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Filing Papers APPOINTMENT OF CAMPAIGN TREASURER RECEIVED AND DESIGNATION OF CAMPAIGN ) 3 ,M DEPOSITORY FOR CANDIDATES MAR 31 2021 (Section 106.021(1), F.S.) 71 --S CITY OF Bfy!I'Ieltl (PLEASE PRINT OR TYPE) airy CLERKS OFFICE NOTE: This form must be on file with the qualifying officer before opening the campaign account. OFFICE USE ONLY 1. CHECK APPROPRIATE BOX(ES): 24 Initial Filing of Form Re-filing to Change: ❑ Treasurer/Deputy ❑ Depository ❑ Office ❑ Party 2. Name of Candidate (inthisorder: First, Middle, Last) 3. Address (include post office box or street, city, state, zip lS r•-€ CG-126(G-126(G-126( 6- CS Y e Isar-a-,v n) code)/B g3 SCU ,2_5 �L 4. Telephone 5. E-mail address go yAil A) a_eite 4- F _ 33 4 2 c ) icS -.3GZ T6 -6re6-4-c(r-/-seft-O\MA;).co\ 6. Office sought (include district, circuit, group number) 7. If a candidate for a nonpartisan office, check if cykrroq R.ectem. c;4-y catM;C s:cifk applicable: ❑ 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 .0 No Party Affiliation ❑ • Party candidate. 9. I have appointed the following person to act as my M Campaign Treasurer ❑ Deputy Treasurer 10. Name of Treasurer or Deputy Treasurer c(-e6- r y l a /14,4N A) 11. Mailing Address 12. Telephone /0 .M3 SCr1 13. City 14. County 15. State 16. Zip Code 17. E-mail address c,yJm&) Betct4- ?vi Z3gc- 33 GreG'#tt�-rsic? Fro- , /I`1, Cowt 18. I have designated the following bank as my J Primary Depository ❑ Secondary Depository 19. Name of Bank 20. Address Care Otic 33 �� -e ve 21. City 22. County 23. State. 24. Zip Code Baal- 0%.t1/ e67 33 q S 3 UNDER PENALTIS OF PERJURY, I DECLARE THAT I HAVE READ THE FOREGOING FORM FOR APPOINTMENT OF CAMPAIGN TREASURER AND DESIGNATION OF CAMPAIGN DEPOSITORY AND THAT THE FACTS STATED IN IT ARE TRUE. 25. Date 26. Signature of Candidate X �. 27. Treasurer's Acceptance of Appointment (fill in the blanks and check the appropriate block) I, c 6-pk,' . j(-4-in/44/A1do hereby accept the appointment (Please Print or Type Name) designated above as: 'j Campaign Treasurer ❑ Deputy Treasurer. X Date Signatur:.ii ampaign Treasurer or Deputy Treasurer DS-DE 9 (Rev. 10/10) Rule 1S-2.0001, F.A.C. APPOINTMENT OF CAMPAIGN TREASURER FtECENO SEP $1 2021 AND DESIGNATION OF CAMPAIGN DEPOSITORY FOR CANDIDATES C"OF BOYNTON BEACH (Section 106.021(1), F.S.) CrTYY CLERICS OFFICE (PLEASE PRINT OR TYPE) NOTE: This form must be on file with the qualifying officer before opening the campaign account. I OFFICE USE ONLY 1. CHECK APPROPRIATE BOX(ES): ❑ Initial Filing of Form Re -filing to Change: ❑ Treasurer/Deputy 0 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) Gregory George Hartmann 1083 SW 25 PL Boynton Beach FL 33426 4. Telephone 5. E-mail address (954 )258-3236 gregharts@protonmail.com 6. Office sought (include district, circuit, group number) 7. If a candidate for a nonpartisan office, check if Boynton Beach Commission district 1 applicable: ❑ 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 El No Party Affiliation ® Party candidate. 9. 1 have appointed the following person to act as my Campaign Treasurer ❑ Deputy Treasurer 10. Name of Treasurer or Deputy Treasurer Gregory George Hartmann 11. Mailing Address 12. Telephone 1083 SW 25 PL Boynton Beach FL 33426 ( 954 ) 258-3236 _ _ 13. City 14. County 115. State 16. Zip Code 17. E-mail address Boynton Beach Palm Beach FL 133426 gregharts@protonmail.com 18. 1 have designated the following bank as my ® Primary Depository ❑ Secondary Depository 19. Name of Bank 20. Address N CONGRESS AVE PNC 500 21. City 22. County ' 23. State 24. Zip Code Boynton Beach Palm Beach �FL 33426 UNDER PENALTIES OF PERJURY, I DECLARE THAT I HAVE READ THE FOREGOING FORM FOR APPOINTMENT OF CAMPAIGN TREASURER AND DESIGNATION OF CAMPAIGN DEPOSITORY AND THAT THE FACTS STATED IN IT ARE TRUE. 25. Date 26. Signature of Candidate 9-21-2021 X 27. Treasurer's Acceptance of Appointment (fill in the blanks and check the appropriate block) 1, Gregory Hartmann , do hereby accept the appointment (Please Print or Type Name) designated above as: © Campaign Treasurer ❑ Deputy Treasurer. 9-21-2021 X S` Date Signature of Campaign Treasurer or Deputy Treasurer DS -DE 9 (Rev. 10/10) Rule 1S-2.0001, F.A.C. OFFICE USE ONLY STATEMENT OF RECENEu 1 S?'(\ CANDIDATE (Section 106.023, F.S.) '(NAR 31 202.1 \ L. (Please print or type) CITY OF BOYNTON BEACH CITY CLERK'S OFFICE 11 r¢ itr+114Nti f candidate for the office of 130l`titr4 _ c,� Ccmiti:%c av b ;4r;c 4,1 have been provided access to read and understand the requirements of Chapter 106, Florida Statutes. • X - .< Signature of Candidate Date Each candidate must file a statement with the qualifying officer within 10 days after the Appointment of Campaign Treasurer and Designation of Campaign Depository is filed. Willful failure to file this form is a first degree misdemeanor and a civil violation of the Campaign Financing Act which may result in a fine of up to $1,000, (ss. 106.19(1)(c), 106.265(1), Florida Statutes). • DS-DE 84(05/11) CANDIDATE OATH — NONPARTISAN OFFICE ��CI (Do not use this form if a Judicial or School Board Candidate) NOV 2 2 Mi Check box only if you are seeking to qualify as a 31 write-in candidate:G) Q� IVT�� BEACH (f6,ElWrite-in candidate OFFICE USE ONLY Candidate Oath (Section 99.021(1)(a), Florida Statutes) C -r -p b r r_4- A/A/ , (Print name a6ove as you wish it to appear on the ballot. If your last name consists of two or more names but has no hyphen, check box ❑ (see page 2 - Compound Last Names). No change can be made after the end of qualifying. Although a write-in candidate's name is not printed on the ballot, the name must be printed above for oath purposes.) am a candidate for the nonpartisan office of 50pNTOAJ W Ck- COM o SS) p _ l (Office) (District #) I am a qualified elector of 'z2AIMCounty, 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. • r Candidate's Florida Voter Registration Number (located on your voter information card): L . Phonetic spelling for audio ballot: Print name phonetically on the line below as you wish it to be pronounced on the audio ballot as may be used by persons with disabilities (see instructions on page 2 of this form): [Not applicable to write-in candidates.] CTS v --e e X �rr-2r-l�c It-DA{� Signature 4 andidate Telephone Number Email Address r -Of-F-3 2-A Address tity State ZIP Code n STATE OF FLORIDA -'m - Ignature of Notary Public COUNTY OF Print, Type, or Stamp Commissioned Name of Notary Public below: Sworn to (or affirmed) and subscribed before me by means of online notarization ❑ OR physical presence ;rR►'' . CRYSTAL D. GIBSON * MY COMMISSION # GG 326964 this day of �QPi 20��. Ma EXPIRES: April 22, 2023 °F^'•' BmM7bruNolmyPuMicUnderrrrlters Personally ❑ OR Produced Identification Personal) Known Type of Identification Produced: ri% MCPs� DS -DE 302NP (Rev. 0512021) Rule 1S-2.0001, F.A.C. RESIDENCY REQUIREMENTS I, ( rint Name) iR.t1 15S m� I"a9+rI'C4 (Mayor/Commissioner — District #) 3, candidate for of Boynton Beach, have received, of the City read and understand the residency requirements of Article II of the Charter of the City of Boynton Beach. (Signature of Candidate) V(Date) S:\CC\WP\ELECTION\Year 2022\CANDIDATE INFORMATION CD\4. Residency Requirements\A. RESIDENCY REQUIREMENTS STATEMENT.doc FORM 1 STATEMENT OF 2020 me, mailing FINANCIAL INTERESTS FOR OFFICE USE ONLY: Please print or type y7and address, agency nam,positionbelow: J LAST NAME -- FIRST NAME -- MIDDLE NAME: Hartmann Gregory George MAILING ADDRESS: 1083 SW 25 PL CITY: ZIP COUNTY Boynton Beach 33426 Palm Beach NAME OF AGENCY: C,+ o q Tsti 16. W-1 ' NAME OF OFFICE OR POSITION HELD OR SOUGHT Boynton Beach Commission District 1 CHECK ONLY IF n CANDIDATE OR ❑ NEW EMPLOYEE OR APPOINTEE **** THIS SECTION MUST BE COMPLETED **** DISCLOSURE PERIOD: THIS STATEMENT REFLECTS YOUR FINANCIAL INTERESTS FOR CALENDAR YEAR ENDING DECEMBER 31, 2020. MANNER OF CALCULATING REPORTABLE INTERESTS: FILERS HAVE THE OPTION OF USING REPORTING THRESHOLDS THATARE ABSOLUTE DOLLAR VALUES, WHICH REQUIRES FEWER CALCULATIONS, OR USING COMPARATIVE THRESHOLDS, WHICH ARE USUALLY BASED ON PERCENTAGE VALUES (see instructions for further details). CHECK THE ONE YOU ARE USING (must check one): ❑ COMPARATIVE (PERCENTAGE) THRESHOLDS OR 0 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 humney & Associates 660 N US 1, North Palm Beach FL Advertising/marketing odernAnimal LLC 1083 SW 25 PL ideo services 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 AA A) PART C -- REAL PROPERTY [Land, buildings owned by the reporting person - See instructions] (If you have nothing to report, write "none" or "nla") You are not limited to the space on the lines on this form. Attach additional one AJ/:f' sheets, if necessary. 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, 2021 (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] I (If you have nothing to report, write "none" or "n/a") TYPE OF INTANGIBLE i BUSINESS ENTITY TO WHICH THE PROPERTY RELATES deposits ii CPEFCU PART E — LIABILITIES [Major debts - See instructions] (If you have nothing to report, write "none" or "nla") NAME OF CREDITOR ADDRESS OF CREDITOR 'apital One 1P.0. Box 30285, Salt Lake City, Utah, 84130-0287 I Lakeview Loan Service 4425 Ponce de Leon, Coral Gables, FL 33146 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 "nla") BUSINESS ENTITY # 1 NAME OF BUSINESS ENTITY /Vf ADDRESS OF BUSINESS ENTITY PRINCIPAL BUSINESS ACTIVITY POSITION HELD WITH ENTITY I OWN MORE THAN A 5% INTEREST IN THE BUSINESS BUSINESS ENTITY # 2 NATURE OF MY OWNERSHIP INTEREST PART G — TRAINING For elected municipal officers, appointed school superintendents, and commissioners of a community redevelopment agency created under Part III, Chapter 163 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 0 SIGNATURE OF FILER: Signature: 11000' Date Signed: 11-22-21 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), send it to CEForml@leg.state.fl.us and retain a copy for your records. Do not file by both mail and email. Choose only one filing method. Form 6s will not be accepted via email. III 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 1F) 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, 2020. CE FORM 1 - Effective: January 1, 2021. PAGE 2 Incorporated by reference in Rule 34-5.202(1), FA -C. Miscellaneous cash A? ecelpt CITY OF BOYNTON BEACH Account No. 001-0000-369-10.00 Received of Gregor -vv Hartmann Address 1083 SW 25 Place Bov For Cit,.. Min,) Fee to run f March 8, 2022 November FL 33426 per.: Fffmlcl. — e L`01119- TJ"bns - 20 21 pipt ai' Tr2q.1 sai.00 WTHIP Dept. Cit Clerk's Off icy—_ By 4 T d r172,121 Tim: Ll i Y U- ti:u% 1 UN &AA CITy r. F Bi--,IiM EIP[h' Cd -u& MPT *** oper: MEM a Type: OC D-dev-: I Date: 11/23/21 01 Receipt no: T241 D2sr-ription Qjdltlty MISMIAEUS mount 93 1.00 $6.00 'Trans nuTber: 33MI9 G/L account number: 00100VE-691000 WITM� - FILIKG FEE GERRY m8far" CITY FIDE FEE Tender detai I CK O -EX 430 $25.00 Total tendered$25.00 Total payment $25.00 Trans date: 111/W?l Time. 164.34:56 TRW YOU FLF YOLR PRAT PAINW Miscellaneous Cash Receipt CITY OF BOYNTON BEACH Account No.00-TV--3ff--10-cV Received Address For er QTY 011 ~TON iL�i I's' int- iMI N ffAl-] CITY OF EUMG1) ii l #* C1tFt RECEIPT*fir' 1 ate. Type: . DatF. 111 /2 1 41 Jc�ipt no: 'tTM ascription hII l antit Amount 1.008 Tris nor, G/L account neer; 00,10000,119 06W Wm- PECITIGN CEPT t E PI om s4 25TH PL ed�eta31 63.80 CK 01STate, tendered $3.80 Total. paywent �'.� Trans date: i l 62/21 ' RTV- 1E:33:39 R*. -K t,9J FOR YOUR PFUIPT PAYNEM' miscellaneous cash Receipt CITY OF BOYNTON BEACH Account No. 001-0000•-369-•10-00 Received of Gregor,! Hartmann Address 1083 SW -25 Place �T Y 0" $ 198.53 November r.-1 _'20 21 h fl 33426 . lY3?Q I i 0'. t For 1% Filino Fee to run forCammiss oz - �� 1 p Ma8 2022 .1,001 f s mi r: 19 . r - _ - . Dept. C1t'� Clerk's Office By < r ' -f/"-: � Marts d8te: `, I:.110c 'Time: 1626:1 rt ti l:IiY U- kU,NfLV IVAJ'i j CITY OFUNM; CLSIDIER FEMIPT *** Gpar: SYEMIE Type: OC Dra,,er: I Date: 11: 3/21 Oi ftcPi.pt no: "'242 Description Qufti& Amount NT 1.00 s19B.53 Trans rater; 97W G/L account nLffber: 00100051000 FW -r" - Il FILING FEF i FEG�' H 63 EW _PSM PL Tender d tai l g1�.5 3 Tta ;r red $19.to Total pawent Trans date: 11/W21 Tim: 16:36:14 Tl -y& "A)i Fly YOLF i'RDWT PAY14Y °�� � V Wendy Sartory Link P� Palm Beach County Supervisor of Elections CERTIFICATION I, WENDY SARTORY LINK, SUPERVISOR OF ELECTIONS, for Palm Beach County, Florida, do hereby certify that 35 signatures on the Nominating Petitions of GREGORY HARTMANN for COMMISSION, SEAT 1, 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 GREGORY HARTMANN is a registered voter in Precinct 3200, in the City of Boynton Beach, Florida. I am only certifying that the signatures match the signatures we have on file and that the electors reside within the municipal limits. I am not certifying the validity or legal sufficiency of the petitions Signed, this the 16th day of November, 2021. ENDY S TORY LINK SUPERVIS OF ELECTIONS PALM BEACH COUNTY (SEAL) 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: -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, w O L_ Se,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 Gregory Hartmann placed on the Primary/General Election Ballot as a: [check/complete box, as applicable] Nonpartisan 9No party affiliation F Boynton Beach City Commission District 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 (MM/DD/YY)3 U ' UU �5) ! ' J 2 9')_Y city County State Zip Code Boynton Beach Palm Beach FL 5 ifs Signature of R Rule 1S4.045. F.A.C. Date Signed (MM/DD/YY) [to be completed by Voter] 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. LAC o, S i I&' f 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 Gregory Hartmann placed on the Primary/General Election Ballot as a: [check/complete box, as applicable] Nonpartisan IN No party affiliation ❑ Party candidate for the office of Boynton Beach City Commission District 1 (insert title of office and include district, circuit, group, seat number, if applicable) Date of Birth or ff Voter Registration Number Address (MMIDDNY) -71 ) 6-\ 0 5 uJ A,/ City County State Zi Code Boynton Beach Palm Beach FL N z Signature of Voter Date Signed (MM/DDIYY) [to be completed by Voter] Rule 1S-2.045, F.A.C. DS -DE 104 (Eff. 09111) b-717 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, .- o .r1 A r: � 1 . \r n .,,- , the undersigned, a registered voter (print name as it appears on your ger information card) in said state and county, petition to have the name of Gregory Hartmann placed on the Primary/General Election Ballot as a: [check/complete box, as applicable] 4 onpartisan QNo party affiliation ❑ Boynton Beach City Commission District 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 (MM/DD/YY) [ v c7U SW City County State Zip Code Boynton Beach Palm Beach Signature of Voter Rule 1S-2.045, F.A.C. Date Signed (MM/DD/YY) [to be cap pleted by Voter] 1� 3 1 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. -It is a crime to knowingly sign more than one petition for a candidate. [Section 104.185, Florida Statutes] - If all requested information on this form is not completed, the form will not be valid as a Candidate Petition form. I, �J�j�°s�`L �� j, A X�Pz� the undersigned, a registered voter G (print name as int' (appears on your voter information card) in said state and county, petition to have the name of Gregory Hartmann placed on the Primary/General Election Ballot as a: [check/complete box, as applicable] onpartisan ,3 No party affiliation ❑ Boynton Beach City Commission District 1 Party candidate for the office of (insert title of office and include district, circuit, group, seat number, if applicable) E(MDate of Birth or Voter Registration Number /DD/YY)111-216 3zr'eC3 Address 111F 54cJ .04e City I County State Zip Code Boynton Beach Palm Beach FL 33 -'/P6 Signature of Voter Date Signed (MM/DD/YY) [to/1 b/e completed by �Vo-•tr] +1e Rule 15-2.045, F.A.C. i Y 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. I, ',_ the undersigned, a registered voter (print name as it app6ars on your voter information card) in said state and county, petition to have the name of Gregory Hartmann placed on the Primary/General Election Ballot as a: [checklcomplete box, as applicable] i Q Nonpartisan R] No party affiliation ❑ Party candidate for the office of Boynton Beach City Commission District 1 (insert title of office and include district, circuit, group, seat number, if applicable) Date of Birth or Voter Registration Number (MM/DD/YY) " a / C,3 '-'18 t/io Address CityCoun1ty State Zip Code Boynton Beach Palm Beach FL 33 /1'-- Signature of Voter f ✓ �i� �1c- �L��� Rule 1S-2.045, F.A.C. Date Signed (MM/DD/YY) [to be completed by Voter] /L)oUa /f 2 0� DS -DE 104 (Eff. 09/1 19a 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 Plot be valid as a Candidate Petition form. tJ N -(, a-( . (print name as it appears on your voter information card) in said state and county, petition to have the name of Gregory Hartmann 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 Boynton Beach City Commission District 1 (insert title of office and include district, circuit, group, seat number, if applicable) Date of Birth %�or(�V ter Relgis ration Number 1Addre(s�s f (MM/DD/YY) V 1 (91 [ l.P 3 1 I �V _�0 �\ City County State Zip Code Boynton Beach Palm Beach FL 3 9 d� Signature of V er Date Signed (MM/DDNY) [to be co pleted y Voter] 11,�1�% -2-/ Rule 15-2.045, F.A.C. DS -DE 104 (Eff. 09111 'd04�6 30 15 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, name as it appears on your voter information card) in said state and county, petition to have the name of Gregory Hartmann placed on the Primary/General Election Ballot as a: [check/complete box, as applicable] NonpartisanWM M No party affiliation ❑ Boynton Beach City Commission District 1 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 (MM/DD/YY) Address ?off L�oy County State Zip Code ynton Beach Palm Beach FL 3 X9240 Signature of V ter Date Signed (MM/DD/YY) [to be completed by Voter] Rule 1S-2.045, F.A.0 DS -DE 1041Eff. 09111 `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. y14i2 US Z<wS� i (print name as it appears on your voter information card) in said state and county, petition to have the name of Gregory Hartmann placed on the Primary/General Election Ballot as a: [check/complete box, as applicable] Nonpartisan 21 No party affiliation El the undersigned, a registered voter Party candidate for the office of Boynton Beach City Commission District 1 (insert title of office and include district, circuit, group, seat number, if applicable) Date of Birth or Vote Registration Number Address (MM/DDNY) q!�zk__s /06Z 5)2 S�6_ city Boynton,peach Sig Rule 15-2.045, F.A.C. County State Zip Code 'Palm Beach FL 33Z(o Date Signed (MM/DDNY) [to be compl ed bj Voter] 11&12-1 DS -DE 104 (Eff. 0911 P'] 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. /] 7z - I! El as 2270 the undersigned, a registered voter L (print name it app arsqjfi your voter informa ion card) in said state and county, petition to have the name of Gregory Hartmann. 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 Commission District 1 (insert title of office and include district, circuit, group, seat number, if applicable) Date of Birth or Voter Registration Number (MM/DD/YY) Address /© �j ,¢� S" 411 i1�,6ev� 41--���� , g/ L�Oyynton County State Zip Code Beach Palm Beach FL Signa tur oterDate Signed (MM/DD/YY) to be completed by Voter] Rule iS-2.045, 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. 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 Gregory Hartmann placed on the Primary/General Election Ballot as a: [check/complete box, as applicable] 0 No party affiliation ❑ Party candidate for the office of ANonpartisan Boynton Beach City Commission District 1 (insert title of office and include district, circuit, group, seat number, if applicable) Date of Birth or Voter Registration Number Address 1-a'1- JL' l City County State Zip Code Boynton Beach Palm Beach Signature of Voter Date Signed (MM/DDNY) [to be completed by Voter] c 3% 20 2 Rule iS-2.045, F.A.C. DS -DE 104 (Eff. 09/11 I _6"o to 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, Jd r y /j a ��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 Gregory Hartmann placed on the Primary/General Election Ballot as a: [check/complete box, as applicable] &Nonpartisan10 No party affiliation ❑ Party candidate for the office of Boynton Beach City Commission District 1 (insert title of office and include district, circuit, group, seat number, if applicable) Date of Birth or Voter Registration Number (MM/DD/YY) & -a r - City County State Zip Code Boynton Beach Palm Beach FL 3-3124 Signature f Voter Date Signed (MM/DDNY) I, [to be complete y Voter] Rule 15-2.04,6, .A.C. 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. - It is a crime to knowingly sign more than one petition for a candidate. [Section 104.185, Florida Statutes] - If all requested information on this form is not completed, the form will not be valid as a Candidate Petition form. I, l W ri'Y1 '-k P_ ( S 4.1 the undersigned, a registered voter name as it appears on your voter information card) in said state and county, petition to have the name of Gregory Hartmann 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 Commission District 1 (insert title of office and include district, circuit, group, seat number, if applicable) Date of Birth or, Voter Registration Number Address (MM/DDIY k6 � ��Z A-ve_ I - �Qs. l) City County State Zip Code Boynton Beach Palm Beach FL -�� Rul Signa or I S-2.04 F.A.C. Date Signed (MM/DDNY) [to be omelet d by Voter] DS -DE 104 (Eff. 09/i C;_ 1C4'16 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 v,) , n --e (�;<n a the undersigned, a registered voter (print name as it appears on your voter information card) in said state and county, petition to have the name of Gregory Hartmann placed on the Primary/General Election Ballot as a: [checWcomplete box, as applicable] Nonpartisan ® No party affiliation ❑ Rul Boynton Beach City Commission District 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 City County State Zip Code Boynton Beach Palm Beach FL � z. o 4nate of Voter, (\�j _U�L 1S-2.045. F.A.C. Date Signed (MM/DD/YY) [to be completed by Voter] DS -DE 104 (Eff. 09111) IIaI\q's '��6 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 voter information card) in said state and county, petition to have the name of Gregory Hartmann placed on the Primary/General Election Ballot as a: [check/complete box, as applicable] (Nonpartisan MMW No party affiliation ❑ Party candidate for the office of Boynton Beach City Commission District 1 (insert title of office and include district, circuit, group, seat number, if applicable) Date of Birth or Voter Registration Number Address (MMIDD City County State Zip Code Boynton Beach Palm Beach FL LS!gna49ftureVoter' _ Date Signed (MM/DD1Ylf) [to be complete by Voter] e 1S- F. DS -DE 104 iEff. 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. 14, Z'41_z" (print name as it appears on your voter information card) in said state and county, petition to have the name of Gregory Hartmann placed on the Primary/General Election Ballot as a: [checklcomplete box, as applicable] nonpartisan 0 No party affiliation ❑ the undersigned, a registered voter Party candidate for the office of Boynton Beach City Commission District 1 (insert title of office and include district, circuit, group, seat number, if applicable) Date of Birth or Voter Registration Number Address I I (MM/DD/YY)y/ j le %Z 51A) City County State Zip Code Boynton Beach Palm Beach FL 3 3 �2 6 to of V ter Rule 15-2.045. F.A.C. Date Signed (MM/DDNY) [to be completed by Voter] DS -DE 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, �2%7 rS�. cj 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 Gregory Hartmann placed on the Primary/General Election Ballot as a: [check/complete box, as applicable] NonpartisanIt No party affiliation ❑ Party candidate for the office of Boynton Beach City Commission District 1 (insert title of office and include district, circuit, group, seat number, if applicable) Date of Birth or Voter Registration Number Address // c (MM/DD/Yl) / 5�--_6 011 1 V w 6 ✓ City County State Zip Code Boynton Beach Palm Beach FL I 33 �� of Voter Date Signed (MM/DDrM [to be completed by Voter] c. _ DS -DE 104 ME 0911 1.Q!!-bLOHd 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 voter information card) in said state and county, petition to have the name of Gregory Hartmann placed on the Primary/General Election Ballot as a: [check/complete box, as applicable] Nonpartisan a No party affiliation ❑ Boynton Beach City Commission District 1 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 (MM/DDNY) Address ��/ City County State Zip Code Boynton Beach Palm Beach FL S 3V,� Signu e ofY er Rule 1S-2.045, F.A.C. Date Signed (MM/DDIYY) [to be completed by Voter] v - -9(- 0a - DS -DE 104 (Eff. 09/1 CANDIDATE PETITION I CQ la q1;'5(40q6 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, _� 5 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 Gregory Hartmann placed on the Primary/General Election Ballot as a: [check/complete box, as applicable] Nonpartisan 0 N party affiliation ❑ Boynton Beach City Commission District 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 (MM/DD/YY) City County State Zip Code Boynton Beach Palm Beach FL 33 -I zz Signature of Voter % Date Signed (MM/DDNY) [to be completed by Voter] Rule 1S-2.045, F.A C. y DS -DE 1041Eff. 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. I' Wf 4 -g114 14CiPt-SNt I I (print name as it appears on your voter information card) in said state and county, petition to have the name of GregoryHartmann placed on the Primary/General Election Ballot as a: [checklcomplete box, as applicable] 56 Nonpartisan No party affiliation ❑ Boynton Beach City Commission District 1 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 (MM/DDNY) -2 - f City Boynton B Signature P/1 re Rule 15-2.045. F.A.C. Address 5 � 11 � Ic.`l �4 i� County State Zip Code Palm Beach FL 3 -� CeA Date Signed (MM/DD/YY) [to be completed by Voter] //- Y a D6) DS -DE 1041Eff. 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 no completed, the form will not be valid as a Candidate Petition form. I, the undersigned, a registered voter (print n e sit appears on your voter information card) in said state and county, petition to have the name of Gregory Hartmann placed on the Primary/General Election Ballot as a: [check/complete box, as applicable] Nonpartisan Wo party affiliation ❑ Party candidate for the office of Boynton Beach City Commission District 1 (insert title of office and include district, circuit, group, seat number, if applicable) Date of Birth or Vo r Registratio umber Address (MM/DD/YY) � L/V 11/l� City Co(_ unty State Zip Code Boynton Beach Palm Beach FL 1 3�2 Signature of Voter DateS' ne (MM/DD/YY) r ~� to bf m eted by Voter] P Ryfe 15-2.045, F.A. DS -DE 104 fEff. 091111 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' 6.ar-ol Eleow"._ (print name as it appears on your voter information card) in said state and county, petition to have the name of Gregory Hartmann placed on the Primary/General Election Ballot as a:. [check/complete box, as applicable] �Nonpartisan M9 No party affiliation ❑ Boynton Beach City Commission District 1 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 (MM/DD1YY) Address 'do -' City County State Zip Code Boynton Beach Palm Beach FL 3 ya Signatur Voter Date Signed (MM/DDNY) [to be complete by Voter] �- /, `l Rule 1S-2.045,LF.A.C. I l - DS -DE 104 tEff. 0911 I CANDIDATE PETITION Notes: -All information on this form becomes a public record upon receipt by the Supervisor of Elections. - It is a crime to knowingly sign more than one petition for a candidate. [Section 104.185, Florida Statutes] - If all requested information on this form is not completed, the form will not be valid as a Candidate Petition form. I, (print name as it appears on your voter information card) in said state and county, petition to have the name of Gregory Hartmann placed on the Primary/General Election Ballot as a: [check/complete box, as applicable] 4Nonpartisan M No party affiliation ❑ the undersigned, a registered voter Party candidate for the office of Boynton Beach City Commission District 1 (insert title of office and include district, circuit, group, seat number, if applicable) Date of Birth or ` Voter Registration Number Address y j (MM/DD/YY) I l 0— 15H a005. 5W �l� ukyq City County State Zip Code Boynton Beach Palm Beach FL �j Signature of Voter Date Signed (MMIDDNY) [to be completed by Voter] Rule 15-2. DS -DE 1041Eff. 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. name as it appears on your voter information card) in said state and county, petition to have the name of Gregory Hartmann placed on the Primary/General Election Ballot as a: [checklcomplete box, as applicable] 0 M NonpartisanNo party affiliation ❑ Boynton Beach City Commission District 1 (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) (P3�(p %1 C2� City County State Zip Code Boynton Beach Palm Beach --j FL sil r 1— Date Signed (MM/DD/YY) [t be completed by Voter] Rule 7S- .045, F.A.C. DS -DE 4 Eff. 0917 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 voter information card) in said state and county, petition to have the name of Gregory Hartmann placed on the Primary/General Election Ballot as a: [check/complete box, as applicable] Nonpartisan 41 No party affiliation ❑ Party candidate for the office of Boynton Beach City Commission District 1 (insert title of office and include district, circuit, group, seat number, if applicable) Date of Birth or Voter Registration Number Address y Z (MM/DD/YY) ":7-!✓ / _ /_ P017' Y.4 I�dr' e k s C� /V/ " City County State Zip Code Boynton Beach Palm Beach FL 3 3 yid Signature of Voter Rule 1S-2.045, F.A.C. Date Signed (MM/DD/YY) [to be completed by Voter] DS -DE 104 f Eff. 09/11 RSI - 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° z1' �'. (print n e as it appears on your voter information card) in said state and county, petition to have the name of Gregory Hartmann placed on the Primary/General Election Ballot as a: [check/complete box, as applicable] 0Nonpartisan a No party affiliation ❑ Boynton Beach City Commission District 1 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) City County State Zip Code Boynton Beach Palm Beach FL 3_3 q Z-42 Signature of Voter Rule 1S-2.04-kF.A.C. Date Signed (MM/DDNY) [to be complete by Voter] DS -DE 104 { Eff. 0911 l 9 L1 CDc-�7CGC�5 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 e- Q z7 79 5171? / 0 r HD ): r` s the undersigned, a registered voter (print name as it appears on your voter information card) in said state and county, petition to have the name of Gregory Hartmann placed on the Primary/General Election Ballot as a:. [check/complete box, as applicable] Nonpartisan go No party affiliation ❑ Party candidate for the office of Boynton Beach City Commission District 1 (insert title of office and include district, circuit, group, seat number, if applicable) Date of Birth or Voter Registration Number Address (MM/DDNY) City County State Zip Code Boynton Beach Palm Beach iFL :1 Signature of Voter Rule IS -2.045, F.A.C. Date Signed (MM/DD/YY) [to :;be 2co;mpllet d by Voter] DS -DE 104 [Eff. 0917 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 (print name as it appears on your voter information card) in said state and county, petition to have the name of Gregory Hartmann placed on the Primary/General Election Ballot as a: [checklcomplete box, as applicable] Nonpartisan �No party affiliation El the undersigned, a registered voter Party candidate for the office of Boynton Beach City Commission District 1 (insert title of office and include district, circuit, group, seat number, if applicable) Date of Birth or Voter Registration Number Address 727,,2 -7-J- City County State Zip Code Boynton Beach Palm Beach FL 33` 2 Signature of Voter Date Signed (MM/DD/YY) [to be completed /Iby Voter] Rule 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. I, " } �GL� _ P K �.z +r the undersigned, a registered voter (print na a as it appears on your voter information card) in said state and county, petition to have the name of Gregory Hartmann placed on the Primary/General Election Ballot as a: [checklcomplete box, as applicable] Nonpartisan No party affiliation E Boynton Beach City Commission District 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 (MM/DDNY) City County Boynton Beach Palm Beach Sig Rule State Zip Code FLzu Datil Signed (MM/DD/YY) [to be completed by Voter] 1C��Gt I2� DS -DE 104 (Eff. 09/17 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 (print name as it appears on your voter information card) in said state and county, petition to have the name of Gregory Hartmann placed on the Primary/General Election Ballot as a: [check/complete box, as applicable] Nonpartisan M No party affiliation F-1 - Boynton Beach City Commission District 1 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)j , Q ,� �t ��I If City County State Zip Code Boynton Beach Palm Beach FL Signatu V Date Signed (MM/DD/YY) [to be com eted y Voted 1® 1312 Rule 15-2.045, F.A.C. DS -DE 104 (Eff. 0911 FA 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 name as it appears on your voter information card) in said state and county, petition to have the name of Gregory Hartmann placed on the Primary/General Election Ballot as a: [check/complete box, as applicable] 0Nonpartisan ® No party affiliation ❑ Boynton Beach City Commission District 1 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 (MM/DD/YY) q I 3 T`t & City County State Zip Code Boynton Beach Palm Beach FL -�'g4q-f,. Signature of Voter Date Signed (MM/DDNY) [to be dompleted by Voter] /o1Z'$)21 Rule 15-2.045, F.A.C. t / DS -DE 104 EEff. 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, F (print name as it appears on your voter information card) in said state and county, petition to have the name of Gregory Hartmann placed on the Primary/General Election Ballot as a: [check/complete box, as applicable] Nonpartisan No party affiliation ❑ Boynton Beach City Commission District 1 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 City County State Zip Code Boynton Beach Palm Beach FL 33Yz� Signature of Voter PL-P Rule 1S-2.045, F.A.C. Date Signed (MM/DD/YY) [to be completed by Voter] DS -DE 1041Eff. 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. I, C ` 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 Gregory Hartmann placed on the Primary/General Election Ballot as a: [check/complete box, as applicable] Nonpartisan 2] No party affiliation Party candidate for the office of Boynton Beach City Commission District 1 (insert title of office and include district, circuit, group, seat number, if applicable) Date of Birth or Voter Registration Number City Boynton Beach Signature of Voter le 1S -2.V45, F.A.C. Address S4, M "� pa� County State Zip Code Palm Beach FL ��'i,2\11 Date Signed (MM/DD/YY) %berruplated beer] 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. (print name as it appears on your voter information card) in said state and county, petition to have the name of Gregory Hartmann placed on the Primary/General Election Ballot as a: [check/complete box, as applicable] the undersigned, a registered voter gNonpartisan INNo party affiliation ❑ Party candidate for the office of Boynton Beach City Commission District 1 (insert title of office and include district, circuit, group, seat number, if applicable) Date of Birth or Voter Registration Number Address (MM/DDNY) -7 r City County State Zip Code Boynton Beach Palm Beach FL 33Y - , Signature of Voter Date Signed (MM/DD/YY) [to be completed by V ter] Rule 1S-2.045. F.A. DS -DE 104 fEff. 09/1 1\'a �Ak Q) 55 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. ME(z4jhQ"11 Yahl'f'e- rint name as it appears on your voter information card) in said state and county, petition to have the name of Gregory Hartmann 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 Boynto6 Beach City Commission District 1 (insert title of office and include district, circuit, group, seat number, if applicable) Date of Birth or VQ1er Registration Number Address 1013 SVU ?z City County State Zip Code Boynton Beach Palm Beach FL ',33q 2-(p Date Signed (MM/DD/YY) [to bej "' feted by Voter] V DS -DE 104 [Eff. 0911 • .moi B �� I `-t l \6) 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, t/! /� ^ !1 r /7/(l AJQ f 12'r the undersigned, a registered voter (print name as it appears on your voter information card) in said state and county, petition to have the name of GregoryHartmann placed on the Primary/General Election Ballot as a: [check/complete box, as applicable] Nonpartisan M No party affiliation ❑ Party candidate for the office of Boynton Beach City Commission District 1 (insert title of office and include district, circuit, group, seat number, if applicable) Date of Birth or Voter Registration Number Address � ��� �� 2 (MM/DDNY) — .�15 6 1 '' rz �54 City County State Zip Code Boynton Beach Palm Beach FL .� Signature of Voter Rule 1S-2.045, F.A.C. Date Signed (MM/DD/YY) [to be completed by Voter] a -a2(. ro.: DS -DE 104 [Eff. 091" ►14H9 -7Q 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. 11(1'`I lj the undersigned, a registered voter (pr'i nt name as it appears on your voter information card) in said state and county, petition to have the name of Gregory Hartmann ONonpartisan pllaced on the Primary/General Election Ballot as a: [check/complete box, as applicable] No party affiliation ❑ Party candidate for the office of Boynton Beach City Commission District 1 (insert title of office and include district, circuit, group, seat number, if applicable) Date of Birth or Voter Registration Number Address r 4 q s- 1� PA C -f City County State Zip Code Boynton Beach Palm Beach FL 3/1'1 Signature of Vote Date Signed (MM/DD/YY) [to be completed by Voter] Rule 15-2.045, F.A.C. DS -DE 704 [Eff. 09/7 11-4 ID 04q 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, /'7). _ .'- ;", _ _ t A.A., the undersigned, a registered voter (✓) ` (print name as it appears on your voter information card) in said state and county, petition to have the name of Gregory Hartmann placed on the Primary/General Election Ballot as a: [check(complete box, as applicable] KI Nonpartisan R] No party affiliation F-1 Party candidate for the office of Boynton Beach City Commission District 1 (insert title of office and include district, circuit, group, seat number, if applicable) Date of Birth or Voter Registration Number Address (MMIDD/YY) 611131 City County State Zip Code Boynton Beach Palm Beach FL 33�� Signature of Vot Date Signed (MM/DDNY) [to be completed by Voter] /6 Rule 15-2.045, F.A.C. DS -DE 104 iEff. 0911 REGiENM CITY 4F B4�!NT ';i1 BEAGF%/,P,v` `� ' cG 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 voter information card) in said state and county, petition to have the name of Gregory Hartmann placed on the Primary/General Election Ballot as a: [check/complete box, as applicable] 0Nonpartisan ® No party affiliation ❑ Party candidate for the office of Boynton Beach City Commission District 1 (insert title of office and include district, circuit, group, seat number, if applicable) Date of Birth or Voter Registration Number (MM/DD/YY) ;'-3!-Ll i Address 16-76 S -,J- 4-0e, City County State Zip Code Boynton Beach Palm Beach FL Signature of Voter 3- Rule 15-2.045. F.A.C. Date Signed (MM/DD/YY) [to be completed by Voted DS-DE 104 f Eff. 09/11