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Filing Papers
APPOINTMENT OF CAMPAIGN TREASURER AND DESIGNATION OF CAMPAIGN DEPOSITORY FOR CANDIDATES (Section 106.021(1), F.S_) (PLEASE PRINT OR TYPE) NOTE: This form must be on file with the qualifying _officer before opening the campal�n account. 1. 9HECK APPROPRIATE BOX(ES): ❑ Initial Filing of Form Re -filing to Change: ❑ 2. Name of Candidate (in this order: First, Middle, Last) 4. Telephone 5. E-mail address A% court&redbarac(" 6. Office sought (include district, circuit, group number) Cif f Comii1i!s,5ion, Drs--r,Gf 3 RECEM JUL 2 0 2021 Cfly OF BOYNTON BEACH OaytS tE 1'03 r CG OFFICE USE ONLY Treasure NDeputy ❑ Depository [—] Office ❑ Party 3. Address (include post office box or street, city, state, zip code) so�, whisperen� Pines road 00LINfO4 8eachi FL 33435 7. If a candidate for a nonpartisan office, check if 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 ❑ No Party Affiliation ❑ _ Party candidate. 9. 1 have appointed the following person to act as my 0 Campaign Treasurer ❑ Deputy Treasurer 10. Name of Treasurer or Deputy Treasurer r/ie.hell't 'coulee 11. Mailing Address . qne sot, uV h t6pe-ting Pines nes .boa d, P�ta�,� �-ovi �3eac.�i I Ft 53y ( 12 T e ) �� 13. City 14. County 15. State 16. Zip Code 17. E-mail address &11On 3.eac.tl P4 IM be" tl I FL 33 LO s mi I� a 11 a I^edbafar�IV co.n 18. 1 have designated the following bank as my Primary Depository ❑ Secondary Depository 19. Name of Bank 20. Address &anv- 04 )qWv er-i CA 5-;tY e woo Itw-i�Yvt- r2(� 21. City 22. County 23. State 24. Zip Code bo4,1 t0 h O eAZ,1�1 ph I w P�•eo col Pt- 1 33 y 35' 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. Signa re f Candid �•2v-Zs XS its 27. Treasurer's Acceptance of Appointment (fill in the blanks and check the appropriate block) 1, I C i e l lf, m eau, i re . , do hereby accept the appointment (Please Print or Type Name) i designated above as: [] Campaign Treasurer ❑ Deputy Treasurer. -7170 /2-0-7Y�- 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 RECEIVED CANDIDATE JUL 2 0 2021 (Section 106.023, F.S.) (Please print or type) CITY OF BOYNTON BEACH CITY CLERK'S OFFICE Jr . '93�m i, .;ourtjandt r'lcQuire, CUA , candidate for the office of btt co m i ss foyleT, p fisf-r i cf 3 have been provided access to read and understand the requirements of Chapter 106, Florida Statutes. t x No 0tv - 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 (05/1 1) RESIDENCY REQUIREMENTS /. lfe'-L I, CoUrtlandi- McQLk f& , candidate for (Print Name) U kr C om m c Ss �0 vi e( - DMy i ci- U- 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. c4w((P- (Signature of Candidate) (Date) S:\CC\WP\ELECTION\Year 2022\CANDIDATE INFORMATION CD\4. Residency Requirements\A. RESIDENCY REQUIREMENTS STATEMENT.doc FORM 1 STATEMENT OF 2020 Please print or type your name, mailing FINANCIAL INTERESTS FOR OFFICE USE ONLY: address, agency name, and position below: LAST NAME -- FIRST NAME -- MIDDLE NAME: FICOU(Ce I COuOland� MAILING ADDRESS : ,�o(o JZ`oa bo n I5ec(ch 33113 of rv► beach - I CITY : ZIP: COUNTY: NAME OF AGENCY: p X30 wn each NAME OF OFFICE OR POSITION HELD OR SOUGHT :I hh,co1�1�I� %q,on , vi5 oH1cf CHECK ONLY IF CANDIDATE OR L3 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 THAT ARE ABSOLUTE DOLLAR VALUES, WHICH REQUIRES FEWER CALCULATIONS, OR USING COMPARATIVE THRESHOLDS, WHICH ARE USUALLY BASED ON PERCENTAGE VALUES (see instructions for further details). CHECK THE ONE YOU ARE USING (must check one): ❑ COMPARATIVE (PERCENTAGE) THRESHOLDS OR ❑ 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 "nla") NAME OF SOURCE SOURCE'S DESCRIPTION OF THE SOURCE'S OF INCOME ADDRESS PRINCIPAL BUSINESS ACTIVITY ,e d &Ar 5n ft° ot+ed 50b u)hl-se rl-ncOn n Loa d VeMSi nc e.n e ar�ffii n (, 0 Vl P x&pi FL 33Li35 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 LL0- 52, SW Wh St _aII Jiqht Club - PART C -- REAL PROPERTY [Land, buildings owned by the reporting person - See instructions] You are not limited to the space on the (If you have nothing to report, write "none" or "n/a") lines on this form. Attach additional 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] (If you have nothing to report, write "none" or "n/a") TYPE OF INTANGIBLE PART E — LIABILITIES [Major debts - See instructions] (If you have nothing to report, write "none" or "nla") NAME OF CREDITOR BUSINESS ENTITY TO WHICH THE PROPERTY RELATES ADDRESS OF CREDITOR PART F — INTERESTS IN SPECIFIED BUSINESSES [Ownership or positions in certain types of businesses - See instructions) (If you have nothing to report, write "none" or "n/a") BUSINESS ENTITY # 1 BUSINESS ENTITY # 2 NAME OF BUSINESS ENTITY ( L L, - ADDRESS OF BUSINESS ENTITY iw � �t` [� I L 3 1 J PRINCIPAL BUSINESS ACTIVITY l J i n Yi t O (,fib POSITION HELD WITH ENTITY I () W n P i I I I I OWN MORE THAN A5% INTEREST IN THE BUSINESS iJ PS I I I NATURE OF MY OWNERSHIP INTEREST V OWn c5C `I - ). F)U� i n e% IGM Li &i .wkms L(C eose - I 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 ❑ SIGNATURE OF FILER: Signature: AI v, Date Signed: I I � /- If 2- 7 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. CE FORM 1 - Uective: January 1, 2021. Incorporated by reference in Rule 34.8202(1). FAC 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. PAGE 2 CANDIDATE OATH - RECEIVED NONPARTISAN OFFICE (`!OV 1 9 202i (Do not use this form if a Judicial or School Board Candidate) Check box only if you are seeking to qualify as a CITY OF BOYNTON H write-in candidate: 57 30Pm cG ❑ write-in candidate OFFICE USE ONLY Candidate Oath (Section 99.021(1)(a), Florida Statutes) j_ ., (Print name above 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 7p l�rl f SS! 7''1 (Office) (District #) �� ` V'vt I am a qualified elector of 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. Candidate's Florida Voter Registration Number o (located on your voter information card):. 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 ersons with disabilities (see instructions on page 2 of this form): [Not applicable to write-in candidates.] ��'` cgs (�-�3� �' ��Ui��re���r✓ X Signature of Candidate Telephone Number Email Address V 4- f V? o Lk3; AjEldress of City State ZIP Code 4.1z. STATE OF FLORIDA Q I Sign re of Notary Public COUNTYOF ]tri LM Print, npe, or Stamp Commissioned Name of Notary Public below: Sworn to (or affirmed) and subscribed before me by means of:iery�'• •. CRYSTAL D. GIBBON •' = MY COMMISSION # GG 326964 online notarization ❑ OR physical presence Eg' _•_ •*: .�n 20 02 _* of EXPIRES: April 22, 2023 Pu this day of e1ry -a '�Of*`OBonded Tian Notary Public Underwrltert x Personally Known ❑ OR Produced Identification i�� Type of Identification Produced: FL�nYec &ia& DS -DE 302NP (Rev. 0512021) Rule 1S-2.0001, F.A.C. miscellaneous cash Receipt CITY OF BOYNTON BEACH Account No. €P01-00-00-369-10-00 R,c,i,,dof— Courtlandt McQuire IV Address 506 Whispering Pines Road Bova For Cito. Filim. Fee r.o run for commis Dutch 8, 2022 Dept. City. Clerk I s Off ice By No. S1.710 $25.00 November 17 20 21 Beachi-33435 ivqm�' uu T-Fvr-WK-'--T- rick- 0 f—P- 1-223.53 Miscellaneous Cash Receipt No. 1*171121 CITY OF BOYNTON BEACH Account No. 001-0000-369-10-00 $ 198.53 i r -- November. 1 20. 21 Received of Coo tlandt McQuire IV Address 506 Whis-oerin-- Pines Road -R.ovnton Bead h,rl 33435 TOM- BY!R4Zb'-. Type: M Dr -R -x ---r: I -K-117Q41*1 mar'bf, no.' ' 96 For It Filimr Fee to run for Commissio'.0F March 8, 2022 Ira -is -xffb2r-;.., J -7T19 1034 - Dept. City Clerk's Office B y .7 coo ?1i i1 LO -n 9, A19P I Hqc: r+ rjF1�n r+ p gi Eg &I Lila Gibson, Crystal From: Gibson, Crystal Sent: Wednesday, December 1, 2021 9:31 AM To: Michelle Borberg Cc: Court McQuire; Stanzione, Tammy Subject: Cashier's Check and Petition Certification Good Morning, Michelle, As a follow-up to our conversation this morning and for official notification, please be advised that the qualifying fee check that was submitted last month was returned by the bank. Per a decision by the Supreme Court of Florida in Wright v. City of Miami Gardens, 200 So.3d 765 (2016), the candidate shall have 48 hours from the time that this notification is received, excluding Saturdays, Sundays, and legal holidays, to pay the fee with a cashier's check purchased from funds of the campaign account. The cashier's check amount would need to be a total of $223.53 ($198.53 for the 1% State Assessment and $25 for the City's Election Filing Fee). The regular campaign check amount we discussed would be for 55.20 for petition certification by the PBC Supervisor of Elections. Please make both payable to the City of Boynton Beach. I look forward to seeing you soon. Please let me know if you have any questions or if I can be of further assistance. Thank you, Crystal miscellaneous cash Receipt CITY OF BOYNTON BEACH ~TON Account No. •di+J �t ",` X1,0— 'y ,tea' I-aP 1 20= Received of Address I CITY CF BMM EECI CITY BMTW **## C1.ffae REl EIPT BfflaM . Tye` IC Dry` 1 Date: 12101/21 01 Receipt no: 7818 D2scriptiimupntit /mount 99 MI 1.00 V-23.53 Tran number2 G/L account numbpr: 001{101303531 =IRE Its - i8% FEE 1% A FvT FEE 506 W411YERING PITS ROPD Tenter detail CK lit 5;X72.13 $M.53 Tntal tend Total paywnt $E3.53 Trans date: 2/01I31 Ti a 10:35:% TW YW FCR W PRWT PA'rTB T , MEZSC011=e0us Cash Receipt .CITY OF BOYNTON. BEACH Account No. 0011-02"-36 Received of J Address .j t� „ i11 For I No. 0.1735 , 20 a L1Tr Cf loll FfAli ITY OF BMMA EE�I J *** 1-6� f I -PT *** Opers ByEffm Type: iC Dra er` 1 Dotes 2,1011/21 01 Pdamipt no: ;'81371 Description luantiI Amunt PJ --p7rrTt'T ew 220 Trans n ra Dept.4 E ;. � - By r4. LX ^tel\` ,t a ¢C R F �v 5 P' WIRE IV - PETIT MU COLMIAWT PUWIRE IV 506 W iI' UING PBES RD PtE-TIT ISN CERT Tender- rhtai i Dl D-EOK 90 $5,20 Total tend2T2 l $5,20 Total payw-nt $5.20 L1Tr Cf loll FfAli ITY OF BMMA EE�I J *** 1-6� f I -PT *** Opers ByEffm Type: iC Dra er` 1 Dotes 2,1011/21 01 Pdamipt no: ;'81371 Description luantiI Amunt 9g mI�M t;vt;SJ. 220 Trans n ra a" G/L account number, 0010 D0036'81txc P' WIRE IV - PETIT MU COLMIAWT PUWIRE IV 506 W iI' UING PBES RD PtE-TIT ISN CERT Tender- rhtai i Dl D-EOK 90 $5,20 Total tend2T2 l $5,20 Total payw-nt $5.20 Trans date} 001:.21 Time: 10:37,' 16 TIIM( Y I FOR YaR PRMPT PAMW Wendy Sartory link Palm Beach County Supervisor of Elections aE�FIVF CERTIFICATION CJTY' OF I-su + N 1 -ON 6FACH I, WENDY SARTORY LINK, SUPERVISOR OF ELECTIONS, for Palm Beach County, Florida, do hereby certify that 46 signatures on the Nominating Petitions of COURTLANDT MCQUIRE for COMMISSION, SEAT 3, 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 COURTLANDT MCQUIRE is a registered voter in Precinct 4054, 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. ': r .. Imo` e6• `' WENDY SART RY LINK >� -- SUPERVISOR OF?E ACTIONS r ` PALM BEACH C(3U-NYIY %SEAL)°F 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 2aoRg233 CANDIDATE PETITION Notes: -All information on this form becomes a public record upon receipt by the Supervisor of Elections. It is a cringe to knowingly sign more than one petition for a candidate. (Section 104.185, Florida Statutesl If all requested information on this form is not completed, the form will not be valid as a Candidate Petition form. 1, 1�f1: (print name as it appears on your voter information card) in said state and county, petition to have the name of Courtlandt McQuire placed on the Primary/General Election Ballot as a: [checklcomplete box, as applicable] E✓ Nonpartisan ❑ No party affiliation ❑ City Commissioner - District 3 the undersigned, a registered voter Party candidate for the office of (insert title of ottice and include district, circuit, group, seat number, if applicable) Date of Birth or Voter Registration Number Address (MM/DD/YY) /q s] -337() R1 City County State Zip Code Boynton Beach Palm Beach Co FL 33435 5 Rule 1S-2.045, F Date Signed (MM/DD/YY) [to be omplet by Voter] DS -DE 104 (EH. 09/11 NoV 12 2021 CITY CX-- BoYNTON SERC' I `�t -( 14q bg6g6 CANDIDATE PETITION Notes: -All information on this form becomes a public record upon receipt by the Supervisor of Elections. It is a crime to 1<n.owingly sign more than one petition for a candidate. (Section 104.185, Florida Stanuesl If all requested information on this form is not completed, the form will not be valid as a Candidate Petition fnrm. 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 Courtlandt MCQuire placed on the Primary/General Election Ballot as a: [check/complete box, as applicable] F - -']Nonpartisan 0 No party affiliation F-1 Party candidate for the office of City Commissioner - District 3 (insert title of office and include district, circuit, group, seat number, if applicable) Date of Birth or Voter Registration Number Address (MM/PD/YY) F v 3 -1 -au D � W' City County State Zip Code Boynton Beach Palm Beach Co FL 33435 Signature of Voter Date Signed (MM/DD/YY) [to be 4co pleted by Voter] I (z 1 Rule 1S-2.045, Fli. . DS -DE 104 (Eft. 09/11 1?..Ioqszq? 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. ISe ction 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 Courtlandt McQuire placed on the Primary/General Election Ballot as a: [check/complete box, as applicable] ED Nonpartisan 0 N party affiliation ❑ City Commissioner - District 3 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 J (MM/DD/YY) 33 90 Rt d � ZS - City Boynton Beach_ Signature of Voter Rule 1S-2.045, F.A.C. County State Zip Code ,Palm Beach Co FL 33435 Date Signed (MM/DD/YY) [to be completed b . Voter] 1J /Z 2 ( DS -DE 104 (Eff. 09/11 �� ZlyO CANDIDATE PETITION Notes: -All information on this form becomes a public record upon receipt by the Supervisor of Elections. It is a crime to knowingly sign more than one petition for a candidate. [Section 104.185, Florida Statutes) If all requested information on this form is not completed, the form will not be valid as a Candidate Petition form. r f r, , C the undersigned, a registered voter /(print name as it appears 6 rtvbur voter information card) in said state and county, petition to have the name of Courtlandt McQuire placed on the Primary/General Election Ballot as a: [check/complete box, as applicable] ✓ONonpartisan F]No party affiliation ❑ Party candidate for the office of City Commissioner - District 3 unser[ title of orrice ana Include district, circuit, group, seat number, if applicable) Date of Birth or Voter Registration Number Address (MM/DD/YY) OF -- D J, fit/. City County State Zip Code Boynton Beach Palm Beach Co FL 33435 Signature of Voter ( Date Signed (MM/DD/YY) [to be completed by Voter] Rule 1S-2.045, .A.C. , DS -DE 104 (Eff. 09/11 CANDIDATE PETITION Notes: -All information on this forma becomes a public record upon receipt ky the Supervisor of Elections. It is a crime to knowingly sign more than one petition,for a candidate. [Section 104.185, Florida Statulesl If all requested information on this form is not completed, the.form will not be valid as a Candidate Petition form. I> V S'� �n 1 Z� the undersigned, a registered voter (print name as it appears on your voter information card) f in said state and county, petition to have the name of Courtlandt McQuire placed on the Primary/General Election Ballot as a: [check/complete box, as applicable] ✓Nonpartisan [—]No party affiliation City Commissioner - District 3 Date of Birth or (MM/DD/YY). .1z2lor/ Party candidate for the office of (insert title of office and include district, circuit, group, seat number, if applicable) Voter Registration Number Address City Boynton Beach Signature of Rule 1S-2.045, F FF G1m nty State Zip Code Beach Co FL 33435 Date Signed (MM/DD/YY) [to be com leted by Voter] 1 :62411' 111,J2 -1z0 ) DS -DE 104 (Eff. 09/11 MM0833 CANDIDATE PETITION Notes: -All information on this form becomes a public record upon receipt b_v the Supervisor of Elections. It is a crime to knowingly sign more than one petition for a candidate. [Section 104.185, Florida Statutesl 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 Courtlandt McQuire placed on the Primary/General Election Ballot as a: [checklcomplete box, as applicable] ❑ No party affiliation F-1❑✓ Nonpartisan City Commissioner District 3 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) City County �ytnon Beach Palm Signature of Voter Rule 1S-2.$45. F.A.C. Address b \U \e1 `S i 1 YAG State Zip Code Beach FL 33435 Date Signed (MM/DD/YY) ' [to be completed by Voter] tl �0 12�Z.1 DS -DE 104 (Eff. 09111 OVP (LI 1 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) 1 f all requested information on this form is not completed, the form will not be valid as a Candidate Petition form. Ul �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 Courtlandt McQuire placed on the Primary/General Election Ballot as a: [check/complete box, as applicable] ED Nonpartisan E] No party affiliation City Commissioner - District 3 Date of Birth or (MM/DD/YY) a1iv7ll C. Party candidate for the office of (insert title of office and include district, circuit, group, seat number, if applicable) Voter Registration Number Address � 10vI/ City County State Zip Code Boynton Beach Palm Beach Co FL 33435 Signature of Voter -- Rule 1S-2.045, F.A.C. S6 k'nc 43 � b /--- Date Signed (MM/DD/YY) [to be completed by Voter] 11l 1-2 / zl DS -DE 104 (Eff. 09/1 I Q24g69Z9 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 Courtlandt McQuire placed on the Primary/General Election Ballot as a: [check/complete box, as applicable] ✓� Nonpartisan E] No party affiliation F_� Party candidate for the office of City Commissioner - District 3 (insert title of office and include district, circuit, group, seat number, if applicable) Date of Birth or Voter Registration Number Address (MM/ DfYY �V � V � � �-✓ i 'fir P4j eS CityCounty State Zip Code Boynton Beach Palm Beach Co FL 33435 Sig r Date Signed (MM/DDNY) [to be mpleted by Voter] Rule 1S-2.045, F.A.C. 9 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, Gr� (print name as it appears bn your voter information card) in said state and county, petition to have the name of Courtlandt McQuire placed on the Primary/General Election Ballot as a: [check/complete box, as applicable] Q✓ Nonpartisan ❑ No party affiliation ❑ the undersigned, a registered voter Party candidate for the office of City Commissioner - District 3 (insert title of office and include district, circuit, group, seat number, if applicable) Date of Birth or Voter Registration Number Address (MM/DD/YY) City County State Zip Code Boynton Beach Palm Beach Co FL 33435 Signature of Voter Date Signed (MM/DD/YY) � [to be completed by Voter] Rule 1S-2.045, .A.C. DS -DE 104 (Eff. 09/11 Sdo U ['.17 +2 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 fonn. (' r5T1rJA 3ALTAMAJ (print name as it appears on your voter information card) in said state and county, petition to have the name of Courtlandt McQuire placed on the Primary/General Election Ballot as a: [check/complete box, as applicable] QNonpartisan 0 N party affiliation ❑ City Commissioner - District 3 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 515 WH l . kg w (, ftNCS (M D Y IM 6j SoArp llJ Sc At, 0,`;<= X35= City County State Zip Code Boynton Beach Palm Beach Co FL 33435 Signate of Voter Date Signed (MM/DD/YY) ' [to be completed by Voter] Rule 1S-2.045, F.A.C. DS -DE 104 (Eff. 09/11 R©3o K 6 CANDIDATE PETITION Notes: -All information on this form becomes a public record upon receipt by the Supervisor of Elections. 1t 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 Courtlandt McQuire placed on the Primary/General Election Ballot as a: [checklcomplete box, as applicable] QNonpartisan FjNo party affiliation City Commissioner - District 3 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/D /YY) �- �c� City County State Zip Code Boynton Beach Palm Beach Co FL 33435 gna of Vr Wr ! Date Signed (MM/DD/YY) ' [to be completed by Voter] n Rule 15-2.045, F.A.C. NJ V 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, t f l\ (print name as it appears on your voter information card) in said state and county, petition to have the name of Courtlandt McQuire placed on the Primary/General Election Ballot as a: [check/complete box, as applicable] Q✓ Nonpartisan F�No party affiliation ❑ the undersigned, a registered voter Party candidate for the office of City Commissioner - District 3 (insert title of office and include district, circuit, group, seat number, if applicable) Date of Birth or Voter Registration Number (MM DD/YY City County ,Boynton Beach Palm Signature Voter Rule 1S-2.045, F.A.C. Address LF iZip Code Beach Co 33435 MQ- I k a v1 ��1 II�K Date Signed (MM/DD/YY) [to be compl ted bVoter] �oF t DS -DE 104 (Eff. 09/11 112-15LHq3 CANDIDATE PETITION Notes: -All information on this farm becomes a public record upon receipt by the Supervisor of Elections. 1t is a crime to knowingly sign more than one petition for a candidate. [Section 104.185, Florida Statutes] 1f all requested information on this form is not completed, the, form will not be valid as a Candidate Petition form. C, o e the undersigned, a registered voter (print name as it appears on your voter infor ation card) in said state and county, petition to have the name of _Courtla dt McQuire placed on the Primary/General Election Ballot as a: [check/complete box, as applicable] ✓❑ Nonpartisan ❑ No party affiliation ❑ Party candidate for the office of City Commissioner District 3 (insert title of office and include district, circuit, group, seat number, if applicable) Date of Birth or Voter Registration Number AddressD/Yr y. (M L Y) t dC to City County State V3�3 ode on Beach Palm Beach FL 35 Signature f Voter Date Signed (MM/DDNY) [to be complete by Voter]. U �7� L Rule 1S-2.045, F.A.C. DS -DE 104 (Eff. 0W11 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 Courtlandt McQuire placed on the Primary/General Election Ballot as a: [check/complete box, as applicable] ❑✓ Nonpartisan [—]No party affiliation ❑ City Commissioner District 3 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 A dress (MMID DN City County State Zip code Boytnon Beach Palm Beach FL 33435 Signatu Rule 1S-2445. F 'k �,4a w ovtpwl� Date Signed (MM/DD/YY) ' [t�� mpl7 t by, Voter] Jj DS -DE 104 (Eff. 09/11 12--.5X5955 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/ //'all requested information on this form is not completed, the form will not be valid as a Candidate Petition form. I, 5 �ACUCA (print name as it appears on your voter information card) in said state and county, petition to have the name of Courtlandt McQuire placed on the Primary/General Election Ballot as a: [check/complete box, as applicable] ✓O Nonpartisan 0 N party affiliation El City Commissioner District 3 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 Addresse (MM/DD/YY)1 j 1 t ,o City County State Zip Code Boytnon Beach Beach FL 33435 Si ture of Voter Date Signed (MM/DD/YY) [to be comple d y Voter] Rule 1S-2.045, F.A.C. DS -DE 1041Eff. 09/11 115; goo ZrpZ CANDIDATE PETITION Notes: -All information on this form becomes a public record upon receipt by the Supervisor of Elections. It is a crime to knowingly sign more than one petition for a candidate. [Section 104.185, Florida Statutes/ If all requested information on this form is not completed, the, form will not be valid as a Candidate Petition form. 1 1 rL0,_' a --G e the undersigned, a registered voter (print name as it appears on your voter information card) in said state and county, petition to have the name of Courtlandt McQuire placed on the Primary/General Election Ballot as a: [check/complete box, as applicable] Q NonpartisanEjNo party affiliation El Party candidate for the office of City Commissioner District 3 (insert title of office and include district, circuit, group, seat number, if applicable) Date of Birth or Voter Registration Number I Address (MM/DD/YY) 14 32-D City County State Zip Code Boytnon Beach Palm Beach FL 33435 Signat re f -Voter Date Signed (MM/DD/YY) [to be completed by Voter] a� Rule 1S-2.04 A.C. DS -DE 104 (Eff. 09/11 t 12368'051 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 forma will not be valid as a Candidate Petition form. `° a 5 p t4 P, FTI t r✓ ss y (print name as it appears on your voter information card) in said state and county, petition to have the name of Courtlandt McQuire placed on the Primary/General Election Ballot as a: [check/complete box, as applicable] F - Nonpartisan ❑ No party affiliation F-1 _ City Commissioner District 3 the undersigned, a registered voter Party candidate for the office of (insert title of office and include district, circuit, group, seat number, if applicable) FDate ofBith or Voter Registration Number Address /JM/DD/YY) l 5157 W q .SPE 1 N G City County State Zip Code [Boytnon Beach Palm Beach FL 33435 Signature of Voter Date Signed (MM/DD/YY) }- -- [to be completed by Voter] / Rule 1S-2.045, F.A.C. DS -DE 104 (Eff. 09/1 IIN899 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. �' GI!L (print name as it appears on your voter information card) in said state and county, petition to have the name of Courtlandt McQuire placed on the Primary/General Election Ballot as a: [check/complete box, as applicable] FV]Nonpartisan D No party affiliation 0 City Commissioner District 3 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/DDN _ Address I City County State Zip Code Boytnon Beach Palm Beach FL 33435 Signature ofV7(MM/DD/YY) Date Signed [to be completed by Voter] Rule 15-2.045, F.A.C. DS -DE 104 (Eff. 09/1 gII26 CANDIDATE PETITION Notes: -A It 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 C 5 �o f �� 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 Courtlandt McQuire placed on the Primary/General Election Ballot as a: [check/complete box, as applicable] ✓Q Nonpartisan []No party affiliation City Commissioner District 3 Party candidate for the office of (insert title of office and include district, circuit, group, seat number, if applicable) 3 oy [Dale ofBirth or Voter Registration Number Address -e3 `y!4>M/DD/YY� �vr f3 � �[ C � � I 3 3 9 ,�� Iy� l City County Boytnon Beach Palm Beach lI.Stalte L Signatureof Voter Rule Zip Code 33435 Date Signed (MM/DD/YY) [to be completed by Voter] DS -DE 104 (Eff. 09/11 �2R3�Z 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 Statutesl 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 Courtlandt McQuire placed on the Primary/General Election Ballot as a: [check/complete box, as applicable] ✓QNonpartisan QNo party affiliation ❑ the undersigned, a registered voter Party candidate for the office of City Commissioner - District 3 (insert title of office and include district, circuit, group, seat number, if applicable) Date of Birth or Voter Registrati (MM D/YY) 9 I9 on Number Address C p L461 --Pt c L PA �.fr-PA, & ff, City County State Zip Code Boynton Beach Palm Beach Co FL 33435 Signature of Voter Rule 1S-2.045, F.A.C. Date Signed (MM/DD/YY) [to be completed by Voter] DS -DE 104 (Eff. 09/11 Il �o4yl 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 shore 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. ti©V Lq /k) CLA ( rint name s it appears on your voter information card) in said state and county, petition to have the name of Courtlandt MCQuire placed on the Primary/General Election Ballot as a: [check/complete box, as applicable] F --']Nonpartisan [:]No party affiliation the undersigned, a registered voter �2o Party candidate for the office of City Commissioner District 3 (insert title of office and include district, circuit, group, seat number, if applicable) Date of Birth or Voter Registration Number Address (MM/DD/YY) City County State Zip Code LBoytnon Beach �P� alm Beach FL 33435 Signature of Vot 1 Date Signed (MM/DD/YY) [to be completed by Voter] Rule 1S-2.045, F.A.C. DS -DE 104 (Eff. 09/11 '3 a VuA �- [�qn CANDIDATE PETITION Notes: -All information on this form becolnes a public record upon receipt l>_v they Supervisor of Elections. It is a crime to knowingly sign more than one petition far a candidate. [Section 104.185, Florida Statutes/ If all requested informationn on this for-rn is not completed, the form will not be valid as a Candidate Petition form. the undersigned, a registered voter (printWame as it appears on gour voter information card) in said state and county, petition to have the name of Courtlandt McQuire placed on the Primary/General Election Ballot as a: [check/complete box, as applicable] ✓Q Nonpartisan [—]No party affiliation ❑ City Commissioner District 3 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) p / kvl2 tfO% !'7 City Boyt/ridn B Sig"'ture :of Vote Rule 1S-2. IM ff =:.-M State Zip Code FL 133435 Date Signed (MM/DD/YY) 2— [to be completed by Voter] DS -DE 104 (Eft. 09/111 11--9 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 Statutesl !f all requested information on this brnl. is not completed, the.forrn will not be valid as a Candidate Petition /innn. I % , 1 1 1. (print name as it appears on your voter i rmation card) in said state and county, petition to have the name of Courtlandt McQuire placed on the Primary/General Election Ballot as a: [check/complete box, as applicable] ✓Nonpartisan ❑No party affiliation City Commissioner - District 3 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 Ad es (MM/DD/YY) /1 C) 9 je� �k4< �)l 't f City County State Zip Code Boynton Beach Palm Beacham FL 33435 Sign ture of V Date Signed (MM/DD/YY) [to be completed by Voter] I Rule 1S -2A45, F.A.C. DS -DE 104 (Eff. 09/11 (Z`4 x'}00 2,2- CANDIDATE Z 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, lail I the undersigned, a registered voter (print name as it appears on your voter information card) in said state and county, petition to have the name of Courtlandt McQuire placed on the Primary/General Election Ballot as a: [check/complete box, as applicable] ✓Nonpartisan F]No party affiliation Party candidate for the office of City Commissioner - District 3 (insert title of office and include district, circuit, group, seat number, if applicable) Date of Birth or Voter Registration Number Address (MM/DD/YY) O 0 1JILS X012a -DL,' City County nFT Boynton Beach Palm Beach Co Signature of Rule 15-2.045, F.A.C. Zip Code 33435 Date Signed (MM/DD/YY) [to be completed by Voter] DS -DE 104 IEff. 09/11 tb5-b-o CANDIDATE PETITION Notes: -All information on this form becomes a public record upon receipt by the Supervisor of Elections. It is a crime to knowingly sign more than one petition for a candidate. (Section 104.185, Florida Statutes) If all requested information on this form is not completed, the form will not be valid as a Candidate Petition form. L CA t Gk n -L, (A N c,3L, L{'Z 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 Courtlandt McQuire placed on the Primary/General Election Ballot as a: [check/complete box, as applicable] F --,]Nonpartisan ONo party affiliation City Commissioner - District 3 Party candidate for the office of (insert title of office and include district, circuit, group, seat number, if applicable) Date of Birth or Vote[,r Registration Number Address (nnM 0�) i2.� (\ l6 -j �0G0 11�I�� �� ( City County State Zip Code Boynton Beach Palm Beach Co FL 133435 Signature of Voter Rule 1S-2.045, F.A.C. Date Signed (MM/DDNY) [to beccllnpletpd by Voter] (,rz/--i DS -DE 104 (Eft. 09/11 l 1126538g�- CANDIDATE PETITION Notes: -All information on this form becomes a public record uponn receipt by the Supervisor of Elections. It is a crinne 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. Oast/ 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 Courtlandt McQuire placed on the Primary/General Election Ballot as a: [check/complete box, as applicable] r✓ Nonpartisan F]No party affiliation F-1 Party candidate for the office of City Commissioner - District 3 (insert title of office and include district, circuit, group, seat number, if applicable) Date of Birth or Voter Registration Number Address (MM/DD/YY) City County State Zip Code Boynton Beach Palm Beach Co FL 33435 Signature of Voter Date Signed (MM/DD/YY) [to be completed y V ter] z,.'- J Rule 1S-2.045, F.A.C. DS -DE 104 (Eff. 09/11 j 0, Ij fIEProo IlK65a, 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 Staturesl If all requested information on this form. is not completed, the form will not be valid as a Candidate Petition.form. I, rprinrrhanle as if appears o your voter information card) in said state and county, petition to have the name of Courtlandt McQuire placed on the Primary/General Election Ballot as a: [check/complete box, as applicable] the undersigned, a registered voter r- Nonpartisan 0 No party affiliation Party candidate for the office of City Commissioner District 3 (insert title of office and include district, circuit, group, seat number, if applicable) Date of Birth or Voter Registration Number Ad/dress f, l nn rd OILIoY-1-7 , City County State Zip Code Boytnon Beach Palm Beach FL 33435 Signature of Voter Date Signed (MM/DD/YY) r� [to be completed by Voter] -2 6) 2) Rule 1S-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 cringe to knowingly sign more than one petition for a candidate. ISection 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. fA0,4K S Le"&.N 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 Courtlandt McQuire placed on the Primary/General Election Ballot as a: [checklcomplete box, as applicable] ✓QNonpartisan F-jNo party affiliation ❑ Party candidate for the office of City Commissioner - District 3 (insert title of office and include district, circuit, group, seat number, if applicable) Date of Birth or Voter Registration Number Address (MM/DD/YY) 1�tA� J f�l City County State Zip Code Boynton Beach Palm Beach Co FL 33435 Signature of V ter Date Signed (MM/DDNY) [to be completed by Voter] LL I I:?/Al Rule 1S-2.045, F.A.C. DS -DE 104 (Eff. 09/11 CANDIDATE PETITION Notes: -All information on this form becomes a public record uponn receipt by the Supervisor of Elections. It is a crime to knowingly sign more than one petition for a candidate. [Section 104./85, 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 undersigned, the registered voter 9 (print kariie as it apnZars on your voter information card) in said state and county, petition to have a name of Courtlandt McQuire placed on the Primary/General Election Ballot as a: [check/complete box, as applicable] ✓QNonpartisan F]No party affiliation City Commissioner - District 3 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 Addre sfifi/ ` (MM/DD/YY) j��l,+ City County State Zip Code Boynton Beach Palm Beach Co FL 3343 Y � 5 Signatu Rule 15-2.045, F.A.C. Date Signed (MM/DD/YY) [to be completed by Voter] DS -DE 104 (Eff. 09/11 IZq CANDIDATE PETITION Notes: -All information on this form becones 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) l 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 -gym your voter information card) in said state and county, petition to have the name of Courtlandt McQuire placed on the Primary/General Election Ballot as a: [checklcomplete box, as applicable] ✓Q Nonpartisan 0 N party affiliation Party candidate for the office of City Commissioner - District 3 (insert title of office and include district, circuit, group, seat number, if applicable) te of Birth or Voter Registration Number Address [Da MM/DD/YY) `� 334{ ({, t, c► Y. n�olynton County State Zip Code Beach Palm Beach Co FL 33435 Signature of Voter Rule 1S-2.045, F.A.C. Date Signed (MM/DD/YY) [to be omp! ted by Voter] �2- za-. 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./bon. 1, 0 b-, o1 DSS -�'j 1,Y) -SOY, 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 Courtlandt McQuire 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 City Commissioner District 3 (insert title of office and include district, circuit, group, seat number, if applicable) Date of Birth or Voter Registration Number Address City County State Zip Code Boytnon Beach Palm Beach FL 5 3� 3 '-- Signature of Voter I&a - "U71 1, � r - Rule 15-2.045. F Date Signed (MM/DD/YY) [to be completed by Voter] In /z6 ) 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 cringe 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. O1D(tLS0tA, 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 Courtlandt McQuire placed on the Primary/General Election Ballot as a: [check/complete box, as applicable] ✓QNonpartisan Q40 party affiliation F-1 Party candidate for the office of City Commissioner District 3 (insert title of office and include district, circuit, group, seat number, if applicable) Date of Birth or (MM/DD/YY) Voter Registration Number I 191 _M'[ ��Sl Address -71S' Wd°`V` 06 -cc City County State Zip Code ,Boytnon Beach I IPalm Beach FL I���� Signature of Voter Rule 1S-2.045, F.A.C. Date Signed (MM/DD/YY) [to be completed by Voter] I C7 IN -( DS -DE 104 (Eff. 09/11 IL 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 ort (prird name as it appears on your voter information card) in said state and county, petition to have the name of Courtlandt McQuire placed on the Primary/General Election Ballot as a: [check/complete box, as applicable] ✓Nonpartisan F]No party affiliation El City Commissioner District 3 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 }� r — Uix — LEytnon County State Beach Palm Beach IFL Signature of Rule 1S-2.045, F.A.C. Zip Code 3E<<3�_ Date Signed (MM/DD/YY) [to be completed by Voter] DS -DE 104 (Eft. 09/11 L3" 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 mn. ore than one petition for a candidate. [Section 104.185, Florida Statutesl If all requested information on this form is not completed, the form will not be valid as a Candidate Petition form. 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 Courtlandt McQuire placed on the Primary/General Election Ballot as a: [checklcomplete box, as applicable] [-.71Nonpartisan F]No party affiliation City Commissioner District 3 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 LFFrL Zip Code Boytnon Beach 'Palm Beach 33435 re of VotJ �Ad(z,.T. �m Rule 1S-2.045, F.A.C. Date Signed (MM/DD/YY) [to be completed by Voter] I (- f0 -Q 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 104.18.5, Florida Statutes/ If all requested information 011 this form is not completed, the form will not be valid as a Candidate Pelition,forrrr. (print na+tn�as it appears on your voter information card) in said state and county, petition c have the name of Courtlandt McQuire placed on the Primary/General Election Ballot as a: [check/complete box, as applicable] F - -']Nonpartisan ❑ No party affiliation ❑ City Commissioner - District 3 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 //���� � 1 (MM/DD/YY) � - ���K/ WlkArCIk 1 ��Y• ci i o"'v 1 I v, City County State Zip Code 'Boynton Beach Palm BeachCo FL 33435 Signature V r Date Signed (MM/DD/YY) 1� [to be completed by Voter] Rule 1S-2.045, F.A.C. 1 ADDS- IDE 104 (Eff. 09/11 21651-&l Lt CANDIDATE PETITION Notes: -A// 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 Courtlandt McQuire placed on the Primary/General Election Ballot as a: [check/complete box, as applicable] ✓� Nonpartisan [—]No party affiliation ❑ Party candidate for the office of City Commissioner - District 3 (insert title of office and include district, circuit, group, seat number, if applicable) Date of Birth or Voter Registration Number Address (MM/DD/YY) City County State Zip Code i.Boynton Beach halm Beach Co FL 33435 Signature of Voter Date Signed (MM/DD/YY) [to bej completed by Voter] Rule 1S-2.045, F. -- - DS -DE 104 (Eff. 09/11 25zgl 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 onn this form is not completed, the form will not be valid as a Candidate Petition form. "K002-r-F.,),/V11cA 4,71 the undersigned, a registered voter J (print name as it,.W12-W12on your voter information card) in said state and county, petition to have the name of Courtlandt McQuire placed on the Primary/General Election Ballot as a: [checklcomplete box, as applicable] MV Nonpartisan 0 No party affiliation M Party candidate for the office of City Commissioner - District 3 (insert title of office and include district, circuit, group, seat number, if applicable) Date of Birth or Voter Registration Number Address , (MM/DD Y) 0 8 0 /i City County StateZip Code Boynton Beach Palm Beach Co FL 33435 Signature of V Date Signed (MM/DD/YY) [to be com leted by Voter] L. Rule 1S-2.045, F.A.C. DS -DE 104 (Eff. 09/11 2gg3I5kz 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.lorin. (print name as it appears on your voter information card) in said state and county, petition to have the nam of ourtlandt McQuire placed on the Primary/General Election Ballot as a: [check/complete box, as applicable] E✓ Nonpartisan D No party affiliation the undersigned, a registered voter Party candidate for the office of City Commissioner - District 3 (insert title of office and include district, circuit, group, seat number, if applicable) Date of Birth or Voter Registration Number Address (MM/DDIYY) lqi llcres� City County State Zip Code Boynton Beach Palm Beach Co FL 3� 34.35 Signature of Voter Rule 19-2.045, F.A.C. Date Signed (MM/DD/YY) [to be completed byVoter] r DS -DE 104 (Eff. 09/11 U 169 U CANDIDATE PETITION Notes: -All information on this form becomes a public record upon receipt Gy the Supervisor of Elections. // is a crime to knowingly .sign more than one petition for a candidate. (Section 104.185, Florida Statutesl 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 Courtlandt McQuire placed on the Primary/General Election Ballot as a: [check/complete box, as applicable] ✓Nonpartisan [:]No party affiliation ❑ City Commissioner - District 3 the undersigned, a registered voter Party candidate for the office of (insert title of office and include district, circuit, group, seat number, if applicable) ( /YJJate of Birth or Voter Registration Number Address MM/DDlj� I City County V�7 Zip Code Boynton Beach Palm Beach Co 33435 Signature of Rule 1S-2.045, F.A.C. wAD Date Signed (MM/DDNY) [ to be completed Voted DS -DE 104 (Eff. 09/11 20VIA 6.5 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./85, Florida Statutes/ - /f all requested information on this form is not completed, the form will not be valid as a Candidate Petition.lbon. Lor—)E: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 Courtlandt McQuire placed on the Primary/General Election Ballot as a: [check/complete box, as applicable] ✓❑ Nonpartisan ❑ No party affiliation M Party candidate for the office of City Commissioner - District 3 (insert title of office and include district, circuit, group, seat number, if applicable) Date of Birth or Voter Registration Number Address (MM/DD/YY) City County State Zip Code Boynton Beach Palm Beach Co FL 33435 Signa a of Voter Date Signed (MM/DD/YY) [to be completed by Voter] Rule 1S-2645, F.A.C. _ DS -DE 104 (Eff. 09/11 1 M1S2.da6 CANDIDATE PETITION Notes: -All information on this form becomes a public record upon receipt Gy 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 Courtlandt McQuire placed on the Primary/General Election Ballot as a: [check/complete box, as applicable] ✓QNonpartisan E]No party affiliation City Commissioner - District 3 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) CityCounty State Zip Code Boynton Beach Palm Beach Co FL 33435 Signature o V to Date Signed (MM/DD/YY) [to be comp .fed by Vater] Rule 15-2.045, F.A.C. DS -DE 104 (Eff. 09/11 r wR�� 16136 CANDIDATE PETITION Notes: -All information on this fornl 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 nae as it appears on your voter information card) in said state and county, petition to have the name of Courtlandt McQuire 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 City Commissioner - District 3 (insert title of office and include district, circuit, group, seat number, if applicable) Date of Birth or Voter Registration Number Address (MM/DD/YY) City County State Zip Code Boynton Beach Palm Beach Co FL 133435_ Sig Rule 1S-2.045. F.A.C. Date Signed (MM/DD/YY) [to be completed by Voter] aI _ DS -DE 104 (Eff. 09/11 21 I o355 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,/, &eV2 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 Courtlandt McQuire placed on the Primary/General Election Ballot as a: [check/complete box, as applicable] R✓ Nonpartisan [:]No party affiliation ❑ Party candidate for the office of City Commissioner - District 3 (Insert title of office and include district, circuit, group, seat number, if applicable) Date of Birth or Voter Registration Number Address (MM/DD/YY) j?�e d2 ks VV d 1`2 City CountyState IF Code Boynton Beach Palm Beach oC FL Y � L33435 Signature of Voter I Date Signed (MM/DDNY) [to be completed by Voter] Rule 1S-2.045, F DS -DE 104 (Elf. 09/11 2( CANDIDATE PETITION Notes: All information on this form becomes a public record upon receipt by the Supervisor of Elections. It is a cringe to knowingly sign more than one petition for a candidate. [Section 104.185, Florida Statutes/ If all requested injbrination 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 iVappears on your voter information card) in said state and county, petition to have the name of Courtlandt McQuire 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 City Commissioner - District 3 (insert title of office and include district, circuit, group, seat number, if applicable) Date of Birth or Voter Registration Number Address J7�o(� jc—"v/--t co C) D� (MM/DD/YY) �- r7tokt L City County State Zip Code Boynton Beach Palm Beach Co FL X33435 Signature of Voter a Rule 1S-2.045, F.A.C. Date Signed (MM/DD/YY) (to/be completed by Voter] DS -DE 104 (Eff. 09/11 I T52ZZ630 CANDIDATE PETITION Notes: All infor1nation 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. ..` e undersigned, a registered voter (print name as it appears on your voteWf o�f`h n card) in said state and county, petition to have the name of Courtlandt McQuire placed on the Primary/General Election Ballot as a: [check/complete box, as applicable] nonpartisan 0 N party affiliation Party candidate for the office of City Commissioner - District 3 (insert title of office and include district, circuit, group, seat number. if applicable; Date of Birth or Voter Registration Number Ad ess 1 CityCounty State Zip Code Boynton Beach Palm Beach Co I JFL 33435 Signature of Vote Date Signed (MM/DD/YY) [to be completed by Voter] AA Vj<z2J'. Rule 15-2.045, F.A. IS -DF 104 (Eff. 09/11 I I_Uz 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, • L i j e' (print name as it appears on your voter information card) in said state and county, petition to have the name of Courtlandt McQuire placed on the Primary/General Election Ballot as a: [check/complete box, as applicable] onpartisan 0 N party affiliation ED the undersigned, a registered voter Party candidate for the office of City Commissioner - District 3 (insert title of office and include district, circuit, group, seat number, if applicable) Date of Birth or Voter RegistrationNum erb Address ------ All City County f State Zip Code Boynton Beach Palm Beach Co FL 33435 Signature Signature of Voter ti Date Signed (MM/DD/YY) [to be copleted by oter] I Rule 1S-2.045, F.A.C. IS -DE 104 fEff. 09/11 015! 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 nwre than one petition for a candidate. (Section 104.185, Florida Statutesl If all requested it(forntation on this fornt. is not completed, the.form will not be valid as a Candidate Petition fmmn. 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 Courtlandt McQuire placed on the Primary/General Election Ballot as a: [check/complete box, as applicable] Z✓ Nonpartisan [:] No party affiliation F-1 Party candidate for the office of City Commissioner - District 3 (insert title of office and include district, circuit, group, seat number, if applicable) Date of Birth or Voter Registration Number Address (MM/DD/YY) o Lj�01 l b I avy-C'Ec« 6V -o(__. CityCounty State Zip Code Boynton Beach Palm Beach Co FL 33435 Signature of Voter t Rule 1S-2.045, F.A.C. Date Signed (MM/DD/YY) [to be com-Weted by Voter] DS -DE 104 (Eff. 09/11 2a 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 r (print name as it appears on your voter information card) in said state and county, petition to have the name of Courtlandt McQuire placed on the Primary/General Election Ballot as a: [check/complete box, as applicable] ✓QNonpartisan [:] No party affiliation F-1 Party candidate for the office of City Commissioner - District 3 (insert title of office and include district, circuit, group, seat number, if applicable) Date of Birth or Voter Registration �JNumber Address gam_ i 1 City County State Zip Code [Boynton Beach Palm Beach Co FL 33435 Signature of r Date Signed (MM/DD/YY) t -7-[to be completed by V ter] Rule 15-2.045, F. C. DS -DE 104 (Eff. 09/11 N A (D) 4JI, 10, 4 'tW ` MLIS MM 3 CANDIDATE PETITION Notes: -All information on this form becomes a public record upon receipt by the Supeno �isor f Elections. It is a cringe to knowingly sign more than one petition for a candidate. [Section 104.185, Florida Statutes/ /f all requested information on this form is not completed, the form will not be valid as a Candidate Petition fnrm. (print name as it appears on your voter information card) in said state and county, petition to have the name of Courtlandt McQuire placed on the Primary/General Election Ballot as a: [check/complete box, as applicable] Q✓ Nonpartisan [—]No party affiliation City Commissioner - District 3 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 Co FL 133435 Signature Rule 1 Date Signed (MM/DD/YY) [too be completed by Voter] DS -DE 104 (Eff. 09/11) 11251234( CANDIDATE PETITION Notes: -All inforination 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 Courtlandt McQuire placed on the Primary/General Election Ballot as a: [check/complete box, as applicable] ✓QNonpartisan F]No party affiliation ❑ City Commissioner - District 3 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 Y)7 // � 4f 7_)`` v 7. City County State Zip Code Boynton Beach Palm Beach Co FL 33435 Signature of Voter Rule 1S -2.045/F,4(6. Date Signed (MM/DD/YY) [to be co plete by Voter] j DS -DE 104 (Eff. 09/11 I 01865`4-65 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./85, Florida Statutes] 1j'all requested information on this form is not completed, the form will not be valid as a Candidate Petition form. 1. j �, kq [ a V\ Kok rt \< 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 Courtlandt McQuire placed on the Primary/General Election Ballot as a: [check/complete box, as applicable] QNonpartisan [:]No party affiliation D City Commissioner - District 3 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 /YAddress J (MM/DDY) l 1 Q 61 qS dvl ( 9.11(� IS f %J City County State Zip Code Boynton Beach Palm Beach :O FL 33435 Signature of Voter Date Signed (MM/DD/YY) [to be completed by Voter] i/f t�%Zl Rule 15-2.045, F. .C. DS -DE 104 (Eff. 09/11 17 2 (O 1 L154 zz CANDIDATE PETITION Notes: -All information on this form becomes a public record upon receipt by the Supervisor of Elections. It is a triune to knowingly sign more than one petition for a candidate. [Section 104.185, Florida Statutesl If all requested information on this form. is not completed, the form will not be valid as a Candidate Petition form. L (print name as it appears on your voter information card) in said state and county, petition to have the name of Courtlandt MCQuire placed on the Primary/General Election Ballot as a: [check/complete box, as applicable] the undersigned, a registered voter F✓ Nonpartisan 0 No party affiliation ❑ Party candidate for the office of City Commissioner - District 3 (insert title of office and include district, circuit, group, seat number, if applicable) Date of Birth or Voter Registration Number Address (MM/DD/YY) j s 2s City County State Zip Code Boynton Beach Palm Beach Co FL 33435 Signature of Voter Date Signed (MM/DD/YY) [to be completed by Voter] Zt Rule 1S-2.045, F.A.C. DS -DE 104 (Eff. 09/1'