of Boynton Beach.
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(Date)
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S:\CC\WP\ELECTION\year 2011\RESIDENCY REQUIREMENTS STATEMENT - 2011.doc
~ITY OF BOYNTmi BEACH
APPOINTMENT OF CAMPAIGN TREASURER CITY C~ERK'S OFFICE
AND DESIGNATION OF CAMPAIGN 10 NOV -9 PM I: 42
DEPOSITORY FOR CANDIDATES
(Section 106.021 (1), F,S.)
(PLEASE PRINT OR TYPE)
NOTE: This form must be on file with the qualifying
officer before openina the campaian account. OFFICE USE ONLY
1. CHECK APPROPRIATE BOX(ES):
eg Initial Filing of Form Re-filing to Change: 0 Treasurer/Deputy o Depository 0 Office 0 Party
2. Name of Candidate (in this order: First, Middle, Last) 3. Address (include post office box or street, city, state, zip
'"~L\., n C-( J J ~ 5 Co. n t L~),. \'1 code)
13 CeJo..r C;vc.:le
4. Telephone 5. E-mail address BO'jnioY\ B<:!6c~, r L
(Sit ) 7/J'f'(f0ff3 Sea h.+~" 4 B&'ce",.t~)L.CvlVl '3~Lf3L.
6. Office sought (include district, circuit, group number) 7. If a candidate for a nonpartisan office, check if
applicable:
8C' Ij I] 1DI1 8 e-c~c ~I CCii11tl1. S5.t/1'l D.-s1qci: <4 D 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
0 Write-In D No Party Affiliation 0 Party candidate.
9. I have appointed the following person to act as my CEl Campaign Treasurer 0 Deputy Treasurer
10. Name of Treasurer or Deputy Treasurer
~ 17V1~ ld l. 5 C <'-\.. V\--t\ "'-VI.
11. Mailing Address 12. Telephone
\3 C~Ja.r C..r"te ( 5.../ ) 7~Lf is C. $" 3
13. City 14. County 15. State 16. Zip Code 17. E-mail address
[SOjhton /3 Uk ~ f'q,/m ~ c"aC}1 fL .-,. 5c~y\'-\:l",- '" 4- Bl.3tc rd')/ML-, C'o/Y"f
~ '31 3?
18. I have designated the following bank as my !1?1 Primary Depository 0 Secondary Depository
19. Name of Bank 20. Address
TD [) c'\ n k I/"O \ W, 8cj n to-1 ()~c~ ()/v J
21. City 22. County 23, State 24. Zip Code
b 0.1 n t <WI V) ec1.-C ~\ Po.I 1->\ B c"lc "'- FL ?''-t3~
UNDER PENAL TIES 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 (1/0 /; /J 26. Signature ri0eP' j:/
X )z v r-1 Jvv' -..
27. Treasurer's Acceptance of Appointment (fill in the blanks and check the appropriate block)
I, 'D eo \oll''' \ d.. k SccHdlClVl , do hereby accept the appointment
(Please Print or Type Name)
designated above as: CY- Campaign Treasurer o Deputy Treasurer.
\lfq/IO X it/&.
Date Signature 0 ampaign Treasurer or Deputy Treasurer
OS-DE 9 (Rev. 10/10)
Rule 15-2.0001, F.A.C.
STATEMENT OF
CANDIDA TE
(Section 106.023, F.S.)
(Please Type)
I,
~ono-ld
L.
S' c ~ n -tla. VI ...
candidate for the office of DC''1nton t5eQc}t COV1lh\l5s.<&'n U:Jt.-tct 4
have received, read and understand the requirements of Chapter 106,
Florida Statutes.
x
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/ Sig ure of Candidate
U/9/IO
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) .
OS-DE 84 (Rev. 03/08)
The City of Boynton Beach
~)
City Clerk's Office
100 E BOYNfON BEACH BLVD
BOYNfON 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 (L8rA) testing of the
voting equipment to be used in the March 8, 2011 General Election will be
held:
Friday, February 18, 2011 - 10:00 a.m.
Supervisor of Elections Office
240 South Military Trail
West Palm Beach, FL 33415
RECEIPT of this notice is hereby documented:
i(~"
/ Sig ture
/'2/1 6//0
Date Received
-----------------------------------------------------
-----------------------------------------------------
(Detach)
IF YOU AND/OR YOUR REPRESENTATIVE(S) plan(s) to attend the Logic & Accuracy
(L&A) testing on Friday, February 18, 2011, please detach and return the lower portion
of this notice to the City Clerk.
Signature
Number Attending
11/16/2010 8:38 AM
jmp
S:\CC\WP\ELECTION\year 2011\PUBNOTE.. L&A TESTING NOTICE FOR CANDIDATE SIGNATURES - 2011.doc
TO:
MATERIAL FOR CANDIDATES
bonoJ~ 5a:A.n +Ia.Il
DATE: 1<:9. -/~ -ID
YOU HAVE INDICATED YOUR DESIRE TO BECOME A CANDIDATE; THEREFORE, WE HAND YOU THE FOLLOWING:
4.
Petition Form - Candidate for Commissioner - TO BE FILLED OUT, CERTIFIED BY SUPERVISOR OF
ELECTIONS AND RETURNED TO CITY CLERK DURING QUALIFYING
../' Form 1 Statement of Financial Interests 2010 - TO BE FILLED OUT, SIGNED & RETURNED TO THE
CITY CLERK DURING QUALIFYING
/' L&A TESTING NOTICE (SIGN AND RETURN AT TIME OF QUALIFYING.)
/' Loyalty Oath - Oath of Candidate (DS-DE 24B) - TO BE RETURNED TO CITY CLERK DURING
QUALIFYING
1.
L
./
2011 Qualifying Information & Municipal Election Schedule
Form DS-DE 9 Appointment of Campaign Treasurer and Designation of Campaign Depository for
Candidates (Rev. 10/10) - TO BE SIGNED AND RETURNED TO CITY CLERK
Form DS-DE 84 Statement of Candidate (Must be filed within 10 days after filing Campaign Treasurer
Appointment) (Rev. 03/08)
State of Florida Election Laws
Guide to Sunshine Amendment & Code of Ethics for Public Officers and Employees
Directions for Posting Temporary Political Signs
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City Commission District Map
Part I Charter, Article VII. Elections - City of Boynton Beach
Part II Code of Ordinances - Chapter 2 Administration, Article III. Elections
Poll Watcher Form & FS 101.131 - "Watchers at Polls"
2010 Election Dates to Remember
Blank Campaign Report Summary Sheets, Contributions Sheets & Expenditures Sheets
/ July 2010 Candidate Handbook for Candidates
../
Statement of Residency Requirements & Article II of City Charter - TO BE SIGNED AND RETURNED
TO CITY CLERK
II. ~ a~
v::v 4J-. ..
Candidate Signature -
5.
/
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Date Signed
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November 17, 2010
S:\CC\WP\ELEmON\year 2011\MATERIAL FOR CANDATES - 2011.doc
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RECEIVED BY:
99-026880 SCANTLAN. DONALD LEE
REP
3122 13 CEDAR CIR
APTA
BOYNTON BEACH FL
33426
11/111954 W M
1/10/1995 1 11212004 I
Palm Beach County
240 SOUTH MILITARY TRAIL
WEST PALM BEACH. FL 33415
POST OFFICE BOX 2230B
WEST PALM BEACH. FL 33416
SUSAN BUCHER
Supervisor of Elections
TELEPHONE: (561) 656-6200
FAX NUMBER: (561) 656-6287
WEBSITE: www.pbcelections.org
CANDIDATE PETITION CERTIFICATION
STATE OF FLORIDA
COUNTY OF PALM BEACH
t. SUSAN BUCHER, SUPERVISOR OF ELECTIONS OF PALM BEACH COUNTY,
FLORIDA, DO HEREBY CERTIFY THAT DONALD SCANTLAN
(NAME OF CANDIDATE OR MINOR PARTY)
SUBMITTED
28
PETITION SIGNATURES FOR THE OFFICE OF
CITY COMMISSIONER - DISTRICT IV of BOYNTON BEACH
(NAME OF OFFICE AND DISTRICT OR GROUP NUMBER)
I FURTHER CERTIFY THAT 25 OF THOSE SIGNATURES WERE
(NUMBER OF VALID SIGNATURES)
QUALIFIED ELECTORS IN THE GEOGRAPHICAL AREA FOR THE OFFICE LISTED ABOVE.
'W'ITN~SS MY HAND AND SEAL, THIS 21st DAY OF
DECEMBER. 2010
(SEAL)
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, SUSAN BUCHER
SUPERVISOR OF ELECTIONS
PALM BEACH COUNTY, FLORIDA
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(DOE FORM CREATED 03/94)
(REVISED 01/2000)
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HJV38 NOlN,~U8 ;10 Al!~
:lTY OF BOYN rON BEACH
NOMINATING PETITION CITY r:LERK'S OFF-ICE
11 JAN - 3 PH 5: 0 I
We the undersigned, duly qualified voters of the CITY OF BOYNTON BEACH, do
hereby nominate:
DoY\~\d lv 5ea..V\,-t\.~\I\
to be a candidate for CITY COMMISSIONER - DISTRICT IV of the City of
Boynton Beach, Palm Beach County, Florida, for the term:
MARCH 2011
to
MARCH 2014
pursuant to the Charter and Ordinances of said City.
, NAME :natu:
I/J,.V.] 1J ~~;;!1 ~0Jn~
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X ANNIE ~{O/..J1
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I, the undersigned, ])0 ()t:Lld L. ~L'Lt\ tla..n
, 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 Mayor for the City of Boynton Beach, Florida.
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Sworn to and subscribed before me at Boynton Beach, Florida, this
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Received at the City Hall in Boynton Beach this ~ day of ~ Q-
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Miscellaneous Cash Receipt
CITY OF BOYNTON BEACH
Account No.
001-0000-369-10-00
Received of DONALD L. SCANTLAN
No. 72680
$ 226.00
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Address 13 CEDAR CIRCLE, BOYNTON BEACH, FL 33436
on March 8, 2011.
For 1% STATE ASSESSMENT FEE to run for:itCpDD,i.ssioner, District 4,
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Dept. City Clerk' 5 Office
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Miscellaneous Cash Receipt
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Account No. 001-0000-369-10-00
Received of DONALD L. SCANTLAN
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Address 13 CEDAR CIRCLE. BOYNTON BEACH, FL 33436
For City Filing Fee to run for Connnisa.i()n~IM' District 4, on
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March 8, 2011
Dept. City Clerk' s Office
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I FORM 1 STATEMENT OF 2010
lease print or type your name, mailing 1 FINANCIAL INTERESTS I
address, agency name, and position below:
c )
LAST NAME -- FIRST NAME -- MIDDLE NAME: FOR OFFICE -
--'" n--'
Scant-l",n nf"'\n=>lr'l Tr..~ USE ONLY: --" --<,
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MAILING ADDRESS' c.... -<'0
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13 Cedar Circle ,OJ
ID Code N r10
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CITY' ZIP: COUNTY: O:Z:
ID No -J ~GJ
Boynton Beach 33436 Palm Beach " _r1
NAME OF AGENCY: ~ n~
Conf Code 0" ;"1'1 0
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NAME OF OFFICE OR'POSITION HELD OR SOUGHT: P. Req. Code
Boynton Beach Commissioner District 4
You are not limited to the space on the lines on this form. Attach additional sheets, if necessary.
CHECK ONLY IF Oil CANDIDATE OR o NEW EMPLOYEE OR APPOINTEE
"BOTH PARTS OF THIS SECTION MUST BE COMPLETED"
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 YE..l\R ENDING EITHER (must check one)'
~ DECEMBER 31, 2010 QB 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 (must check one):
:J COMPARATIVE (PERCENTAGE) THRESHOLDS Q!3. 0 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")
NAME OF SOURCE SOURCE'S DESCRIPTION OF THE SOURCE'S
OF INCOME ADDRESS PRINCIPAL BUSINESS ACTIVITY
WorkforC"'p 21.1 1 ; =>nroo .111:\ ~ T"li yi Q Ut.1" f.7PJ:l 11L1.()1 ('lr.lln...." .. , r ~ ..:I
Pension POBOX ;'130 London, KY 40742 Military
PART 8 -- 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
None
PART C -- REAL PROPERTY [Land, buildings owned by the reporting person] FILING INSTRUCTIONS for
(If you have nothing to report, you must write "none" or "n/a") when and where to file this form
Home: 1 3 Cedar Circle Boynton Beach, FL 33436 are located at the bottom of page 2.
Family residence: 30 Camden BB, FL 33426 (30%) 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 . Effective Janual)' 1. 2011 Refer to Rule 34-8 202(1). FA C.
(Continued on reverse side)
PAGE 1
PART D -INTANGIBLE PERSONAL PROPERTY rStocks honds '~elllflcates -j deDaS" c."
(If you have nothing to report. you must wrih, ""one" "'1ia'"
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rYPE OF INfANGIBLE
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IlU::'iNESS ENTiTY TU 'NHICH THE "'ROPEPT, RELATES
Mutual Fund
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Mercer
Mutual Fund
Templeton
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i
PART E - LIABILITIES [Major debts] 1
(If you have nothing to report, you must write "none" or "nla") i
NAME OF CREDITOR ^iODRESS OF CREDITOR ..
~
rh",C::Q '0 3415 Vision Dr, Columbus. OH 41?1Q i
!
'..- ~.
~
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")
I U'-.lll'f 1...-1'11'1 " I UVUfl'lLU 1..,...1'<1'1 I ..,-.c.. L_"..,.JVII'IL-VU 1.-1 ,,' " 0 I
! !
NAME OF BUSINESS ENTITY Nonp
ADDRESS OF BUSINESS ENTiTY .~
PRINCIPAL BUSINESS ACTIVITY
POSITION HELD WITH ENTITY
I OWN MORE THAN A 5% I
INTEREST IN THE BUSINESS ... -~--- -~.- "''"._--~~..- '~'T'__. ,
NATURE OF MY :1
OWNERSHIP INTEREST i
IF ANY OF PARTS A THROUGH F ARE CONTINUED ON A SEPARATE SHEET, PLEASE CHECK HERE 0
SIGNATURE (required): DATE SIGNED (required)'
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 tile Commission Initially, each iocal 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. return the form to file within 30 days of the date of hiS or he,'
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 "nia" in that of Elections of the county in which they perm a- 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 cate ot theil
in Florida, file Wlttl the Supervisor of the county appointment
Facsimiles wilt not be accepted. where your agency has Its headquarters' Candidates for publicly-elected local office
NOTE: State officers or specified state employees Inus! file at (fie same lime the, iile their
I MULTIPLE FILING UNNECESSARY: file with the Commission on Ethics, PO 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 Sllltp officers, and specified state employees are
second Form 1 for the same year. However, a 201 Tallahassee. FL 323i2 lequlred to file oy Juiy 1 st follOWing eacn
candidate who previousl filed Form 1 because Candidates fil thiS form io ether with the!! calendar year In which they hold their pos',
81 JC'J\IESS Cp\ITir", .u 1
01 1C'II\ICCS C/I.,IT:TV .u .-,
Wi 1C'1J\Ii::CC Cf\JTIT .;..;-
Y
of another public position must at least file a copy
of his or her original Form 1 when qualifying
e
qualifying papers
r 0 determine what category your pOSition
falls under. see the "Who Must File" Instructions
on pilge "
g
!lOllS
Finally, at the elld of office or employment,
each local officer/employee, state officer. and
3pecified state employee Is required (0 file a
;Inal disclosure iorm (Form; Ft withl! fie: dClVS
)f leaving office 01 employment
CE FORM 1 Effective January 1 2011 Refer to Rule 34-8.202 (1'1 ~ /1 ,.
Pl>,GE 2
LOYALTY OATH
(Sections 876.05-876.10, Florida Statutes)
CANDIDATE WITH NO PARTY AFFILIATION
~'r...' 'IF B:YY t~ \ Uti BEACH
.11 I \-' "', ~
ClT'( CLERK S OFfle...
11 JAN 27 AM 7: 46
OFFICE USE ONLY
I, I D <' f\0.1 J.
First Name
L
:s C~ 'n fl~H1
Middle Name/lnitial
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, r::D 0 n t\ t J l 5 co. Y\ -t t a. n
(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 with no party affiliation for the office of C (J t'lI\ m f S ~ ion er 4
(office) (district #)
; I am a qualified elector of l=> t\ , "" ~ tCIt:1 e h County, Florida;
(circuit #) (group or seat #)
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
(sa) r a4. U () ; { {g, J 'S
Sect"t\Al\
Email Address
Telephone Number
· Please print name phonetically on the line below as you wish it to be pronounced on the audio ballot for persons
with disabilities (see instructions on page 2 of this form):
'1)0 n A.W LJ
s k QI'l'1-\ a r1
STATE OF FLORIDA
COUNTY OF fJt&.M l1earJ..
VII
Sworn to (or affirmed) and subscribed before me this ~ 7 day of
NOTARY PUBUC-STATE 0' MlUDA
............... Judith A. Pyle
f W } Commission # DD870304
..'!iII'., Expires: APR. 21, 2013
BOND'.;D THRU ATLANTIC BONDING CO., INe.
Personally Known:
~
or
,20...LL-.
Produced Identification:
ure of Notary Public
, Type, :JUbJc;Misii.ed ~ L~~ Public
Type of Identification Produced:
OS-DE 248 (Rev. 10/10)
Rule 1S-2.0001, F.A.C.