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Filing Papers TheFloridaLawOffice.com t r We'll Help you find your way.__ i. Steven Benjamin Grant, Esquire "' � i Attorney & Counselor at Law (DC, FL, MD, WV) a Help @TheFloridaLawOffice.com 24/7 Phone 1- 866 - 385 -1241 ' A Facsimile 1 -561- 423 -3769 200 Knuth Rd, Suite 118 t� ;7,i . j Text/SMS 1- 561 -880 -5529 Boynton Beach, FL 33436 xr_el MATERIAL FOR CANDIDATES YOU HAVE INDICATED YOUR DESIRE TO BECOME A CANDIDATE; THEREFORE, I HAND YOU THE • FOLLOWING: 1. Qualifying Information & Municipal Election Schedule 2. IV Dates to Remember 3. V 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. ` 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. ,� State of Florida Election Laws - Chapters 99, 105 & 106 7. Guide to Sunshine Amendment & Code of Ethics for Public Officers and Employees 8. f 7 Directions for Posting Temporary Political Sign 9. k/ City Map and District Maps 10. t..7 Part I Charter, Article VII. Elections - City of Boynton Beach ® 11. Part II Code of Ordinances - Chapter 2 Administration, Article III. Elections 12. ,/ PoII Watcher Form & FS 101.131- "Watchers at Polls" 13. :.7 Public Campaign Financing Handbook 14. Candidate Petition Handbook 15. Blank Campaign Report Summary Sheets, Contributions Sheets & Expenditures Sheets 16. L ,/ 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 RECEIVED BY 97ell ?coLs Can. idate Signature Date Signed Janet M. Prainito, MMC City Clerk 5/26/2015 3:33 PM S: \CC \WP \ELECTION \YEAR 2016 \Information Packets \MATERIAL FOR CANDATES.doc APPOINTMENT OF CAMPAIGN TREASURER AND DESIGNATION OF CAMPAIGN . : c, -T., DEPOSITORY FOR CANDIDATES I ,ice (Section 106.021(1), F.S.) tri -C (PLEASE PRINT OR TYPE) - c>z •. riw NOTE: This form must be on file with the qualifying w Fn officer before opening the campaign account. OFFICI'`tJSLY 1. CHECK APPROPRIATE BOX(ES): M Initial Filing of Form Re- filing to Change: ❑ Treasurer /Deputy 0 Depository ❑ Office Q Party 2. Name of Candidate (in this order: First, Middle, Last) 3. Address (include post office box or street, city, state, zip code) 136 NE 3rd Avenue Steven B. Grant 4. Telephone 5. E-mail address Boynton Beach, FL 33435 ( 866 ) 385 - 1241 help@TheFloridaLawOffice.com 6. Office sought (include district, circuit, group number) 7.. If a candidate for a nonpartisan office, check if applicable: Mayor J 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 O Write -In No 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 . Steven B. Grant 11. Mailing Address 12. Telephone PO Box 424 ( 561 ) 880 - 5529 13. City 14. County 15. State 16. Zip Code . 17. E - mail address Boynton Beach Palm Beach FL 33425 help @TheFloridaLawOffice.com 18. I have designated the following bank as my 0 Primary Depository E] Secondary Depository 19. Name of Bank 20. Address Wells Fargo Bank 1600 S Federal Hwy 21. City 22. County 23. State 24. Zip Code. Boynton Beach Palm Beach Florida 33435 UNDER PENALTIES OF PERJURY, I DECLARE THAT 1 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 /) // /j P 26. Sign re andi ate /0 X 27. Treasurer's Acceptance:of Appointment (fill in the blanks and check the appropriate block) I Steven B. Grant _ , do hereby: accept the appointment (Please Print. or Type Name) • - - '' •signated above © Campaign Treasurer 0 Deputy Treasurer. F Zoo a te Signature of Campaign Treasurer or Deputy Treasurer DS -DE 9 (Rev. 10/10) Rule 1S- 2.0001, F.A.C. c-) - OFFICE USE ONLY -°° STATEMENT OF C.J' -<` CI -77 CANDIDATE (Section 106.023, F.S.) (Please print or type) _ a o z a +.,. ,c Steven B. Grant candidate for the office of Mayor have been provided access to read and understand the requirements of Chapter 106, Florida Statutes. 40/5/74/5 Signature of 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) RESIDENCY REQUIREMENTS - c*) CFI «� —4 C,-r, .9 co ria St B. Grant o ...4 ''' I, , candidate for (Print Name) Mayor of the City (Mayor /Commissioner m District #) Beach, have received, read and understand the residency requirements of Article II of the Charter of the City of Boynton Beach. dr 6 ,r, i e 4 . (Signature o Ca didate) S S ?O Ls (Date 11/12/2013 12:31 PM S: \CC\WP \ELECTION \Year 2014\Information Packets \RESIDENCY REQUIREMENTS STATEMENT.doc Nimik • 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 : Grant Steven Benjamin • MAILING ADDRESS : c-3 P.O. Box 424 [17.,• C')-.( c� CITY : ZIP : COUNTY : l Boynton Beach, FL 33425 Palm Beach ` cn. NAME OF AGENCY : 21 ' • cri' --t - C3. NAME OF OFFICE OR POSITION HELD OR SOUGHT : tp Mayo of Boynton Beach rrl . 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, 2014 QR ❑ SPECIFY TAX YEAR IF OTHER THAN THE CALENDAR YEAR: MANNER OF CALCULATING REPORTABLE INTERESTS: FILERS HAVE THE OPTION OF USING REPORTING 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 Q)3 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 SOURCE'S DESCRIPTION OF THE SOURCES OF INCOME ADDRESS PRINCIPAL BUSINESS ACTIVITY Self - Employed 200 Knuth Rd, Suite 118, Boynton Beach, FL 33436 Attorney Grant, Rifflcin, & Strauss, P.C. 15204 Omega Drive, Suite 210, Rockville, MD 20850 Attorney 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 "nla ") 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 - See instructions] (If you have nothing to report, write "none" or "n/a") FILING INSTRUCTIONS for when i and where to file this form are 136 NE 3rd Ave, Boynton Beach, FL 33435 located at the bottom of page 2. INSTRUCTIONS on who must file this form and how to fill it out begin on page 3. CE FORM 1 - Effective: January 1. 2015 (Continued on reverse side) PAGE 1 Adopted by reference in Rule 348.202(1), F.A.C. PART 0 — 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 Stock Merck, Inc.; Kinder Morgan, Inc.; Realty Income Corp, Closed End Fund Blackrock Capital and Enhanced Income Fund PART E — LIABILITIES [Major debts - See instructions] (if you have nothing to report, write "none" or "nla ") NAME OF CREDITOR ADDRESS OF CREDITOR Irene Grant 6 Freas Court, North Potomac, MD 20878 . c — `< PART F — INTERESTS IN SPECIFIED BUSINESSES [Ownership or positions In certain types of businesses - See instructions] 1 r"t CFI rrI (If you have nothing to report, write "none" or "n /a ") BUSINESS ENTITY # 1 BUSINESS ENTITY # 2 rz" NAME OF BUSINESS ENTITY = (Jr) ADDRESS OF BUSINESS ENTITY i9 PRINCIPAL BUSINESS ACTIVITY — POSITION HELD WITH ENTITY X 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 I O S S ❑ SIGNATURE OF FILED, CPA or ATTORNEY SIGNATURE ONLY If a certified public accountant licensed under Chapter 473, or Signature: OF attorney in good standing with the Florida Bar prepared this form for " ou, he or she mu compete the following statement: I, 7 e veh 5' 44 prepared i 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: /Z / r ll sr/ S � ,s 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, signino 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, return 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 prior to confirmation, even if that is less than section(s). permanently reside. (If you do not permanently 30 days from the date of their appointment. 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 A candidate who previously filed Form 1 because file with the Commission on Ethics, P.O. Drawer Thereafter, local officers /employees, state 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 t ether with their Finally, at the end of office or employment, each or Supervisor of Elections. local officerlemployee, state officer, and specified qualifying papers. state employee is required to file a final disdosure To determine what category your position falls form (Form 1F) 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 Ltd relieve Facsimiles w ill not b e 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 341202(1), FA.C. CITY CLERK'S OF BOYNTON BEACH OFFICE CANDIDATE OATH - NONPARTISAN OFFICE Nov �� 34 • (Not for use by Judicial or School Board Candidates) OFFICE USE ONLY OATH OF CANDIDATE (Section 99.021, Florida Statutes) Steven B. Grant (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 Mayor of Boynton Beach (offiCe) (district #) ; I am a qualified elector of Palm Beach County, Florida; (circuit #) (group or seat #) 1 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. X Iii 4 (S�f) ��D ����°� lie/ - -Xe F , (6 n Signature of Candidate Telephone Number Email Address 136 NE 3rd Avenue Boynton Beach, FL 33435 Address City State ZIP Code Candidate's Florida Voter Registration Number (located on your voter information card): 115754446 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): StEE -ven Grant STATE OF FLORIDA COUNTY OF Piake e-AC Sworn to (or affirmed) and subscribed before me this 5 day of OVerri oer , 20 1 Personally Known: (/ or _ Sig ature of Notary Public Produced Identification: Pi t, Type, or Stamp Commissioned Name of Notary Public Type of Identification Produced: ,.O" "•`yep; JANET M. PRAINITO ;Y MY COMMISSION # FP 142411 t•.. -. o EXPIRES: September 22, 2018 DS -DE 25 (Rev. 5/11) • u e - 0001, F.AC. r The City of Boynton Beach o0 - Y o, City Clerk's Office ^ '^ t 100 E BOYNTON BEACH BLVD ..._J, BOYNTON BEACH FL 33435 °�� 1 0 - s (561) 742 -6060 CS --( c) FAX: (561) 742 -6090 ` ��- ` N e '•" E -mail: prainitoj @bbfl.us C, 7.. c www.boynton- beach.org zz v'o PUBLIC NOTICE `° 1 rn M C) 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 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 r- r / ` his notice is he L. . ocumented: 1 i/5//S Signature Date Received DETACH IF YOU AND /OR YOUR REPRESENTATIVE(S) plan(s) to attend the Logic & Accuracy (L&A) testing on , 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 OF F , OA A =I s Palm Beach County yG Qs 4 OF Pp 3k �`'`,,,, 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 26 signatures on the Nominating Petitions of STEVEN B. GRANT 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 STEVEN B. GRANT is a registered voter in Precinct 7182, in the City of Boynton Beach, Florida. Signed, this the 4th day of November, 2015. • SU AN BUCHER o -So SUPERVISOR OF ELECTIONS PALM BEACH COUNTY cn (SEAL) rn 0 -73 Lh I 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 completerZ the form will not be valid as a Candidate Petition form. I, Nb O C S .Q LC 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 Steven B. Grant 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 of Boynton Beach (insert title of office and include district, circuit, group, seat number, if applicable) Date of Birth or Voter Registration Number Address a r (MM/DDIYY0 ) y t5 1101 7 1 3.7 City Co my State Zip Code Si ature of Voter Date Signed (MMIDD/YY) [to be c mplete by Voter] 641U271) I Rule 1S- 2.045, F.A.C. DS -DE 104 (Eff. 04/11) nw ^J f... rri c_n :t - - CEI x -a 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 completer the form will not be valid as a Candidate Petition form. • ), t (/ I / i 3 l! r f O S 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 Steven B. Grant 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 of Boynton Beach (insert title of office and include district, circuit, group, seat number, if applicable) Date of Birth or Voter Re istration Number Address ` (MMIDDIYY) 0 S� L I )1 0 ( r 511/ Fc r Ci ,'� 6(4,c.? r County I, Pe4,t State Code f j�/ Signature of Voter Date Signed (MMIDD/YY) w [to be completed by Voted / Rule 1S-2.045, F.A,C. ////1 DS -DE 104 (Eff. 09111) r a ri m r"i , i ✓ f Inv . Dn't, 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, � \ the undersigned, a registered voter (print me as it appears on your voter information card) in said state and county, petition to have the name of Steven B. Grant 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 of Boynton Beach (insert title of office and include district, circuit, group, seat number, if applicable) Date of Birth or Voter Registration Number Address (MMIDDIYY) a. SS` 6 o\ - \ C,\V� City County State Zip Code �� r\ c A c" F ^ 33 3 Signature of Voter Date Signed (MMIDD/YY) [to be completed by Voter] Rule 1S -2.045 F.A.C. DS -DE 104 Eff.09111 • S © �ss CI 1-11 i.y ,7 =t � p � i^ 3 --r .7 C. rr. : ;, ti i1,v . O 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 completer the form will not be valid as a Candidate Petition form. ) yy 13) P i- v , \ D 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 Steven B. Grant 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 of Boynton Beach (insert title of office and include district, circuit, group, seat number, if applicable) Date of Birth or Voter Re istration Number Address (MMIDDIYY) / l 73S6 Ci County State Zip Code A [6 6061,-, e G 1 1' L- 3 3 y 7 Z S' ture of Voter Date Signed (MM /DD/YY) � Qv C [to be co pte�1 y Voter] 04,-) l lI .� (/ Rule 15 . 45, F.A.C. DS -DE 104 (Eff. 09111) .., r--: c= ri U ' G! cp { ter'\ v Dt3 V CANDIDATE PETITION /S 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. /J Al 7 f� v 2 — V IV O 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 Steven B. Grant 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 of Boynton Beach (insert title of office and include district, circuit, group, seat number, if applicable) Date of Birth or V ter Regist tion Number Add / ess f 3 / City Cou ty S Zip Co o� � a.� frti vi ( fit Wi6 �� (7.7Z Signature 4 Vot r Date Signed (MMIDDIYY) [to be com lets by "ter] mmia) If 5 /( Rule 154045, F.A,C. ( DS -DE 104 (Eff. 09!11) . L: u. '17 c-- rx } r • C C 3 °; j • \ V. D 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. the undersigned, a registered voter in - (print name s it ap• on your voter forma '• •) in said state and county, petition to have the name of Steven B. Grant 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 of Boynton Beach (insert title of office and include district, circuit, group, seat number, if applicable) Date of Birth or Voter Registration Number Address 1,� cR ,A, (MM/DD ) !L\ I C t'`2/ I i ce_ = r r�, 41: air- �_. —;� City County State . Zip Code ((kr)t\---e-r(\--ke•Ar-- C___. 3 Signature of Voter Date Signed (MM!DD/YY) \ [to be co plated y Voter] ‘i, Rule 1S- 2.045, F.A.C. DS-DE 104 (Eff. 09!11) r c".71. C,3 , 6 c -' w t3 G' ° 4 a r ';max CANDIDATE PETITION P5 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 AV 1 G f s l Ive, h 6 r - 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 Steven B. Grant 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 of Boynton Beach (insert title of office and include district, circuit, group, seat number, if applicable) Date of Birth or oter Reg / tration Number Addre s (MMIDD/YY) / Z l� 5 g q zit v V ti g City Couri i State. Zip Code -/Ii .6dfc 4 K, I in, 60, t 1 1 rt.- 33` 7 Signatu of Voter Date Signed (MMIDDY) / /Y [to be completed by V ] ,(}1..r( l /// 3 / / S Rule 1S- 2.045, F.A.C. DS -DE 104 (Eft 09111) ' ta"` r , r�s, L , 1 :'°-3 17:7 " CANDIDATE PETITION 1 � 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 completes the form will not be valid as a Candidate Petition form. I, / t-ctt A-6 / t- l Z L"C-1, 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 Steven B. Grant plac&d on the Primary/General Election Ballot as a: [check/complete box, as applicable] ❑ Nonpartisan ® No party affiliation ❑ Party candidate for the office of Mayor of Boynton Beach (insert title of office and include district, circuit, group, seat number, if applicable) Date of Birth or Voter Registration Number Address , � / . C, Y (MMIDD/YYC9 60 f k Z/ 3 1 2 6 v 2 Vl ,n , r/ City County State Zip Code Signature of Vote ♦ Date Signed (MM /DD/YY) [to be completeg by Vo er] Rule 1S- 2.045, F.A.C. / DS -DE 104 Eff. 09111 „F "0 ' — t ED Fis rte;, 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 re, uested inf. matio I on this or : not completer4 the form will not be valid as a Candidate Petition form. C � M the undersigned, a registered voter r (print name a it .ppears on your v•er information card) in said state and county, petition to have the name of Steven B. Grant 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 of Boynton Beach (insert title of office and include district, circuit, group, seat number, if applicable) Date of Birth or Voter Registration Number Address 6 Al .4// /C2V3 V671 Con Zip coche 7 4/ 1 /144, 1 Signa rei Vote L Date Signed (MMIDDIYY) �. [to be completed by V er] � / t Rule 1 - . , F. • . . DS -DE 104 (Eff. 09111) c,.) 1 C 3 CANDIDATE PETITION N E ETI I® N 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 the form will not be valid as a Candidate Petition form. �q/ I, �, t v u C h C rr C: 11 e Y lC (I (c�_Y l (Jfl 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 Steven B. Grant 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 of Boynton Beach (insert title of office and include district, circuit, group, seat number, if applicable) Date of Birth or Voter Registration Number Address 19 16 (PI igA CO ., 11 t A,.. E City County State Zip Code ISM nkn /P a.M. QcU I� po (k . 4 3 3 �N-(() Signature of Voter Date Signed (MMIDDIYY) [to be completed by Voter] iq 6 3 /,i5 Rule 1S- 2.046, F.A.C. l DS -DE 104 (ER. 09/11) r k± v cn CANDIDATE PETITION Notes: - All information on this form becomes a public record upon receipt by the Supervisor of Elections. ki - 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 completes the form will not be valid as a Candidate Petition form. • I, t t .4f (( L if I h t the undersigned, a registered voter V (pri t name as it pears on your voter information card) in said state and county, petition to have the name of Steven B. Grant 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 of Boynton Beach (insert title of office and include district, circuit, group, seat number, if applicable) Date of Birth or Voter Registration J J� tion Number Address (MM/DD/YY) 2 D f %J � I j q . g / `� W $We— ty 1 I 6A /� ` � ounty > � State Zip Code • Signature of Voter ! 1 '1 Date Signed (MMIDDIYY) [to be co plat d by Voter] ,A),(..4 A c if 3 /5 i Rul 1S- , .A.C. DS -DE 104 (ER. 09/11) p ter, e- T $ A z t" tK.. C ,.i V 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 forin is not completed the form will not be valid as a Candidate Petition form. I, 1 S ( v�r� the undersigned, a registered voter vri (print me as it appears on your voter information card) in said state and county, petition to have the name of Steven B. Grant placed on the Primary/General Election Ballot as a: [check/complete box, as applicable] 0 Nonpartisan ® No party affiliation ❑ Party candidate for the office of Mayor of Boynton Beach (insert title of office and include district, circuit, group, seat number, if applicable) Date of Birth or Voter Registration Number Address (MMIDDIYY) 1/3a7 / � 6 at ,5 $ s -,c- \4,\--61-- rink City County State Zip Code l 9C VI 4-0 r 3 ems, t r--) FL_ 3 3 _5 Signature of Voter Date Signed (MMIDDM() • 4 [to be completed by Voter] .f. l.' ■JA / j � i. L_ 0 2 Rule 1S- 2.045, F.A.C. / DS -DE 104 (Eff. 0811 r�r y rr l �w -s` a La cn • -e3 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, tli n 04 0^ ` (t c< the undersigned, a registered voter (print name a6 it appears on your voter information card) in said state and county, petition to have the name of Steven B. Grant 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 of Boynton Beach (insert title of office and include district, circuit, group, seat number, if applicable) Date of Birth or Voter Registration Number Address Cit County Sta Zip Code o do 0 C b ecticl\ \ -v Signature of Voter Date Signed (M /DD/YY) [to be completed by Voter] 01 S Rule 1S- 2.045, F.A.C. DS -DE 104 (Eff. 09111) w:r — c MI 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. � Vl /I �/- Uv , c -F a , k ! 24 the undersigned, a registered voter j (print name as it appears on your voter information card) in said state and county, petition to have the name of Steven B. Grant 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 of Boynton Beach (insert title of office and include district, circuit, group, seat number, if applicable) Date of Birth or Voter Registration Number Pen si `l � ` City County State Zip Code iiezbelh pa) tyi 6ear,11, 33L/2 (,a Signature of Voter Date Signed (MM /DDIYY) 1/4__AOLkyjj_keq--eutj2._ i [to be completed by Voter] 1 IF Rule 1S- 2.045, F.A.C. DS -DE 104 (Eff. 09111) - - -1 > cam c _rs 7-9 czs -„ C:) C CANDIDATE PETITION ipr- 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 requeste information on this form is not completed, the form ill not be valid as a Candidate Petition form. I, L/ E � ` 5 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 Steven B. Grant 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 of Boynton Beach (insert title of office and include district, circuit, group, seat number, if applicable) Date of Birth or V ter Registration Number Address 9114) 4-em /� (MM/DDIYY) ' / 3/ l/Vt 3 °s City County State Zip Code Si of Date Signed M Y 14 c ompl [to be ted y VoteD/Y ) r] // 3 /5 Rule 1S- 2.045, F.A.C. / DS-DE 104(Eff.09111) r al 176 a: Ex V b cl JAN CANDIDATE PETITION /pice-7 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, �� j 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 Steven B. Grant 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 of Boynton Beach (insert title of office and include district, circuit, group, seat number, if applicable) Date_O.Birth or Voter Registration Number Address �/J/� �, ') ,(,ri MI _ t ) f 617 (" 11,11" C nvt, City County Sta a Zip Code T i m & ( // ( / t 1� � ;1 Signature of Vote Date Signed (MMIDD/YY) 4t [to be comple d y Voter] Rule 1S- 2.045, F.A.C. DS -DE 904 (ER. 09111) Ji uJ C:3 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, J S ` ^ 1 L vikkL 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 Steven B. Grant 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 of Boynton Beach (insert title of office and include district, circuit, group, seat number, if applicable) Date of Birth or Voter Registration Number Address (MMIDDNY) U Li 1 City County State Zip Code Signature of Voter Date Signed (MMIDDIYY) [to be i completed by Voter] / 5-j Aor Rule 1S-2.045 F.A.C. DS -DE 104 Eff. 09111 - 4rn . r+M-- l`i't cD ML�� 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 foorm is not completed the form will not be valid as a Candidate Petition form. 1, : ' r 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 Steven B. Grant placed on the Primary/General Election Ballot as a: [check/complete box, as applicable] 0 Nonpartisan ® No party affiliation 0 Party candidate for the office of Mayor of Boynton Beach (insert title of office and include district, circuit, group, seat number, if applicable) Date of Birth or Voter Registration Number Address ( 9( 7 7( a 5z., 2711_ - City County State Zip Code D f t .6fc g/ft? geqc4 35'3.x' Signature tr Date Signed (MMIDDIYY) [to be co pleted y Voter] Rule 1S -2445, - .A.C. DS -DE 104 (Eff. 09/11) r rr art ' °,. - Con r,t1 7A 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 forin is not completed the form will not be valid as a Candidate Petition form. 1 * - ePS (5'" 1 b 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 Steven B. Grant 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 of Boynton Beach (insert title of office and include district, circuit, group, seat number, if applicable) Date of Birth or Voter Registration Number Address (MAMMY) — 2 (� - ra l 'Sol_ / q e l 5 � c (1Ciik, 'Q City County State Zi Code �• ` � Q- 33 �3 C Signa *,e of oter Date Signed (MMIDDIYY) [to be completed by Voter] - 3 — 20 LS Rule 1S- 2.045, !A.C. DS -DE 104 (Eft 09/11) , TP , oq y l „. 4 . CR. 17 2i 411 CANDIDATE PETITION 10( 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 completer the form will not be valid as a Candidate Petition form. I G <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 Steven B. Grant 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 of Boynton Beach (insert title of office and include district, circuit, group, seat number, if applicable) Date of Birth or Voter Registration Number Address (MMIDD/YY) r h' D X T 1 lob ,- Cou t y State Zip Cod 4 03 �� v&) � n ( ,ure • r- Date Signed (MM/DD/YY) [to be commplet d by Voter] fa Rule 1S•2.045, F.A.C. DS-DE 104 (Eff. 09/11) v 2 l :4r ' C I , - rr9 rn- 3 cti cp cri CANDIDATE PETITION 0 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, c S J r n � cu s the undersigned, a registered voter G ' 1 (print name as it appears on your voter information card) in said state and county, petition to have the name of Steven B. Grant 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 of Boynton Beach (insert title of office and include district, circuit, group, seat number, if applicable) Date of Birth or Voter Registration Number Address 12 07 � (92R" ,( / d 10 City County State Zip Code 2 :&cylA101 r 6e- 4 PA VA Beadki FL- Signature of Voter Date Signed (MM/DD/YY) [to be completed by Voter] 1 /s / Rule 1S- 2.045, F.A.C. DS-DE 104 (Eff. 09/11) i 1 ' erg /�IGk� �'F .� «„� �- S ON fo : ,A011.0313 .:10 110:Sikeit 3drif*3 v/� 0 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. ( O I, I 1 M c f (ptn,� , 1 kk �' 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 Steven B. Grant 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 of Boynton Beach (insert title of office and include district, circuit, group, seat number, if applicable) Date of Birth or Voter Registration Number Address (MMJDD/YY) (/ 2 i h 4 / `- City Stat, r Zip Code ( GZc- ( G ' �i 3 5 gn u e of Voter Date Signed (IVIM/DD/YY) [to be completed by Voter] tV,621 K Rule 1S- 2.01c DS -DE 104 (Eft 09 /11) 1 0... ' • t.,-.. 1 N/ 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 ( j f r' ' ,_ e b f o o k the undersigned, a registered voter / t I +.r (print name as it appears on your voter information card) in said state and county, petition to have the name of Steven B. Grant 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 of Boynton Beach (insert title of office and include district, circuit, group, seat number, if applicable) Date of Birth or 77 Voter gistration Number Address (c,,y (MMIDDIYY) J 13 � I S 1 1> 2 r 3z_ 3 ft 1 �y'i f t � City County State Zip Code 77 Boynton Beach Palm Beach FL 3 / J Signature of Voter Date Signed (MMIDDIYY) -e--.6,..LA-107-k [to be completed by Voter] Rule 1S- 2.045, F.A.C. DS -DE 104 (Eff. 09!11) bz , CC- 44 c,„ 3 t w1 1- Via. CANDIDATE PETITION f 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, i17 l: , i- q h e (15 the undersigned, a registered voter l (print name as it appears on your voter information card) in said state and county, petition to have the name of Steven B. Grant 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 of Boynton Beach (insert title of office and include district, circuit, group, seat number, if applicable) Date of Birth or ter Regis ration Number Address V iPt- (MM1DD/YY) 0 z �S 1 1 / O 'J .j ,.9--/(9,e(--- City County State Zip Code Boynton Beach Palm Beach FL -..,j, -' f -1---- Signature of Voter Date Signed (NIMIDDIYY) [to a com let d b r [ p r] i 1 Rule 1S -745 F.A.C. ////"" DS -DE 104 (Eff. 091111_ - Fl y" r" a L.0 Ls-.' re i "n rte' .m,r. : n , 9:": .. 1 Cm1 , w a 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, ( v . j r 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 Steven B. Grant 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 of Boynton Beach (insert title of office and include district, circuit, group, seat number, if applicable) Date of Birth or oter Re stration Number Address (MMIDDIYY) ) 3 07 / f �g d 3 6 Alit c City County State Zip Code °h ,� ` eqc J��� Ac4 L ? -S Sign r o o r Date Signed (MMIDDIYY) [to be complet by V er] V/ 45 Rule 1S 2.045, F.A.C. DS -DE 104 (Eft. 09111) a t . 4 77 7,2 e � ;y; cm , CANDIDATE PETITION k \t' 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 forin is not completed the form will not be valid as a Candidate Petition form. I, —14q5 N A C 1 ��A the undersigned, a registered voter �!1 (print name as it appears on your voter information card) in said state and county, petition to have the name of Steven B. Grant 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 of Boynton Beach (insert title of office and include district, circuit, group, seat number, if applicable) Date of Birth or Voter Registration Number Address (MM/DD77 City County State Zip Code bC X16 A, Pbe /CL. S Signature of Voter Date Signed (MMIDDIYY) (Lad "Olt—. [to be completed by Voter] , 11 /6 L IP5 ' Rule 1S- 2.045, F.A.C. DS-DE 104 (Eff. 09/11) A • 'il3 rat z1PadCIa 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, , C() 1P Bea- 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 Steven B. Grant 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 of Boynton Beach (insert title of office and include district, circuit, group, seat number, if applicable) Date of Birth or Voter Registration Number Address (MMIDDIYY) ( 1\)& 01 (04In Av -c. City County State Zip Code to v -Von ject.e -N- Po cAA 53q35 Signature of Voter Date Signed (MMIDDIYY) / [to be completed by Voter] UP Rune 1S- 2.045, F.ac. DS -DE 104 (ER. 09111) 07 t 4µ. CANDIDATE PETITION Notes: - All information on this form becomes a public record upon receipt by the Supervisor of Elections. 0 0/ _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, l "Gr.lf 6 P P.o a A-It- 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 Steven B. Grant 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 of Boynton Beach (insert title of office and include district, circuit, group, seat number, if applicable) Date of Birth or Voter Registration Number Address (MM/DD/YYI 06 Ali '9 City County State Zip Code gO yh n Beal Putm gea(i ) Fes- 3 ?ct Signature of Voter Date Signed (MMIDDIYY) [to be completed by Voter] Rule 1S-2.045, F.A.C. DS-DE 104 (Eff. 09111) • c • C. ' ;=1 7,73 % • • N i { 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 forin is not completes the form will not be valid as a Candidate Petition form. I, , /01111 the undersigned, a registered voter (print name as on your voter information card) in said state and county, petition to have the name of Steven B. Grant placed on the Primary/General Election Ballot as a: [check/complete box, as applicable] QNonpartisan ®No party affiliation Party candidate for the office of Mayor of Boynton Beach (insert title of office and include district, circuit, group, seat number, if applicable) Date of Birth or Vote Registration Number Address / U � l`G/ � � � /�� (MMIDDNY) / Q v --' / j City r Cou ty p ' State - Zip Code Si ter-- - Date Signed (MMIDDIYY) [to be completed y Vote ] Rule 1S- 2.045, F.A.C. DS-DE 100. Aff. 09/41) 'a; N S t Q -= W CD 1.ri iil ^1 - - I CD -.4 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' i . -r lCx' LO c � l S the undersigned, a registered voter t ( name as it appears on your voter information card) in said state and county, petition to have the name of Steven B. Grant 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 of Boynton Beach (insert title of office and include district, circuit, group, seat number, if applicable) Date of Birth or Voter Registration Number Address r _ o 77q 07 d-1 ► LI Alf 15 s-F r�A-' City C ounty State Zip Code J v\- c V\ •6ecA I YQiYrk teack rL ; Signature of Voter Date Signed (MMIDDIYY) [to be com leted by Voter] 6" 10 6 I �DE 104 (Eff. 09111) CO Rule 1S- 2.045, F.A.C. w p „ 3 i , c= i";17 rrt r --i Cr? C) tif7 = . r C - ' CI) 1�3 C • CANDIDATE PETITION ()5 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. f, - S 6A61 4-10 1 /114 (, r 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 Steven B. Grant 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 of Boynton Beach (insert title of office and include district, circuit, group, seat number, if applicable) Date of Birth or Voter Registration Number Address (M -(/ ) G 2 S ` "t' z C C C �� � � 6-t e cc`r- cirn County State Zip Code n4 1 ( Signature of r Date Signed (MM/DDIYY) [to be completed by Voter] Gc, -6''- t, - Rule 1S -2.045 .C. DS -DE 104 (Eff. 09/11) i I r rr � r'7' 31 . Q.14� '� f V rq v w #: I ' L i CANDIDATE PETITION V ___, 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. I85,. Florida Statutes] Pr----• - If all requested information on this form is not completed the form will not be valid as a Candidate Petition form. 1,�) rl AFC' / / the undersigned, a registered voter ■ (print name as it appe: rs on your voter information card) in said state and county, petition to have the name of Steven B. Grant i. 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 of Boynton Beach (insert title of office and include district, circuit, group, seat number, if applicable) Date of Birth or Voter Registration Number Address (M�IIDD,YY) D oc (7q � 0 o3 7- ;- -0 , i \A City County State Zip Code '8�. Vegh, 8 Z._, ZIT c„ c Signat of - el . Date Signed (MMIDDIYY) t ` kr [to be completed by Voter Rule 1S- 2.045, F.A.C. DS -DE 104 (Ef. 09/11) .... °' rte E_ C"? —7l r P x C? '°i 2 ""0 rn rrl --r N 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 I, �a \ ` C c \Q� ,f'? the undersigned, a registered voter ti L l (print name as it appears on your voter information card) in said state and county, petition to have the name of Steven B. Grant 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 of Boynton Beach (insert title of office and include district, circuit, group, seat number, if applicable) plicable) 1' Date of Birth or Voter Registration Number Address (r2 ` ) tc U cLC (MMIDDlYY) P IIJC l City Co ty State Zip Code r40 I L ' - L 0 Signature of Voter Date Signed (MM/DD/YY) [to be completed by�/oter] P ( 1 5 Rule 1S- 2.046, F.A. . DS -DE 104 (Eff. 09111) ff7 ery C) 7? C_,) r- i I 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 completea� the form will not be valid as a Candidate Petition form. r I, t ' p CJ , ` — f the undersigned, a registered voter {print-name as it appears on your voter information car in said state and county, petition to have the name of Steven B. Grant 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 of Boynton Beach , {insert title of office and include district circuit group, seat n umber, if applicable) Date of Birth or Voter Registration Number Address (N11111/DDIYY) / jq4 1 1 .O U � f � City County State Zip Code 5 3 Signature of Voter Ito Date Signed (MMIDD/YY) D Pr be completed by Vote Rule 1S- 2.045, F.A.C. DS-DE 104 (Elf. 09111) N v m, 7 al C'? - C -,4 4 co, :3 b rte ` "0 rel cr= F ,d - 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] - "fall requested information on this forin is not completed, the form will not be valid as a Candidate Petition form. I, o0 ` 1 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 Steven B. Grant 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 of Boynton Beach (insert title of office and include district, circuit, group, seat number, if applicable) Date of Birth or Voter Registration Number Address (MMIDDIYY)64.41/- , L' 7 C City County State Zip Code 414"? G ? Signa re ,i'1' >r Date Signed (MMIDD/YY) [to be completed by Vo er] Ira ale //L) /2 ci / 5 Rule 1S- 2.045 '.A.C. DS -DE 104 (Eif. 09/11) CIO ' 1 CJ ® ("4: C'° CAI cr) W .w:f CANDIDATE PETITION V 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 I, e ` l ici( . iiCS boJ the undersigned, a registered voter �' (pr name as it appears on your voter information card) in said state and county, petition to have the name of Steven B. Grant 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 of Boynton Beach (insert title of office and include district, circuit, group, seat number, if applicable) Date of Birth or Voter Registration Number Address (M !DD T) I ( ( SE off- ' *4-'E- City County State Zip Code 166(ti� ` A ? F 35 Sig =ture of Voter Date Signed (MM/DD/YY) [to be complete by Voter] So` , r �. L 6 ilt- � j le 15-2.045 F.A.C. — ` ' / DS -DE 104 (Eff. 09111) / ,ri.> Fv E±a d Zr C) — T,1 W rr l co -t� Miscellaneous Cash Receipt No. 85701 CITY OF BOYNTON BEACH - _ _ o u �P ~ rO N Account No. 001 - 0000 - 369 -10 -00 $ 259.26 ) 20 Received of Steven B. Grant Address 136 NB 3rd Avenue, Boynton Beack, 413435 Date 71/05/15 01 Receipt no; 4 For iS State Assessment to run for Mayo +tlo>i ch 15. 201t ' TOt pa?YI?I�l' 's Dept. City Clerk's Office B STEVEN B. GRANT CAMPAIGN ACOUNT 6 City of Boynton Beach 11/5/2015 State Assessment Fee 259.26 Mayor for Boynton Be State Assessment Fee 259.26 STEVEN B. GRANT CAMPAIGN ACOUNT 6 City of Boynton Beach 11/5/2015 State Assessment Fee 259.26 Mayor for Boynton Be State Assessment Fee 259.26 www.techchecks.net ORDER # 258498 Miscellaneous Cash Receipt � CITY OF BOYNTON BEACH (-' No. 85702 r � U TON 0 Account No. 001- 0000- 369 -10 -00 $ 25.00 20 Received of Steven B. Grant Address 136 NE 3rd Avenue, Boynton Beach. FL, 33435 i te: 11/05115 01 R e_i pt Ll38 For City Filing Fee to run for Mayor one r'5, 2016 S.00 Total payment C5.P Dept. City Clerk's Office B { 1 STEVEN B. GRANT CAMPAIGN ACOUNT 5 City of Boynton Beach 11/5/2015 City Filing Fee 25.00 for Boynton Be City Filing Mayor o Boy ty g Fee 25.00 STEVEN B. GRANT CAMPAIGN ACOUNT 5 City of Boynton Beach 11/5/2015 City Filing Fee 25.00 Mayor for Boynton Be City Filing Fee 25.00 www.techchecks.net ORDER # 258498