Filing Papers M TERI t,L FOR CANDIDATES
YOU HAVE INDICATED YOUR DESIRE TO BECOME A CANDIDATE; THEREFORE, I HAND YOU THE
• FOLLOWING:
1. c/ Qualifying Information & Municipal Election Schedule
2. ✓ Dates to Remember
3. t/ Form DS -DE 9 Appointment of Campaign Treasurer and Designation of Campaign Depository for
Candidates (8/03) - TO BE SIGNED AND RETURNED TO CITY CLERK INDICATING YOUR
/ INTENT TO RUN.
4. a/ Residency Requirements (To be filled out and returned to City Clerk)
5. ✓ Form DS - DE 84 Statement of Candidate & copy of Chapter 106, Florida Statutes (Must be filed with
City Clerk within 10 days after filing Appointment of Campaign Treasurer - Intent )
6. ,Z State of Florida Election Laws - Chapters 99, 105 & 106
7. ✓ Guide to Sunshine Amendment & Code of Ethics for Public Officers and Employees
8. ./ Directions for Posting Temporary Political Sign c;
9. ,/ City Map and District Maps
c - TS
10. ./ Part I Charter, Article VII. Elections - City of Boynton Beach rsici
PI -.4.
11. / Part II Code of Ordinances - Chapter 2 Administration, Article III. Elections, u;-+
12. ✓ Poll Watcher Form & FS 101.131 - "Watchers at Polls" -*
/ rn
13. ✓ Public Campaign Financing Handbook
14. Candidate Petition Handbook
15. � Blank Campaign Report Summary Sheets, Contributions Sheets & Expenditures Sheets
16. tf Petition Form - Candidate for Commissioner - TO BE FILLED OUT CERTIFIED BY SUPERVISOR
OF ELECTIONS AND RETURNED TO CITY CLERK DURING QUALIFYING
17. Form 1 Statement of Financial Interests 2014 - TO BE FILLED OUT, SIGNED & RETURNED TO
THE CITY CLERK DURING QUALIFYING
18. ✓ L&A TESTING NOTICE (SIGN AND RETURN AT TIME OF QUALIFYING.)
19. ✓ Loyalty Oath - Oath of Candidate (DS - DE 24B) - TO BE RETURNED TO CITY CLERK DURING
QUALIFYING
RECEIV
` �� 7-7- ,5
Candidate Signature / Date Signed
O
Alz,t la PhisumAl
Janet M. Prainito, MMC
Cit'y Clerk
5/26/2015 3:33 PM
S: \CC \WP \ELECTION \YEAR 2016 \Information Packets \MATERIAL FOR CANDATES.doc
II
Cl" " BUY tS F10EN
APPOINTMENT OF CAMPAIGN TREASURER CI C LERK
AND DESIGNATION OF CAMPAIGN Q 40 43
DEPOSITORY FOR CANDIDATES 15 iUL _
(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. 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
6 /..b scorr 7, t 2- code) 8 5C•e, t v.Q.
p AP/1/779,V $S 4C% � ;4} a
4. r T / ele hone y 5. E -mail address
( J 41 ) ? c f- � L � ° r
6. Office sought (include district, circuit, group number) 7. If a candidate for a nonpartisan office, check if
� � applicable:
/ - N ❑ 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. I have appointed the following person to act as my ❑ Campaign Treasurer ❑ Deputy Treasurer
0. Name of Treasurer or Deputy Treasurer
GE.t LP S. ,1911. d 2
11. Mailing Address 12. Telephone
/peg 4 ( )
13. City 14. County 15. State 16. Zip Code 17. E -mail address N
1331/4r144) i? A L rni&N.9 o F 3 .70 ( 77 L s vQ .7 ffL4 e2 a
18. I have designated the following bank as my ❑ Primary Depository ❑ Secondary Depository
19. Name of Bank 20. Address
w MAC fl %./ad n1, aopv6/ EC .gum, gPywr ,r / , �L
21. City 22. County 23. State 24. Zip Code
ii%', 1 I ��! gi gcdt / �- 3X ( f - 7
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
d J LY 02691 X lAd te / � k=d-? /--
27. Treasurer's Acceptance of Appointment (fill in the blanks and check thappropriate block)
1, a E/1.9 6D L. 7 , do hereby accept the appointment
(lease Print or Type Name)
'esignated above as: ►j Campaign Treasurer ❑ Deputy Treasurer.
°7J L 02 d Sr x avehte
ate Signature of Campaign T surer or Deputy Treasurer
DS -DE 9 (Rev. 10/10) Rule 1S- 2.0001, F.A.C.
• EH ON B1=A
STATEMENT OF CITY C K'S OFFICE
CANDIDATE I5: —
JUL - 7 �� 10; 43
(Section 106.023, F.S.)
(Please print or type)
Cg4j4ca Scar 7 /z a 2
candidate for the office of /ill Yea- of FO /p / 2 4 ,�� • ;
have been provided access to read and understand the requirements of
Chapter 106, Florida Statutes.
•
X �� / 7 golf 2oi.s
Signature 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)
fi
RESIDENCY REQUIREMENTS
Go oo 3 s��-r- 7;0 d , candidate for
(Print Name)
i A/ 2 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.
of C didate
(Signature )
(Date)
C J �
F"'
I • � 1^ CS7
- Cn
'�
11/12/2013 12:31 PM
S: \CC \WP \ELECTION \Year 2014 \Information Packets \RESIDENCY REQUIREMENTS STATEMENT.doc C7 n 1''1
>
112219689 TAYLOR, GERALD S REP 3200 1086 SW 26TH AVE
BOYNTON BEACH FL 33426 11/11/1935 W M 11/22/1983 11/6/2012 22
34 91 3 4 BB BB1
_t �. ✓ i r y'i' x v a F _ ; ,. .: .., r • :.r.+5 s-- - , ,- : - _
f TIM. <.Y0J FCC;`? PRINT PA'MN
f _ °- Miscellaneous Cash Receipt N o . 7 b t ` : ; : CITY OF BOYNTON BEACH
_ ._, r
1 To N 0
Account No. 001-0000-369-10-00
$. 25.00
CITY CFll 'TPT#
, 20 r� 0 t 4s Type: CC DrE� r a t � .
Gerald Ta$ Taylor Dates 11/05/ 01 Receipt no:
: 1
Received of y nt
D28I F t i O 1 ant
1 �� 6 SW 2 Pith Avenue. Boynton 3 t PSI 1 00 .00
Address +' .. �+ , 656446
Date 11 rtv5, i 01 " Res i pt no: 4 Trans nu 3ter,
City Filing Fee to run for Mayor onT � 5, 2016 ti Gil accaunt numter9
For ■.!.?::en A., . - 0011 ` ?a+ 1G �J
F RAT os 00 G TAYLOR
CITY FILM FE
Dept. City Clerk's O fiee By Tender detail (�
3 5.00
L� �G
Total centered eQ0
„ t FQP, r OR PRGTT Pl-NE T"
Miscellaneous Cash Receipt 01 O
No � ,
CITY OF BOYNTON BEACH
~T ON - - -..
Account No. 001.0000- 369 -10 -00 _
- .. $ :: 259.26`` � +�1
. Or; E Zk :::::cure,t4 CE IPT * **
Date: 11/05/ 01 ip � a -° er.04 ��s�r ipt�nn �
Received of Gerald Taylor MISIILAKEar,, Amount
1 °
Trans r i; CP_r '�3, 2F,
108.6 26th Avenue Bo . ton Be .. f-b p -,33426 G /L a ccount n�rJa?rs 5`
Address 00 t7
Date: 11/05.11 C. i01 _,Reci flO L �0 t RC 91
For 1% State Assessment to run for Mav t ga=r ..ch 15 _ 201 $ X95
G n. I G4.'R fl _'T
T�}nder ta:
Asss
C>4
Dept. City Clerk's ° Office B Total tPade, ed 4 8
Total payment ,26
_ a
FORM 1 STATEMENT OF 2014
Please print or type your name, mailing FINANCIAL INTERESTS I FOR OFFICE USE ONLY:
address, agency name, and position below:
LAST NAME -- FIRST NAME -- MIDDLE NAME :
7 Yj 0 2 G�"4�2A s�o
MAILING ADDRESS :
70 e‘ so 0 , 24 /IVY)/ .: (.,
go lI "°4/ �9G f 33'46 60M i �.`. o
CITY : - ZIP : COUNTY : T
aYn7r - oil/ 370-( cn
NAME OF AGENCY :
01 ,;effii [AA/ §s �1 .. `n
•
NAME OF OFFICE OR POSITION HELD OR SOUGHT: w gip
ati rri
You are not limited to the space on the lines on this form. Attach additional sheets, if necessary. 3
Z..
CHECK ONLY IF 7CANDIDATE 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 eck one):
DECEMBER 31, 2014 OR ❑ SPECIFY TAX YEAR IF OTHER THAN THE CALENDAR YEAR:
MANNER OF CALCULATING REPORTABLE INTERESTS:
FILERS HAVE THE OPTION OF USING THRESHOLDS THATARE 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 9 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, write "none" or "n /a ")
NAME OF SOURCE SOURCES DESCRIPTION OF THE SOURCES
OF INCOME ADDRESS PRINCIPAL BUSINESS ACTIVITY
C) V a?- /747 C/ad /fro ' E gDfe47, Zc9Cl,/ J wl> 334'23 Pou ia)//5w -
3oeF.fL SYGa 2trf ;3S,4y7Zt9f3 /034; �e 3 se S,./li G - T
9X.4 - 7. - P>r J L • ,e 9 /l e-AO/ r for 0, x 5'orxo r i. 41 as.C¢o_, r- & 3 a 31$" v
n>�/G FiL,vF s% .P (P.FOX 9j963, C2,"a, c, 3 0 75— 4 ice ftfJk/L.., Ita;i uc/W
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
/2 /' /1"2/
PART C – REAL PROPERTY [Land, buildings owned by the reporting person - See instructions]
(If you have nothing to report, write "none" or "n /a ") FILING INSTRUCTIONS for when
and where to file this form are
located at the bottom of page 2.
//
,p INSTRUCTIONS on who must file
6 / this form and how to fill it out
v begin on page 3.
CE FORM 1 - Effective: January 1, 2015 (Continued on reverse side) PAGE 1
Adopted by reference in Rule 34-8.202(1), F.A.C.
PART D — INTANGIBLE PERSONAL PROPERTY [Stocks, bonds, certificates of deposit, etc. - See instructions]
(If you have nothing to report, write "none" or "n /a ")
TYPE OF INTANGIBLE BUSINESS ENTITY TO WHICH THE PROPERTY RELATES
vt/ Il p, o • an-Z 9 a — Cole 7/ o4- 1, aovr> - L ?Tr
46 5 `P A� G-o y
4i r ✓(fir
�L Cleo 3 roM e n/ Pei 400' 3 ,
PART E — LIABILITIES [Major debts - See instructions]
(If you have nothing to report, write "none" or "n /a ")
• NAME OF CREDITOR ADDRESS OF CREDITOR
aPACA -A✓, 1 5 17,94//K /? D, .70 '1)/3 �' 620. 69e, l iofiy if 7die
Pv, -t.9, ii r‘14
PART F — INTERESTS IN SPECIFIED BUSINESSES [Ownership or positions in certain types of businesses - See instructions]
(If you have nothing to report, write "none" or "n/a")
BUSINESS ENTITY # 1 BUSINESS ENTITY # 2
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 OF FILER: CPA or ATTORNEY SIGNATURE ONLY
If a certified public accountant licensed under Chapter 473, or
Signature: attorney in good standing with the Florida Bar prepared this
form for you, he or she must complete the following statement:
prepared
the CE Form 1 in accordance with Section 112.3145, Florida
Statutes, and the instructions to the form. Upon my reasonable
knowledge and belief, the disclosure herein is true and correct.
Date Signed:
/ CPA/Attorney Signature:
'
/ / Date Signed:
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 officer,
sianing and dating it, send back only the first on Ethics or a County Supervisor of Elections for and specified state employee must file within
sheet (pages 1 and 2) for filing. your annual disclosure filing, retum the form to 30 days of the date of his or her appointment
that location. or of the beginning of employment. Appointees
If you have nothing to report in a particular Local officers /employees file with the who must be confirmed by the Senate must file
section, you must write "none" or "n /a" in that Supervisor of Elections of the county in which they 30 dao c d te l theat is le s than
section(s). permanently reside. (If you do not permanently
reside in Florida, file with the Supervisor of the Candidates for publicly - elected local office must
NOTE: county where your agency has its headquarters.) file at the same time they file their qualifying
MULTIPLE FILING UNNECESSARY: papers.
State officers or specified state employees Thereafter, local officers/employees, state
A candidate who previously filed Form 1 because file with the Commission on Ethics, P.O. Drawer
of another public position must at least file a copy 15709, Tallahassee, FL 32317 -5709; physical officers, and specified state employees are
of his or her original Form 1 when qualifying. A address: 325 John Knox Road, Building E, Suite required to file by July 1st following each calendar
candidate who files a Form 1 with a qualifying 200, Tallahassee, FL 32303. year in which they hold their positions.
officer is not required to file with the Commission Candidates file this form together with their Finally, at the end of office or employment, each
or Supervisor of Elections. g local officer /employee, state officer „and specified
qualifying papers. state employee is required to file a final disclosure
To determine what category your position falls . form (Form 1 F) within 60 days of leaving office or
under, see the "Who Must File” Instructions on employment. However, filing a CE Form 1F (Final
page 3. Statement of Financial Interests) does not relieve
Facsimiles will not be accepted, the filer of filing a CE Form 1 if he or she was in
their position on December 31, 2014.
CE FORM 1 - Effective: January 1, 2015. PAGE 2
Adopted by reference in Rule 34- 8.202(1), F.A.C. -
4 ,-;-17 4
o
I Palm Beach County
OF ppV - J
240 SOUTH MILITARY TRAIL
WEST PALM BEACH, FL 33415
POST OFFICE BOX 22309
WEST PALM BEACH, FL 33416
SUSAN BUCHER
Supervisor of Elections TELEPHONE: C561] 656 -6200
FAX NUMBER: C581] 656 -6287
WEBSITE: www.pbcelections.org
CERTIFICATION
I, SUSAN BUCHER, SUPERVISOR OF ELECTIONS, for Palm Beach County, Florida, do
hereby certify that 29 signatures on the Nominating Petitions of GERALD "JERRY"
TAYLOR for MAYOR of BOYNTON BEACH 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 GERALD S. TAYLOR is a registered voter in Precinct 3200, in
the City of Boynton Beach, Florida.
Signed, this the 4th day of November, 2015.
` ...a L 7
S 'SAN BUCHER
SUPERVISOR OF ELECTIONS sec c, �r
- PALM'BEACH COUNTY C;.i rn`
,(SE �� f
The City of Boynton Beach
; •r "' o f - 4 City Clerks Office
100 E BOYNTON BEACH BLVD e`9
g BOYNTON BEACH FL 33435 (xi ``
(561) 742 -6060 a �
.r . FAX: (561) 742 -6090 c n f'' r .f E -mail: prainitoj @bbfl.us l c,
www.boynton- beach.org
cn;o
PUBLIC NOTICE
OD
TO: CANDIDATES, POLITICAL PARTIES AND OTHERS c
NOTICE IS HEREBY GIVEN that the Logic & Accuracy (L&A) testing of the
voting equipment to be used in the March 15, 2016 General Election will be
held:
Wednesday, February 24, 2016 @ 10:00 a.m.
Supervisor of Elections Warehouse
7835 Central Industrial Drive
Riviera Beach, Florida
RECEIPT of this notice is hereby documented:
tel..,./ / /
Signature / Date Received
DETACH
IF YOU AND /OR YOUR REPRESENTATIVE(S) plan(s) to attend the Logic &
Accuracy (L&A) testing on F b wick c2'- ifgO t(v , please detach
and return the lower portion of this notice to the City Clerk.
Signature #Attending
S: \CC \WP\ELECTION\YEAR 2016 \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
CiTY OF 80Y�dT0�l
CITY GLE T S OFFICE BEACH
CANDIDATE OATH —
1514 -5 PM 3.
NONPARTISAN OFFICE
(Not for use by Judicial or
School Board Candidates)
OFFICE USE ONLY
OATH OF CANDIDATE
(Section 99.021, Florida Statutes)
I, re-, /L 0 K.
(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 1 /0)t
(office) (district #)
; I am a qualified elector of / D /}l fl' /3 G✓!G/�( 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; 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; and I will support the Constitution of the United States and the Constitution of the
State of Florida.
( t ) 79 /1 y�v�ca� sou,
-47 = . ,���
Signature Candidate Telephone Number Email Address
fo fro W tFedc . 33f AZ
Address City State ZIP Code
Candidate's Florida Voter Registration Number (located on your voter information card): //c) PCq 6 P ?
* 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 de
STATE OF FLORIDA
COUNTY OF PALM 2EACI
Sworn to (or affirmed) and subscribed before me this day of NOIe91Y1I , 20 IJ .
SOL
Personally Known: or vogis • PA:o.„Li
Sig i ature of Notary Public
Produced Identification: P -' t, Type, or Stamp Commissioned Name of Notary Public
Type of Identification Produced: Y ay,,•
JANET M. PRAINITO
'!'*=
MY COMMISSION # FF 142411
EXPIRES: S
e 'tember • •
r
nY,�,(iT niviv• u ic erwrite
DS -DE 25 (Rev. 5/11) _ .0001, F.A.C.
CANDIDATE PETITION
Notes: - All information on this form becomes a public record upon receipt by the Supervisor of Elections.
- It is a crime to knowingly sign more than one petition for a candidate. [Section 104.185, Florida Statutes]
- If all requested information on this form is not completed, the form will not be valid as a Candidate Petition form. ---'" L Ig � 5 LCC 5 44 `� the undersigned, a registered voter
(print name as it appears on your voter information card)
in said state and county, petition to have the name of . c't2 t CIAO (C3
placed on the Primary/General Election Ballot as a: [check/complete box, as applicable]
n onpartisan ❑ No party affiliation ❑ Party candidate for the office of
R;Ok-1 r 7ci \ op{
(insert title of office and include district, circuit, group, seat number, if applicable)
Date of Birth or Voter Registration Number Address l
` /Gi.q IZc Sw►1i Avg
.cl abli . 11�' Zip C
33
�
Signat o r Date Signed (MM /DD/YY)
[to be c mpleted y Voter]
14 ILA) I
Rule 1S- 2.045, F.A.C. DS -DE 104 (Eff. 09/11)
I �
CO
E G1
I 1. e ^ -- at"
'c:-:. r.
yw
' I
SUPERVISOR OF LFCTIO
2015 ETON -44 AM 9: II I
I L ; CANDIDATE PETITION
Notes: -All information on this form becomes a public record upon receipt by the Supervisor of Elections. PrZ7
- It is a crime to knowingly sign more than one petition for a candidate. [Section 104.185, Florida Statutes]
- If all requested information on this form is not completed, the form will not be valid as a Candidate Petition form.
y ( /13 S i c . � G the undersigned, a registered voter
(print name as it appears on your voter information card)
in said state and county, petition to have the name of Gerald "Jerry" Taylor
placed on the Primary/General Election Ballot as a: [check/complete box, as applicable]
I Nonpartisan ❑ No party affiliation ❑ Party candidate for the office of
Mayor
(insert title of office and include district, circuit, group, seat number, if applicable)
Date of Birth or Voter. Registration Number Address
(MM /DDIYY)
(9& ° /r$ i / Q ,(12 G)
City County State Zip Code
Boynton Beach Palm Beach Florida
Signature of Voter Date Signed (MM /DD/YY)
�ff [to be completed by Voter]
?
Rule 1 2.045,
DS -DE 104 (Eff. 09/11)
Political advertisement pald for and approved by Jerry Taylor for Mayor.
•
'..ifi ErVISCR OF E1 .0 ]G,`= .
2015 N V -14 AM 9: 14 I
' L bE ` i-Th `" ' ' ` ` "" CANDIDATE PETITION
Notes: - All information on this form becomes a public record upon receipt by the Supervisor of Elections,
- It is a crime to knowingly sign more than one petition for a candidate. [Section 104.185, Florida Statutes]
- If all requested information on this form is not completed, the form will not be valid as a Candidate Petition form.
th undersigned,
-�-�' ����� /� � � ��/� -�lC� a registered voter
(print name as It appears on your voter information card)
in said state and county, petition to have the name of Gerald "Jerry" Taylor
placed on the Primary/General Election Ballot as a: [check/complete box, as applicable]
r Nonpartisan ❑ No party affiliation ❑ Party candidate for the office of
•
Mayor
(Insert title of office and include district, circuit, group, seat number, if applicable)
Date of Birth or Voter. Registration Number Address
(MMIDDIYY)
I�
City County State Zip Code
Boynton Beach Palm Beach Florida '74‘
Signatu : • f V- ter Date Signed (MM/DD/YY)
4 [to be comp to by V oter
Rule 1S•2.045, F.A.C. DS•DE 104(Eff. 09/11)
Political advertisement paid for and approved by Jerry Taylor for Mayor.
SUPERVISOR OF I LEC€UON
2010 NOV -4 Ali 9 :42
CANDIDATE PETITION
I/ i
Notes: - All information on this form becomes a public record upon receipt by the Supervisor of Elections.
- It is a crime to knowingly sign more than one petition for a candidate. [Section 104.185, Florida Statutes]
- Ilan requested information on this form is not completed, the form will not be valid as a Candidate Petition form.
I °4' 'e d e a i1 iG 7 the undersigned, a registered voter
(print name as It appears on your voter Information card)
in said state and county, petition to have the name of Gerald "Jerry" Taylor
placed on the Primary /General Election Ballot as a: [check/complete box, as applicable]
IA Nonpartisan ❑ No party affiliation ❑ Party candidate for the office of
Mayor
(Insert title of office and include district, circuit, group, seat number, If applicable)
Date of Birth or Vo er.Regl tration Number Address
`DD 03 0 7 q � 5 C G 3 6 /V , T✓c/ Vt
City County State Zip Code
Boynton Beach Palm Beach Florida [ J .. 3_. ? </ 3_1-5-
Signature •, ote Date Signed (MMJDD/YY)
dilli -1:p .7
[to be comp' ted by ter]
Rule 13- 2.048, A.C. DS•DE 104 (Eff. 09/11)
Political advertisement pald for and approved by Jerry Taylor for Mayor.
•
,
SUPERVISOR Of ELEC -TI H
20i5 NOV -14 M1 9: 42
PALM BEACH ' T GA NDIDATE PETITION
Notes: - All information on this form becomes a public record upon receipt by the Supervisor of Elections.
- It is a crime to knowingly sign more than one petition for a candidate. [Section 104.185, Florida Statutes]
- If all requested information on this form is not completed, the form will not be valid as a Candidate Petition form
, .. 4 n- 'c f ( A the undersigned, a registered voter
(print name as It appears on your voter information card)
In said state and county, petition to have the name of Gerald "Jerry" Taylor
placed on the Primary /General Election Ballot as a: [checWcomplete box, as applicable]
00 Nonpartisan 0 No party affiliation 0 Party candidate for the office of
Mayor
(Insert title of office and include district, circuit, group, seat number, if applicable)
Date of Birth or Voter. Registration Number Address
MM/DD
1 L (0 !mac Ld c.a 1 \ 41 cs
City County State Zip Code
Boynton Beach Palm Beach Florida , . `(
4 .
Signature of Voter v, Date Signed (MM /DD/YY)
'-'] (-)L(-)j-) .--- - - lie: 2 — z —,,,..__ JO be completed by Voter
_� (c - -C
Rule 15•2.045, F A.C, DS•DE 104 (Eff. 09/11)
Political advertisement paid for and approved by Jerry Taylor for Mayor.
S E Vl`.3 11 OF ELtrCi 0 §t;.
2015 NOV ° Ali 9: 42
tit\!TVG. , 14s} j }'„ CANDIDATE PETITION
Notes: - All information on this form becomes a public record upon receipt by the Supervisor of Elections.
- It is a crime to knowingly sign more than one petition for a candidate. [Section 104.185, Florida Statutes]
- If all requested information on this form is not completed, the form will not be valid as a Candidate Petition fo .
AI ' t 24? 4 A- 1 - C the undersigned, a registered voter
(print name as k appears on your voter Information card)
in said state and county, petition to have the name of Gerald "Jerry" Taylor
placed on the Primary /General Election Ballot as a: [check/complete box, as applicable]
10 Nonpartisan ❑ No party affiliation ❑ Party candidate for the office of
Mayor
(insert title of office and include district, circuit, group, seat number, If applicable)
Date of Birth or Voter•Registration Number Address
(MM/DDNYY)
( - )0 7/( 74'7 , 406Y. 5 ,r.." a A I ea g
City County State Zip Code
Boynton Beach Palm Beach Florida
Signature of Voter Date Signed (MM /DD/YY)
[to be completed by Voter]
/1/4 5
Rule 15.2.045, F.A.C. i DS -DE 104 (Eff. 09111)
Political advertisement paid for and approved by Jerry Taylor for Mayor,
StipERVISOR OF REM US
2815 NOY -4 Ati 9: 42
CANDIDATE PETITION
Notes: - All information on this form becomes a public record upon receipt by the Supervisor of Elections,
- It is a crime to knowingly sign more than one petition for a candidate. [Section 104.185, Florida Statutes]
- If all requested information on this form is not completed, the form will not be valid as a Candidate Petition for .
'"°1 JOA4 - 1i. /L1,6M4ti the undersigned, a registered voter
(print name as it appears on your voter information card)
In said state and county, petition to have the name of Gerald "Jerry" Taylor
placed on the Primary/General Election Ballot as a: [check/complete box, as applicable]
r Nonpartisan ❑ No party affiliation ❑ Party candidate for the office of
Mayor
(insert title of office and include district, circuit, group, seat number, if applicable)
Date of Birth or Voter Registration Number Address
(MM /DD/YY)
Etf- O 2 2 t! 3 G c - ( D COuwdu 14 i°i - PI,
City County State Zip Code
Boynton Beach Palm Beach Florida ,, 3 3 Ci Z 6'
Signature of Voter Date Signed (MM /DD/YY)
[to be completed by Voter]
L,� C 11 - 0-- 15
Rule 1S- 2.045, F.A.C. DS -DE 104 (Eff. 09 /11)
Political advertisement pald for and approved by Jerry Taylor for Mayor.
SUPERVISOR Od ELEC tM _
2015 NOV - Rj4 9:42
CANDIDATE PETITION ti
Notes: - All information on this form becomes a public record upon receipt by the Supervisor of Elections.
- It is a crime to knowingly sign more than one petition for a candidate. [Section 104.185, Florida Statutes]
- If all requested information on this form is not completed, the form will not be valid as a Candidate Petition form.
I, 1 J ✓ `�. , h g t \ � the undersigned, a registered voter
(print name as it appears on your voter information card)
in said state and county, petition to have the name of Gerald "Jerry" Taylor -
placed on the Primary/General Election Ballot as a: [check/complete box, as applicable]
Nonpartisan ❑ No party affiliation ❑ Party candidate for the office of
Mayor
(insert title of office and include district, circuit, group, seat number, if applicable)
Date of Birth or Voter Registration Number Address
(MM/ D/YY)
9 7 7 710 L-z.r- p 7 j- e.
City County State Zip Code
Boynton Beach Palm Beach Florida -
? q 5 i�'
Signature of Vote Date Signed (MM /DD/YY)
/I
[to be co pleted by Voter]
1 i 3 7 ( c ..,--
Rule 1S- 2.045, F.A.C.// / -DE 104 (Eff. 09/11)
I/ Political advertisement paid for and approved by Jerry Taylor for Mayor.
CANDIDATE PETITION
Notes: - All information on this form becomes a public record upon receipt by the Supervisor c f Elections.
- It is a crime to knowingly sign more than one petition for a candidate. [Section 104.185, Florida Statutes] L'714)5
- kfall requested information on this form is not completed, the form will not be valid as a Candidate Petition form.
I r ,4/ the undersigned, a registered, voter
(pnnt name as it appears on your voter information card)
in said state and county, petition to have the name of Gerald "Jerry" Taylor
placed on the Primary/General Election Ballot as a: [check/complete box, as applicable]
[I Nonpartisan ❑ No party affiliation ❑ Party candidate for the office of
Mayor
(insert title of office and include district, circuit, group, seat number, if applicable)
Date of Birth or Voter Registration Number Address 11.1i+ s'Z
(MM /DD/YY)
K' 760 c-)cm A -dc -- 62 , i,der,fac__VP.
City County State Zip Code ` - ' 9
1.7 Boynton Beach Palm Beach Florida ,33,33 —
ry
Signature of Voter Date Signed (MM /DD/YY) .: -`
[to be completed by Voter]
J ' 1 ' 1 / � 7/Z UV to
Rule 1S -2.045 F.A.C. DS -DE 104 Eff. 09/11 "'''' .
Political advertisement paid for and approved by Jerry Taylor for Mayor. r--
CANDIDATE PETITION
I Notes: - All information on this form becomes a public record upon receipt by the Supervisor cfElections.
- It is a crime to knowingly sign more than one petition for a candidate. [Section 104.185, Florida Statutes]
- if all requested irformation on this form is not completed, the form will not be valid as a CandidattPetition form.
I �� M4. s AA Co—rr the undersigned, a registered voter
(print name as it appears on your voter information card) `
in said state and county, petition to have the name of Gerald "Jerry" Taylor
placed on the Primary/General Election Ballot as a: [check/complete box, as applicable]
%Nonpartisan ❑ No party affiliation ❑ Party candidate for the office of
Mayor
(insert title of office and include district, circuit, group, seat number, if applicable)
Date of Birth or Voter Registration Number Address
(MM /DD/YY) Og 1 / 3 /10 I ( S e/Vs; v �/
C 21u = /lc--/
City County State Zip Code
Boynton Beach Palm Beach Florida g 3 0 z� .t
Signature of Voter Date Signed (MM /DD/YY) F :j
[to be completed by Voter] a
/ - 4., - AI. ' ••• --- \\) I xe.
Rule 1S- 2.045 F.A.C. C DS -DE 104 (Eff. 09/11) r f
Political advertisement paid for and approved by Jerry Taylor for Mayor. - La
IN)
auPERVISOR OF ELECTIONS-
2015 NOV -4 AN 9: 42
CANDIDATE PETITION /
Notes: - All information on this form becomes a public record upon receipt by the Supervisor of Elections.
- It is a crime to knowingly sign more than one petition for a candidate. [Section 104.185, Florida Statutes]
- If all requested information on this form is not completed, the form will not be valid as a Candidate Petition for .
TcN k-Qc2 the undersigned, a registered voter
(print name as It appea s on your voter information card)
in said state and county, petition to have the name of Gerald "Jerry" Taylor
placed on the Primary/General Election Ballot as a: [check/complete box, as applicable]
10 Nonpartisan ❑ No party affiliation ❑ Party candidate for the office of
Mayor
(insert title of office and include district, circuit, group, seat number, if applicable)
Date of Birth or Voter Registration Number Address
(MM /DD
City County State Zip Code
Boynton Beach Palm Beach Florida
Signature of Voter Date Signed (MMIDD/YY)
[to be completed by Voter]
Rule 18-2.045, F.A.C. DS•DE 104 (Eff. 09/11)
Political advertisement paid for and approved by Jerry Taylor for Mayor.
GliPERVISOR OF ELEGTIM
2015 NOV - 419 42
r.
CANDIDATE PETITION
Notes: - All information on this form becomes a public record upon receipt by the Supervisor of Elections, p\
- It is a crime to knowingly sign more than one petition for a candidate. [Section 104.185, Florida Statutes]
- If all requested information on this form is not completed, the form will not be valid as a Candidate Petition form.
I, O0' Ott' ,- / 4 the undersigned, a registered voter
(print name as it appears on your voter information card)
in said state and county, petition to have the name of Gerald "Jerry" Taylor
placed on the Primary/General Election Ballot as a: [check/complete box, as applicable]
I Nonpartisan ❑ No party affiliation ❑ Party candidate for the office of
Mayor
(insert title of office and include district, circuit, group, seat number, if applicable)
Date of Birth or Voter. Registration Number Address
ofV o f fer /27 /z `!4 ,7 i - B., FL.
1
City County State Zip Code
Boynton Beach Palm Beach Florida 33P
Signature of Vote A Date Signed (MM /DD/YY)
• .41r- [to be c mpleted by Voter]
iv /0 )30," 3
Rule 1S- 2.045, F.A.C.
DS -DE 104 (Eff. 09/11)
Political advertisement paid for and approved by Jerry Taylor for Mayor.
SUPERVISOR of :, E ri f,A I
2015NOV -4 AM 9: 42
CANDIDATE PETITION
Notes: - All information on this form becomes a public record upon receipt by the Supervisor of Elections.
- It is a crime to knowingly sign more than one petition for a candidate. [Section 104.185, Florida Statutes]
- If all requested information on this form is not completed, the form will not be valid as a Candidate Petition form.
1 ' 1. A ui X 6.1?/ c .
//. VA/y g 7 t YZ K the undersigned, a registered voter
(print name as it appears on your voter information card)
In said state and county, petition to have the name of Gerald "Jerry" Taylor
placed on the Primary/General Election Ballot as a: [check/complete box, as applicable]
I Nonpartisan 0 No party affiliation ❑ Party candidate for the office of
Mayor
(insert title of office and include district, circuit, group, seat number, if applicable)
Date of Birth or Voter Registration Number Address
(MM /DDNY)
-/ erg j-3 Rt, 5 W /V Alfr
City County State Zip Code
Boynton Beach Palm Beach Florida 3 3 V.,/-
Signat a of Voter e--(A
Date Signed (MM /DDNY)
% �� a7 [to be completed by Voter]
a ' a-,� G O� 1/ 03 — 1
Rule 1S- 2.045, F.A.C. DS•DE 104 (EH. 09111)
Political advertisement paid for and approved by Jerry Taylor for Mayor.
2015 NOV -14 AN 9: 42
RAtii e,i x`
CANDIDATE PETITION
Notes: - All information on this form becomes a public record upon receipt by the Supervisor of Elections. ‘..4k5
- It is a crime to knowingly sign more than one petition for a candidate. [Section 104.185, Florida Statutes]
- If all requested information on this form is not completed, the form will not be valid as a Candidate Petition form.
I, ,n /(5 / /41, T ` /ij4/ /{5/c A/T the undersigned, a registered voter
r � (print name as appears on your voter information card)
In said state and county, petition to have the name of Gerald "Jerry" Taylor
placed on the Primary/General Election Ballot as a: [check/complete box, as applicable]
0 0 Nonpartisan ❑ No party affiliation ❑ Party candidate for the office of
Mayor
(insert title of office and include district, circuit, group, seat number, if applicable)
Date of Birth or Voter. Registration Number Address
(MM /DD/YY) 0 / -- a 3 — a 2 sle9
City County State Zip Code
Boynton Beach Palm Beach Florida "53 'z
Signature of Voter Date Signed (MM /DD/YY)
[to be completed by Voter]
1l �C f /�j 1j /G /� � // -
Rule 1S-2.045, F.A.C. DS -DE 104 (Eft 09/11)
Political advertisement paid for and approved by Jerry Taylor for Mayor.
WPM/ ISOR OF FLECTIRIC
2015 NOV -1.4 ii 9: ti 2
CAN DIDATE PETITION
Notes: - All information on this form becomes a public record upon receipt by the Supervisor of Elections.
- It is a crime to knowingly sign more than one petition for a candidate. [Section 104.185, Florida Statutes]
- If all requested information on this form is not completed, the form will not be valid as a Candidate Petition fo .
e the undersigned, a registered voter
(print name as it appears on your voter information card)
in said state and county, petition to have the name of Gerald "Jerry" Taylor
placed on the Primary /General Election Ballot as a: [check/complete box, as applicable]
IX Nonpartisan D No party affiliation ❑ - Party candidate for the office of
Mayor
(insert title of office and include district, circuit, group, seat number, if applicable)
Date of Birth or Voter Registration Number Address
(MM7 +9 r,
Rk-kRAk
City County State Zip Code
Boynton Beach Palm Beach Florida 3 r1`�--4'
igna re of Vote Date Signed (MM /DD /YY)
go. ' ®
to be comp fe by gofer]
Rule 15- 2.045, F.A.C. \. DS -DE 104 (Eff. 09/11)
'olitical advertisement paid for and approved by Jerry Taylor for Mayor.
2015 NOV -E4 MI 9 14 2
Y
CANDIDATE PETITION /
Notes: - All information on this form becomes a public record upon receipt by the Supervisor of Elections. 1/ �
- It is a crime to knowingly sign more than one petition for a candidate. [Section 104.185, Florida Statutes]
- If all requested information on this form is not completed, the form will not be valid as a Candidate Petition form.
/1/4//r i ee VGO the undersigned, a registered voter
(print name as it appears on your voter information card)
in said state and county, petition to have the name of Gerald "Jerry" Taylor
placed on the Primary/General Election Ballot as a: [check/complete box, as applicable]
%Nonpartisan ❑ No party affiliation ❑ Party candidate for the office of
Mayor
(insert title of office and include district, circuit, group, seat number, if applicable)
Date of Birth or Voter Registration Number Address
(MM/DD/Yy)
City County State Zip Code
Boynton Beach Palm Beach Florida 33 9a6
Signature of Voter Date Signed (MM /DD/YY)
[to be completed by Voter]
/I / / 5
Rule 1S -2.045 .A.C. DS -DE 104 (Eff. 09/11)
Political advertisement paid for and approved by Jerry Taylor for Mayor.
SUPEPO1MOR OF EI,ECTiGn
2065 NOV --4 AM 9: 43
CANDIDATE PETITION /
Notes: - All information on this form becomes a public record upon receipt by the Supervisor of Elections. ‘,/ _
- It is a crime to knowingly sign more than one petition for a candidate. [Section 104.185, Florida Statutes]
If all requested information on this form is not completed, the form will not be valid as a Candidate Petition fo .
F s )C } A-R F/ o i ' the undersigned, a registered voter
(p IQ (print name as it appears on y our voter information card)
in said state and county, petition to have the name of Gerald "Jerry" Taylor
placed on the Primary/General Election Ballot as a: [check/complete box, as applicable]
IX Nonpartisan ❑ No party affiliation ❑ Party candidate for the office of
Mayor
(insert title of office and include district, circuit, group, seat number, if applicable)
Date of Birth or Voter Registration Number Address
(MM /DD/YY) p (C\ / /'�/71J-� /j t
City County State Zip Code
Boynton Beach Palm Beach Florida
Signature of Voter Date Signed (MM /DD/YY)
&IA) I fLAI
[to be completed by Voter]
I( ,/
Rule 1S- 2.045, F.A.C. DS -DE 104 (Eff. 09/11)
Political advertisement paid for and approved by Jerry Taylor for Mayor.
upr vls R OF ELECTIONa
2015 NOV -4 A 9: 43
CANDIDATE PETITION
Notes: - All information on this form becomes a public record upon receipt by the Supervisor of Elections.
- It is a crime to knowingly sign more than one petition for a candidate. [Section 104.185, Florida Statutes] t/A-deD
- If all requested information on this form is not completed, the form will not be valid as a Candidate Petition form.
Ate the undersigned, a registered voter
(print name as it appears on your voter information card)
in said state and county, petition to have the name of Gerald "Jerry" Taylor
placed on the Primary/General Election Ballot as a: [check/complete box, as applicable]
Nonpartisan ❑ No party affiliation 0 Party candidate for the office of
Mayor
(insert title of office and include district, circuit, group, seat number, if applicable)
Date of Birth or Voter Registration Number Address
(MM /DD/YY)
City County State Zip Code
Boynton Beach Palm Beach Florida
Signatu of oter Date Signed (MM /DD /YY)
[to be completed by Voter]]
Rule 1S- 2.045, F.A.C. DS -DE 104 (Eff. 09/11)
Political advertisement paid for and approved by Jerry Taylor for Mayor.
SUPERVISOR OF EL Nt7 4t
2015 NOV -4 All 9 43
PALKETAC!zi
CANDIDATE PETITION
Notes: - All information on this form becomes a public record upon receipt by the Supervisor of Elections.
- It is a crime to knowingly sign more than one petition for a candidate. [Section 104.185, Florida Statutes]
- If all requested information on this form is not completed, the form will not be valid as a Candidate Petition form.
I, n 1 nn the undersigned, a registered voter
(print name as it appears on your voter information card)
in said state and county, petition to have the name of Gerald "Jerry" Taylor
placed on the Primary/General Election Ballot as a: [check/complete box, as applicable]
IX Nonpartisan ❑ No party affiliation ❑ Party candidate for the office of
Mayor
(insert title of office and include district, circuit, group, seat number, if applicable)
Date of Birth or Voter Registration Number Address / �
(MM /DD/YY) JCo. /CE-/LQcSSC 1C. ' r vt o nS
�d
®9I 1 4 � 4i 14prt. *4
City County State Zip Code
Boynton Beach Palm Beach Florida 3�7�
ignature of Voter Date Signed (MM /DD/YY)
[to be completed by Voter]
Rule 76. 2.045, F.A.C. DS -DE 104 (Eff. 09/11)
Political advertisement paid for and approved by Jerry Taylor for Mayor.
r Et y.
tIO
2015 NOV _L AM 9.43
C PETITION a
N
l A 5
otes: - All information on this form becomes a public record upon receipt by the Supervisor of Elections. �✓
- It is a crime to knowingly sign more than one petition for a candidate. [Section 104.185, Florida Statutes]
- If all requested information on this form is not completed, the form will not be valid as a Candidate Petition form.
I, 4-71- g 1 / A� 0A-4-6, (� D c 6 A-4615±-79- the undersigned, a registered voter
� (pprint name as it appears on your voter information card)
in said state and county, petition to have the name of Gerald "Jerry" Taylor
placed on the Primary/General Election Ballot as a: [check/completebox, as applicable]
IX Nonpartisan ❑ No party affiliation ❑ Party candidate for the office of
Mayor
(insert title of office and include district, circuit, group, seat number, if applicable)
Date of Birth or Voter Registration Number Address / y
(MM /DD/YY) S j C i < -- b . r/
City County State Zip Code
Boynton Beach Palm Beach Florida 31 74
Signatur of Voter _ Date Signed (MINI /DD /YY)
p / [to be co pl ted by Voter]
/.# / Rule 1S- 2.045, F.A.C. DS -DE 104 (Eff. 09/11)
Political advertisement paid for and approved by Jerry Taylor for Mayor.
SUPER-Vrnfi OF ELECT1O `
2015 NOV -4 AM 9: 143
CANE'FPA F E tf` iO
Notes: - All information on this form becomes a public record upon receipt by the Supervisor of Elections.
3
- It is a crime to knowingly sign more than one petition for a candidate. [Section 104.185, Florida Statutes]
- If all requested information on this form is not completed, the form will not be valid as a Candidate Petition for 0
1, O--Vkt 30 c...» V \, 9-C o ,V� the undersigned, a registered voter
(print name as it appears on your voter information card)
in said state and county, petition to have the name of Gerald "Jerry" Taylor
placed on the Primary/General Election Ballot as a: [check/complete box, a,s applicable]
Nonpartisan ❑ No party affiliation ❑ Party candidate for the office of
Mayor
(insert title of office and include district, circuit, group, seat number, if applicable)
Date of Birth or Voter Registration Number Address
(M F
M/ D/YY) ed e A Ri 'R I o g.
OrIPZOf' .)-0 14 Sou-ten
City County State Zip Code
Boynton Beach Palm Beach Florida '33(435— _
Signature of Voter Date Signed (MM /DD/YY)
[to be compl ted by Voter]
r /LI AL d 6L--6--N,Li ri,..e.,...,.....„ ill + J
Rule 1S -2.045 F.A.C.
DS -DE 104 (Eff. 09/11)
Political advertisement paid for and approved by Jerry Taylor for Mayor.
SUP Jr l SOR-OFELECTIqiiS .
7015 NOV - AM 9: 1 43
PAtimcfSNPIPANTE PETITION
Notes: - All information on this form becomes a public record upon receipt by the Supervisor of Elections.
- It is a crime to knowingly sign more than one petition for a candidate. [Section 104.185, Florida Statutes]
- If all requested information on this form is not completed, the form will not be valid as a Candidate Petition form.
I, the undersigned, a registered voter
(print name as it appears on your voter information card)
in said state and county, petition to have the name of Gerald "Jerry" Taylor
placed on the Primary/General Election Ballot as a: [check/complete box, as applicable]
%Nonpartisan ❑ No party affiliation ❑ Party candidate for the office of
Mayor
(insert title of office and include district, circuit, group, seat number, if applicable)
Date of Birth or Voter Registration Number Address
(MM /DD/YY)
SI 30 ) !� of $ Q,0 7 A
City County State Zip Code
Boynton Beach Palm Beach Florida 3`P9‘
Signature of Voter Date Signed (MM /DD/YY)
[to be com !et d by Voter]
/(/ /'
Rule 1S- 2.045, F.A.C. DS -DE 104 (Eff. 09/11)
Political advertisement paid for and approved by Jerry Taylor for Mayor.
",�J► �rI t �'� V ELtZI' 4
2V5 WV —14 MM 9. 4 3
e 04, ,
CANDIDATE PETITION
Notes: - All information on this form becomes a public record upon receipt by the Supervisor of Elections.
- It is a crime to knowingly sign more than one petition for a candidate. [Section 104.185, Florida Statutes] A C:7
- If all requested information on this form is not completed, the form will not be valid as a Candidate Petition form.
1, ,�p 2 r -,.0
the undersigned, a registered voter
(print name as it appears on your voter information card)
in said state and county, petition to have the name of Gerald "Jerry" Taylor
placed on the Primary /General Election Ballot as a: [check/complete box, as applicable]
II Nonpartisan ❑ No party affiliation ❑ Party candidate for the office of
Mayor
(insert title of office and include district, circuit, group, seat number, if applicable)
Date of Birth or Voter. Registration Number Address
(MM/DDNY) lAko,r \ COL -c-C. �"
6,/ flo ��lea 41,
City County State Zip Code
Boynton Beach Palm Beach Florida 3313
Signa - .f Voter Date Signed (MM /DD/YY)
d [to be completed by Voter]
/ 1110 f 15
RuI = •2.045, F.A DS-DE 104 (Eff. 09/11)
Political advertisement paid for and approved by Jerry Taylor for Mayor.
Je
,
W ERVISCR OF . ELECTIdtth
Di5 EV -4 hri 9 :43
141ji ttNb r P ETITION
Notes: - All information on this form becomes a public record upon receipt by the Supervisor of Elections. ipc
- It is a crime to knowingly sign more than one petition for a candidate. [Section 104.185, Florida Statutes]
- If all requested information on this form is not completed, the form will not be valid as a Candidate Petition form.
1, cl dike lA the undersigned, a registered voter
(print name nit appears on your voter information card) -
In said state and county, petition to have the name of Gerald "Jerry" Taylor
placed on the Primary/General Election Ballot as a: [check/complete box, as applicable]
IV Nonpartisan ❑ No party affiliation . ❑ Party candidate for the office of
Mayor
(Insert title of office and include district, circuit, group, seat number, If applicable)
Date of Birth or Voter Registration Number Address
(MM/DDIYY) [ a/ 16 ` / i ° l t l < - 3 S � , i/if , 7 o Ni'
City County State Zip Code
Boynton Beach Palm Beach Florida 9 3 •l 3 5
Signature of Vote Date Signed (MMJDD/YY)
/ [to be completed by Voter]
Rule 152.048,F.A.0 /A~/ J
DSODE 104 (Eff. 091111
Political advertisement paid for and approved by Jerry Taylor for Mayor.
fUPERVi U OF ELECTIOM
21115 -Li All 9 :43
M �
. 3
bk► t. NIDATE PETITION
ip
Notes: - All information on this form becomes a public record upon receipt by the Supervisor of Elections.
- It is a crime to knowingly sign more than one petition for a candidate. [Section 104.185, Florida Statutes]
- If all requested information on this form is not completed, the form will not be valid as a Candidate Petition form.
I, 3, the undersigned, a registered voter
(print name as it appears on your voter information card)
in said state and county, petition to have the name of Gerald "Jerry" Taylor
placed on the Primary/General Election Ballot as a: [check/complete box, as applicable]
Nonpartisan ❑ No party affiliation ❑ Party . candidate for the office of
Mayor
(insert title of office and include district, circuit, group, seat number, if applicable)
Date of Birth or Voter.Registratlon Number Address 7/K
(MM /DDIYY)
City County State Zip Code
Boynton Beach Palm Beach Florida
Signature of Voter Date Signed (MM /DD/YY)
[to be completed by Voter]
// Z/s
Rule 1S•2.045, F.A.C.
DS-DE 104 (Eff. 09/11)
Political advertisement paid for and approved by Jerry Taylor for Mayor.
SUPERVISOR OF ELECTIONS
2015 NOV — AM 9: 143
CANDIDATE PETITION
Notes: - All information on this form becomes a public record upon receipt by the Supervisor of Elections.
- It is a crime to knowingly sign more than one petition for a candidate. [Section 104.185, Florida Statutes]
- Vail requested information on this form is not completed, the form will not be valid as a Candidate Petition form.
I, J (, 0,r 25 rt&i pu3 A/ the undersigned, a registered voter
(print name as it appears on your voter information card)
in said state and county, petition to have the name of Gerald "Jerry" Taylor
placed on the Primary/General Election Ballot as a: [check/complete box, as applicable]
I Nonpartisan ���
p ❑ No party affilia ❑ �= `_'� =�'� Party candidate for the office of
Mayor
(insert title of office and include district, circuit, group, seat number, if applicable)
Date of Birth or VoterRegistration Number Address
(MM /DD/YY) ( ` 3 j
l 076 5, kis vl 6 K ve
City County State Zip Code
Boynton Beach Palm Beach Florida 5,V olh
Signature of Voter Date Signed (MM/DD/YY)
� 7 [to be completed by Voter]
Rule 1S- 2.045, F.A.C. DS -DE 104 (Eff. 09/11)
Political advertisement paid for and approved by Jerry Taylor for Mayor.
SUPERVISOR F ELECTIONS `
2015 NOV -4 AN 9 43
CAND ` A I'E 8 . N ..'
Notes: - All information on this form becomes a public record upon receipt by the Supervisor of Elections. V
- It is a crime to knowingly sign more than one petition for a candidate. [Section 104.185, Florida Statutes]
- Ilan requested information on this form is not completed, the form will not be valid as a Candidate Petition form.
I,
O A , a ] Z r k - K '
t the undersigned, a registered voter
(print name as it appea on your voter Information card)
in said state and county, petition to have the name of Gerald "Jerry" Taylor
placed on the Primary /General Election Ballot as a: [check/complete box, as applicable]
ix Nonpartisan ❑ No party affiliation
Party candidate for the office of
Mayor
(insert title of office and include district, circuit, group, seat number, if applicable)
Date of Birt or Voter. Registration Number Address COL. — )'k ri c E it f
.), 4( 4(0
City County State Zip Code , (---
Boynton Beach Palm Beach Florida `D
Signatur • Vote r Date Signed (MM /DD/YY)
e co plet d
[ta b by Voter] A.,_ 4 0 ,
r
Rule 1S -2.045 F A •. ` 1 i DS•DE 104 Eff( 09 L
Politic:I adverbs ment paid for and approved by Jerry Taylor for Mayor.
SUPERVISOR OF FLT-' TI K:.
20I5 NOV -14 AM 9: t:3 .'
CANDIDATE PETITION
1.../cp
Notes: - All information on this form becomes a public record upon receipt by the Supervisor of Elections.
- It is a crime to knowingly sign more than one petition for a candidate. [Section 104.185, Florida Statutes]
- If all requested information on this form is not completed, the form will not be valid as a Candidate Petition form.
UCa -ne,T Is.._e(. Proji n i TC) the undersigned, a registered voter
(print name as it appears on your voter information card)
in said state and county, petition to have the name of Gerald "Jerry" Taylor
placed on the Primary/General Election Ballot as a: [check/complete box, as applicable]
IX Nonpartisan - No party affiliation ❑ Party candidate for the office of
Mayor
(insert title of office and include district, circuit, group, seat number, if applicable)
Date of Birth or Voter Registration Number Address
(MM /DD/YY)
DS- 1& -1 q47 /7QD eee< Cf
City County State Zip Code
Boynton Beach Palm Beach Florida ‘3‘13
Signature of Voter Date Signed (MM /DD/YY)
[to be completed by Voter]
/ I / Ca - 6301.5 --
Rule 1 -2.04 .A.C. DS -DE 104 (Eff. 09/11)
Political advertisement pald for and approved by Jerry Taylor for Mayor.
SUPERV,ISOR OF ELECTIONS
7015 NOV ' -t AN 9: 43
CANDIDATE PETITION
Notes: - All information on this form becomes a public record upon receipt by the Supervisor of Elections.
-11 is a crime to knowingly sign more than one petition for a candidate. [Section 104.185, Florida Statutes]
- Ti all requested information on this form is not completed, the form will not be valid as a Candidate Petition form.
1, , �-� i 7/ the undersigned, a registered voter
(prin name as it appears on your voter Information card ) -
in said state and county, petition to have the name of Gerald "Jerry" Taylor
placed on the Primary /General Election Ballot as a: [check/complete box, as applicable]
II Nonpartisan ❑ No party affiliation ❑ Party candidate for the office of
•
Mayor
(Insert title of office and include district, circuit, group, seat number, if applicable)
Date of Birth or Voter. Registration Number Address
(MMIDDIYY) .
69 1 nc)/
City County State Zip Code
Boynton Beach Palm Beach Florida 2 3 26
Signature of 1. Date Signed (MM /DDIYY)
[to be c • m eted by Voter]
Rule 13 2.045,
DS•DE 104 (Eft. 09/11)
Political advertisement paid for and approved by Jerry Taylor for Mayor.
CANDIDATE PETITION
Notes: - All information on this form becomes a public record upon receipt by the Supervisor of Elections.
- It is a crime to knowingly sign more than one petition for a candidate. [Section 104.185, Florida Statutes]
- If all requested information on this form is not completed, the form will not be valid as a Candidate Petition form.
I,
1 S c L D/4? .._ the undersigned, a registered voter
(print name as it appears on your voter information card)
in said state and county, petition to have the name of
placed on the Primary/General Election Ballot as a: [check/complete box, as applicable]
❑ Nonpartisan ❑ No party affiliation ❑ Party candidate for the office of
(insert title of office and include district, circuit, group, seat number, if applicable)
Date of Birth or Voter Registration Number Address
(MM /DD/YY)
a ck6 5 ' 114; 4-444a
City County State Zip Code
Signature of Voter a t fined (MM/DD/YY)
c -- - [to be completed by Voter]
ti� c� � C��1 v / ! /'L/Lt L/
Rule 1S- 2.045, F.A.C. DS -DE 104 (Eff. 09/11)
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1-,UPERVisoR OF JO
20151407 -14 AEA 9:
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CANDIDATE PETITION UZV
Notes: - All information on this form becomes a public record upon receipt by the Supervisor of Elections.
- It is a crime to knowingly sign more than one petition for a candidate. [Section 104.185, Florida Statutes]
- If all requested information on this form is not completed, the form will not be valid as a Candidate Petition form.
I, e �`, N e I , S ' 71- 1 ,. ° - f p the undersigned, a registered voter •
(print name as it appears on your voter information card)
in said state and county, petition to have the name of Gerald "Jerry" Taylor
placed on the Primary/General Election Ballot as a: [check/complete box, as applicable]
IX Nonpartisan ❑ No party affiliation ❑ Party candidate for the office of
Mayor
(insert title of office and include district, circuit, group, seat number, if applicable)
Date of Barth or Voter Registration Number Address
(MM /DD/YY) 1 d s J � e- ea--; L k W •
/ 7 /3 LT I
City County State Zip Code
Boynton Beach Palm Beach Florida ri/A
Signature of Voter Date Signed (MM /DD/YY)
[to be 7m7tedby Voter]
Rule 1S- 2.045, F.A.C. DS -DE 104 (Eff. 09/11)
Political advertisement paid for and approved by Jerry Taylor for Mayor.
CANDIDATE PETITION
Notes: - All information on this form becomes a public record upon receipt by the Supervisor of Elections.
- It is a crime to knowingly sign more than one petition for a candidate. [Section 104.185, Florida Statutes]
- If all requested information on this form is not completed, the form will not be valid as a Candidate Petition forn
6 4 4-1,v s ' � the undersigned, a registered voter
(print name as it appears on your voter - • car.
in said state and county, petition to have the name of
placed on the Primary/General Election Ballot as a: [check/comple e .o , . •plieablel
❑ Nonpartisan ❑ No party affiliation ❑ Party candidate for the office of
(insert title of office and include district, clrcul ,group, sea number, if applicable)
Date of Birth or Voter Registration Number Address
(MM /DD/YY)
rvdV /),j/1 10 .s a� .yam
City County State Zip Code
idt97404r 1 i t /31 3 �
Signature of Voter • ate (MM /DD/YY) � 7 �,��
[to be completed by Voter]
Rule 1S- 2.045, F.A.C. -195DE104 (Eff. 09/11)
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240 SOUTH MILITARY TRAIL
811PERVISOR OF ELECTIONS WEST PALM BEACH, FL 33415
POST OFFICE BOX 22309
SUSAN BUCHER 206 Ifl t -14 AM 9' 43 WEST PALM BEACH, FL 3341 6
Supervisor of Elections TELEPHONE: [5613656-6200
r � ,
1��.��� '3> � FAX NUMBER: C561) 658 -8287
WEBSITE: www.pbcelections.org
PETITION SUBMETTANCE FORM
NAME OF PETITION OR COMMITTEE: /)
C` 0 Ryni,m,
OFFICE TITLE, DISTRICT, GROUP, Ci
SEAT NUMBER (IF APPLICABLE): fn (o< ecyNnTec 1Ri
NUMBER OF PETITIONS SUBMITTED:
•
ADDRESS: , G - c W ►
(STREET)
(CITY /ZIP)
TELEPHONE: C99 - cP6D7
NAME OF PERSON SUBMITTING
PETITION: A�[ l� Z
SIGNATURE:
DATE: I C
Staff Initials: WO
L; ISHARE\OIliceFormsWelition Submit Form REV 05.01- 2012.tloc