Filing Papers :i[NCH
APPOINTMENT OF CAMPAIGN TREASURER r`"
AND DESIGNATION OF CAMPAIGN E
''�,. r _,
DEPOSITORY FOR CANDIDATES ' 2 ` °' 10: 6
(Section 106 021(1), F S )
(PLEASE PRINT OR TYPE)
NOTE: This form must be on file with the qualifying
officer before opening the campaign account. OFFICE USE ONLY
1. 9CK APPROPRIATE BOX(ES):
[ z 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
code)
(e t Scdrs � � �y � t ires 1c'�(� S� 6 `it 41L
4 Telephone 5 E -mail address )13c 1J-r(( -'i ) ' � f " )
( � G ) s 114 {'y4)4) _ d
6 Office sought (include district, circuit, group number) 7 If a candidate for a nonpartisan office, check if
applicable:
A \ ,) 0 c C itiv ikdc K1 r ❑ 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 czi No Party Affiliation ❑ Party candidate
9 I have appointed the following person to act as my Campaign Treasurer ❑ Deputy Treasurer
10 Name of Treasurer or Deputy Treasurer
E/+ iL 1,4 1- 2
11 Mailing Address 12 Telephone
y w /9 I 410 Yti iJ T/( ( 56/ ) 7%. 3�
13 City 14 County 15 State 16 Zip Code 17 E -mail addres
o' /, oo :! /� 'I�G LiM i tl
Y l � �9 �9c ��� �' L- 33yo J ern e eit_444/1
18 I have designated the following bank as my eLi Primary Depository ❑ Secondary Depository
19 Name of Bank 20 Address
ii&,t'LLS 1. ; ()ZOO , eor 2,4/4WrC
21 City _ 22 County 23 State 24 Zip Code
Xjz y,Vr G v ` /3' 1/0 -, 1O).04 f3i4(' Fiv e k.»),1J 33
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
7 A /,
27. Treasurer's Acceptance of Appointment (fill in the blanks and check t e appropriate block)
--- fe•qA/ IC: LO/C , do hereby accept the appointment
(Please Print or Type Name)
designated above as Er Campaign Treasurer 111 Deputy Treasurer
Date ignature of Campaign Tr surer or Deputy Treasurer
DS -DE 9 (Rev. 10/10) Rule 1S- 2.0001, F.A.C.
OFFICE USE ONLY
STATEMENT OF
CANDIDATE
(Section 106.023, F.S.)
(Please print or type)
candidate for the office of //471; t= bby,v av L
have been provided access to read and understand the requirements of
Chapter 106, Florida Statutes.
•
X 9 � � 1 " �y Y/2
Signature f 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) il3V ;'a y;?
RESIDENCY REQUIREMENTS
I, 6'n2,41-P F o 7T MY' 6 4 , candidate for
(Print Name)
rn yd A— of the City
(Mayor /Commissioner — District #)
Beach, have received, read and understand the
residency requirements of Article II of the Charter of
the City of Boynton Beach.
4."d-
(Signature of Candid )
7/d //)-
(Date)
\ 91‘
4
8/18/2009 5:43 PM , ‘ i I •
S: \CC \WP \ELECTION \Year 2010 \RESIDENCY REQUIREMENTS STATEMENT.doc ` p
l
Miscellaneous Cash Receipt °' °
No. 77104
CITY OF BOYNTON BEACH
a _ r
~ TO N
001 -0000- 369 -10 -00 •
Account No.
S 25. 00
2/4 20 13
Received of Terry Taylor
Address /082 5 W CVO (' Ve . 8 3+ a(Z'
For
City filing fee for the Mayor at Targ€� seat for
March 12, 2013 election 13 01 Receipt no: 13650
.red $25.00
Total payment i'S.Bd
Dept. Cit Clerk B Stanzione
Miscellaneous Cash Receipt 0-C Y OR,
CITY OF BOYNTON BEACH No. 77103
__ r
0 01 - 0000- 369 -10 -00 ° ~ TO N g�P
Account No. qq
i
$ 259.26
4 13
20
Received of u erry Taylor
Address /ABb 511) 6 / l Ve LJ B
For I% s tate assessment fee for Mayor at Large for the
tlper: BTB2JXS !!
March 12, 2013 election Date: 2/04/1:3 91 Receipt no: 136532
Total to deicd 4259,26
City clerk Total payment $259.26
Dept. y B St anzione
�IZY �F ffi,rc�ri �Ae�
rtT cr ERYrc oYN V 0>=�i't E
CANDIDATE OATH —
NONPARTISAN OFFICE
13 FEB - PM 3' 13
(Not for use by Judicial or
School Board Candidates)
OFFICE USE ONLY
OATH OF CANDIDATE
(Section 99 021, Florida Statutes)
I, / a r c'-f jaY
(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 nonpartisan office of /V/4- c'C' - ' / db/ / /& , Pit4,
(office) (district #)
, I am a qualified elector of 7:4 4 i i fy County, Florida;
(circuit #) (group or seat #)
I am qualified under the Constitution and the Laws of Honda 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, Honda Statutes, and I will support the Constitution of the United States and the Constitution of the
State of Florida
X / • „,--)/- ( 'CC" 7;;Iyie/1—yi
c� r
Sign ture Candidate Telephone Number Entail Address
�C1 (C-b g / /Li l •• • % �7
Address City State ZIP Code
Candidate's Honda Voter Registration Number (located on your voter information card) II ° ye 6 Y
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)
7
STATE OF FLORIDA
COUNTY OF PAI--I■A VeitC.44
Sworn to (or affirmed) and subscribed before me this q day of rr b rLizk y _, 20 / .3 .
Personally Known or ` _ . 11 • mil_
Sig ature of Notary Public
Produced Identification P t, Type, or Stamp Commissioned Name of Notary Public
Type of Identification Produced NOTARY PUBLIC-ST Cv FLORIDA
Janet M
„'. ? Co m , EE028433
,VI) 77.7014
BONDED TER ntiZ I C BONDING cO.,INC.
DS -DE 25 (Rev. 5/11) Rule 1S- 2.0001, F.A.C.
The City of Boynton Beach
City Clerk's Office
100 E BOYNTON BEACH BLVD
BOYNTON BEACH FL 33435 -) _74
{ (561) 742 -6060 -<
FAX: (561) 742 -6090 1
E -mail: prainitoj @bbfl.us co 1 op
www.boynton- beach.org .4- 7j
PUBLIC NOTICE w_
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 12, 2013 General & Special
Elections will be held:
Friday, February 22, 2013 @ 3 :00 p.m.
Supervisor of Elections Warehouse
7835 Central Industrial Drive
Riviera Beach, Florida
RECEIPT of this notice is hereby documented:
16 /
Signature Date Received
DETACH
IF YOU AND /OR YOUR REPRESENTATIVES) plan(s) to attend the Logic &
Accuracy (L&A) testing on Friday, February_1.8; 2013, please detach and
return the lower portion of this notice to the City Clerk.
Signature #Attending
S: \CC \WP \ELECTION \Year 2013 \INFORMATION PACKETS \L&A Testing Public Notice - For Candidate's Signature.doc
Catch a Wave, Catch a Fish, Catch Your Breath - Breeze Into Boynton Beach
America's Gateway to the Gulfstream
FORM 1 STATEMENT OF 2012
Please print or type your name, mailing 1 FINANCIAL INTERESTS
address, agency name, and position below FOR OFFICE USE ONLY:
LAST NAME -- FIRST NAME -- MIDDLE NAME .
yL IZ C '�:�►,�tv s� err
MAILING ADDRESS
J6 St-d c2/0 ,Lz w
CA.)
160,
'7',/ g I J 7 5/4 / L i .vF , P6
CITY ZIP . COUNTY Q7 7
�Q
NAME OF AGENCY
"
NAME OF OFFICE OR POSITION HELD OR SOUGHT W -or
/1) / ) 1 e9/ #0) �� .e/ W rn>
You are not limited to the space on the lines on this form, Attach additional sheets, if necessary.
CHECK ONLY IF CANDIDATE OR ❑ 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 YEAR ENDING
EITHER (must check one)
DECEMBER 31, 2012 OR ❑ 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) CHECK THE ONE YOU ARE USING �, /
❑ COMPARATIVE (PERCENTAGE) THRESHOLDS OR air DOLLAR VALUE THRESHOLDS
PART A -- PRIMARY SOURCES OF INCOME [Major sources of Income to the reporting person - See Instructions]
(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
/2l, f �Q ,)p» r A,liegi-„l4`rJ /w",f1 0,240 /J 7 di. 2,` 7:4.4r
f " -QL- 5zgzr1" 2/ f 5> - 7 5 S h45‘) o / /!
.5J 9�. a „/s' 0 r >,4 /to- � yr../ 7 ?ri �. ��� & c
� v 130/11w
N�rj.ur�, r^Yzr.�j�+ pc i c /96c Xey 'r ru ms
PART B -- SECONDARY SOURCES OF INCOME
(Major customers, clients, and other sources of Income to businesses owned by the reporting person - See instructions]
(If you have nothing to report, write "none" or "n /a ")
NAME OF NAME OF MAJOR SOURCES ADDRESS PRINCIPAL BUSINESS
BUSINESS ENTITY OF BUSINESS' INCOME OF SOURCE ACTIVITY OF SOURCE
/44
1
/
PART C -- REAL PROPERTY [Land, buildings owned by the reporting person - See instructions] FILING INSTRUCTIONS for
(If you have nothing to report, you must write "none" or "n /a ")
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.
GE FORM 1 - Effect,v January 1 2013 Refer to Rule 34 -8 202(1) FA C (Continued on reverse side) PAGE 1
FORM 1 STATEMENT OF 2012
Please print or type your name, mailing 1 FINANCIAL INTERESTS I
address, agency name, and position below: FOR OFFICE USE ONLY:
LAST NAME -- FIRST NAME -- MIDDLE NAME :
1- fiy ei )2___ 6' ;edLv 5c'fF
MAILING ADDRESS :
4 (k6 5L4/ o?& 91 Mze �,
060)91fra,✓ gr4th 1 r� 3 3 z`�� ,fiL 9F94 Pi
CITY : ZIP : COUNTY : CO -
m
NAME OF AGENCY : .=---
NAME OF OFFICE OR POSITION HELD OR SOUGHT : W T1
, ' 1 4 Y - 9/ )60/. A'4/ It ,9i/ m
CA) rn
You are not limited to the space on the lines on this form. Attach additional sheets, if necessary. S
CHECK ONLY IF Ar CANDIDATE OR ❑ 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 YEAR ENDING
EITHER (must check one):
DECEMBER 31, 2012 OR ❑ 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). CHECK THE ONE YOU ARE USING:
❑ COMPARATIVE (PERCENTAGE) THRESHOLDS OR I:d DOLLAR VALUE THRESHOLDS
PART A -- PRIMARY SOURCES OF INCOME [Major sources of income to the reporting person - See instructions]
(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
A iA y4' /2 1 P i1 /47 b/ Q-- r✓i Atig..a,d. ib /2g ItiliZtootiP /J? Af.'i_i ey
J0 sz ev?2; 7/ $ 54- 'r k, 5 lie ,CXSv� oll f ? s •L,si— J.` 1
i Y.r 7 9 Y .t _y 63'6 a_d v�
�V 4 ,7 1E 7 t' r- /ev .j,- Pe ia'74.y- e , CA n; _re 4,67 attdsa4b
PART B -- SECONDARY SOURCES OF INCOME
[Major customers, clients, and other sources of income to businesses owned by the reporting person - See instructions]
(If you have nothing to report, write "none" or "n /a ")
NAME OF NAME OF MAJOR SOURCES ADDRESS PRINCIPAL BUSINESS
BUSINESS ENTITY OF BUSINESS' INCOME OF SOURCE ACTIVITY OF SOURCE
iNi / / i/ 4
PART C -- REAL PROPERTY [Land, buildings owned by the reporting person - See instructions] FILING INSTRUCTIONS for
(If you have nothing to report, you must write "none" or "n /a ")
when and where to file this
J form are located at the bottom
/ of page 2.
,t/ / 1 INSTRUCTIONS on who must
/ V file this form and how to fill it
out begin on page 3.
CE FORM 1 - Effective. January 1. 2013. Refer to Rule 34- 8.202(1), F.A.C. (Continued on reverse side) PAGE 1
•
PART D — INTANGIBLE PERSONAL PROPERTY [Stocks, bonds, certificates of deposit, etc. - See instructions]
(If you have nothing to report, you must write "none" or "n /a ")
TYPE OF INTANGIBLE BUSINESS ENTITY TO WHICH THE PROPERTY RELATES
� /4 C' C,✓ /�f26 - ` 1 • s� L- ua /rt" gl c ✓i'_
T%Z L./ S r r ✓'/)) /9 02 L � , �" ,-9ccod.�7"
PART E — LIABILITIES [Major debts - See instructions]
(If you have nothing to report, you must write "none" or "n /a ")
NAME OF CREDITOR ADDRESS OF CREDITOR
/ 9) , 4 .r,) ) 64 .3c
PART F — INTERESTS IN SPECIFIED BUSINESSES [Ownership or positions in certain types of businesses - See instructions]
(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
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 ARE CONTINUED ON A SEPARATE SHEET, PLEASE CHECK HERE ❑
SIGNATURE (required): DATE SIGNED (required):
d , / ... � , /77,41"--'
7-
FILING- INSTRUCTIONS:
WHAT TO FILE: WHERE TO FILE: WHEN TO FILE:
After completing all parts of this form, If you were mailed the form by the Commission Initially, each local officer /employee,
including signing and dating it send back on Ethics or a County Supervisor of Elections state officer, and specified state employee
only the first sheet (pages 1 and 2) for filing. for your annual disclosure filing, return the must file within 30 days of the date of
form to that location. his or her appointment or of the beginning
If you have nothing to report in a particular Local officers /employees file with the of employment. Appointees who must be
section, you must write "none" or "n /a" in that Supervisor of Elections of the county in confirmed by the Senate must file prior to
section (s). confirmation, even if that is less than 30
(s ) which they permanently reside. (If you do not con days from the date of their appointment.
permanently reside in Florida, file with the
NOTE: Supervisor of the county where your agency Candidates for publicly - elected local office
MULTIPLE FILING UNNECESSARY: has its headquarters.) must file at the same time they file their
Generally, a person who has filed Form 1 State officers or specified state employees qualifying papers.
for a calendar or fiscal year is not required file with the Commission on Ethics, P.O. Thereafter, local officers /employees, state
to file a second Form 1 for the same year. Drawer 15709, Tallahassee, FL 32317 -5709. officers, and specified state employees
However, a candidate who previously filed are required to file by July 1st following
Form 1 because of another public position Candidate file this form together with their each calendar year in which they hold their
must at least file a copy of his or her original qualifying papers. positions.
Form 1 when qualifying. To determine what category your position falls Finally, at the end of office or employment,
under, see the "Who Must File" Instructions on each local officer /employee, state officer, and
page 3. specified state employee is required to file a
final disclosure form (Form 1 F) within 60 days
Facsimiles will not be accepted. of leaving office or employment. However,
filing a CE Form 1F (Final Statement of
Financial Interests) does not relieve the filer
of filing a CE Form 1 if he or she was in their
position on December 31, 2012.
CE FORM 1 - Effective: January 1, 2013 . Refer to Rule 34 -8.202 (1), FA C. PAGE 2
, �, ' _ INTArv: -ib F L <ut ,,, ,C'r'F ,
,
PE,.,r _ . _� _ , _ r It ____ _... _R
n
1
PART E — LIABILITIES [Major debts - See instructions'
(If you have nothing to report, you must write 'none" of ' nia"i
NAME OF CREDITOR ADDRESS OF CREDITOR
j ` - '' 7e
fi
PART F — INTERESTS IN SPECIFIED BUSINESSES [Ownership or positions ,?, certain types r;r'sutimesses SPP Instruc+u n_
(If you have nothing to report, you must write "none" or'°n /a "t
BUSINESS ENT 1 )' a ; BUSINESS ENTITY # 2 E SUSINESS ENTr1't « :.5
NAME OF BUSINESS ENTITY I
ADDRESS OF BUSINESS ENTITY i
PRINCIPAL BUSINESS ACTIVITY ,
r
POSITION HELD WITH ENTITY i
OWN MORE THAN A 5% -_._ ._ , 1 ___ _
INTEREST IN THE BUSINESS _l___ _ __ __ _ - ��__ _. _ -_
NATURE OF MY ■ '
OWNERSHIP INTEREST
IF ANY OF PARTS A THROUGH F ARE CONTINUED ON A SEPARATE SHEET, PLEASE CHECK HERE j
SIGNATURE (required): DATE SIGNED (required):
/
i
FILING INSTRUCTIONS:
WHAT TO FILE: WHERE TO FILE. WHEN TO FILE
After completing all parts .,f th,s form 5 f you were marled the form by the C,Ummission initially - o , , L-6 oit employef ;!
Including signing and dating it send back on Ethics or a County Supervisor of Elections -Sate officei a r,ci specifieo state employee,
only the first sheet (pages 1 and 21 for Sling for your annual disclosure film() ' ,,- 5 r- ' lus, 13ik_ mthrn 30 days - tr E gate . l
form to that location 'pis or her appointment a s the begmninc
If you have nothing to report in a particular Local officers /employees file with the of employment Appointees who must he
section, you must write "none" or "n /a" in that Supervisor of Elections of the county it confirmed by the Senate must file pno to
section(s) which they permanently reside (If you do not d ays atior� even `that is Bess Char "3t`
permanently reside in Florida, file with the days ran hn 7atF of "lerr appointmer °<
NOTE: Supervisor of the county where your agency Candidates for uobihcly- elected local office
MULTIPLE FILING UNNECESSARY has its headquarters ) must file at the same time they File they
Generally a person who has filed Form 1 State officers or specified state employees , qualifying paoer'
for a calendar or fiscal year is not required file with the Commission on Ethics, P C Thereafter iocai officers/employees state
to file a second Form 1 for the same year Drawer 15709, Tallahassee, FL 32317 5709 officers and specified -tate employees
However, a candidate who previously filed are required to file by iuly 1 st following
Form 1 because of another public position C fide this form together with their each calendar year , r which they hold them
must at least file a copy of his or her original qualifying papers positions
Form 1 when qualifying To determine what category your position falls F at the end of office of employment
under, see the "Who Must Fde" instructions on each local officer /employee, state officer, and
page 3 specified state employee is required to file ,
-
final disclosure forrr (Form 1F) within 60 days
Facsimiles will not be accepted. ,/ leaving office - smpluyroent r
filing a CE Forni ' F (Final Statement
5 5nancial interests; does not relieve the tile;
of filing a CE Fora 1 if he or she was ir tSrr
aosition on December 31 2012
OF F
�F \GaLSE
V Palm Beach County
Y OF pp
240 SOUTH MILITARY TRAIL
WEST PALM BEACH, FL 33415
POST OFFICE BOX 22309
WEST PALM BEACH, FL 33416
SUSAN BUCHER
Supervisor of Elections TELEPHONE (561) 656 -6200
FAX NUMBER (561) 656 -6287
WEBSITE • www. pbcelections org
CERTIFICATION
I, SUSAN BUCHER, SUPERVISOR OF ELECTIONS, for Palm Beach County, Florida, do
hereby certify that Jerry Taylor submitted 37 petition signatures for the office of Mayor of
the City of Boynton Beach.
I further certify that 32 of those signatures are registered electors in the City of Boynton
Beach, according to the registration records on file in this office.
This is to further certify that Gerald S. Taylor is a registered voter in Precinct 3200, in the
City of Boynton Beach, Florida.
Signed, this the 30th day of January, 2013. 1274
CA) .f-t
9gliktY/VN bAthi,‘ -n
SUSAN BUCHER 7:1_<
SUPERVISOR OF ELECTIONS a
PALM BEACH COUNTY °
w .,,
_ rn
ca ri
(SEAL)
1TY OF BOYNTON BEACH
CITY CLERK'S OFFICE
13 FEB -4 PM 3: 13 NOMINATING PETITION
We the undersigned, duly qualified voters of the CITY OF BOYNTON BEACH, do hereby
nominate:
3 Cam`" (01P
to be a candidate for MAYOR of the City of Boynton Beach, Palm Beach County, F11-ida, for
the term:
MARCH, 2013 to MARCH, 2016
pursuant to the Charter and Ordinances of said City.
ry
r- ry
NAME
1 ZS S
t .4 V 41 ‘‘‘ * b C1AM,(A zesc 5'(-J D 5://nvx,/eld
, � c 1 ho i I 471c /91rcv � �
_/Ai
/ L--.1`/L, OZ. N V 1 (*) 7 51,1,
M a, -C , , 2.512_ c. 334(26
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t k (K -k - P 4c,c__
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7 i e'd b Ss 1/t a c�, C c- s 3 f'i'b
Lao i s too j (
NOMINATING PETITION
We the undersigned, duly qualified voters of the CITY OF BOYNTON BEACH (Sec. 2 -42,
City Code of Ordinances), do hereby nominate:
2 i oi
to be a candidate for MAYOR AT -LARGE City of Boynton Beach, Palm Beach County,
Florida, for the term:
MARCH 2013 to MARCH 2016.
pursuant to the Charter and Ordinances of said City.
_7
SIGNATURE ADDRESS ^ n,.
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_____-- +u-L-_-, A rm* -,- _ 3 V.3
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e O r\) 'hee a /a S 3 1 x ) t 5 A u ' . Ba yr7t t./ 61431-
NOMINATING PETITION
We the undersigned, duly qualified voters of the CITY OF BOYNTON BEACH, do hereby
nominate:
e r^ �, -7-3t y o s
to be a candidate for MAYOR of the City of Boynton Beach, Palm Beach County, Florida, for
the term:
MARCH, 2013 to MARCH, 2016
pursuant to the Charter and Ordinances of said City.
c7
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NAME
`;
j /44/1- ZC/ �G
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I, the undersigned, 1 ,_,e , t 7 f r ) ,% r - z , do solemnly swear (or affirm)
that I am duly qualified to hold offic' 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 At -Large for the City of Boynton Beach, Florida.
Sworn to and subscribed before me at Boynton Beach, Florida, this day of
- 1..L.Ce) A ) , A.D. 20 f .' .
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Received at the City Hall in Boynton Beach this '7 day of &. ,
20 /.3 at -4,9 P.M.
City Clerk
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