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Filing Papers APPOINTMENT OF CAMPAIGN TREASURER CBER�'S OFFICE • AND DESIGNATION OF CAMPAIGN DEPOSITORY FOR CANDIDATES '15 OCT 20 WI 144 (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): E] 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 IVI icAaet r ill, Fi4--Zpw +r - L code) I 7 5. 5 L a nc 3T 1 4. Telephone 5. E -mail address /3 o1 o n V eGc- k, F L. 33 Y3 s (.J661 ) 63 z-.? 578- -f i - 2,,e4-041-1.4.@- "-CI ''s �J 6. Office sought (include district, circuit, group number) 7. If a candidate for a nonpartisan office, check if 6. i. Y 6.04 nabs 06( 'Q S 4. 3 y 6 ott14 ;6 tit ,6Bao,L applicable: ❑ My intent is to run as a Write -In candidate. 8. If a candidate for 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 IR Campaign Treasurer El Deputy Treasurer P0. Name of Treasurer or Deputy Treasurer Avl 1C 1 l,cc..eA /1'1. Pi tz pei : a 11. Mailing Address 12. Telephone (75' y c ) A - ST (5'61) 63 x`75°78 13. City 14. County 15. State 16. Zip Code 17. E -mail address ,& o y VLlem 14 e.ect Pol 16erea - 33 V35 -C%4a r 4e44 j lo&-cl us 18. I have designated the following bank as my 0 Primary Depository ❑ Secondary Depository 19. Name of B nk 20. Address 3 (A)005 0��5 F `6 3 '� _ ,.1 #wc 21. City 22. County 23. State 24. Zip Code A ociIA 4 - .9 LA Ilee, k 13 .l 141 6ear.11 FL, 33 V36.-. UNDER PENALTIES OF PERJURY, 1 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 Ca idate a(r D LL ao /,5 X 27. Treasurer's Acceptance of Appointment (fill in the blanks and check the appropriate block) I, V'l) c- VL ILL f'i +Z Q i-v - te-- , do hereby accept the appointment (Please Print or Type Name) •esignated above as: 2 Campaign Treasurer ❑ Deputy Treasurer. a© Dc-Z,,?o,- /J o-t. Date Signature of Campaig r easurer or Deputy Treasurer DS -DE 9 (Rev. 10/10) - - - Rule 1S- 2.0001, F.A.C. APPOINTMENT OF CAMPAIGN TREASURER AND DESIGNATION OF CAMPAIGN DEPOSITORY FOR CANDIDATES (Section 106.021(1), F.S.) (PLEASE PRINT OR TYPE) NOTE: This form must be on file with the qualifying officer before opening the campaign account. OFFICE USE ONLY 1. CHECK APPROPRIATE BOX(ES): ❑ Initial Filing of Form Re- filing to Change: I1 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 Michael Fitzpatrick code) 175 SW 2nd St Boynton Beach, FL 33435 4. Telephone 5. E -mail address (561 ) 732 -9578 P'} ®6V1' u5 6. Office sought (include district, circuit, group number) 7. If a candidate for a nonpartisan office, check if Boynton Beach City Commission District 3 applicable: ❑ My intent is to run as a Write -In cdidate. 8. If a candidate for a partisan office, check block and fill in name of party as applicable: My intent iss run a a U Write -In ❑ No Party Affiliation 0 Party icanc i e. c -. < 9. I have appointed the following person to act as my ❑ Campaign Treasurer © Deputy Treeure_ 10. Name of Treasurer or Deputy Treasurer m Lisa Hanley ;v c 11. Mailing Address 12. Telephone e 175 SW 2nd St (5 ) 63A -c t+?7u 13. City 14. County 15. State 16. Zip Code 17. E -mail address Boynton Beach Palm Beach FL 33435 Iisahanley2003 @yahoo.com 18. I have designated the following bank as my ❑ Primary Depository ❑ Secondary Depository 19. Name of Bank 20. Address 21. City 22. County 23. State 24. Zip Code 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 26. Signature of C ndidate ,? 1,5 X fr k_ 27. Treasurer's Acceptance of Appointment (fill in the blanks and check the appro iate block) I Lisa Hanley , do hereby accept the appointment (Please Print or Type Name) designated above as: ❑ Campaign Treasurer 1 Deputy Treasurer. X �C r _ ,f l ' , 01 `( pF ALE ONLY STATEMENT OF ev“ G • CANDIDATE a 2a piv,tt :4 (Section 106.023, F.S.) (Please print or type) i,t G w,e / F + �`f"Y d C I p candidate for the office of C; y Co k'19. sS % °ueo .6%0 ���- - ; have been provided access to read and understand the requirements of Chapter 106, Florida Statutes. • X 1,ej fr il` 2 a o /5 Signature of Cand;r: ate 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) 112118195 FITZPATRICK, MICHAEL MARTIN DEM 7186 175 SW 2ND ST 1 BOYNTON BEACH FL 33435 6/27/1953 W M 9/29/1971 11/6/2012 5617329578 20 co m m ti co co co M iscellaneous Cash Receipt No. � , CITY OF BOYNTON BEACH 9 } ~ TON Account No. 001.-0000-369-10-00 $ ,.;222.57 , 20 Received of Michael M. Fitz Address 175 SW 2nd Street, Boynton Bead., 1L 33'435 • . F or 1% State Assessment to run for C oMEIME X i Str egTWT 1 otul payren t -5247.,57 ' on. March 15, 2016. Dept - i City Clerk's Office B -,,. v u .- r .. � �,.,;„.4.,:., k S Miscellaneous Cash Receipt °'=Y °. 7 v No. 453 i CITY OF BOYNTON BEACH -- L �P ~ 7-0N ° Account No. 001-0000-369-10-00 $ 25.00 , 20 Received of Michael M. Fitzpatri Address - 175 SW 2nd Street, Boynton Beacp A 74.1 . D 1 1') t 5 oa .. EEEU? t rc '1$115.._ For City Filing Fee to run for ComelissirealeVntaistrict 3 ''697. l otal P�f1 �= Sc`f r •„i,!_ . . March 15, 2016. . , Dept. City Clerk ° s Office By r • C7 Q 'CCD • CANDIDATE OATH — �? NONPARTISAN OFFICE w :x) (Not for use by Judicial or (a - School Board Candidates) cn Fzs rn OFFICE bsE Otl0'[ OATH OF CANDIDATE (Section 99.021, Florida Statutes) 1, t G 1 1, a.Q, L 14- Fi t-a 4vr-c (0 (PLEASE PRINT NAME AS YOU WISH IT TO APPEAR ON THE B LOT * - NAME MAY NOT BE CHANGED AFTER THE END OF QUALIFYING) am a candidate for the nonpartisan office of C i ti Co en. ws t$ S 3 , - /�,� '' nn (office) (district #) ,t /T ; I am a qualified elector of P 1 ant 6eae, tot. County, Florida; (ci uit #) (grou 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. • 11111 X / ( .5di 4 3 2 -- g 5 - Zg , C %k: . a.�! ? Signature of Candid Telephone Number Email Address 0 i .09011,. vii U 74' 5 �o dress pi, � Cit y � O� � ii. �`� Sta .3 3 Y3C� Candidate's Florida Voter Registration Number (located on your voter information card): 112 I 1 $ 1 9S * 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): STATE OF FLORIDA COUNTY OF PALM Lae AC Sworn to (or affirmed) and subscribed before me this 9 day of N O V c . „ Y Y 1 ber , 20 1 b . Personally Known: V or ell IIII ' /A • Pitt:ccuitt) Sig <ture of Notary Public Produced Identification: Pr' t, Type, or Stamp Commissioned Name of Notary Public • Type of Identification Produce ~ +c .,,, JANET M. PRAINITO 1 , •: i : MY COMMISSION # FF 142' : .` .'a EXPIRES: September 2' 0: ?oM n l z Anneldl Time PIn1,v Q ax,- .,e. ax,- X1110 ... DS -DE 25 (Rev. 5/11) Rule 1S- 2.0001, F.A.C. 10 , RESIDENCY REQUIREMENTS 1 o c -t r- w .Q .- . - cn CPI ° IT] I, ( . c(Vz- i6 candidate for (Print Name) ( Apt) 0.1 - S5'r 6 �� Dr46- 3 of the City (Mayor /Commissioner — District #) 1 le Beach, have received, read and understand the residency requirements of Article II of the Charter of the City of Boynton Beach. 1114 1114'Cl-tf 1 (Signature of Candidate) p °V 02 046- (Date) 11/12/2013 12:31 PM S: \CC \WP \ELECTION \Year 2014 \Information Packets \RESIDENCY REQUIREMENTS STATEMENT.doc The City of Boynton Beach c Y off. City Clerk's Office .j . (Is= 100 E BOYNTON BEACH BLVD =+ p CA.- c_n BOYNTON BEACH FL 33435 0_ , " ? (561) 742 -6060 . r �' -° a3 o '� FAX: (561) 742 -6090 o 7.7 1' I e E -mail: prainitoj @bbfl.us . = w ww.boynton- beach.org a C : 4 ? �C2 PUBLIC NOTICE cri ` 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 this notice is hereby documented: ieit 44_ ___, I V° t 2e945 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 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 : Fitzpatrick, Michael, M MAILING ADDRESS : cm) _.... 175 SW 2nd St e.= C j ;Z7 CITY : ZIP : COUNTY :`Ltt Boynton Beach 33435 Palm Beach NAME OF AGENCY : �p CO City of Boynton Beach c) NAME OF OFFICE OR POSITION HELD OR SOUGHT : W ' *t City Commission District 3 tJt rr You are not limited to the space on the lines on this form. Attach additional sheets, if necessary. rri CHECK ONLY IF 0 CANDIDATE OR J 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 OR ❑ SPECIFY TAX YEAR IF OTHER THAN THE CALENDAR YEAR: MANNER OF CALCULATING REPORTABLE INTERESTS: FILERS HAVE THE OPTION OF USING REPORTING THRESHOLDS THAT ARE ABSOLUTE DOLLAR VALUES, WHICH REQUIRES FEWER CALCULATIONS, OR USING COMPARATIVE THRESHOLDS, WHICH ARE USUALLY BASED ON PERCENTAGE VALUES (see instructions for further details). CHECK THE ONE YOU ARE USING: ❑ COMPARATIVE (PERCENTAGE) THRESHOLDS OR f 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 SOURCE'S OF INCOME ADDRESS PRINCIPAL BUSINESS ACTIVITY 'Salem Trust 1715 N. Westshore Blvd. #750 Tampa FL 33607 Pension Sale of America Movil stock 970 N Congress Ave, Boynton Beach, FL 33436 Brokerage 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 N/A 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. 101 SW 4th Ave, Boynton Beach, FL 33435 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 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 See attached PART E — LIABILITIES [Major debts - See instructions] (If you have nothing to report, write "none" or "n /a ") NAME OF CREDITOR ADDRESS OF CREDITOR Juan Mocci 2833 SW 4th St Boynton Beach, FL 33435 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 N/A N/A ADDRESS OF BUSINESS ENTITY PRINCIPAL BUSINESS ACTIVITY POSITION HELD WITH ENTITY I OWN MORE THAN A 5% INTEREST IN THE BUSINESS NATURE OF MY OWNERSHIP INTEREST IF ANY OF PARTS A THROUGH F 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 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: ! , }O v 02 O `G CPA/Attorney Signature: 'v c7 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, signing 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 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: p a p ers. 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 Finally, at the end of office or employment, each or Supervisor of Elections. Candidates file this form together with their 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 1F) within 60 days of leaving office or under, see the "Who Must File" Instructions on employment. However, filing a CE Form IF (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 P 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. Michael Fitzpatrick Form 1, Statement of Financial Interests, attachment PART D Intangible Personal Property Stocks Scottrade Checking Account PNC Bank Checking Account Wells Fargo Bank DROP Boynton Beach Firefighters Plan o CO mc, co Cil I_ - OFZ,,N,,h rP�,00AI '4,O,i i co ,!l Palm Beach County 4 G ',. GPs ,f,11 OF Pp,` 240 SOUTH MILITARY TRAIL WEST PALM BEACH, FL 33415 POST OFFICE BOX 22309 WEST PALM BEACH, FL 33416 SUSAN BUCHER Supervisor of Elections TELEPHONE: C561) 656 -6200 FAX NUMBER: (5613656-6287 WEBSITE: www.pbcelections.org CERTIFICATION I, SUSAN BUCHER, SUPERVISOR OF ELECTIONS, for Palm Beach County, Florida, do hereby certify that 31 signatures on the Nominating Petitions of MICHAEL M. FITZPATRICK for BOYNTON BEACH CITY COMMISSIONER, DISTRICT 3 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 MICHAEL MARTIN FITZPATRICK is a registered voter in Precinct 7186, in the City of Boynton Beach, Florida. Signed, this the 29th day of October, 2015. SU AN BUCHER ..< SUPERVISOR OF ELECTIONS '.PALM BEACH, to z mi cis -1 W 'n3 (SEAL) r w n 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] 8 - If all requested information on this form is not completed the form will not be valid as a Candidate Petition form. 1, a —1. 17Z1 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 Michael M. Fitzpatrick placed on the Primary/General Election Ballot as a: [check/complete box, as applicable] Q Nonpartisan ❑ No party affiliation 0 Party candidate for the office of Boynton Beach City Commissioner, District 3 (insert title of office and include district, circuit, group, seat number, if applicable) Date of Birth or Voter Registration Number Address (MM/DD/) 45 5 ( .2 5,1// 1h 4 City CouAy State Zip Code . Z9yo-reo V14 33 q-3 Signature of Voter Date Signed (MM /DD/YY) [to be com late Voter] / /s Rule 1S- 2.045, F.A'.C. DS -DE 104 (Eff. 09/11) Thank you helping me get re- elected. Please return completed forms to 101 SW 4 Avenue (a 1920s two story yellow house, my childhood home) and place in the former mailbox attached to the wall by the front door, or call me at 561 - 632 -9578 to arrange for your candidate petition to be picked up. Mike Fitzpatrick, District 3, Boynton Beach City Commissioner CANDIDATE PETITION Notes: - All information on this form becomes a public record upon receipt by the Supervisor of - 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 rr r au s 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 Michael M. Fitzpatrick placed on the Primary/General Election Ballot as a: [check/complete box, as applicable] Nonpartisan ❑ No party affiliation ❑ Party candidate for the office of Boynton Beach City Commissioner, District 3 (insert title of office and include district, circuit, group, seat number, if applicable) Date of Birth or Voter Registration Number Address (MM (DD/YY) 1 2rZ 5 4f C' Cp io "t_t-60 6 County` 7 f G4 State Zip } C E O 'T vV Signature of Voter Date Signed (MM /DDIYY) [to be competed b Voter] /o/ Rule 1S- 2.045, F.A.C. DS -DE 104 (Eff. 09/11) Thank you helping me get re- elected. Please return completed forms to 101 SW 4 Avenue (a 1920s two story yellow house, my childhood home) and place in the former mailbox attached to the wall by the front door, or call me at 561 -632 -9578 to arrange for your candidate petition to be picked up. Mike Fitzpatrick, District 3, Boynton Beach City Commissioner 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, Jan 1 the undersigned, a registered voter (pr t name as it appears on your voter information card) in said state and county, petition to have the name of Michael M. Fitzpatrick placed on the Primary/General Election Ballot as a: [check/complete box, as applicable] IR] Nonpartisan ❑ No party affiliation ❑ Party candidate for the office of Boynton Beach City Commissioner, District 3 (insert title of office and include district, circuit, group, seat number, if applicable) Date of Birth or. Voter Registration Number Address .l (MM /DD/YY) )46 zL S , (/ I City County State Zip Code -- 60t4e"Z - Ze- 111 2 1. \ Signature of Voter Date Signed (MM /DD/YY) [to be comp) ed by Voter] /0 IS IS Rule 1S- 2.045, F.A.C. DS -DE 104 (Eff. 09/11) Thank you helping me get re- elected. Please return completed forms to 101 SW 4 Avenue (a 1920s two story yellow house, my childhood home) and place in the former mailbox attached to the wall by the front door, or call me at 561 - 632 -9578 to arrange for your candidate petition to be picked up. Mike Fitzpatrick, District 3, Boynton Beach City Commissioner 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, p� i &IP1 z 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 Michael M. Fitzpatrick placed on the Primary/General Election Ballot as a: [check/complete box, as applicable] L] Nonpartisan ❑ No party affiliation ❑ Party candidate for the office of Boynton Beach City Commissioner, District 3 (insert title of office and include district, circuit, group, seat number, if applicable) Date of Birth or Voter Registration Number Address (MM /DD/YY) MA1 ‘1 VD ° iriqp-mc b- PrPt 1 City County State Zip Code eio y pio t, Paup Pm -� � � f1-014 33 if Signature of Voter Date Signed (MM /DD/YY) [to be completed by Voter] Rule 1S- 2.045, F.A.C. DS -DE 104 (Ef 09/11) Thank you helping me get re- elected. Please return completed forms to 101 SW 4 Avenue (a 1920s two story yellow house, my childhood home) and place in the former mailbox attached to the wall by the front door, or call me at 561 - 632 -9578 to arrange for your candidate petition to be picked up. Mike Fitzpatrick, District 3, Boynton Beach City Commissioner 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, i41 '// , 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 Michael M. Fitzpatrick placed on the Primary/General Election Ballot as a: [check/complete box, as applicable] [1 Nonpartisan ❑ No party affiliation ❑ Party candidate for the office of Boynton Beach City Commissioner, District 3 (insert title of office and include district, circuit, group, seat number, if applicable) Date of Birth or Voter Registration Number Address yv (MM /DD/YY) J /v GY(�JOf'7 S 6/Pi City County State Zip Code oyn.tU - h • nn f3' eotc 3 3-43 3 Signature of Voter Date Signed (MM /DD/YY) S c_71,)? [to be c mp/ete by Voter] Rule 1S- 2.045, F.A.C. DS -DE 104 (Eff. 09/11) Thank you helping me get re- elected. Please return completed forms to 101 SW 4th Avenue (a 1920s two story yellow house, my childhood home) and place in the former mailbox attached to the wall by the front door, or call me at 561 - 632 -9578 to arrange for your candidate petition to be picked up. Mike Fitzpatrick, District 3, Boynton Beach City Commissioner 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. r ! 4i the undersigned, a registered voter . . (print name as it appears on your voter iiformation card) in said state and county, petition to have the name of Michael M. Fitzpatrick placed on the Primary/General Election Ballot as a: [checWcomplete box, as applicable] IiiNonpartisan ❑ No party affiliation ❑ Party : candidate for the office of Boynton Beach City .Commissioner, District 3 (insert title of office and include district, circuit, group, seat number, if applicable) Date of Birth or Voter Registration Number Address 5,go U1 '/ - 2 City County State Zip Code G \ / ht) r /LJt) - 4)6b1 1 /5 a 1 - Signature of Voter Date Signed (MM /DD/YY) 6‘2 [to be completed by Voter] Rule 1S- 2.045, F.A.C. DS -DE 104 (Eff. 09/11) Thank you helping me get re- elected. Please return completed forms to 101 SW 4 Avenue (a 1920s two story yellow house, my childhood home) and place in the former mailbox attached to the wall by the front door, or call me at 561 - 632 -9578 to arrange for your candidate petition to be picked up. Mike Fitzpatrick, District 3, Boynton Beach City Commissioner 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, p 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 Michael M. Fitzpatrick placed on the Primary/General Election Ballot as a: [check/complete box, as applicable] Nonpartisan ❑ No party affiliation ❑ Parry candidate for the office of Boynton Beach City Commissioner, District 3 (insert title of office and include district, circuit, group, seat number, if applicable) Date of Birth or Voter Registration Number Address (MM /DD ) a.e3a /10.8/z0 bi/ J� County State Zip. Code Ci 4 74/,x/7 i i19//w 1C2/ Signature of Voter Date Signed (MM /DDIYY) l [to be com Ieted by Voter] Rule 1S- 2.045, F.A.C. DS -DE 104 (Eff. 09/11) Thank you helping me get re- elected. Please return completed forms to 101 SW 4 Avenue (a 1920s two story yellow house, my childhood home) and place in the former mailbox attached to the wall by the front door, or call me at 561 - 632 -9578 to arrange for your candidate petition to be picked up. Mike Fitzpatrick, District 3, Boynton Beach City Commissioner 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, ! / t' a 'r)0(- ) the undersigned, a registered voter (print narhe as it appears on your voter information card) in said state and county, petition to have the name of Michael M. Fitzpatrick placed on the Primary/General Election Ballot as a: [check/complete box, as applicable] Nonpartisan ❑ No party affiliation ❑ Party candidate for the office of Boynton Beach City Commissioner, District 3 (insert title of office and include district, circuit, group, seat number, if applicable) Date of Birth or Voter Registration Number Address (MM /DD/YY) f / 6 ge g, � X695 City County State j Zip Code 73 0 y Signature of Voter Date Signed (MM /DDIYY) 42-d [to be completed by Voter] / Rule 1S- 2.045, F.A.C. DS - DE 104 Eff. 09/11 Thank you helping me get re- elected. Please return completed forms to 101 SW 4 Avenue (a 1920s two story yellow house, my childhood home) and place in the former mailbox attached to the wall by the front door, or call me at 561- 632 -9578 to arrange for your candidate petition to be picked up. Mike Fitzpatrick, • District 3, Boynton Beach City Commissioner 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 Z 11:2- the undersigned, a re iste bd vote (print name as it appears or your voter information car3) in said state and county, petition to have the name of Michael M. Fitzpatrick placed on the Primary/General Election Ballot as a: [check/complete box, as applicable] Nonpartisan ❑ No party affiliation ❑ Party candidate for the office of Boynton Beach City Commissioner, District 3 (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 e)crq c J +- PA Lipt 60 PI nziO 3:03.5" Si nat of Voter Date Signed (MM /DD/YY) tL [to be completed by Voter] // v Rule 1S- 2!045(F.A.C. A I DS -DE 104 (Eff. 09/11) r Thank you helping me get re- elected. Please return completed forms to 101 SW 4 Avenue (a 1920s two story yellow house, my childhood home) and place in the former mailbox attached to the wall by the front door, or call me at 561- 632 -9578 to arrange for your candidate petition to be picked up. Mike Fitzpatrick, District 3, Boynton Beach City Commissioner 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] p c.i5 - 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 Michael M. Fitzpatrick 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 Boynton Beach City Commissioner, District 3 (insert title of office and include district, circuit, group, seat number, if applicable) Date of Birth or Voter Registration Number Address y-� (MMIDD/YY) 0 2? CO/(90/0 l C / of N r' /ro7 /6,,s- 7-g– City County State Zip Code 60 r12 /4:w 6-each Pam 6e aeh - Z• 33g3 Signature of Voter Date Signed (MM /DD/YY) [to be completed by Voter] 9 1 ' ` c7‘16—)9 r 10 /7- .2 ev /5 Rule 1S- 2.045, F.A.C. DS -DE 104 (Eff. 09/11) Thank you helping me get re- elected. Please return completed forms to 101 SW 4 Avenue (a 1920s two story yellow house, my childhood home) and place in the former mailbox attached to the wall by the front door, or call me at 561 - 632 -9578 to arrange for your candidate petition to be picked up. Mike Fitzpatrick, District 3, Boynton Beach City Commissioner 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] i - If all requested information on this form is not completed, the form will not be valid as a Candidate Petition for, . C = , / ®� // „ the undersigned, a registered voter �� I (print name as it appears on your voter information card) in said state and county, petition to have the name of Michael M. Fitzpatrick placed on the Primary/General Election Ballot as a: [check/complete box, as applicable], IR] Nonpartisan ❑ No party affiliation ❑ Party candidate for the office of Boynton Beach City Commissioner, District 3 (insert title of office and include district, circuit, group, seat number, if applicable) Date of Birth or Voter Registration Number Address 02/7 (MM /DDIYY) Cctd y City i County Stat Zip Code y °� G Signature ofV•ter Date Signed (MM /DDIYY) [to be completed by Voter] / � QGg , */ /1 71/7/6 Rule 1S- 2.045, F.A.C. S -DE 104 (Eff. 09/11) Thank you helping me get re- elected. Please return completed forms to 101 SW 4 Avenue (a 1920s two story yellow house, my childhood home and place in the former mailbox attached to the wall by the front door, or call me at 561 - 632 -9578 to arrange for your candidate petition to be picked up. Mike Fitzpatrick, District 3, Boynton Beach City Commissioner 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, t ` ' /wle /� �J'J �: 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 Michael M. Fitzpatrick placed on the Primary/General Election Ballot as a: [check/complete box, as applicable] Q Nonpartisan ❑ No party affiliation ❑ Party candidate for the office of Boynton Beach City Commissioner, District 3 (insert title of office and include district, circuit, group, seat number, if applicable) Date of Birth or Voter Registration Number Address (MM /DD/YY) f ( 5' 0 ;4 of City County State Zip Code &VA/-to� c �°� - T� 3 3e3 Signature of Voter Date Signed (MM /DD/YY) kJ -04 [to be completed by Voter] Rule 1S- 2.045, F.A.C. DS -DE 104 (Eff. 09/11) Thank ou helping me get re- elected. Please return completed forms to 101 SW 4 Avenue (a Y p g 1920s two story yellow house, my childhood home) and place in the former mailbox attached to the wall by the front door, or call me at 561 - 632 -9578 to arrange for your candidate petition to be picked up. Mike Fitzpatrick, District 3, Boynton Beach City Commissioner 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 (- C (e'-e Gee_ 0- a j / it y 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 Michael M. Fitzpatrick placed on the Primary/General Election Ballot as a: [check/complete box, as applicable] Nonpartisan ❑ No party affiliation ❑ Party candidate for the office of Boynton Beach City Commissioner, District 3 (insert title of office and include district, circuit, group, seat number, if applicable) Date of Birth or Voter Registration Number Address (MM /DD/Y, / / ( ! 15 b3 U ' 7-0 "-5 4-sr Ci County State Zip Code 16,[4c - (p/4 (6.2ec ct - Pie Ih 3 Signature of Voter Date Signed (MM /DD/YY) [to be completed by Voter] �r Rule 1S- 2.045, F.A.C. DS -DE 104 (Eff. 09/11) Thank you helping me get re- elected. Please return completed forms to 101 SW 4 Avenue (a 1920s two story yellow house, my childhood home) and place in the former mailbox attached to the wall by the front door, or call me at 561 - 632 -9578 to arrange for your candidate petition to be picked up. Mike Fitzpatrick, District 3, Boynton Beach City Commissioner 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 1 , ��C . G / / W� f/ ` - S 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 Michael M. Fitzpatrick placed on the Primary/General Election Ballot as a: [checWcomplete box, as applicable] Q Nonpartisan ❑ No party affiliation ❑ Party candidate for the office of Boynton Beach City Commissioner, District 3 (insert title of office and include district, circuit, group, seat number, if applicable) Date of Birth or Voter Registration Number Address �✓� 6 Z (MM/DD/YY) (/ City County State Zip Code A /4, g6 Signature of Voter Date Signed (MM /DD/YY) [to be completed by Voter] jam , -- Rule 1S- 2.045, F.A.C. DS -DE 104 (Eff. 0 Thank ou helping get re- elected. Please return completed forms to 101 SW 4 Avenue (a y p g me g 1920s two story yellow house, my childhood home) and place in the former mailbox attached to the wall by the front door, or call me at 561 - 632 -9578 to arrange for your candidate petition to be picked up. Mike Fitzpatrick, District 3, Boynton Beach City Commissioner 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 forme I, .��7 ne E, Dal,* l 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 Mirhapl M. Fit7natrirk placed on the Primary/General Election Ballot as a: [check/complete box, as applicable] ® Nonpartisan ❑ No party affiliation ❑ Party candidate for the office of Boynton Beach City Commissioner, District 3 (insert title of office and include district, circuit, group, seat number, if applicable) Date of Birth or Voter Registration Number Address (MM /DD/YY) q _ dVo 0 /if S,9 -e(s, T Rl`l, ' City County State Zip Code ge r/JThO 6e./96 eq &4 h (=-Z_ .3 3913 6 Signatur= • Vot -r /.17--- Date Signed (MM /DD/YY) ' 41 G p 4 / [to b c ompleted by . (" S c! / / Rule 1S- 2.045, F DS -DE 104 (Eff. 09/11) Thank you helping me get re- elected. Please return completed forms to 101 SW 4 Avenue (a 1920s two story yellow house, my childhood home) and place in the former mailbox attached to the wall by the front door, or call me at 561 - 632 -9578 to arrange for your candidate petition to be picked up. Mike Fitzpatrick, District 3, Boynton Beach City Commissioner 1 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, R). ( ( Z ra VIA , I i9j - 11-0 the undersigned, a registered voter (print name a ears on our ote formation card) your ) in said state and county, petition to have the name of Michael M. Fitzpatrick placed on the Primary/General Election Ballot as a: [check/complete box, as applicable] q Nonpartisan ❑ No party affiliation ❑ Party candidate for the office of Boynton Beach City Commissioner, District 3 (insert title of office and include district, circuit, group, seat number, if applicable) Date of Birth or Voter Registration Number Address (MM /DD/YY) 1 1 7 t O 1 g 3- (o ( o e -i 1 . e1r� L , r A T City C ty Sta Zip Code 33 6.24-eit a y-3- 'gip ture of Voter Date Signed (MM /DD/YY) [to be completed by Voter] L k j i: J.• (0, Rule 1S- 2.045, F.A.C. DS -DE 104 (Eff. 09/11) Thank you helping me get re- elected. Please return completed forms to 101 SW 4 Avenue (a 1920s two story yellow house, my childhood home) and place in the former mailbox attached to the wall by the front door, or call me at 561 - 632 -9578 to arrange for your candidate petition to be picked up. Mike Fitzpatrick, District 3, Boynton Beach City Commissioner 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, (� p the undersigned, a registered voter (print name as it appears on your voter iry#ormation card) in said state and county, petition to have the name of , Michael M. Fitzpatrick placed on the Primary/General Election Ballot as a: [check/complete box, as applicable] Nonpartisan ❑ No party affiliation ❑ Party candidate for the office of Boynton Beach City Commissioner, District 3 (insert title of office and include district, circuit, group, seat number, if applicable) Date of Birth a Voter Registration Number Address _ r� (MM/DC7 ■ � Ci County,„ State Zip Code = e c • T,S '- gnature of Voter Date Signed (MM /DD/YY) [to be completed by Vo er] / S C , ems Rule 1S- 2.045, F.A.C. DS -DE 104 (Eft. 09/11) Thank you helping me get re- elected. Please return completed forms to 101 SW 4 Avenue (a 1920s two story yellow house, my childhood home) and place in the former mailbox attached to the wall by the front door, or call me at 561 - 632 -9578 to arrange for your candidate petition to be picked up. Mike Fitzpatrick, District 3, Boynton Beach City Commissioner • • 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] - Ilan requested information on this form is not completed the form will not be valid as a Candidate Petition form. 1 G 2 e / Al. Ah 107-1L- 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 Michael M. Fitzpatrick placed on the Primary/General Election Ballot as a: [check/complete box, as applicable] IW Nonpartisan ❑ No party affiliation ❑ Party candidate for the office of Boynton Beach City Commissioner, District 3 (insert title of office and include district, circuit, group, seat number, if applicable) Date of Birth or Voter Registration Number Add ress / (MM/ D/YY) /1"/73.D- C , (c /ICJ /gl2<5 /0c5 —S7 ,36-C Ci Co State Zip Code �enic/J• ...- ,446 A I ei9c I //72 y � Sig ature of Voter Date Signed (MM /DD/YY) � )7 7 [to be completed by Voter] aAr.)-P,P 0 ( (// e o 6 /'///5 Rule 1S- 2.045, F.A.C. DS -DE 104 (Eff. 09111) Thank you helping me get re- elected. Please return completed forms to 101 SW 4 Avenue (a 1920s two story yellow house, my childhood home) and place in the former mailbox attached to the wall by the front door, or call me at 561- 632 -9578 to arrange for your candidate petition to be picked up. Mike Fitzpatrick, District 3, Boynton Beach City Commissioner CANDIDATE PETITION Note - 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. r I, ` f�> % ee/P /9 �/ 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 Michael M. Fitzpatrick placed on the Primary/General Election Ballot as a: [check/complete box, as applicable] Q Nonpartisan ❑ No party affiliation ❑ Party candidate for the office of Boynton Beach City Commissioner, District 3 (insert title of office and include district, circuit, group, seat number, if applicable) Date of Birth or Voter Registration Number Address (MM /DD/YY) 4008 dgo . City County State Zip Code op/ d /Oa Lfed Signature of Voter Date Signed (MM /DD/YY) [to be completed by Voter] Rule 1S- 2.045, Y /YC. DS -DE 104 (Eff. 09111) Thank you helping me get re- elected. Please return completed forms to 101 SW 4 Avenue (a 1920s two story yellow house, my childhood home) and place in the former mailbox attached to the wall by the front door, or call me at 561- 632 -9578 to arrange for your candidate petition to be picked up. Mike Fitzpatrick, District 3, Boynton Beach City Commissioner 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 m. I, it l ,.. ji. 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 Michael M. Fitzpatrick placed on the Primary/General Election Ballot as a: [check/complete box, as applicable] Q Nonpartisan ❑ No party affiliation ❑ Party candidate for the office of Boynton Beach City Commissioner, District 3 (insert title of office and include district, circuit, group, seat number, if applicable) Date of Birth . or Voter Registration Number Address (MM /DD/YY) 7,706 7,53 eY P 1 el 76 3 Le City County State Zip Code sky--/ 4Z/27 lege/1 _73 y,3 y Signature of Voter Date Signed (MM /DD/YY) [to be completed by Voter] pfed / / /5 i Rule 1S- 2.045, FAG DS -DE 104 (Eff. 09/11) Thank you helping me get re- elected. Please return completed forms to 101 SW 4 Avenue (a 1920s two story yellow house, my childhood home) and place in the former mailbox attached to the wall by the front door, or call me at 561 - 632 -9578 to arrange for your candidate petition to be picked up. Mike Fitzpatrick, District 3, Boynton Beach City Commissioner 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 V A 4 - ) 40 cco the undersigned, a registered voter IL- 9�e (print name as it appears 6n our voter information card) ) in said state and county, petition to have the name of Michael M. Fitzpatrick placed on the Primary/General Election Ballot as a: [check/complete box, as applicable] Q Nonpartisan 0 No party affiliation ❑ Party candidate for the office of Boynton Beach City Commissioner, District 3 (insert title of office and include district, circuit, group, seat number, if applicable) Date of Birth or Voter Registration Number Address (MM /DD/YY) 3 Yo Hot/2,64 cv,0 577 Afi / off City County State Zip Code 6 o yw A ,e A c- PA- 1-41- Ao acff` &,q y a •i Signature of Voter Date Signed (MM /DDIYY) [to be completed by Voter] Rule 1S- 2.045, F.A.C. / DS -DE 104 (Eff. 09/71 Thank you helping me get re- elected. Please return completed forms to 101 SW 4 th Avenue (a 1920s two story yellow house, my childhood home) and place in the former mailbox attached to the wall by the front door, or call me at 561 - 632 -9578 to arrange for your candidate petition to be picked up. Mike Fitzpatrick, District 3, Boynton Beach City Commissioner 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 E / 2 mg, p� the undersigned, a registered voter (print name as it appee�ars on your voter information card) in said state and county, petition to have the name of Michael M. Fitzpatrick placed on the Primary/General Election Ballot as a: [check/complete box, as applicable] Nonpartisan ❑ No party affiliation ❑ Party candidate for the office of Boynton Beach City Commissioner, District 3 (insert title of office and include district, circuit, group, seat number, if applicable) Date of Birth or Voter Registration Number Address (MM /DD/YY) 4 /41‘14 - ° °4; £. - &042.fI L / �' 3 City County // �� / State Zip Code 4Dyit)7Lo PAL Signature of Voter Date Signed (MM /DD/YY) C [to be completed by Voter] C�� / Rule 1S- 2.045, F.A.C. U DS -DE 104 (Eff. 09/11) Thank you helping me get re- elected. Please return completed forms to 101 SW 4 Avenue (a 1920s two story yellow house, my childhood home) and place in the former mailbox attached to the wall by the front door, or call me at 561- 632 -9578 to arrange for your candidate petition to be picked up. Mike Fitzpatrick, District 3, Boynton Beach City Commissioner CANDIDATE PETITION Notes: - All information on this form becomes a public record upon receipt b the Su Supervisor of Elections. E .f P p by P .f - 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) 1 �' '(' the undersigned, a registered voter ld (print name as it appears on your voter information card) in said state and county, petition to have the name of Michael M. Fitzpatrick placed on the Primary/General Election Ballot as a: [check/complete,box, as applicable] Q Nonpartisan ❑ No party affiliation ❑ Party candidate for the office of Boynton Beach City Commissioner, District 3 (insert title of office and include district, circuit, group, seat number, if applicable) Date of Birth or Voter Registration Number Address (MM/ D/YY ) o2() / 76 2/07 S - City ?siic4 C ty State Zip Code Signature of Voter Date Signed (MM /DD/YY) [to om feted by Voter] Rule 1S- 2.045, F.A.C. DS -DE 104 (Eff. 09111) Thank you helping me get re- elected. Please return completed forms to 101 SW 4 th Avenue (a 1920s two story yellow house, my childhood home) and place in the former mailbox attached to the wall by the front door, or call me at 561 - 632 -9578 to arrange for your candidate petition ' to be picked up. Mike Fitzpatrick, District 3, Boynton Beach City Commissioner 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: A/9-R4" /Lf /e.n rUELLi' /-09 -u rite /9-/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 Michael M. Fitzpatrick placed on the Primary/General Election Ballot as a: [check/complete box, as applicable] [k] Nonpartisan D No party affiliation ❑ Party candidate for the office of Boynton Beach City Commissioner, District 3 (insert title of office and include district, circuit, group, seat number, if applicable) Date of Birth ) or Voter Registration Number Address 00/ S L 77 � t / y .6 q03 MM /DD/YY c2 6 115 Flo FOA City County State Zip Code Bow-Nu 3 &mN 7 L/-� r =�� -f 33 S� Signature of Voter Date Signed (MM /DD/YY) [to be completed by Voter] e 4 4 .4e , / ! /0 ^/5`001 Rule 1S- 2.045, F.A.C. DS -DE 104 (Eff. 09/11) Thank you helping me get re- elected. Please return completed forms to 101 SW 4 Avenue (a 1920s two story yellow house, my childhood home) and place in the former mailbox attached to the wall by the front door, or call me at 561- 632 -9578 to arrange for your candidate petition to be picked up. Mike Fitzpatrick, District 3, Boynton Beach City Commissioner 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 k -ei zrr g - Ge e ti, .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 Michael M. Fitzpatrick placed on the Primary/General Election Ballot as a: [check/complete box, as applicable] lil Nonpartisan ❑ No party affiliation ❑ Party candidate for the office of Boynton Beach City Commissioner, District 3 (insert title of office and include district, circuit, group, seat number, if applicable) Date of Birth or Voter Registration Number Address (MM /D /YY) /c7/3 // ? z/Z a9 (;0 Niff ax , /06 City County State Zip Code nieiv J8e ' ,- PA Z , F a 33 _ Signs a of Voter 01 4. Date Signed (MM /DD/YY) [to be completed by. Voter] net, + /6 001.6 Rule 1S- 2.045, F.A.C. DS -DE 104 (Eff. 09/11) Thank you helping me get re- elected. Please return completed forms to 101 SW 4 Avenue (a 1920s two story yellow house, my childhood home) and place in the former mailbox attached to the wall by the front door, or call me at 561 =632 -9578 to arrange for your candidate petition to be picked up. Mike Fitzpatrick, . District 3, Boynton Beach City Commissioner II 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, a , r the undersigned, a registered voter (print nafne as it appears on your voter information card) in said state and county, petition to have the name of Michael M. Fitzpatrick placed on the Primary/General Election Ballot as a: [checWcomplete box, as applicable] Q Nonpartisan EJ No party affiliation ❑ Party candidate for the office of Boynton Beach City Commissioner, District 3 (insert title of office and include district, circuit, group, seat number, if applicable) Date of Birth or Voter Registration Number Address 7s 54( (MM /DD/YY) �`1 5 - 7 7 /c6 / /'so City County State Zip Code PP/ 70 i3 Gz e 4 Pa 1 3 ear /. 3 2435 Signature of Vote Date Signed (MM /DD/YY) [to be completed by Voter] v 10 / /'/ 2t' /s Rule 1S- 2.045, F.A.C. DS -DE 104 (ES . 02:1j ... 1 Thank you helping me get re- elected. Please return completed forms to 101 SW 4 Avenue (a 1920s two story yellow house, my childhood home) and place in the former mailbox attached to the wall by the front door, or call me at 561 - 632 -9578 to arrange for your candidate petition to be picked up. Mike Fitzpatrick, District 3, Boynton Beach City Commissioner 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. EWP-Ia o GULIIAAJ 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 Michael M. Fitzpatrick placed on the Primary/General Election Ballot as a: [checWcomplete box, as applicable] I Nonpartisan ❑ No party affiliation ❑ Party candidate for the office of Boynton Beach City Commissioner, District 3 (insert title of office and include district, circuit, group, seat number, if applicable) Date of Birth or Voter Registration Number Address ,+ / ✓� (MM 07/0516,1 DD/YY) 2 '1 1 qq i/ E . of l iot Lr / lid: 1d3o City D � i �� �� County � State Zip • Code / � y 71 / 3373 ;„ Signature of V• Date Signed (MM /DD/YY) [to be co plete by Voter] • 101 15 Rule 1S -2.0 • . DS -DE 104 (Eff. 09/11) • • Thank you helping me get re- elected. Please return completed forms to 101 SW 4 Avenue (a 1920s two story yellow house, my childhood home) and place in the former mailbox attached to the wall by the front door, or call me at 561 - 632 -9578 . to arrange for your candidate petition to be picked up. Mike Fitzpatrick, District 3, Boynton Beach City Commissioner • • CANDIDATE PETITION p(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. h tei A /..( , / ') 11 / /1/4(0 the undersigned, a registered voter (print name as it appears onur voter information card) in said state and county, petition to have the name of Michael M. Fitzpatrick placed on the Primary/General Election Ballot as a: [check/complete box, as applicable] Li Nonpartisan ❑ No party affiliation ❑ Party candidate for the office of Boynton Beach City Commissioner, District 3 (insert title of office and include district, circuit, group, seat number, if applicable) Date of Birth or Voter Registration Number Address (MM /DD/YY) io / 30/WO 2Q S. R �2 )466,/ - 6 City County State Zip Code @ ec/ LLt P:} ltM r/J c.A R- 3-3 Signature of Voter Date Signed (MM /DD/YY) [to be completed by Voter] - i °/l `71 is- Rule 1S- 2.045, F.A.C. DS -DE 104 (Eff. 09/11) Thank you helping me get re- elected. Please return completed forms to 101 SW 4 Avenue (a 1920s two story yellow house, my childhood home) and place in the former mailbox attached to the wall by the front door, or call me at 561 - 632 -9578 to arrange for your candidate petition to be picked up. Mike Fitzpatrick, District 3, Boynton Beach City Commissioner • 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 farm will not be valid as a Candidate Petition form. • 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 Michael M. Fitzpatrick placed on the Primary/General Election Ballot as a: [check/complete box, as applicable] [ Nonpartisan ❑ No party affiliation ❑ Party candidate for the office of Boynton Beach City Commissioner, District 3 (insert title of office and include district, circuit, group, seat number, if applicable) Date of Birth or Voter Registration Number Address (MM /DD ) City Cou State Zip Code T7 • 1I /1 0 L Signature Voter Date Signed (MM/DD/YY) [to be comple d by V erg • Rule 1S -2. 45, F.A. DS -DE 104 (Eff. 09/11) Thank you helping me get re- elected. Please return completed forms to 101 SW 4 th Avenue (a 1920s two story yellow house, my childhood home) and place in the former mailbox attached to the wall by the front door, or call me at 561 - 632 -9578 to arrange for your candidate petition to be picked up. Mike Fitzpatrick, District 3, Boynton Beach City Commissioner 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, `Thee_ „ n Q (. itit A Q.y-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 Michael M. Fitzpatrick placed on the Primary/General Election Ballot as a: [check/complete box, as applicable] Q Nonpartisan ❑ No party affiliation ❑ Party candidate for the office of • Boynton Beach City Commissioner, District 3 (insert title of office and include district, circuit, group, seat number, if applicable) Date of Birth or Voter Registration Number Address (MM /DD/YY) — .S yL. 6 'se S N act Aid D 7 City County State Zip Code or/nere AC 6e,4 FL. 334e s Signature of Voter Date Signed (MM /DD/YY) Ac�" [to be completed by Voter] f' o -/S- Rule 1S- 2.045, F.A.C. DS -DE 104 (Eff. 09/11) Thank you helping me get re- elected. Please return completed forms to 101 SW 4 Avenue (a 1920s two story yellow house, my childhood home) and place in the former mailbox attached to the wall by the front door, or call me at 561 - 632 -9578 to arrange for your candidate petition to be picked up. Mike Fitzpatrick, District 3, Boynton Beach City Commissioner • 1 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�/1t M it /3 -- pe - l - , ; L the undersigned, a registered voter s (print name as it appears o(i your voter information card) in said state and county, petition to have the name of Michael M. Fitzpatrick placed on the Primary/General Election Ballot as a: [check/complete box, as applicable] Q Nonpartisan ❑ No party affiliation ❑ Party candidate for the office of Boynton Beach City Commissioner, District 3 (insert title of office and include district, circuit, group, seat number, if applicable) Date of Birth or Voter Registration Number Address (MM /DD/YY) f75- off? 06f 27 1 W 13 / City County State Zip Code 6,c/ - 194 & `1 Pee 3 3 y3 Signature of Voter Date Signed (MM /DDIYY) �j �✓ ... [to be completed by Voter] doh pi/ 3' Rule 1S- 2.045, F.A.C. DS -DE 104 Eff 09/11 Thank you helping me get re- elected. Please return completed forms to 101 SW 4 Avenue (a 1920s two story yellow house, my childhood home) and place in the former mailbox attached to the wall by the front door, or call me at 561 - 632 -9578 to arrange for your candidate petition to be picked up. Mike Fitzpatrick, District 3, Boynton Beach City Commissioner