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Filing PapersAPPOINTMENT OF CAMPAIGN TREASURER REOMM AND DESIGNATION OF CAMPAIGN DEPOSITORY FOR CANDIDATES SEP 13 2021 (Section 106.021(1); F.S.) (PLEASE PRINT OR TYPE) CITY OF BOYNTON BEACH CITY CLERK'S 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): Initial Filing of Form Re-filing to Change: ❑ Treasurer/Deputy ❑ Depository Office Party 2. Name of Candidate (in this order: First, Middle, Last) 3. Address (include post office box or street, city, state, zip j1�1 code) %71 dt / i 1f E l 3C TI t 2�'n St a E. a ce.C-V%, 4. Telephone 5. E-mail address 4 0 13,,+c In qx V% 1 l? oyw /1 v .r % 0, (5L ! ) 177-• 4 $ 9% $ akf* - C j>rn 6. Office sought (include district, circuit, group number) 7. If a candidate for a nonpartisan office, check if r cL 3 c.} (�ohVn applicable: i 55 nor 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 ED'No Party Affiliation F1 Party candidate. 9. 1 have appointed the following person to act as my Campaign Treasurer Deputy Treasurer 10. Name of Tre surer, or Deputy Treasurer 11. Mailing Address 12. Telephone S i Oct, A, ApT 370 ()"6l ) ?7Z7S0 13. City 14. Count15. State 16. Zip Code 17. E-mail address ! C-; chi C(AT 1,1- tAl�o�-- 18. 1 have designated the following bank as my Primary Depository Secondary Depository 19. Name of Bank 20. Address aahK i-os rr Co���rLs 5 �yL 21. City 22. County 23. State 24. Zip Code NIU^ T_ - C, (v PR L 33 y 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 R I 26. Signature of Candi e L3121 X 27. Treasurer's Acceptance of Appointment (fill in the blanks and check the appropriate block) 1, cexor ��. A, , do hereby accept the appointment (Please Print or Type Name) designated above as: Campaign Treasurer E] Deputy Treasurer. ZU-L� x 4�:2n " Date Signature o Campaign Treasurer or Deputy Treasurer DS -DE 9 (Rev. 10/10) Rule 1S-2.0001, F.A.C. (Section 106.023, F.S.) (Please print or type) OFFICE USE ONLY RECEIVED SEP 13 2021 CITY OF BOYNTON BEACH r:ITY CLERK'S OFFICE I, fasI% candidate for the office of vJ- ZJ;,s CA C o wAr-1 1 s -g ; o r have been provided access to read and understand the requirements of Chapter 106, Florida Statutes. Signature of Candidate 4��3 a�zl 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 (05111) DS -DE 9 (Rev. 10/10) Rule 1S-2.0001, F.A.C. RECEIVED APPOINTMENT OF CAMPAIGN TREASURER 2021 SEP 112021 AND DESIGNATION OF CAMPAIGN DEPOSITORY FOR CANDIDATES CITY OF BOYNTON BEACH (Section 106.021(1), F.S.) CITY CLERKS OFFICE V ' (PLEASE PRINT OR TYPE) NOTE: This form must be on file with the qualifying officer before opening the campaign account. OFFICE USE ONLY 1. CHECK APPROPRIATE BOX(ES): Initial Filing Form Re to Change: Treasurer/Deputy of -filing ❑ Depository ❑ Office ❑ Party 2. Name of Candidate (in this order: First, Middle, Last) 3. Address (include post office box or street, city, state, Zip /'1'jar,'i' LCitSL �(�d ee�r1 code) �. 3 7D 310 6, t D c t ar► t h e tP 4. Telephone 5. E-mail address d j j a c_ , t� L `3 3 y 3 S (Slsl ) 777-,1P3P i'►(a.rit 0 b. f6-,- '6 -,-3erY. cov-n 0 a.,r . 6. Office sought (include district, circuit, grou number) 7. If a candidate for a nonpartisan office, check if 0 rn M 5 5 t o ✓1 T i ted- Di S +V- c i applicable: My intent is to run as a Write -In candidate. 8. If a candidate for aap rtisan office, check block and fill in name of party as applicable: My intent is to run as a ❑ Write -In [2/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 � L -R.,, , rl d2lLS a ✓v 11 Mailing Address /� 12. Telephone Yl0 �. OCeAN ! `eP A 37� ('5 4 1 Ll- 27Ev 13. City 14. County r 3U e_4C.( PA_ I.n 15. State +-L 16. Zip Code 33'i35 17. E-mail address + _0ATVvAreW- ivTo�j' I� c! Ct 18. 1 have designated the following bank as my Er Primary Depository ❑ Secondary Depository 19. Name of Bank rA 20. Address vile -((.S RG o t ()_0 S . �e elm 21 Cityf 22. County 23. State 24. Zip Code UNDER PENALTIES OF PERJURY, I DECLARE THAT I HAVE READ THE FOREGOING FORM FOR APPOINTMENT OF CAMPAIGN TREASURER AND DESIGNATION OF CAMPAIGN DEPOSITORY AND THAT THE FACTS STATED IN IT ARE TRUE. 25. Date (71/ ZO21 26. Signature of Candid X `�• "�- ° � 27 Treasurer's of Appointment (fill in the blanks and check the appropriate block) jAc�c�eptance �i `" t /L """0''" 1, , do hereby accept the appointment (Please Print or Type Name) iesignated above as: 0' Campaign Treasurer ❑ Deputy Treasurer. Date Signature of Campaign Treasurer or Deputy Treasurer DS -DE 9 (Rev. 10/10) Rule 1S-2.0001, F.A.C. APPOINTMENT OF CAMPAIGN TREASURER RECEIVED AND DESIGNATION OF CAMPAIGN SEP 117 2021 DEPOSITORY FOR CANDIDATES (Section 106.021 (1), F.S.) ' CITY OF BOYNTON BEACH (PLEASE PRINT OR TYPE) CITY CLERK'S OFFICE fa( NOTE: This form must be on file with the qualifying officer before opening the campaign account. OFFICE USE ONLY 1. CHECK APPROPRIATE BOX(ES): Change: d Treasurer/Deputy Depository ❑ Initial Filing of Form Re-filing to ❑ ❑ Office ❑ Party 2. Name of Candidate (in this order: First, Middle, Last) 3. Address (include post office box or street, city, state, zip %%jA+�r F code) 51O �QSf V�tCin Ave Arf. 370 4�0�+��on 1�aat�., L=L �33�13 4. Telephone 5. E-mail address i¢0- b0+ano.r� (611 )777-yS3F pJar &.,d Bt.- . C-0^_1 6. Office sought (include district, circuit, group number) 7. If a candidate for a nonpartisan office, check if � 1 ✓� ` ; S } r t } Cp I �1 ✓�1 i S 5 h T 'J 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 D-'No Party Affiliation ❑ _ Party candidate. 9. 1 have appointed the following person to act as my ❑ Campaign Treasurer 0-*' Deputy Treasurer 10. Name of Treasurer or Deputy Treasurer 11. Mailing Address 12. Telephone `-:_es4 d (¢c-h /-vc- (561 ) 777- 4 ? 5F- 13. City 14. County 15. State 16. Zip Code 17. E-mail address -6J _52ac.� i06 FL 33Lj36- bvtclns+ra.AJ,bar. caM n'�on 18. 1 have designated the following bank as my R1 Primary Depository ❑ Secondary Depository 19. Name of Bank �rt/r'S %'4r9p 20. Address l &oO 5• re a(A r-tJ tR vC 21. City 22. County 23. State 24. Zip Code- odeJ3aCni B0 CAf\iOct13 e.a cV,- pow., PL_ .3 c3 4 (V () 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 9/11.el20Z 26. Signature of Candid 27. Treasurer's Acceptance of Appointment (fill in the blanks and check the appropriate block) I, f't a,,,4 _Je n , do hereby accept the appointment (Please Print or Type Name) designated above as: ❑ Campaign Treasurer Deputy Treasurer. ZO Z l Date Signature of Campaign Treasurer or Deputy Treasurer DS -DE 9 (Rev. 10/10) Rule 1S-2.0001, F.A.C. RESIDENCY REQUIREMENTS I, Ma-rj f He dte.n candidate for (Print Name) CL m� i S51 Oh�.ar l,iS�Y �-t 3 of the City (Mayor/Commissioner — District #) of Boynton Beach, have received, read and understand the residency requirements of Article II of the Charter of the City of Boynton Beach. (Signature of Candidate) (Date) S:\CC\WP\ELECTION\Year 2022\CANDIDATE INFORMATION CD\4. Residency Requirements\A. RESIDENCY REQUIREMENTS STATEMENT.doc C, FORM I 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: /-I,, 7 QY / '% , 1 l J a -- MAILING ADDRESS: Sl d C. Gaza n R ve- 1 J 7t'7-> CITY: ZIP: COUNTY: 3 3 `t S i= at vn 1 u�� loll _ NAME O AGENCY : y \/ 4 z 0 i�l-.T ,8 r,_ y Q� NAME OF OFFIC OR POSITION HELD OR SOUGHT: y— T / J I \ `i r.C: f �A, Ki.3 —it 0 /7 A.✓ CHECK ONLY IF 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 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 I PRINCIPAL BUSINESS ACTIVITY �AC_J,r -15(D r_- . o,., ave 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 I 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 "nla'') 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- Effeclive: January 1, 2021 (Continued on reverse side) PAGE 1 Incorporated by reference in Rule 34-8202(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 "n1a") TYPE OF INTANGIBLE BUSINESS ENTITY TO WHICH THE PROPERTY RELATES d to PART E — LIABILITIES [Major debts - See instructions] (If you have nothing to report, write "none" or "nla") NAME OF CREDITOR 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 ADDRESS OF BUSINESS ENTITY V- A v PRINCIPAL BUSINESS ACTIVITY POSITION HELD WITH ENTITY�Crt I OWN MORE THAN A 5% INTEREST IN THE BUSINESS I \,,) -;, NATURE OF MY OWNERSHIP INTEREST Li ei 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. IF. ANY OF PARTS A THROUGH G ARE CONTINUED ON A SEPARATE SHEET, PLEASE CHECK HERE ❑ SIGNATURE OF FILER: Signature: Date Signed: /1 TILING 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 Eth.ics_. 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 CEForm1@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. CPA or ATTORNEY SIGNATURE ONLY If a certified public accountant licensed under Chapter 473, or attorney in good standing with the Florida Bar prepare_ d 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 1F (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 34-8.202(1), F.A.C. CANDIDATE OATH - RECENED NONPARTISAN OFFICE NOV 2 2 2021 (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 BEACH write-in candidate: CITY CLERK'S OFFICE g?WAM (/1 ❑ Write-in candidate OFFICE USE ONLY Candidate Oath (Section 99.021(1)(a), Florida Statutes) (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 �10 A M (Office) (District #) I am a qualified elector of P6, /11. 1�)4 aCA_ 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. /I Q" S 1 5 Candidate's Florida Voter Registration Number (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 persons with disabilities (see instructions on page 2 of this form): [Not applicable to write-in candidates.] Signature of Candidate Telephone Number Email Address 510 QC2e,-Ay&3-70 r �.- Address City State ZIP Code STATE OF FLORIDA �Ii, ig ture of Notary Pub is D Q `, COUNTY OF l ��Y11 LutN1 Pri , Type, or Stamp Commissioned Name of Notary Public below: :;"•• Sworn to (or affirmed) and subscribed before me by means ,ofCRYSTAL D. GIBSON/ My COMMISSION#GG 326964 online notari ation ❑ OR physical presence LVJ "; '; EXPIRES: April 22,2023 this day of 2020-4.i3 K-: Bonftd Thru Notary PU k UmleIM br! � � �}� , Personally Known ❑ OR Produced Identification ED Type of Identification Produced:. 6V% Gt➢CPt'lr DS -DE 302NP (Rev. 0512021) Rule 1S-2.0001, F.A.C. Misceiki us cash Receipt CITY OF BOYNTON BEACH Account No. 001-00006369-10-00 Received of Marit Hedeen Address 510 E Ocean For Citv- Filin, F Aazch 8, 2022 Dept. . . - C I e 3- It I s 0 f T i (I (-- By Miscellaneous Cash Receipt CITY OF BOYNTON BEACH Account No. No.- 2��2,694 25.00 November 9 20 ktA rl Type: OC Dr&jej. 541 E 1.00 v , � Coo $M*tb Tr�s c6tL-.'_ 11/" 131 1N.: 1229,*F41- NO: 11 198.53 November 9 _,20.21 Marit Hadeen Received of Address 510 E Ocean Ave Boynton Aeach FL 33435, lype: 01 Draer: I na, T For I % Filing Fe& to run for Via rch 8, 2022 I.t70$1S 513 . City Clerk's Officer. $ =E Dept. By Trffls tLqtP_.* 1 0 UEVEI Tfm2: 2'. L RD LOC LD r-nq 70 Ln M 9 F -P miscellaneous cash Receipt No. 91736 CITY OF BOYNTON BEACH Account No 0-11 Received of Address A-ve, Dept. CITY T Pai'mW ffpo� CITY CIF B24W01 001 4* CU-31rje. VRErr--IPT OC WDat�l .Z/oa/21 01 Receipt no-� 7392b Description I W&A 135 MISCRIA, EW3 A11.0unt 1.00 $4.10 Trans nuter: 9385c -b-9 G/L account number: C U07-03691000 RifflI - PETITI(II CERT, jVRI-r �,�-D� 510 E MEAN A\F RUITICNCETMIFICA'110td Tbrdpr Mall LY. C�EGt 1004 4.1'J Total tendemd $4.10 Total paymnt T,W,s Nate IZ/01 /?I T;7F-'. 152921 M Fr -F Yap, PpowT PAMM *:-'0Pj F rr Wengy Sartory link �f °): P Palm Beach County Supervisor of Elections �NEp CERTIFICATION Nov Y 6 2021 CffyOFI SOYNT'OAI g Crry CCERMS OFFIC E I, WENDY SARTORY LINK, SUPERVISOR OF ELECTIONS, for Palm Beach County, Florida, do hereby certify that 26 signatures on the Nominating Petitions of MARIT HEDEEN 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 MARIT HEDEEN is a registered voter in Precinct 7188, 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 12th day of November, 2021. a , r) WENDY SPATORY LINK -J SUPERVIS R OF ELECTIONS PALM BEACH COUNTY (SEAL) 240 South Military Trail, West Palm Beach, FL 334151 Post Office Box 22304. West Palm Beach. FL 33416 Telephone: 561.656.62001 Fax Number: 561.656.6287 V L 1119 -1v, -)G7 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' Ek )- yio Suzanne ' 0r+C the undersigned, a registered voter (print name as it appears on your voter information card) in said state and count ! y, petition to have the name of r � �(" �-i OtdX_� placed on the Primary/General Election Ballot as a: [check/complete box, as applicable] [Nonpartisan ❑No party affiliation ❑ Rule Party candidate for the office of 3 �� � ► 5 �'< <C_�i �_o M Nl:i SSI o 1Lt-�'` (insert title of office and include district, circuit, group, seat number, if applicable) Date of Birth or Voter Registration Number Address (MM/DD/YY) SW 25�`' City County State Zip Code n+on Bcach FP - alarm &ach TL 33 -35 Signature of Vpter Date Signed (MM/DDNY) [to be completed by Voter] IZ.1ZI DS -DE 104 f Eff. 0911 IQ ��2yaq-7 CANDIDATE PETITION Notes: - All information on this form becomes a public record upon receipt by the Supervisor of Elections. - It is a crime to knowingly sign more than one petition for a candidate. [Section 104.185, Florida Statutes] - If all requested information on this form is not completed, the farm will not be valid as a Candidate Petition form. the undersigned, a registered voter (print name as it appears on your voter information card) in said state and county, petition to have the name of fi? Q r f, i 9t d 40-10 placed on the Primary/General Election Ballot as a: [check(complete box, as applicable] []Nonpartisan ❑No party affiliation ❑ Party candidate for the office of (insert title of office and include district, circuit, group, seat number, if applicable) Date of Birth or Voter Registration Number Address (MM/DDlYY)��-- City PountSode -) &e�h FL -5- Signatu r T Rule 1S-2.045, 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. I, ro C R A t N �GfLS Ct-' 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 Qr 4 G n placed on the Primary/General Election Ballot as a: [check(complete box, as applicable] [Nonpartisan []No party affiliation ❑ -Party candidate for the office of (insert title of office and include district, circuit, group, seat number, if applicable) Date of Birth or Voter Registration Number Address (MM/DD)ti 64 11-764S37 ceAN Avw. ) APS 37( City County StateZip Code T3 e YNT4^+ � (,L PAL I. tA C-1 1 c 33 L/ 7 S— Signature of Date Signed (MM/DD/YY) [to be completed by Voter] DS -DE 1041Eff. 0911 H I 9 4� q'5fll 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, /oaf;t ,Else. l�cdten- (print name as it appears on your voter information card) in said state and county, petition to have the name of placed on the Primary/General Election Ballot as a: [check/complete box, as applicable] ❑ Nonpartisan [ONo party affiliation ❑ the undersigned, a registered voter Party candidate for the office of rd -DiS+r"1CA C0^M%5510V'-- S --- W (insert title of office and include district, circuit, group, seat number, if applicable) Date of Birth or Voter Registration Number r Address (MM/DDIYY) r t! IMT IS 9 N J-1 o 6. O c e o. - A v t Af 3 70 /2 f City County State Zip Code fav I'�-�'c+1 ��OC�. ���,r� �� c•ck- r L 3 y 3S Signature of Voter Date Signed (MMIDD/YY) [to be completed by Voted Rule 1S-2.045, F.A.C. DS -DE 104 ME 09111 RECEIVE® 14 SEP 13 2021 (J v CITY OF BOYNTON BEACH '_;ITY CLERKS OFFICE CANDIDATE PETITION Notes: -.411 information on this form becomes a public record upon receipt by the Supervisor of Elections. - It is a crime to knowingly sign more than one petition for a candidate. [Section 104.185, Florida Statutes] -,[f all requested information on this form is not completed, the form will not be valid as a Candidate Petition form. I,A-66e-CCA' ' the undersigned, a registered voter (print name as it appears on your voter iinffor�m7ation card) in said state and county, petition to have the name of r'�`I i T 1J e t M V- placed on the Primary/General Election Ballot as a: [check/complete box, as applicable] dNonpartisan ❑ No party affiliation ❑ Party candidate for the office of (insert title of office nd include district, circuit, group, seat number, if applicable) Date of Birth or Voter Registration Number Address City County State Zip Code ?bpaif-- _ 3313 " Signature of Voter Rule 1S-2.045. F.A.C. Date Signed (MMIDD/YY) [to be completed by Voter] DS -DE 104 [Eff. 0911 FIEUIVED Nov1�s.... CITY (F BOYNTON BEACH 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 in said state and county, petition to have the name of the undersigned, a registered voter in card) aj Q.SL� placed on the Primary/General Election Ballot as a: [check/complete box, as applicable] NonpartisanNo party ffiliation ❑ Party candidate for the office of (inse�t,116f office and include district, circuit, group, seat number, if applicable) Date of Birth or Voter Registration Number Address (MM/D9/YY) CityCounty State Zip Code h �jeu 93 `/3S Signature of Voter Date Signed (MM/DD/YY) [to be completed by Voter] /0 -23- UZI Rule 1S-2/045, F.A. . DS -DE 104 f Eff. 09111 Uloy— 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 onthis form is not completed, the form will not be valid as a Candidate Petition form. I, P C V Gt n G; j) -e S a, I the undersigned, a registered voter (pri i,Jame as it appears on your voter information card), in said state and county, petition to have the name of fAolr 1 � 1 o—&Q-Q"C1 placed on the Primary/General Election Ballot as a: [check/complete box, as applicable] gNonpartisan FeNo party affiliation ❑ Party candidate for the office of D i trtti, 5 -s'% o n � (insert title of office and include district, circuit, group, seat number, if applicable) Date of Birth or Voter Registration Number Address,fid-e.'sA.l . 1 'g i W &4 (MM/DD/YY) 3 j,q i, q 3,50/� 1 C-Gt SA C O S IM City County State Zip Code aoyti4on 13 -ea cti pelli; %3a'( -h - FL_ 33L3 S— Signature ofVote Date Signed (MM/DDIYY) ; A� N[to be completed by Voter] /6)//S7/ 2-cr2_1 Rule 1S-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,, V-) wNt.) ers the undersigned, a registered voter (print name as it appears on your voter information card)l in said state and county, petition to have the name of d �'i LAuLx\ placed on the Primary/General Election Ballot as a: [check/complete box, as applicable] Nonpartisan No party affiliation ❑ Party candidate for the office of (insert title of office and include district, circuit, group, seat number, if applicable) Date of Birth or Voter Registration Number Address (MM/DD/YY) l01 S. '�Ccrw , (4f City County State Zip Code 33LA 5 Signature of Voter Rule 1S-2.045, F.A.C. Date Signed (MM/DD/YY) [to be completed by Voter] 10 (21 2t ia('p5-1,3an 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 /%�'4< t 4 00-44-110L placed on the Primary/General Election Ballot as a: [check/complete box, as applicable] Nonpartisan eNo party affiliation ❑ _ Party candidate for the office of f i ).+v- [ c C-0cfS -tet. 'r'. (insert title of office and include district, circuit, group, seat number, if applicable) Date of Birth or Voter Registration Number Address � / i ��i 19s S-0 �- 0 c a -n r City Ity StateZip Code Signatu of ter Date Signed (MM/DD/YY) l [to be co pleted by Voter] C Rule 1S-2.045. .A 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. the undersigned, a registered voter (print name as it appears on you v ter information card) (� in said state and county, petition to have the name of o�✓ r '7 r10__C>r►�Q.I�- _ placed on the Primary/General Election Ballot as a: [check/complete box, as applicable] Nonpartisan &rNo party affiliation ❑ Party candidate for the office of (insert title of office and include district, circuit, group, seat number, if applicable) Date of Birth or Voter Registration Number Address % (MM/DD/YY) 93 C�`T 14-0 " '242, City Count State Zip Code -321V3 Rule 1S-2.045, F.A.C. Date Signed (MM/DD/YY) [to be completed by Voter] /0 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, (print name as it appears on your voter informatio 1n in said state and county, petition to have the name of d�'e t 7 the undersigned, a registered voter placed on the Primary/General Election Ballot as a: [check/complete box, as applicable] 'Nonpartisan party affiliation ❑ Party candidate for the office of CA �f_oy&YV%A (insert title of office and include district, circuit, group, seat number, if applicable) Date of Birth or Voter Registration Number Address (MM/DDNY 07 W " / City County State Zip Code Signature of Voter _. Date Signed (MM/DD/YY) [to be completed by Voter] Rule IS-2.046_F.A.C. DS -DE 104 (Eff. 0911 I1��5-7,350 CANDIDATE PETITION Notes: -All information on this form becomes a public record upon receipt by the Supervisor of Elections. - It is a crime to knowingly sign more than one petition for a candidate. [Section 104.185, Florida Statutes] - If all requested information on this form is not completed, the form will not be valid as a Candidate Petition form. I, ` the undersigned, a registered voter (print name as it appears on your voter information card) in said state and county, petition to have the name of &,i 4 placed on the Primary/General Election Ballot as a: [check/complete box, as applicable] Nonpartisan No party affiliation ❑ Party candidate for the office of �d (insert title of office and include district, circuit, group, seat number, if applicable) Date of Birth or Voter Registration Number Address (MM/DDNY) Q Le DriCity County State Zip Code Signature of Voter t (/ [ Rule 1S-2.045, F.A.C. Date Signed (MM/DDNY) [to be completed by Voter] v? If I DS -DE 1041Eff. 09/1 11 S3 SCM ID -7 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,lcl 4Z S'e et( the undersigned, a registered voter print name as it appears on your voter information card) in said state and county, petition to have the name of placed on the Primary/General Election Ballot as a: [check/complete box, as applicable] Nonpartisan No party affiliation ❑ _ _ _ _ -Party candidate for the office of (insert title of office and include district, circuit, group, seat number, if applicable) Date of Birth or Voter Registration Number Address (MM/DD/YY) l `✓ U< t � 9 G r�� / e 061,1,-710 City County State Zip Code �'l foq 0 e -to fq IpI 9 eq c 4 3_4 Signature of V er Date Signed (MM/DD/YY) [to be completed by Voter] 5, t i Qc, a-Ic,1437 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 n me as it appears on your voter information card) in said state and county, petition to have the name of placed on the Primary/General Election Ballot as a: (check/complete box, as applicable] dNonpartisanFlo party affiliation ❑ the undersigned, a registered voter Party candidate for the office of t GC7Ylit�1 X51 Z R g �' (insert title of office and include dist(ct, circuit, group, seat number, if applicable) Date of Birth or Voter Registration Number Address��y (MMlDDlYY) City County State Zip Code Signature of Voter Date Signed (MM/DD/YY) [to be completed by oter] 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,s r + f l QL�Y [ L�r�p 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 ^i A t"I L K placed on the Primary/General Election Ballot as a: [check/complete box, as applicable] NonpartisanNo party affiliation ❑ Party candidate for the office of (insert title of office and include district, circuit, group, seat number, if applicable) Date of Birth or Voter Registration Number Address (MM D/YYC zz� City County State Zip Code c r��zy) PjeaL- Po . rn 6 CaLk Signa re f Voter Date Signed (MM/DD/YY) [to be coppliq ted by Mot rj acp 13 r 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, �n e� i 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 ��ili ✓ , roti �cL i placed on the Primary/General Election Ballot as a: [check/complete box, as applicable] LA Nonpartisan #rNo party affiliation ❑ Party candidate for the office of (insert title of office and include district, circuit, group, seat number, if applicable) Date of Birth or Voter Registration Number Address (MM/DD/YY)e,I/v( Jr, City C my State Zip Code Pvkck Sig . ture of Voter Date Signed (MM/DD/YY) VA [to be completed by V t r] 3/ Rule 1S-2.0 , F.A.C. DS -DE 104 (Eff. 09111 11-1 �o(P CANDIDATE PETITION Notes: -.411 information on this form becomes a public record upon receipt by the Supervisor of Elections. - It is a crime to knowingly sign more than one petition for a candidate. [Section 104.185, Florida Statutes] - If all requested information on this form is not completed, the form will not be valid as a Candidate Petition form. F. 4/V lkaoA (print name as it appears on your voter information card) in said state and county, petition to have the name of 'Ll R C i r NJ��o� placed on the Primary/General Election Ballot as a: [check/complete box, as applicable] Nonpartisan No party affiliation ❑ Party candidate for the office of 1.1rI D;S7ric-f Coj-,x-Sii•r,tr 130/J.i-" 17CAS (insert title of office and include district, circuit,gr uo p seat number, if applicable) Date of Birth or Voter Registration Number Address (MM/DD/YY) �6/I Sry O� Ate, r 3�� City r County j State Zip Code P4A jImo- �� �L /atJ ,! L Y 7 S the undersigned, a registered voter Signature of V - , /?L� \_1 Rule 15-2.045, F.A.C. Date Signed (MM/DD/YY) [to be completed by Voter] /o .1 DS -DE 104 [Eff. 091111 1x -1q c6 z�-?-73 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�in/ ormation car7)f in said state and county, petition to have the name of ! V � : j , t- t l e 4e rn placed on the Primary/General Election Ballot as a: [check/complete box, as applicable] Nonpartisan No party affiliation ❑ Party (insert title of office and include district, circuit, group, seat number, if applicable) Date of Birth or Voter %Registration Number Address (MMIDDNY) 0 Signature of Voter Rule 1S-2.045. F.A.C. candidate for the office of Stat Zip Cod LO Date Signed (MM/DD/YY) [to be completed by V er] Ol 11 a a_0H 1-6i(c) 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 dej1x1 a2a/u/'�) the undersigned, a registered voter (print name as it appe on your votqkinfolmation c'U) �;7 in said state and county, petition to have the name of Y `q/ &1 laea(t /I placed on the Primary/General Election Ballot as a: [checWcomplete box, as applicable] Nonpartisano party affiliation liation El -1-1 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 Ci_Nurfy s P"IM State Zip Code �'5:5q3 Signature Rule 1 Date Signed (MM/DD/YY) [to be completed by Voter] DS -DE 104 f Eff. 0911 III Cioc'�®s) CANDIDATE PETITION Notes: -All information on this form becomes a public record upon receipt by the Supervisor of Elections. - It is a crime to knowingly sign more than one petition for a candidate. [Section 104.185, Florida Statutes] - If all requested information on this form is not completed, the form will not be valid as a Candidate Petition form. I, the undersigned, a registered voter - (print name as it appears on your voter information card) in said state and county, petition to have the name of d. Y _z 1�2yL— placed on the Primary/General Election Ballot as a: [check/complete box, as applicable] 21 _A9K Nonpartisan gffNo party affiliation ❑ Party candidate for the office of tt __ f � --) �c_� (" '`) rv-vv� (insert title of office and include district, circuit, group, seat number, if applicable) Date of Birth or Voter Registration Number Address (MM/DD/YY) iG cY.J- l J ej� City Cou ty State Zip Code ,(,f I-7 �CZ Date Signed(MM/DD ) [to be comple d by ter] DS -DE 104 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, Cyd — \ S '1 1 L the undersigned, a registered voter Cyw— (print rfa me as it appears on your voter information card) in said state and county, petition to have the name of eL r � 4- H r• p_r2.4 L placed on the Primary/General Election Ballot as a: [check(complete box, as applicable] ❑✓Nonpartisan M&o party affiliation ❑ Party candidate for the office of (insert title of office and include district, circuit, group, seat number, if applicable) Date of Birth or Voter Registration Number Address 0a a, AfL Lbk Rub city , County State Zip Code 1 Signature of Voter i c.9 nes G e n Date Signed (MM/DD/YY) [to be completed by Voter] 1 ' Z DS -DE 104 fEff. 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' �] 6SE �� 151 GC�1'1 i (print name as it appears on your voter information card) ,� in said state and county, petition to have the name of 1 r ` 0 �i ti ;' �A 2_d U_Y'L the undersigned, a registered voter placed on the Primary/General Election Ballot as a: [check/complete box, as applicable] Nonpartisano party affiliation ❑ Party candidate for the office of r �S kvCA- (insert title of office and include district, circuit, group, seat number, if applicable) Date of Birth or Voter Registration Number Add/dress (MM1DD brLIQ Ce�s/q L_0 " T lr0 C X30) City County State Zip Code Signature of Voter Rule 19.2.045. F.A.C. Date Signed (MM/DD/YY) [to be completed by Voter] �a zo 10, 1 _ r DS -DE 1041Eff. 0911 CANDIDATE PETITION Notes: —411 information on this form becomes a public record upon receipt by the Supervisor of Elections. - It is a crime to knowingly sign more than one petition for a candidate. [Section 104.185, Florida Statutes] - If all requested information on this form is not completed, the form will not be valid as a Candidate Petition form. I' 4ZE ap (print OU K010 as it appears on your voter information the undersigned, a registered voter in said state and county, petition to have the name of 1 ' I (N 1 1-1 P Q Q LAI -"- placed on the Primary/General Election Ballot as a: [check/complete box, as applicable] Nonpartisan jNo party affiliation ❑ Party i c% (insert title of office and include district, circuit, group, seat number, if applicable) candidate for the office of Date of Birth or Voter Registration Number Address r _ /LA j M Mi D/YYM1 City County State Zip Code cam, OUV�. �J�[ Signature of Date Signed (MM/DD/YY) [to be colnpleted 6 Voter] Rule 1S-2.045. Pte. ! f I DS -DE JA Q(P-1 -ZQ-7S� 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. TAI (print name as it appears on your voter information card) in said state and county, petition to have the name ofer placed on the Primary/General Election Ballot as a: [check/complete box, as applicable] [Nonpartisan eNo party affiliation ❑ the undersigned, a registered voter _ Party candidate for the office of (insert title of office and include district, circuit, group, seat number, if applicable) Date of Birth or Voter Registration Number Address (MM/DD/YY) Li L 91tCounty State Zip Code a ��c � F :33 135 Signature of Voter Rule 1S-2.045, F.A.C. Date Signed (MM/DD/YY) [to be completed by Vo7,2 ] oIr c 1 09!11 1q 1,-5a 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. the undersigned, a registered voter �J (print name as it appears on your voter information card) in said state and county, petition to have the name of s i ¢girl placed on the Primary/General Election Ballot as a: [check/complete box, as applicable] Nonpartisan MNo party affiliation ❑ Party candidate for the office of t^& (insert title of office and include district, circuit, group, seat number, if applicable) Date of Birth or Voter Registration Number Address (Moe ) -j-1 q�� City- y County �' • State Zip Code nature of V r Date Signed (MM/DD/YY) [to be completed by Voter] A^& o /z0//'ozj A45, F.A. DS -DE 104 i Eff. 0911 19 -7 '7 -7 -1 ®COU 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 rk el IC .yL0-1 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 _ �� ✓t "! .!4_d JL placed on the Primary/General Election Ballot as a: [check/complete box, as applicable] 1ANonpartisan JKNo party affiliation Rul Party candidate for the office of .r0 r � S-kY, t C_V (� DM WL-i'j`5,t (insert title of office and include district, circuit, group, seat number, if applicable) Date of Birth or Voter Registration Number Address `M o IlRlj�6 L / 7 0 //a c t'o'ot City County State Zip Code — �0 YXAGn &4r� N(/'� 33y3y Date Signed (MMIDD/YY) [to be completed by Voter] ')-d l;'�2 I A 9919 15�T5LD9 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 cna_Ajtex�_ in said state and county, petition to have the name of f'� w'C I placed on the Primary/General Election Ballot as a: [check/complete box, as applicable] 6onpartisan &No party affiliation ❑ the undersigned, a registered voter Party candidate for the office of (insert title of office and include district, circuit, group, seat number, if applicable) Date of Birth or tlVoter Registration Number Address ` (MM/DDo) AOA City County State Zip Code Uri Signature of Voter Date Signed (MM/DDNY) 4[to be completed by Voter] Co I _ a 1S-2. P.A.C. 4 1 DS -DE 104IEff. 0911' II IC, 1330 c-;), 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' Y� Gla\ CU.S (print name as it appears on your voter information card in said state and county, petition to have the name of /7? &r + + �aj Q placed on the Primary/General Election Ballot as a: [check/complete box, as applicable] Nonpartisan eNo party affiliation ❑ (insert title of office and include Date of Birth or Voter Registration Number ('01 /DD/YY) 0 011 city Signature of Voter the undersigned, a registered voter Party candidate for the office of a w'+ h'l 1 SS r0 rx - listrict, circuit, group, seat number, if applicable) Address -�310 W 4cca n;`re County State Zip Code � 33�f�rj Date Signed (MM/DD/YY) [to b completed by Voter] 10 IL312-0-:41 DS -DE 104 SEff. 0911 I oto 175 q0 y' CANDIDATE PETITION Notes: -All information on this form becomes a public record upon receipt by the Supervisor of Elections. - It is a cri �o-knowingly sign more than one petition for a candidate. [Section 104.185, Florida Statutes] *affrequested information on this form is not completed, the form will not be valid as a Candidate Petition form. the undersigned, a registered voter (print narrX as it appears on your voter in said state and county, petition to have the name of placed on the Primary/General Election Ballot as a: [check bomplete box, as applicable] gNonpartisan OTNo party affiliation ❑ Party candidate for the office of Yn (insert title of office and include district, circuit, group, seat number, if applicable) Date of Birth r Vor Registration Number Address �%p �� cri City Co my State Zip Code Signatu of oter Date Signed (MM/DD/YY) [to be co p�'"Z ter] /d Rule 15.2.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, c r (print name as it appears on your voter i formation card) J o in said state and county, petition to have the name of / ' (0- r( + f Y��U 9-1 placed on the Primary/General Election Ballot as a: [check/complete box, as applicable] NonpartisanNo party affiliation ❑ (insert title of office and include Date of Birth or Voter Registration Number (MM/DD/YY) the undersigned, a registered voter Party candidate for the office of circuit, group, seat number, if applicable) Address City County State Zip Code _P4 -4f V1 Signature of Vo Rule 7S-2.045, F.A.C. Date Signed (MM/DD/YY) [to be completed by Voter] DS -DE 104 (Eff. 09/7 t ©( —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, �en� (�4 t'� 'J "" L 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 JK$4 ,/� placed on the Primary/General Election Ballot as a: [check/complete box, as applicable] nonpartisan party affiliation ❑ Party candidate for the office of ' 'K J, D1 i� 1 C_-� C3NJ iv1( (insert title of office and include district, circuit, group, seat number, if applicable) Date of Birth or Voter Registration Number Address (MMIDDNY) City County State Zip Code /J !.� Signature of V Rule 7S-2.045, F.A.C. Date Signed (MM/DD/YY) [f b j`corrlpleted y Voter] DS -DE 104;Eff. 09177 I I"-� q 9`4 7 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, klo L4 h n affi 0 �IW 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 /-/ /' Y 1 7 placed on the Primary/General Election Ballot as a: [check(complete box, as applicable] &npartisan eNo party affiliation ❑ Party candidate for the office of ST Y) C i eom r1/1 i 5s t 6 V\ Qx- (insert title of office and include district, circuit, group, seat number, if applicable) Date of Birth or Voter Registration Number Address �^ Y t�+ C (MM/DD/YY) lO I • 9' ��.�+ f „ __ Y'� y V J ( City County State Zip Code w ��° pot, ►� Y�-ea,c � 3 3 43 ,�_ Sig atu of Voter Date Signed (MM/DD/YY) [to be completed by Voter] �01�5 Z l Rule 1S-2.045. F.A.0 DS -DE 1041Eff. 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. � C'`C the undersigned, a registered voter V (print name as itappearson your voter information card) in said state and county, petition to have the name of % � ;? 6-)-1,4e d -c placed on the Primary/General Election Ballot as a: [check/complete box, as applicable] Nonpartisan TrNo party affiliation ❑ Party candidate for the office of (insert title of office and include district, circuit, group, seat number, if applicable) Date of Birth or Voter Registration Number Address (MM/DD/YY) o 1 8`3 101 5 (— i� A-er-SQ ��`t S `� Q 1 City Coun State Zip Code &acjn _ e �L 35 y 3s" Signature of Voter Rule IS -2.045. F.A.C. Date Signed (MM/DDNY) [to be completed by Voter] Ick/�s 1." CANDIDATE PETITION Notes: -All information on this form becomes a public record upon receipt by the Supervisor of Elections. - It is a crime to knowingly sign more than one petition for a candidate. [Section 104.185, Florida Statutes] - If all requested information on this form is not completed, the form will not be valid as a Candidate Petition form. 1,#vthe 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 / ' 10 r I k .�j g 41 e e placed on the Primary/General Election Ballot as a: [check/complete box, as applicable] Rul Nonpartisan M No party affiliation ❑ Party candidate for the office of (insert title of office and include district, circuit, group, seat number, if applicable) Date of Birth or Voter Registration Number Address (MM/DD/YY) / Z-/7// �FG 7,0 3 City County State Zip Code 331/ 3 Signature of . AC 7 BAG r w r Date Signed (MM/DD/YY) [to be com meted by Voter] z 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 completeq; the form will not be valid as a Candidate Petition form. the undersigned, a registered voter (print name as it appears on your voter info ation card) in said state and county, petition to have the name of placed on the Primary/General Election Ballot as a: [check/complete box, as applicable] dNonpartisan rNo party affiliation ❑ Party candidate for the office of (insert title of office and include district, circuit, group, seat number, if applicable) Date of Birth or oter Regis ration Number Address (MM/DD/YY) � �� q 0(./V �] L of Voter Rule IS'2.045. F.A.C. County State Zip Code AWM AM1 Date Signed (MMIDD/YY) [to be completed by Voter] la -2 -.;6 - DS -DE 104 (Eff. 09/1 I a4s(21C(f) (4PILi 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 W� C2 LJ" Lila- t G Wv) placed on the Primary/General Election Ballot as a: [check/complete box, as applicable] 9Nonpartisan JNo party affiliation ❑ the undersigned, a registered voter Party candidate for the office of (insert title of office and include district, circuit, group, seat number, if applicable) Date of Birth or Voter Registration Number Address (MM/DD/YY)S hw� y� t &D ox Igqu �� � Qd�rra I H City ` County '&CLCD State Zip Code '33 w 3 S tCL r'i(\ QcLI \ --)rl Signature of Voter Rule 1S-2.045, F.A.C. Date Signed (MM/DDIYY) [to be completed by Voter] )012y 21 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,� G j nl 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 _ (_Y\ C' j placed on the Primary/General Election Ballot as a: [check/complete box, as applicable] [Nonpartisan JKNo party affiliation ❑ Party candidate for the office of 1 61— 1._J �i � 1 0 W 1N,� 5 k �` (insert title of office and include district, circuit, group, seat number, if applicable) Date of Birth or Voter Registration Number Address (MM/DD/YY) EppJ i 9 3 �� q q S. feL-- City County State Zip Code p�.ral. > pe :A01 palm �3eac► Lf3-r,, Signature of Voter �J Rule 1S-2.045, F.A.C. Date Signed (MM/DD/YY) [to be completed by Voter] i0 i 2q/ 2 i DS -DE 104 [Eff. 09/1 A 0`a H-79 �5q 7 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�/J%' J �� the undersigned, a registered voter (print name as it appears on your voter informatlon card) in said state and county, petition to have the name of 1911(6"-'1 placed on the Primary/General Election Ballot as a: [check(complete box, as applicable] Nonpartisan No party affiliation ❑ Party candidate for the office of (insert title of office and include district, circuit, group, seat number, if applicable) Date of Birth or Voter Registration Number Address j (MM/DDlYY03 I a o JPS l City County State Zip Code Signature of Voter Rule 1S-2.045. F.A.C. Date Signed (MM/DD/YY) [to be comp rrted by Voter] - ?- 20ZI I I F51 L4 CANDIDATE PETITION Notes: - All information on this form becomes a public record upon receipt by the Supervisor of Elections. - It is a crime to knowingly sign more than one petition for a candidate. [Section 104.185, Florida Statutes] - If all requested information on this form is not completed, the form will not be valid as a Candidate Petition form. I, the undersigned, a registered voter (print name as it appears on your voter information card) in said state and county, petition to have the name ofr , y- _ 1'� /'' J,rjT placed on the Primary/General Election Ballot as a: [check/complete box, as applicable] [Nonpartisan No party affiliation ❑ Party candidate for the office of (insert title of office and include district, circuit, group, seat number, if applicable) Date of Birth or Voter Registration Number Address rr' I City l County State Zip Code I 13CP112-� 6cl,-1 PA I ►n `a n CP-t F2__ Signature of Voter Date Signed (MM/DD/YY) [to be completed by Voter] Rule 1S-2.045, F.A.C. DS-DE 104(Eff. 091111 I I ' 'A C1 ► �'-701 CANDIDATE PETITION Notes: -.411 information on this form becomes a public record upon receipt by the Supervisor of Elections. - It is a crime to knowingly sign more than one petition for a candidate. [Section 104.185, Florida Statutes] - If all requested information on this form is not completed, the form will not be valid as a Candidate Petition form. I, ,.v .- (print name as it appe s on your voter information card) �� 1] in said state and county, petition to have the name of 0- Y) placed on the Primary/General Election Ballot as a: [check/complete box, as applicable] []Nonpartisan MNo party affiliation ❑ Rule the undersigned, a registered voter Party candidate for the office of Ph /ft (insert title of office and include district, circuit, group, seat number, if applicable) Date of Birth or Voter Registration Number Address (MM/DDY) a( 23 X16 City Coun State Zip Code P)ok4�,o &&'r� FL 33826 Date Signed (MM/DD/YY) [to be complet d by Voter] 1 U2( CANDIDATE PETITION Notes: -.411 information on this form becomes a public record upon receipt by the Supervisor of Elections. - It is a crime to knowingly sign more than one petition for a candidate. [Section 104.185, Florida Statutes] - If all requested information on this form is not completed, the form will not be valid as a Candidate Petition form. I, +� {�l� C—r45 .41 .t the undersigned, a registered voter ' (print naive as it appears on yourNoter information card) / in said state and county, petition to have the name of placed on the Primary/General Election Ballot as a: [check/complete box, as applicable] dNonpartisanNo party affiliation ❑ Party candidate for the office of (insert title of office and include district, circuit, group, seat number, if applicable) Date of Birth 2or gV�oter Registration Number Addreesss t - 7 t 714, City County i State Zip Code ta ^Signature of Voter Date Signed (MM/DD/YY) - [to be co leted y Voter] j l g 21 21S-2.045, F.A.C. V-� DS -DE 104 (Eff. 09/11 RECEIVED NOV 0 0 207', CITY OF BOYNTON BEACH