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Filing PapersDS -DE 9 (Rev. 10/10) Rule 1S-2.0001, F.A.C. fii' `c ii ; t� A C APPOINTMENT OF CAMPAIGN TREASURER i-' ';' �'�E 'i'S OFFICE AND DESIGNATION OF CAMPAIGN 131 N 1 18 �' nR DEPOSITORY FOR CANDIDATES (Section 106.021(1), F.S.) (Section (PLEASE PRINT OR TYPE) NOTE: This form must be on file with the qualifying officer before opening the campaign account. OFFICE USE ONLY 1. CHECK APPROPRIATE BOX(ES): ❑ Initial Filing of Form Re-filing to Change: ❑ Treasurer/Deputy ❑ Depository ❑ Office ❑ Party 2. Name of Candidate (in this order: First, Middle, Last) 3. Address (include post office box or street, city, state, zip code) Vq-T- 4. Telephone 5. E-mail address (8-6 1 ) 0 �' r -2ff 6. Office sought (include district, circuit, group number) 7. If a candidate for a nonpartisan office, check if applicable: C' ITY C�A� I SS t M L� `� r$ ❑ My intent is to run as a Write-In candidate. 8. If a candidate for a partisan office, check block and fill in name of party as applicable: My intent is to run as a Write-In ❑ No Parry Affiliation ® Party candidate. 9. 1 have appointed the following person to act as my Ej Campaign Treasurer ❑ Deputy Treasurer 10.Na of Treasurer or leputyi'7Trreasurer , ut v 11. Mailing Address 67 U- 4Y e:7- 12. Telephone (5-61 )gs� 12<R�o 1City loymTKA eL 14. ounty Vq e 15. State 16. Zip Code 17. E-mail address D t fq � -3 -R� 3in 18. 1 have designated the following bank as my JQ Primary Depository ❑ Secondary Depository 19. Name of Bank LAS V'�-a 20. Address 15 24-53ity 2 ounty 23. to 24. Zip Code UNDER PENALTIES OF PERJURY, I DECLARE THAT I HAVE READ THE FOREGOING FORM FOR APPOINTMENT OF CAMPAIGN TREASURER AND DESIGNATION OF CAMPAIGN DEPOSITORY AND THAT THE FACTS STATED IN IT RE TRUE. 25. Date11 1 26. Signatur of d to 1 ISI X° lq X 27. __,_) Treasurer's Acceptance of Appointment (fill in the blanks and check the appropriate block) I,:k�a-T , do hereby accept the appointment (Please F3rint or Type Name) designated above. as: Campaign Treasurer Dep Tre u r. 0ao i� x D to Signature of Campaign TreasslArer or Deputy Treasurer DS -DE 9 (Rev. 10/10) Rule 1S-2.0001, F.A.C. STATEMENT OF CANDIDATE (Section 106.023, F.S.) (Please print or type) 1 �)(A\ FFFiC lj-�ta ONLY ('1 r '~ ' 1- El", 0FFIC ja nFr, -1 A1110. 17 candidate for the office of L i Y 'N'T q have been provided access to read and understand the requirements of Chapter 106, Florida Statutes. X Signa a of Can (date bate 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 (05111) Please print or type your name, mailing address, agency name, and position below: LAST E -- FIRST NAG�E —MIDDLE qTZ_ J Av 17 MAILING ADDRESS . I P W6b STATEMENT OF 2018 FINANCIAL �l�rTTiil�i+LS..tf i`.rj l CE USE ONLY: C CITY. ZIP: COUNTY : NAME OF AGENCY . CI iy 1,e cyLN t NAME OF OFFICE OR POSITION HELD OR SOUGHT: r1Ccrn�tSscavL� 1)Is'[- y You are not limited to the space on the lines on this form. Attach additional sheets, if necessary. CHECK ONLY IF b�- 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, 2018 OR ❑ 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_ VAL�see instructions for further details). CHECK THE ONE YOU ARE USING (must check one): ❑ COMPARATIVE (PERCENTAGE) THRESHOLDS OR CDOLLAR VALUE THRESHOLDS 1 �C`VVV - 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 "nla") NAME OF SOURCE SOURCE'S DESCRIPTION OF THE SOURCE'S OF INCOME ADDRESS PRINCIPAL BUSINESS ACTIVITY S'v ct S't CVrZ �) C t 2 caz (Iyol 7,-c 2 & ffi ED J 12 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 -- �+ 6Z C Jt;��iZ• M tr t�(* �Ix�i L ! / S� N� MI e t G 1 7T [ �yuve Rz�l-c 7-j<y,140Vn i21O /fL l(j 2 L�70 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. INSTRUCTIONS on who must file this form and how to fill it out begin on page 3. CE FORM 1 - Effective: January 1, 2019 (Continued on reverse side) PAGE 1 Incorporated 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 I BUSINESS ENTITY TO WHICH, THE PROP.ERTY,, TES f`,}_ _ . ICE PART E — LIABILITIES [Major debts - See instructions] (If you have nothing to report, write "none" or'Wa") NAME OF CREDITOR ADDRESS OF CREDITOR L-vuYSeet m -a--'.)" f e U e t r0 ' MAS 61 w?6- fin, q 6( 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 NAME OF BUSINESS ENTITY ADDRESS OF BUSINESS ENTITY PRINCIPAL BUSINESS ACTIVITY POSITION HELD WITH ENTITY BUSINESS ENTITY # 2 I I OWN MORE THAN A 5% INTEREST IN THE BUSINESSI I ` I NATURE OF MY OWNERSHIP INTEREST I I PART G — TRAINING For elected municipal officers required to complete annual ethics training pursuant to section 112.3142, F.S. ❑ I CERTIFY THAT I HAVE COMPLETED THE REQUIRED TRAINING. I IF ANY OF PARTS A THROUGH G ARE CONTINUED ON A SEPARATE SHEET, PLEASE CHECK HERE ❑ SIGNATURE OF FILER: Signature: Date Signed: FILING INSTRUCTIONS: If you were mailed the form by the Commission on Ethics or a County Supervisor of Elections for your annual disclosure filing, return the form to that location. To determine what category your position falls under, see page 3 of instructions. Local officers/employees file with the Supervisor of Elections of the county in which they permanently reside. (If you do not permanently reside in Florida, file with the Supervisor of the county where your agency has its headquarters.) Form 1 filers who file with the Supervisor of Elections may file by mail or email. Contact your Supervisor of Elections for the mailing address or email address to use. Do not email your form to the Commission on Ethics it will be returned. State officers or specified state employees who file with the Commission on Ethics may file by mail or email. To file by mail, send the completed form to P.O. Drawer 15709, Tallahassee, FL 32317-5709; physical address: 325 John Knox Rd, Bldg E, Ste 200, Tallahassee, FL 32303. To file with the Commission by email, scan your completed form and any attachments as a pdf (do not use any other format) and send it to CEForml@leg.state.fl.us. Do not _fille b,. both mgil and email. Choose only one Pilin; method. Form 6s will not be accepted via email. CPA or ATTORNEY SIGNATURE ONLY If a certified public accountant licensed under Chapter 473, or attorney in good standing with the Florida Bar prepared this form for you, he or she must complete the following statement: I, , prepared the CE Form 1 in accordance with Section 112.3145, Florida Statutes, and the instructions to the form. Upon my reasonable knowledge and belief, the disclosure herein is true and correct. CPA/Attorney Signature: Date Signed: Candidates file this form together with their filing papers MULTIPLE FILING UNNECESSARY: A candidate who files a Form 1 with a qualifying officer is not required to file with the Commission or Supervisor of Elections. WHEN TO FILE: Initially, each local officer/employee, state officer, and specified state employee must file within 30 days of the date of his or her appointment or of the beginning of employment. Appointees who must be confirmed by the Senate must file prior to confirmation, even if that is less than 30 days from the date of their appointment. Candidates must file at the same time they file their qualifying papers. Thereafter, file by July 1 following each calendar year in which they hold their positions. Finally, file a final disclosure form (Form 1 F) within 60 days of leaving office or employment. Filing a CE Form 1 F (Final Statement of Financial Interests) does not relieve the filer of filing a CE Form 1 if the filer was in his or her position on December 31, 2018. CE FORM 1 - Effective: January 1, 2019. PAGE 2 Incorporated by reference in Rule 34-6.202(1), F.A.C. r, i fr��l I BEACH . .�T 1i ('.. RESIDENCY REQUIRE _nkl ri'. TS CD x_ M I, a fix ,-k-) EN -1-2— , candidate for (Print Name) C-�s� o� Ns < (N�ti� of the City (Mayor/Commissioner — District #) of Boynton Beach, have received, read and understand the residency requirements of Article II of the Charter of the City of Boynton Beach. (Signature of Candidate) l �C (D te) S:\CC\WP\ELECTION\Year2020\CANDIDATE INFORMATION CD\4. Residency Requirements\RESIDENCY REQUIREMENTS STATEMENT.doc CANDIDATE OATH - NONPARTISAN OFFICE (Not for use by Judicial or School Board Candidates) OFFICE USE ONLY OATH OF CANDIDATE (Section 99.021, Florida Statutes) (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 01 V1 ISS Io(y (office) (district #) � AL I am a qualified elector of 4 County, Florida; (circuit #) (group or seat #) I am qualified under the Constitution and the Laws of Florida to hold the office to which I desire to be nominated or elected; I have qualified for no other public office in the state, the term of which office or any part thereof runs concurrent with the office I seek; and I have resigned from any office from which I am required to resign pursuant to Section 99.012, Florida Statutes; and I will support the Constitution of the United States and the Constitution of the State of Florida. X (�M( h S3 9 f F0 �zM (TKAvd-w&Y', Signature of Ca ate Telephone Number Email Address me g 9 V1, 2�'(436 Address City State ZIP Code Candidate's Florida Voter Registration Number (located on your voter information card): �����/ / y * Please print name phonetically on the line below as you wish it to be pronounced on the audio ballot for persons with disabilities (see instructions on page 2 of this form): STATE OF FLORIDA( COUNTYOF ]E4VAl ,k Sworn to (or affirmed) and subscribed before me this 6 day of , 20-1�—. e. 10K NotOueaenester Nieves Public State of Florida Personally Known: or My Commission GG 210021 Expires 07116/2022 ;#nature of Notary Pub;Ic p, Produced Identification: Print, Type, or Stamp Commissioned Name of Notary Public Type of Identification Produced: i" Z>+je-+ si C •f+ 5 Q4eeneaer Nieves k32. -1(.e _5 I -);L a DS -DE 25 (Rev. 5111) Rule 1S-2.0001, F.A.C. The City of Boynton Beach CITY CLERK'S OFFICE 3301 QUANTUM BLVD. SUITE 101 BOYNTON BEACH, FL 33426 PHONE: (561) 742-6060 FAX: (561) 742-6090 E-MAIL: dtyderk@bbfl.us www.boynton-beach.org PUBLIC NOTICE 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 17, 2020 General Election will be held: Wednesday, February 26, 2020 @ 10:00 A.M. Palm Beach County Supervisor of Elections Service Center 7835 Central Industrial Drive Riviera Beach, Florida 33404 Attendance at the L&A testing is strictly optional for candidates and you are welcome to observe. PLEASE SELECT YOUR AVAILABILITY BELOW: I will be attending the Logic & Accuracy (L&A) testing of the voting equipment on February 26, 2020 @ 10:00 a.m. Estimated number of attendees: I will not be available to attend the Logic & Accuracy (L&A) testing of the voting equipment on February 26, 2020 @ 10:00 a.m. I ACKNOWLEDGE RECEIPT OF THIS NOTICE OF LOGIC & ACCURACY (L&A) TESTING. ,I I Candidate's Signature S:\CC\WP\ELECTION\Year 2020\L&A Testing Public Notice - For Candidate's Signature.doc Updated 12/5/2019 f a/6� Date Miscellaneous Cash Receipt No. 92183 CITY OF BOYNTON BEACH Account No. 001 -0000-3fA-10-00 \ 1 A Received of DAVID A. KATZ _ Address 67 MIDWOOD LANE BOYNTON BEACH, FL 33436 For CITY FILING FEE TO RUN -FOR COMMISSIONER — DISTRICT IV ON MARCH 17, 2020. , Dept. C.1 -TY CLERK'S OFFICE -- By Miscellaneous Cash Receipt CITY OF BOYNTON BEACH Account No. 001 —0000-36A-1_0-00 G\T Y O c • . 92184 O — U ~ 710 N Receivedof-__DAVIILA_ KATZ_ - Address 67 KIDWOOD I -ME BOYNTON BEACH, FL 33436 For 1% FILING FEE TO RUN FOR COMMISSIONER — DISTRICT IV ON _ MARCH- -17-, 2020. Dept._ CITY CLERK'S OFFICE By ti OF [O t e'rCt Wendy artory Link € < < I ERS ,'s OFFICE ' l 9 DEC �- 5 AN 10. 11 Palm Beach County Supervisor of Elections CERTIFICATION I, Wendy Sartory Link, Supervisor of Elections, for Palm Beach County, Florida, do hereby certify that 30 signatures on the Nominating Petitions of David Katz for Commission District 4 for the City 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 David Alan Katz is a registered voter in Precinct 3138, in the City of Boynton Beach, Florida. Signed, this 4th day of December, 2019. 240 South Military Trail, West Palm Beach, FL 334151 Post Office Box 22309, West Palm Beach, FL 33416 Telephone: 561.656.62001 Fax Number: 561.656.6287 CANDIDATE PETITION Notes: -411 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 (print name as it appears on your va>`er information papd) in said state and county, petition to have the name of j l Z__ placed on the Primary/General Election Ballot as a: [check/complete box, as applicable] Nonpartisan [:] No party affiliation F-1 Party candidate for the office of (insert title of office and include district, circuit, group, seat number, if applicable) Date of Birth or Voter Registration Number Address 112 (MM/DD/YY) j ,,, 7 7 1. fl f itet_:7� M FL, yC ty State Zip Code Signan Date Signed (MM/DD/YY) n_'e/ I [to be, completed by Voter] 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. [Sed tion 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. �iA 0' the undersigned, a registered voter (print name as it appears on your vQLer information payd) in said state and county, petition to have the name of placed on the Primary/General Election Ballot as a: [checklcomplete box, as applicable] onpartisan ❑ No party affiliation ❑ _ Party candidate for the office of (insert title of office and include district, circuit, group, seat number, if applicable) Date of Birth or Voter Registration Number Address C:7 M/eZ��DrYY)��� �Riti7l J4h j L'A' & V4 N C ty n State Zip Code rel10��f&��5�jj� L i `� � '�::1 -5 3 1r 3 S_ Signature of oter Date Signed (MM/DD/YY) [to be completed by Voter] Rule 15-2.045,P.A.C. DS -DE 104 (Eff. 0911 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. t, Ia ithe undersigned, a registered voter (print name as it appears on y ur ter information qarP in said state and county, petition to have the name of J' K f z -- placed on the Primary/General Election Ballot as a: [check/complete box, as applicable] I�Onpartisan ❑ No party affiliation ❑ Party candidate for the office of r_�% 1 iS!,-7-1 �, (insert title of office and include district, circuit, group, seat number, if applicable) Date of Birth or Voter Registration Number (MM/DD/YY) ity Cunty rIALN) Signature of Voter jam 0 Rule 1S-2.045, F.A C. Address 6;q ff IG wow LaO6 e -L -e -C4 State Zip Code Fl- � ;5q3 Date Signed (MM/DD/YY) [to be co mpleteq by Voter] DS -DE 104 (Eff. 09111 CANDIDATE PETITION Notes: -All information on this form becomes a public record upon receipt by the Supervisor of Elections. -ft 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. VI (print name as it appears on your ter information qaq in said state and county, petition to have the namK�-., I. z-- placed on the Primary/General Election Ballot as a: [check/complete box, as applicable] �' Onpartisan []No party affiliation ❑ the undersigned, a registered voter Party candidate for the office of GST'UTI IIST­ (insert title of office and include district, circuit, group, seat number, if applicable) Date of Birth or Voter RegistrationNumber Address (MMI D/YY) p ityC unty State Zip Code ALNI eco � 1 3Z 36 Signature of oter F.A.C. Date Signed (MMIDD/(Y) [to be complet dVoter] r5 DS -DE 104 � Eff. 09111 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. T, PA -4 the undersigned, a registered voter (print name as it appears on you in said state and county, petition to have the name of placed on the Primary/General Election Ballot as a: [check/complete box, as applicable] �' OOnpartisan No party affiliation ❑ Party candidate for the office of TCM M 19 9 WNL 7 �'Yn�i ei=� -I iS� 'L (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.A.C. ( f State J Zip Code Date Signed (MM/DD/YY) [to be comp/ It by Voter] C DS -DE 104 (Eff. 09111 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. N C the undersigned, a registered voter (print name as it appears on yourar.Qter information in said state and county, petition to have the name of placed on the Primary/General Election Ballot as a: [check/complete box, as applicable] �' OOnpartisan ❑ No party affiliation ❑ Party candidate for the office of � (CN `i Y I -bIsg— V (insert title of office and include district, circuit, group, seat number, if applicable) Date of Birth or Voter Registration Number Address (M /DD ) Icy Z_�/0 K C unity State Zip Code Signature of Voter Rule 1S-2.045, F.A.C. Date Signed (MM/DD/YY) [to be co pl ed b Voter] 1 3 � DS -DE 104IEff. 09/1 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. o the undersigned, a registered voter (print.name as it appears on your ter informationar in said state Z'county, petition to have the name of A-1 —Z— T placed on the Primary/General Election Ballot as a: [check/complete box, as applicable] 001TOnpartisan ❑ No party affiliation ❑_ _.n_ Party candidate for the office of TI Cc �s� nil ici�l� i "�t-� -4 l!S (insert title of office and include district, circuit, group, seat number, if applicable) =of or Voter Registration Number Address / ems" � � ��Y1/li� � � '' JD ►' C= I y C unty I State Zip Code n q , ) C.' � Y F11 �3 Signature Voter � � Date Signed (MM/DD/YY) [to be c3 pl ed by Voter] IS -2.045, F.A.C. DS -DE 104 (Eff. 0911 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. rW,9AfG (print name as it appears on your ter information Gard in said state and county, petition to have the name of _ R\c (b KA-- j -z-- placed on the Primary/General Election Ballot as a: [check/complete box, as applicable] the undersigned, a registered voter Wonpartisan ❑ No party affiliation ❑ .. Party candidate for the office of �I' T 'qIc�n(L� 5? C­tl-fp-`�l - - f I Isg— �f (insert title of office and include district, circuit, group, seat number, if applicable) Date of Birth or Voter RegistrationNum erb Address 2-11- �7 fi /77 ea- do (MM/DD/YY) Signature of Voter �fG F.A.C. State Zi Code Date Signed (MM/DD/YY) [to be completed by Voter] DS -DE 104 (Eff. 09!11 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 forr . V the undersigned, a registered voter (print name as it appears on your voter information pa in said state and county, petition to have the name of placed on the Primary/General Election Ballot as a: [checWcomplete box, as applicable] Nonpartisan ❑ No party affiliation ❑ _ __ Party candidate for the office of -,l (insert title of office and include district, circuit, group, seat number, if applicable) Date of Birth or Voter Registration Number Address (MM/DD/YY) ityC ty State Zip Code 'Q�OLNUMN � cm 3g `t 3 Signature of Voter Date Signed (MM/DD/YY) [to be completed by Voter] Rule 15-2.045, F-Ak. DS -DE 1041Eff. 0911 CANDIDATE PETITION Notes: -.411 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 fore . the undersigned, a registered voter (print name as it appears on your v er information pa ) in said state and county, petition to have the name of I� placed on the Primary/General Election Ballot as a: [check/complete box, as applicable] partisan ❑ No party affiliation F-� Party candidate for the office of 6' (M 0 S9 I M-Yz PYIIQ60�471W (;L--T-NrA -b6T A (insert title of office and include district, circuit, group, seat number, if applicable) Date of Birth or Voter Registration Number Address (MM/DD/YY ity C ty State Zip Code Signature of Voter ! ! w Rule 1S-2.045. F.A.C. Date Signed (MM/DD/YY) [to be completed by Voter] 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. (print r{ame as it appears on your water information in said state and county, petition to have the name of �lT i placed on the Primary/General Election Ballot as a: [check/complete box, as applicable] O No party affiliation the undersigned, a registered voter Party candidate for the office of (insert title of office and include district, circuit, group, seat number, if applicable) Date of Birth or Voter Registration Number Address (MM/DD/YY _A4 ? Loo 64 L_,Y) ity C ty2t_7_f)e_q State Zip Code L11lwrffm�`R fALel �3 3 3 Signatu of Voter i 1 ' !1S-2.045. F.A.C. Date Signed (MM/DD/YY) [to be completed by Voter] L 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 (print name as it appears on your ver .a.d) in said state and county, petition to have the name of j er .A--7,1 placed on the Primary/General Election Ballot as a: [check/complete box, as applicable] nonpartisan ❑ No party affiliation ❑ _ _ _ _ _ _ Party candidate for the office of (insert title of office and include district, circuit, group, seat number, if applicable) Date of Birth or Voter Registration Number Address (MM/DDNY) u�rt 11PQJ0W �(t-- ty C ty State Zip Code AfALM2 t_-�Mq FL,_ -33q36 Signature of oter Date Signed (MM/DD/YY) f [to be completed by Voter] Rule 1S-2.045 .AX. DS -DE 104tEff. 09111 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. /-`/Y n C e &N e� the undersigned, a registered voter (print name as it appears on your ter information card)/ in said state and county, petition to have the name of Pf placed on the Primary/General Election Ballot as a: [checWcomplete box, as applicable] ❑Nonpartisan ❑No party affiliation ❑ Party candidate for the office of M m Ss1c--(2 9% n om/ 8L� Ciq D 1 s T (insert title of office and include district, circuit, group, seat number, if applicable) Date of Birth or Voter Registration Number Address —M � --3 m I ('Q ��� ---o "'P County State Zip Code en 3 Signature of Vo Date Signed (MMIDD/YY) [to be co+ pleted y Voter] 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. t' Let cN 2 �A�ethe undersigned, a registered voter (print name as it appears on your er information rd in said state and county, petition to have the name of U AV 1 T -2 --- placed on the Primary/General Election Ballot as a: [check/complete box, as applicable] Piivonpartisan ❑ No party affiliation ❑ _ Party candidate for the office of rn t S X72 INbYNtVP-C-H__lI S j (insert title of office and include district, circuit, group, seat number, if applicable) Date of Birth // or Voter Registration Number Address (MM/DD1YY) %!o / 7 q zl % City C unty State Zip Code L3 of Vote Date Signed (MM/DD/YY) [to be completed by,otteer] /8 / L DS -DE 104 (Eff. 09/1 CANDIDATE PETITION Notes: -All information on this form becomes a public record upon receipt by the Supervisor of Elections. J - It is a crime to knowingly sign more than one petition for a candidate. [Section 104.185, Florida Statutes] v - If all requested information on this form is not completed, the form will not be valid as a Candidate Petition form. Y2_1 C e J -A K N) the undersigned, a registered voter (print name as it appears on your voter information c in said state and county, petition to have the name of placed on the Primary/General Election Ballot as a: [check/complete box, as applicable] Wnpartisan [:]No party affiliation ❑ Party candidate for the office of lY Cern m 19 �9 (eN LAK? -bi Si -9 (insert title of office and include district, circuit, group, seat number, if applicable) Date of Birth or Voter Registration Number Address (2GC Cit n my State Zip Code -elq F7L Sig of Voter Date Signed (MM/DD/YY) c [to be c mplete b ter] Rule IS -2.0/5. FAX.,— DS -DE 104 (Eff. 0911 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 (print name as it appears on yourTAN r informatiortca ] _ in said state and county, petition to have the name of 42 A) placed on the Primary/General Election Ballot as a: [check/complete box, as applicable] npartisan F-1 No party affiliation ❑ Party candidate for the office of �"F C,fJr`l1 i s S ? GrVL�2 e L`(arepi (insert title of office and include district, circuit, group, seat number, if applicable) Date of Birth or Voter Registration Number Address bt� 3 (MM/DD/YY) Cs5-15-1°15 ity unty State Zip Code c �• L-�-e� c� �(='�e� 3 Signature of of FDate Signed (MM/DD/YY) [to be completed by Voter] -Z O Rule 15-2.045, F.A.C. DS - E 104 tEff. 09111 CANDIDATE PETITION Notes: - All information on this form becomes a public record upon receipt by the Supervisor ofElectiom). - 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 (print namk as it appears on in said state and county, petition to have the name of]) placed on the Primary/General Election Ballot as a: [check/complete box, as applicable] �' Onpartisan FjNo party affiliation Party candidate for the office of (�115C t crN 0-2 t�3 � 7Gt1� _W_ (insert title of office and include district, circuit, group, seat number, if applicable) Date of Birth or Voter Registration Number Addd(ress (MM/DD/YY) itY C ty e ode StatZip C e ° PLM et ��- 3�( Signature of Voter Date Signed (MM/DD/YY) [to be comp! ted b Voter] Rule 1S-2.045, F.A.C. DS -DE 104 [Eff. 09111 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, (print name as it appears on your-uQter information in said state and county, petition to have the name of IJ RY 1�) j -{-}fes placed on the Primary/General Election Ballot as a: [check/complete box, as applicable] lonpartisan F-1 No party affiliation ❑ �T misSlay uQ_�bY 1 i zcq 1)s �-I (insert title of office and include district, circuit, group, seat number, if applicable) the undersigned, a registered voter Party candidate for the office of LDaMle:of Birth or Voter Registration Number Ad ress D/YY) i s ity Co ty State Zip Code �YNTC at + e f Voter Date Si ed (MM/DD/YY) [to be c pleted by Voter] Rule 1S- . 45, F.A.C. DS -DE 104 (Eff. 09/11 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. Ll 1, (print namle as it appears -0 youP vr infIbrmation card in said state and county, petition to have the name of [ placed on the Primary/General Election Ballot as a: [check/complete box, as applicable] t2i Nonpartisan F]No party affiliation ❑ Date of Birth (MM/DD/YY) tic F insert title of office and include district, circuit, group, seat number, if or Voter Registration Number the undersigned, a registered voter Party candidate for the office of Address I i i'-fL County State Zip Code — P — R�M F -L -,3 -� q 3(e Vii Date Signed (MM/DD/YY) [to tae cgmpletedby Voler] CANDIDATE PETITION Notes: -.411 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—O �- Y7'� C�- (� f ,A I\j z— the undersigned, a registered voter (print name as it appears on your v4er information card)] in said state and county, petition to have the name of placed on the Primary/General Election Ballot as a: [check/complete box, as applicable] npartisan ❑ No party affiliation ❑ Party candidate for the office of (insert title of office and include district, circuit, group, seat number, if applicable) Date of Birth or Voter Registration Number Address (MM/DD/YY) 5- 0 Qj -- i I i �A -), / &5- - ] City Cmy State Zip Code 11�� (\Trml Qpf( Signature of Voter Date Signed (MM/DD/YY) A n A [to be completed by Voter] 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 name as it appears on yourler information in said state and county, petition to have the name of F77— placed on the Primary/General Election Ballot as a: [cheWcomplete box, as applicable] nonpartisan ❑ No party affiliation ❑ Party candidate for the office of TY Cwfql�slm (insert title of office and include district, circuit, group, seat number, if applicable) Date of Birth or Voter Registration Number Address ) (M?71V6 Z . `� Co ty State Zip Code �n 1� Ir' � f-rL. eu-ctr�( Fi,, Signature of Voter Date Signed (MM/DD1YY) [to b1 70,pleted b/V� F 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 �� 5HA T rj, v M,/'�,7% the undersigned, a registered voter (print name as it appears on your vote ,knformation card) in said state and county, petition to have the name of W� �� /" �� placed on the Primary/General Election Ballot as a: (check/complete box, as applicable) F._-�Nonpartisan ❑ No party affiliation D Party candidate for the office: of (insert title of office and include district, circuit, group, seat number, if applicable) Date of Birth or Voter Registration Number (MMIDDIYY) 24-7Z Address City County State Zip Code V1 Lqel Signature of Voter Date Signed (MM/DID/YY) [to be completed by Voter] l� 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 form is not completed, the form will not be valid as a Candidate Petition form. the undersigned, a registered voter (print name as it appears on your v❑formation card) _ in said state and county, petition to have the name of �%� \I I Z) t* placed on the Primary/General Election Ballot as a: [check/complete box, as applicable] ElNonpartisan ❑ No party affiliation ❑ Party candidate for the office of (insert title of office and include district, circuit, group, seat number, if applicable) Date of Birth or Voter Registration Number Address (MM/DD/YY G�w/ C� p{ 1 Je C unty State Zip Code say �c � �r� 1�L t 33 L/3 Voter Date Signed (MM/DDIYY) [to be completed by Voter] DS -DE 104 (Eff. 09h 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, h , `," "-� '#- „ _ the undersigned, a registered voter (print name as it appears on yoter informati rd) in said state and county, petition to have the name of &TZ placed on the Primary/General Election Ballot as a: [check(complete box, as applicable] [—]No party affiliation ❑ Party candidate for the office of C I TY em M (S� f C1­1(_&Yz_ 131PY(\7:T-6gl L�L-i2vc H -b1 ST Li (insert title of office and include district, circuit, group, seat number, if applicable) Date of Birth or Voter Registration Number Address -Cjty I unty State Zip Code ty ej::�e-q jrtoj R� :? -?Y?,el Signature of Voter Date Signed (MM/DD/YY) [to be c ple /d by Voter] 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,-Eti vl C/ 5 the undersigned, a registered voter (print name as it appears on voter information ard) in said state and county, petition to have the name of -11)v )2—placed on the Primary/General Election Ballot as a: [check/complete box, as applicable] PiKonpartisan ❑ No party affiliation ❑ Q Party candidate for the office of (insert title of office and include district, circuit, group, seat number, if applicable) [Date of Birth or Voter Registration Number Address /DD/YY v 11 'Y�3 f F 0 1 we Cr 11 33 y3G City Cmunty State Zip Code Signature of Voter Rule Date Signed (MM/DD/YY) [to be completed by Voter] 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 form is not completed, the form will not be valid as a Candidate Petition form. I, %i l `moi" N CCZ �l (print name as it :appears on your `` r information ard) in said state and county, petition to have the name of 1 I placed on the Primary/General Election Ballot as a: [check/complete box, as applicable] �onpartisan [:] No party affiliation El L1 -T`1 ( M+Q:;il (insert title of office and include district, circuit, group, seat number, f. Date of Birth or Voter Registration Number Address (MM/D M) � `f J S- I the undersigned, a registered voter Party candidate for the office of ,(� C State Zip Coe 331/ 3 G Signature of Voter Date Signed (MM/DD/YY) ��� � [to be c mple ted by Voter] Rule 1S-2.045, F.A.C. nc-nr- InA11= f nail CANDIDATE PETITION Notes: -All information on this form becomes a public record upon receipt by the Supervisor of Elections. l - 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 '(P'rinifnaeiie as it appears on your vote_r information card), , in said state and county, petition to have the name of PAv i D KAT placed on the Primary/General Election Ballot as a: [check/complete box, as applicable] Nonpartisan ❑ No party affiliation ❑ Party candidate for the office of C l TY Cc l(`�IS�� L�2 P6Y(\�I (3E 1-' � (insert title of office and include district, circuit, group, seat number, if applicable Date of Birth or Voter egistration NumberAddress (MM/DD/YY) �J�1� ity Co State Zi Code Signature of Voter Date Signed (MM/DD/YY) 4 to be c mpl ed by Voter] CANDIDATE PETITION Notes: -All information on this form becomes a public record upon receipt by the Supervisor ofElecti• - 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 (print name as it appears on your voter informatiZA-11 rd) in said state and county, petition to have the name of [ Z placed on the Primary/General Election Ballot as a: [check/complete box, as applicable] Nonpartisan F� No party affiliation F-1 Party candidate for the office of Grp -:w�gT- '-i Rule 1 (insert title of office and include district, circuit, group, seat number, if applicable) Date of Birth or Voter Registration Number Ac;lrpss(MM�) Co ty State Zip Code Date Signed (MM/DD/YY) [to be c mplet d by Voter] DS -DE 104 f Eff. 09111 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) V/ - If all requested information on this form is not completed, the form will not be valid as a Candidate Petition form. C- vY1 /'K (print natfie as it appears i your r information in said state and county, petition to have the name of -r-)-ft 1 L placed on the Primary/General Election Ballot as a: [check/complete box, as applicable] unpartisan F-1 No party affiliation the undersigned, a registered voter Party candidate for the office of �1 Cc ISS �cNL'CZ UC�I N ll��' ''C I t s- '_i - (insert title of office and include district, circuit, group, seat number, if applicable) Date of Birth or Voter Registration NuAddress (MM/DDNY) `1 I W _21 Number City Co ty State Zip Code Vi� 3 3e-13� Signature of Voter Date Signed (MM/DD/YY) [to be c mp/ ed by Voter] F.A.C. DS -DE 104 (Eff. 09111 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. " _� �0� 1w _ the undersigned, a registered voter (print name as it appears on your_v�ter information c;rd) in said state and county, petition to have the name of 'Victv -rt> K A -T — placed on the Primary/General Election Ballot as a: [check/complete box, as applicable] Ruh unpartisan ❑ No party affiliation ❑ Party candidate for the office of ti 1^j_MM15S10Ytfz (insert title of office and include district, circuit, group, seat number, if applicable) Date of Birth or Voter Re istrat1ion Number Addre s (MM/DD/YY) /,0 � untynn State Zip Code NAn Sig tur of Voter V 9R_9 nd6 r. e C Date Signed (MM/DD/YY) [to be corn' l�terd�by Voter] 104 iEff. 0911 N CANDIDATE PETITION Notes: -All information on this form becom public record upon receipt by the Supervisor of Elections. - It is a cito knowingly sign mo th n one petition for a candidate. [Section 104.185, Florida Statutes] - If all regt ste information on this o1 t is not completed, the form will not be valid as a Candidate Petition form. the undersigned, a registered voter (print name as it appeArs NQoJr voter inform in said state and county, petition to have the name of ] I L_ placed on the Primary/General Election Ballot as a: [c eck/complete box, as applicable] Nonpartisan ❑ No party affiliation ❑ Party candidate for the office of m i S,� i mv ez RdY rY77(V L-70-e/JT (insert title of office and include district, circuit, group, seat number, if applicable) Date of Birth r Voter Registration Number Address _ p (MM/DD/YY) ��o®(D� Ci County State Zip Code Fz— Signatu of v igned (MM/DD/YY) j� [to be completed by Voter] 1S-2.045, F.A.C. DS -DE 104 (Eff. 09111 CANDIDATE PETITION C� -1,0- ckh.t-AZ-, 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. (print h1bme as it appears on yourter information card) in said state and county, petition to have the name of �i �(i 7 4T__ placed on the Primary/General Election Ballot as a: [check/complete box, as applicable] "Nonpartisan ❑ No party affiliation ❑ the undersigned, a registered voter Party candidate for the office of c i Ty (�O M M t5s11 rr-42 ��yVM �Mfq DIST Lf (insert title of office and include district, circuit, group, seat number, if applicable) Date of Birth or Voter Registration Number Address / cs7lL ,n z4 7 CA -10 cd CityCP nty State Zip Code "PC F&, I Signature Voter Date Signed (MMIDD/YY) [to be completed by Voter] tt/ 1 71 Lc CANDIDATE PETITION '�� do -k Q, 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, ti (� M IFS j� a rA y 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 placed on the Primary/General Election Ballot as a: [checWcomplete box, as applicable] ❑ Nonpartisan ❑ No party affiliation ❑ �>M I [ SSi (insert title of office and i Party candidate for the office of circuit, group, seat number, if appl Date of Birth or Voter Registration Number Address (MM40 ) �U County State Zip Code of Voter Date Signed (MM/DDNY) [to be compl ted by Voter] 1 / f3 t DS -DE 104 iEff. 09/1 CANDIDATE PETITION Lip,l `,v 01Q -c C4 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 (print name as it appears on your voter information in said state and county, petition to have the name of 7— placed on the Primary/General Election Ballot as a: [check/complete box, as applicable] ❑ No party affiliation ❑ Party candidate for the office of C)T aNm m{W1(-Ntz 3NR►YC%NI Q ))tSi c (insert title of office and include district, circuit, group, seat number, if applicable) Date of Birth or Voter Registration Number Address (MM/DD/YY) c/► lr City County State Zip Code �Mjyvilvq P-tC'-(' P&(M 33 4 2 (P Signature of Vo Date Signed (MM/DD/YY) _ [to be completed by Voter] / [Ijc3 lC, CANDIDATE PETITION ­Qj 12 CJCkA-'e' 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 complreted, the form will not be valid as a Candidate Petition form. the undersigned, a registered voter (print na(mc' as it appears on your vcker information card) in said state and county, petition to have the name of placed on the Primary/General Election Ballot as a: [check/complete box, as applicable] Nonpartisan ❑ No party affiliation ❑ Party candidate for the office of (insert title of office and include district, circuit, group, seat number, if appl Date of Birth or Voter Registration Number Address 6" 9 (MM/DD/YY) ����� 0 City R_7_�_OA County State Zip Code �0.TTMI Signature of Voter 15-2- Ar,- &'AC. Date Signed (MM/DD/YY) [to be co,Ipleted b // /7 ;Voter] 1 CANDIDATE PETITION ..Pj k e CCL_,kQ, 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, LA Nt I -) K )7-- the undersigned, a registered voter (print name as it appears on your vo information car ) in said state and county, petition to have the name of Z placed on the Primary/General Election Ballot as a: [check/complete box, as applicable] E Nonpartisan ❑ No party affiliation Party candidate for the office of C iT� &M(qSSI(-(\/u✓ Re- m-FMi ern-n'q _-J)IS') Ll (insert title of office and include district, circuit, group, seat number, if applicable) Date of Birth or Voter Registration Number Address (MM/DDY) A �% ►7 'VY �1y`� OXY �-� Ci Coups State Zip Code 6 G\1� Ml 6t=�j lquae � I R,_ -3 � N6 Signature of Voter QL i1A Date Signed (MM/DD/YY) [to be co p!e d by Voter] 1' 1 CANDIDATE PETITION C` ie Ckcx-Ac 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. V+ f 1� f l w�o the undersigned, a registered voter (print name as it appears on yo oter informati n ard) in said state and county, petition to have the name of I J �� placed on the Primary/General Election Ballot as a: [check/complete box, as applicable] donpartisan F] No party affiliation El Party candidate for the office of Tir �c !lSSfG�(L �� Til QufA -bin ti (insert title of office and include district, circuit, group, seat number, if applicable) Date of Birth or Voter Registration Number Address (MM70�1 /YY) _ M1 1 P /d woo L CityCourcy n State Zip Code Signature of Voter e Date Signed (MM/DDNY) [to be plete 'by Voter] 117l DS -DE 104 [Eff. 09111 :n CANDIDATE PETITION _Cjc, Ctc:�-4e, Notes: —411 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" n UjQ �CCq— name as it appears on yobk[yoter in said state and county, petition to have the name of placed on the Primary/General Election Ballot as a: [check/complete box, as applicable] unpartisan F] No party affiliation ❑ _ t -j G-YOTANI�t (insert title of office and include district, circuit, group, seat number, if applicable) the undersigned, a registered voter Party candidate for the office of Date of Birth or Voter Registration Number Address (MM/DD/YY) e s� 310tLiIQ-Q-r,Q-kv\C� ity C unty State Zip Code pta'q , -3 --2, (f 2_ (a Signature of Voter F.A.C. Date Signed (MM/DD/YY) [to be completed by Voter] 10Al :I- L') I DS -DE 104 (Eff. 0911 CANDIDATE PETITION '112 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 l l e g A l:FL R v (z (VS the undersigned, a registered voter (print name as it appears on your voter informationare' in said state and county, petition to have the name of �/��j 11, placed on the Primary/General Election Ballot as a: [check/complete box, as applicable] onpartisan ❑ No party affiliation ❑ rM rn► 3 1 mr (insert title of office and include district, circuit, group, seat nulerLii, Party candidate for the office of Date of Birth or Voter Registration Number Address t© bsl 3 z 14/1 L el Cou State Zip Code Signature of Voter [Date Signed (MM/DD/YY) be completed by Voter] ,-' i1 i3 JR Rule 15-2.045, F.A.C. DS -DE 1041Eff. 09111 G7f-:o CANDIDATE PETITION -P' k'e CICLA2, 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. cn–r "— the undersigned, a registered voter (print name as it appears on your \M*r information card)/ in said state and county, petition to have the name of PrTZ placed on the Primary/General Election Ballot as a: [check/complete box, as applicable] unpartisan �No party affiliation f CI (insert title of office and include Party candidate for the office of circuit, group, seat number, if applicable) Birth or Voter Registration Number Address `+4 t Lk:16-I,CtwL[D7ate ZYY) Rule 1 City C unty State Zip Code _331f r'0 f Voter F.A.C. Date Signed (MMZDDZYY) [to be completed by Voter] / -,'n19 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 (print name as it appears on yovoter informs o ard) in said state and county, petition to have the name of W (P placed on the Primary/General Election Ballot as a: [checklcomplete box, as applicable] npartisan ❑ No party affiliation ❑ Party candidate for the office of 6'f'Tem M) 5 Sla(YC��2 tSC7`iCf �='SFE 'bm:T �'— (insert title of office and include district, circuit, group, seat number, if applicable) Date of Birth or Voter Registration Number Address (MM/DD/YY) t County State Zip Code Signature of Voter Rule Date Signed (MM/DD/YY) [to be completed by Voter] f_. acJn e 4 CANDIDATE PETITION duxes 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 (print name as it appears on your v 'nformation card) in said state and county, petition to have the name of AN I� placed on the Primary/General Election Ballot as a: [check/complete box, as applicable] ®I1onpartisan ❑ No party affiliation ❑ Party candidate for the office of �C (InseA title of office and include district, circuit, group, seat number, if applicable) Date of Birth or Voter Registration Number Address (MM/DDIYY) 9 City County State Zip Code 1-4 Signature of Voter Date Signed (MM/DD/YY) - —"" [to be completed by Voter] Y DS -DE 1041Eff. 09111 CANDIDATE PETITION l Q do j 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 (print name as it appears on your � er informatio ca .d) in said state and county, petition to have the name PY 1 '�)ft Z placed on the Primary/General Election Ballot as a: [checklcomp/ete box, as applicable] f14'onpartisan ❑ No party affiliation F-1 Party candidate for the office of Cem0)1SclONLTZ �C ar q Rme- (insert title of office and include district, circuit, group, seat number, if applicable) Date of Birth or Voter Registration Number Address (MM/DD/YY 'ty Col jty &_Y�-eq State Zip Code _�((v 7ZTl 6M( q I Atty) Signature of Voter e 15-2.045, F.A.C. Date Signed (MM/DD/YY) [to be completed by Voter] CANDIDATE PETITION .06,e (DApLA 4e4 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 (print name as it a4ears on your tioter inform in said state and county, petition to have the name of placed on the Primary/General Election Ballot as a: [check/complete box, as applicable] partisan [] No party affiliation D Party candidate for the office of '8"n(1ZR/ &W H JIST q (insert title of office and include district, circuit, group, seat number, if applicable) Date of Birth or Voter Registration Number Address (MM/DD/YY) ` r o LC Ltic CA L-(---, I -Q, ity County State Zip Cod P�Lm 33, Date Signed (MM/DD/YY) [to be completed by Voter] F.A.C. C CANDIDATE PETITION .Ct I ,e 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, U a zl/; ,z /'Iq ";' s- ty t% (print name as it appears on your vot nformation card in said state and county, petition to have the name of placed on the Primary/General Election Ballot as a: [check/complete box, as applicable] the undersigned, a registered voter lQonpartisan [—]No party affiliation ❑ . Party candidate for the office of (insert title of office and include district, circuit, group, seat number, if applicable) Date of Birth or Voter Registration Number Address (M7'/ D ) t llama ��W �/' City County State Zip Code 3Bv,'1Vo'1 eac� A 12Pq cl2 Signature of Voter Rule 15-2.045. F Date Signed (MM/DD/YY) [to be completed by Voter] r°l l I