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Packets Pulled MATERIAL FOR CANDIDATES YOU HAVE INDICATED YOUR DESIRE TO BECOME A CANDIDATE; THEREFORE, I HAND YOU THE FOLLOWING: 1. ,.7 Qualifying Information & Municipal Election Schedule 2. L_ / Dates to Remember 3. ✓ Form DS -DE 9 Appointment of Campaign Treasurer and Designation of Campaign Depository for Candidates (8/03) TO BE SIGNED AND RETURNED TO CITY CLERK INDICATING YOUR INTENT TO RUN 4. ✓ Residency Requirements (To be filled out and returned to City Clerk) 5. ✓ Form DS - DE 84 Statement of Candidate & copy of Chapter 106, Florida Statutes (Must be fled with City Clerk within 10 days after filing Appointment of Campaign Treasurer - Intent ) 6. ✓ State of Florida Election Laws - Chapters 99, 105 & 106 (2012) 7. Guide to Sunshine Amendment & Code of Ethics for Public Officers and Employees 8. c/ Directions for Posting Temporary Political Sign 9. ✓ City Commission District Map 10. ,./ Part I Charter, Article VII. Elections - City of Boynton Beach 1 11. Part II Code of Ordinances - Chapter 2 Administration, Article III. Elections 12. Poll Watcher Form & FS 101.131- "Watchers at Polls" 13. t.2014 Public Campaign Financing Handbook 14. Candidate Petition Handbook 15. •— Blank Campaign Report Summary Sheets, Contributions Sheets & Expenditures Sheets 16. ✓ Petition Form - Candidate for Commissioner - TO BE FILLED OUT, CERTIFIED BY SUPERVISOR OF EL EC !IONS AND RE 1 URNED TO CITY rLERK DURING QUALIFYING 17. ✓ Form 1 Statement of Financial Interests 2009 - TO BE FILLED OUT, SIGNED & RETURNED TO THE CI CLERK DURING QUALIFYING 18. t.7 L&A TESTING NOTICE (SIGN AND RETURN AT TIME OF QUALIFYING.) 19. Loyalty Oath - Oath of Candidate (DS - DE 24B) TO BE RETURNED TO CITY CLERK DURING QUALIFYING RECEIVED BY: 1 _ _ _ , c 2 - to - thi Cand" ate Signature Date Signed 1' Janet M. Prainito, MMC City Clerk 11/14/2013 3.47 PM S: \CC \WP \ELECTION \Year 2014 \Information Packets \MATERIAL FOR CANDATES.doc i i Y !,f �H �. r,! v r i , , r .� -,. APPOINTMENT OF CAMPAIGN TREASURER AND DESIGNATION OF CAMPAIGN 14 FEB 10 PM 1: 59 DEPOSITORY FOR CANDIDATES 09 (Section 106 021(1), F S) C 8 2Q (PLEASE PRINT OR TYPE) q.®,' O . i c e NOTE: This form must be on file with the qualifying a�tiy officer before opening the campaign account. OFFICE USE ONLY 1. CHECK APPROPRIATE BOX(ES): Ell Initial Filing of Form Re- filing to Change ❑ Treasurer /Deputy [] Depository ❑ Office ❑ Party 2 Name of Candidate (in this order Fir t, Middle, Last) 3 Address (include post office box or street, city, state, zip V / (� code ) /J C 6 �I ��r� 0 r� l r� t� ;c Cp / /� /4 ./1 n a-, c 4 Telephone 5 E -mail address <._ �c )11-e0 / 1.1 6 (S- /) CI G /o7 90 6 Office sought (include district, circuit, group number) 7 If a candidate for a nonpartisan office, check if applicable: � , S 2/c, , C 7/ �r ., ' "i ,_0-, tai, - - ❑ My intent is to run as a Wnte -ln 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 El Write -In ❑ No Party Affiliation ❑ Party candidate q I have appointed the following person to act as my El Campaign Treasurer ❑ Deputy Treasurer 0 N e of Treasurer or Deputy Treasurer 11 Mailing Address 12 Telephone C o / ; / r 7 `? /..y, Or/ t ( / ) 6 0 / r 07 9 a 13 City 14 County 15 State 16 Zip Code 17 E -mail address /SC j' /2i)r/.,�(' /V/) X, /` C 35 Ys J 14 c 7 1 - 0 , . c 362 .) ()-M01/ (O/Y} 18 1 have designated the following bank as my § Primary Depository ❑ Secondary Depository 19 Name of Bank f C L- 20 l f , 20 Address n1 X� Q rn lS c.� Cc (),-) � � l% C1� C�/ iY C'..,,, / -eSf 4 - � X211 City 1 �% 2 County 23 State 24 Zip Code UNDE R PENALTIES OF PERJURY, I DECLARE THAT I HAVE READ THE FOREGOING FORM FOR APPOINTMENT OF CAMPAIGN TREASURER AND DESIGNATION OF CAMPAIGN DEPOSITORY AND THAT THE FACTS STATED IN IT ARE TRUE. 25 Date 26 Signature of Candidate , / ,,, —97/0// X ' /! ./( /(a-t ------4— 27 Tr Acceptance of Appointment (fill in the blanks and check the appropriate block) 1 , 1/ , /,/ , �� O - rc' 1 , do hereby accept the appointment (Please Print or Type Name) 'esignated above as Campaign Treasurer n Deputy Treasurer / /62)//j/ to X j-� < ` - Date Signature of am paign Trea er or Deputy Treasurer DS -DE 9 (Rev. 10/10) Rule 1S- 2.0001, F.A.C. D. F! oexi n MATERIAL FOR CANDIDATES YOU HAVE INDICATED YOUR DESIRE TO BECOME A CANDIDATE; THEREFORE, WE HAND YOU THE FOLLOWING: v 1. Qualifying Information & Municipal Election Schedule 2. ./ Dates to Remember 3. Form DS -DE 9 Appointment of Campaign Treasurer and Designation of Campaign Depository for Candidates (8/03) — TO BE SIGNED AND RETURNED TO CITY CLERK (s 4. Residency Requirements (To be filled out and returned to City Clerk) 5. 4 Form DS -DE 84 Statement of Candidate & copy of Chapter 106, Honda Statutes (Must be filed with City Clerk within 10 days after filing Appointment of Campaign Treasurer) 6. ` State of Honda Election Laws - Chapters 99, 105 & 106 (2012) 7. 1./ Guide to Sunshine Amendment & Code of Ethics for Public Officers and Employees 8. ,/ Directions for Posting Temporary Political Sign ' 9. EV City Commission District Map 10. V Part I Charter, Article VII. Elections — City of Boynton Beach 11. ✓ Part II Code of Ordinances — Chapter 2 Administration, Article III. Elections 12. Poll Watcher Form & FS 101.131— "Watchers at Polls" 13. ✓ Candidate Handbook for Candidates 14. ✓ Blank Campaign Report Summary Sheets, Contributions Sheets & Expenditures Sheets 15. / Petition Form - Candidate for Commissioner — TO BE FILLED OUT, CERTIFIED BY SUPERVISOR OF ELEC I IONS AND RETURNED TO CITY CLERK DURING QUALIFYING 16. i., Form 1 Statement of Financial Interests 2009 — TO BE FILLED OUT, SIGNED & RETURNED TO THE CITY CLERK DURING QUALIFYING 17. ,. L&A TESTING NOTICE (SIGN AND RETURN AT TIME OF QUALIFYING.) 18. Loyalty Oath - Oath of Candidate (DS -DE 24B)— TO BE RETURNED TO CITY CLERK DURING QUALIFYING RECEIVED BY: Candidate Signature Date Signed Janet M. Prainito, MMC City Clerk October 18, 2012 S. \CC \WP \ELECTION \Year 2013 \MATERIAL FOR CANDATES.doc Page 1 of 2 Prainito, Janet From: Prainito, Janet Sent: Monday, December 10, 2012 9 11 AM To: 'DivElections @dos.state fl us' Subject: Municipal Election Question Good morning: I attempted to reach your office by telephone this morning at 8 55 a m , unfortunately, the call would not go through I was calling (850) 245 -6200 On Thursday, a business owner in the City of Boynton Beach came into my office seeking to pull papers to run for the Mayoral seat that will become vacant in March 2013 When he called for an appointment the day before, I did some preparatory work and determined that David Floering has an address in the City of Boynton Beach, which is 417 NE 6 Avenue, but that address is listed as being zoned M1 -Light Industrial and it is used as Auto Sales. It is his business address as a tow operator. The other address that appears to be owned by David S. Floering & Barbara A. Floering is located in the unincorporated area at 4973 Waverly Woods Terrace, Lake Worth, FL 33463. Additionally, I checked with the Supervisor of Elections for Mr. Floering's voter registration and was told that Mr. Floering is not registered to voter in Palm Beach County. Section 17 of the City Charter reads as follows: (a) In order to qualify for the office of Mayor, a candidate must be a qualified elector of the City of Boynton Beach and have resided within the City for a period of not less than one (1) year prior to filing for office, and who shall have attained the age of twenty -one (21) years on or before the date the candidate files and qualifies for office. The Mayor of the City of Boynton Beach may reside in any of the four (4) election districts and shall be elected by a city -wide vote. I explained the residency requirements to Mr. Floering and at first he said he was doing the same thing as Marlene Ross. When I repeated to him the requirements plus the fact that he needed to be a registered voter within the City, he said he was working on the voter registration and that he lives at the 417 NE 6 Avenue address. I told him I would be discussing this situation with legal which he agreed I should. He also mentioned that if he were not permitted to run, he would file a lawsuit. In the information binder I provide to all candidates, they sign a residency form that confirms the fact that they have received, read and understand the residency requirements in Article II of the Charter of the City of Boynton Beach. I sent this similar e-mail to our City Attorney who is reviewing the situation, but asked me to contact your office for an opinion on how to handle this situation. Mr. Floering has not yet returned with his fully executed Appointment of Campaign Treasurer & Designation of 12/10/2012 Page 2 of 2 Campaign Depository. When he returns with that form, I would normally have him also returned the signed Residency form. Can you offer me some guidance? JGlAtt M Pr2i,witc, MMC City CL el'2 City of Boynton Beach 100 E. Boynton Beach Blvd. Boynton Beach, FL 33435 Phone: (561) 742 -6061 FAX. (561) 742-6090 email Prainitoi @bbfl us 12/10/2012 Page 1 of 1 Prainito, Janet From: Jim Cherof [JCherof @cityatty com] Sent: Thursday, December 06, 2012 10 59 AM To: LaVerriere, Lori Cc: Swanson, Lynn, Prainito, Janet Subject: Candidate As you know, a City employee, Mike Fitzpatrick, has indicated that he is candidate for a City Commission seat. I have contacted him regarding the provision of law that would prohibit him from being employed by the City should he be elected. The City Clerk has likewise been advised. Either you or the Fire Chief should communicate the following provision of law to him together with any applicable APMs: (3) A candidate may not, in the furtherance of his or her candidacy for nomination or election to public office in any election, use the services of any state, county, municipal, or district officer or employee during working hours. (4) No person shall make and no person shall solicit or knowingly accept any political contribution in a building owned by a governmental entity. For purposes of this subsection, "accept" means to receive a contribution by personal hand delivery from a contributor or the contributor's agent. This subsection shall not apply when a government -owned building or any portion thereof is rented for the specific purpose of holding a campaign fund raiser. § 106.15, Fla. Stat. Ann. James A. Cherof GOREN, CHEROF, DOODY & EZROL, P.A. 3099 East Commercial Boulevard, Suite 200 Fort Lauderdale, Honda 33308 Broward (954) 771 -4500 x 304 Palm Beach (561) 276 -9400 x 304 Fax (954) 771 -4923 Email: icherof @cityatty.com www.cityatty com Offices in Fort Lauderdale and Delray Beach, Honda 12/6/2012 Page 1 of 1 Prainito, Janet From: Prainito, Janet Sent: Thursday, December 06, 2012 12:39 PM To: 'Jim Cherof Cc: Swanson, Lynn Subject: Candidate Good afternoon Jim: David Floering was in my office this morning to pull papers to run for Mayor in March. When he called for an appointment yesterday, I did some preparatory work and determined that David Floering has an address in the City of Boynton Beach, which is 417 NE 6 Avenue, but that address is listed as being zoned M1 -Light Industrial and used as Auto Sales. The other address that appears to be owned by David S. Floering & Barbara A is located in the unincorporated area at 4973 Waverly Woods Terrace, Lake Worth, FL 33463. Additionally, I checked with the Supervisor of Elections for Mr. Floering's voter registration and was told that Mr. Floering is not registered to vote in Palm Beach County. Section 17 of the City Charter reads as follows: (a) In order to qualify for the office of Mayor, a candidate must be a qualified elector of the City of Boynton Beach and have resided within the City for a period of not less than one (1) year prior to filing for office, and who shall have attained the age of twenty -one (21) years on or before the date the candidate files and qualifies for office. The Mayor of the City of Boynton Beach may reside in any of the four (4) election districts and shall be elected by a city -wide vote. I explained the residency requirements to Mr. Floering and at first he said he was doing the same thing as Marlene Ross. When I repeated to him the requirements plus the fact that he needed to be a registered voter within the City, he said he was working on the voter registration and that he lives at the 417 NE 6 Avenue address. I told him I would be discussing this situation with legal which he agreed I should. He also mentioned that if he were not permitted to run, he would file a lawsuit. Can you give me some guidance? )avAtet M Pv Lv to, MMC cJt j CLtvR, City of Boynton Beach 100 E. Boynton Beach Blvd. Boynton Beach, FL 33435 Phone. (561) 742 -6061 FAX. (561) 742-6090 email: PrairntolObbfl us 12/6/2012 Page 1 of 1 `�` "` ° 6, Gary R. Nrkoilts, CFA Property Appraiser's Public Access P APA ■ Property Ap r Lser ° t. . ;+ ,k . Kil County tilligi UV* Location Address 4973 WAVERLY WOODS TER Municipality UNINCORPORATED , Parcel Control Number 00- 42- 44 -26 -1 3- 000 -0160 Subdivision WAVERLY WOODS PL NO 2 Official Records Book 22500 Page 1358 Sale Date MAR -2008 Legal Description WAVERLY WOODS PL NO 2 LOT 16 Owners Mailing address BOYD- FLOERING BARBARA A & 4973 WAVERLY WOODS TER FLOERING DAVID LAKE WORTH FL 33463 5247 Sales Date Price OR Book /Page Sale Type Owner MAR -2008 510 22500 / 1 358 QUIT CLAIM BOYD- FLOERING BARBARA A & MAY -2001 5200,000 12519 / 0440 WARRANTY DEED BOYD FLOERING BARBARA A & MAY-1992 5100 07248 / 1 335 WARRANTY DEED DEC -1987 5100 05521 / 0277 WARRANTY DEED FEB-1985 550 000 04474 / 0902 WARRANTY DEED 12 Exemption Applicant /Owner Year Detail BOYD FLOERING BARBARA A & 2012 Number of Units 1 *Total Square Feet 3514 Acres 1 Use Code 0100 - SINGLE Zoning RT - Residential Transitional ( 00- FAMILY UNINCORPORATED ) Tax Year 2012 2011 2010 Improvement Value 51 55,178 $155,983 $158,278 Land Value 591,800 $91,800 591,800 Total Market Value 5246,978 $247,783 5250,078 All values are as of January 1st each year Tax Year 2012 2011 2010 Assessed Value $246,387 $239,211 5235,676 Exemption Amount 550,000 $50,000 $50,000 Taxable Value 5196,387 $189,211 $185,676 Tax Year 2012 2011 2010 Ad Valorem 53,955 53,910 $3,875 Non Ad Valorem $888 5888 $875 Total tax $4,843 54,798 54,750 http: / /www.pbcgov com/ papa / Asps / PropertyDetail /PropertyDetail.aspx ?parcel= 004244261... 12/6/2012 Page 1 of 1 % Gary R. Nikon ts, CFA Property Appraiser's Public Access ' PAPA ■ - .. J Pro , A # \try 00- * ..,- • , 4'.. - 4101)(ty , 0 4 , * Location Address 41 7 NE 6TH AVE Municipality BOYNTON BEACH Parcel Control Number 08- 43- 45- 21 -18- 000 -0961 Subdivision ARDEN PARK ADD IN Official Records Book 08166 Page 0505 Sale Date MAR -1994 Legal Description ARDEN PARK E 65 FT OF LTS 96 TO 98 INC Mailing address Owners 417 NE 6TH AVE FLOERING DAVID BOYNTON BEACH FL 33435 3877 ■ Sales Date Price OR Book /Page Sale Type Owner MAR -1994 $120,000 08166 / 0505 WARRANTY DEED JUN -1992 $100 07283 / 1825 DEED OF TRUST MAY -1989 $125,000 06091 / 0814 WARRANTY DEED MAY 1989 $100 06091 / 0802 QUIT CLAIM No Exemption Information Available Number of Units 0 *Total Square Feet 1950 Acres 0 2171 Use Code 2700 - AUTO SALES Zoning Ml - Light Industrial (08- BOYNTON BEACH ) Tax Year 2012 2011 2010 Improvement Value $51,261 $53,935 553,930 Land Value $113,484 $113,484 $162,032 Total Market Value 5164,745 $167,419 $215,962 All values are as of January 1st each year Tax Year 2012 2011 2010 Assessed Value $164,745 $167,419 $215,962 Exemption Amount $0 $0 $0 Taxable Value 5164,745 $167,419 $215,962 Tax Year 2012 2011 2010 Ad Valorem $3,737 $3,802 $4,852 Non Ad Valorem $807 $811 $702 Total tax $4,544 $4,613 $5,554 http: / /www.pbcgov.com/ papa / Asps / PropertyDetail /PropertyDetail.aspx ?parcel = 084345211... 12/6/2012 CftQ0L N Attone y MATERIAL FOR CANDIDATES YOU HAVE INDICATED YOUR DESIRE TO BECOME A CANDIDATE; THEREFORE, WE HAND YOU THE FOLLOWING: 1. (� Qualifying Information & Municipal Election Schedule 2. Dates to Remember 3. ✓ Form DS -DE 9 Appointment of Campaign Treasurer and Designation of Campaign Depository for Candidates (8/03) — TO BE SIGNED AND RETURNED TO CITY CLERK 4. Residency Requirements (To be filed out anc returned to City Clerk) 5. Form DS - DE 84 Statement of Candidate & copy of Chapter 106, Florida Statutes (Must be filed witn City Clerk within 10 days after fling Appointment of Campaign Treasurer) 6. ` / State of Florida Election Laws - Chapters 99, 105 & 106 (2012) 7. ✓ Guide to Sunshine Amendment & Code of Ethics for Public Officers and Employees 8. ✓ Directions for Posting Temporary Political Sign 9. d City Commission District Map 10. c/ Part I Charter, Article VII. Elections — City of Boynton Beach 11. t� Part II Code of Ordinances — Chapter 2 Administration, Article III. Elections 12. (O Poll Watcher Form & FS 101.131— "Watchers at Polls" 13. Candidate Handbook for Candidates 14. ✓ Blank Campaign Report Summary Sheets, Contributions Sheets & Expenditures Sheets 15. tVPetition Form - Candidate for Commissioner — TO BE FILLED OUT, CERTIFIED BY SUPERVISOR OF ELECTIONS AND RE I URNED 70 CITY Cl ER DURING QUALIFYING 16. ✓ Form 1 Statement of Financial Interests 2009 — TO BE FILLED OUT, SIGNED & RETURNED TO THE CITY CLERK DURING QUALIFYINGG 17. L&A TESTING NOTICE (SIGN AND RE' URN AT TIME DF QUALIFYING.) 18. 1 ° Loyalty Oath - Oath of Candidate (DS - DE 24B) TO BE RE I URNED TO CITY CLERK DURING QUALIFYING RECEIVED BY: Candidate Signature Date Signed Janet M. Prainito, MMC City Clerk October 18, 2012 S' \CC \WP\ELECTION \Year 2013 \MATERIAL FOR CANDATES.doc kcn 1a-i t MATERIAL FOR CANDIDATES YOU HAVE INDICATED YOUR DESIRE TO BECOME A CANDIDATE; THEREFORE, WE HAND YOU THE FOLLOWING: 1. ✓ Qualifying Information & Municipal Election Schedule 2. ✓ Dates to Remember 3. 1. Form DS -DE 9 Appointment of Campaign Treasurer and Designation of Campaign Depository for Candidates (8/03) — TO BE SIGNED AND RETURNED TO CITY CLERK 4. Residency Requirements (To be filled out and returned to City Clerk) 5. g Form DS - DE 84 Statement of Candidate & copy of Chapter 106, Florida Statutes (Must be flied with City Clerk within 10 days after filing Appointment of Campaign Treasurer) 6. _ ✓ State of Florida Election Laws - Chapters 99, 105 & 106 (2012) 7. Guide to Sunshine Amendment & Code of Ethics for Public Officers and Employees 8. Directions for Posting Temporary Political Sign 9. City Commission District Map 10. ' Part I Charter, Article VII. Elections — City of Boynton Beach 11. v Part II Code of Ordinances — Chapter 2 Administration, Article III. Elections 12. ✓ Poll Watcher Form & FS 101.131 — "Watchers at Polls" 13. ✓ Candidate Handbook for Candidates 14. ✓ Blank Campaign Report Summary Sheets, Contributions Sheets & Expenditures Sheets 15. ✓ Petition Form - Candidate for Commissioner — TO BE FILLED OUT, CERTIFIED BY SUPERVISOR OF ELECTIONS AND RETURNED TO CITY CLERK DURING QUALIFYING 16. Form 1 Statement of Financial Interests 2009 — TO BE FILLED OUT, SIGNED & RETURNED TO THE CITY CLERK DURING QUALIFYING 17. / L&A TESTING NOTICE (SIGN AND RE ! URN AT TIME OF QUALIFYING.) / 18. c Loyalty Oath - Oath of Candidate (DS -DE 24B)— TO BE RE 1 URNED TO CITY CLERK DURING QUALIFYING RECEIVED BY.: 7-1 7a.,/t4 ///1/ Candidate Signature Dat Signed Janet M. Prainito, MMC City Clerk October 18, 2012 S: \CC \WP \ELECTION \Year 2013 \MATERIAL FOR CANDATES.doc L,Oe, CASe_j(o MATERIAL FOR CANDIDATES YOU HAVE INDICATED YOUR DESIRE TO BECOME A CANDIDATE; THEREFORE, WE HAND YOU THE FOLLOWING: 1. t V Qualifying Information & Municipal Election Schedule 2. r.. Dates to Remember 3. ✓ Form DS -DE 9 Appointment of Campaign Treasurer and Designation of Campaign Depository for Candidates (8/03) — TO BE SIGNED AND RETURNED TO CITY CLERK 4. ✓ Residency Requirements (To be filled out and returned to City Clerk) 5. ✓ Form DS - DE 84 Statement of Candidate & copy of Chapter 106, Florida Statutes (Must be filed with // City Clerk within 10 days after filing Appointment cf Campaign Treasurer) 6. ✓ State of Florida Election Laws - Chapters 99, 105 & 106 (2012) 7. ✓ Guide to Sunshine Amendment & Code of Ethics for Public Officers and Employees 8. L Directions for Posting Temporary Political Sign 9. r/ / City Commission District Map 10. ✓ Part I Charter, Article VII. Elections — City of Boynton Beach 11. ✓ Part II Code of Ordinances — Chapter 2 Administration, Article III. Elections 12. ..7 Poll Watcher Form & FS 101.131 — "Watchers at Polls" 13. f Candidate Handbook for Candidates 14. ✓ Blank Campaign Report Summary Sheets, Contributions Sheets & Expenditures Sheets 15. ✓ Petition Form - Candidate for Commissioner — TO BE FILLED OUT, CERTIFIED BY SUPERVISOR OF ELECTIONS AND RETURNED TO CITY Ci ERK DURING QUALIFYING 16. ✓ Form 1 Statement of Financial Interests 2009 — TO BE FILLED OUT, SIGNED & RETURNED TO THE CITY CLERK DURING QUALIFYING 17. ✓ L&A TESTING NOTICE (SIGN AND RETURN AT TIME OE QUALIFYING ) 18. ✓ / Loyalty Oath - Oath of Candidate (DS - DE 24B) TO BE RETURNED TO CITv CLERK DURING QUALIFYING RECEIV BY: ' / ___ 9 _,____7 0 a Candid Signatture Date Si gned A P �, w • - ' Ja -t M. Prainito, MMC C Clerk October 18, 2012 S \CC \WP \ELECTION\Year 2013 \MATERIAL FOR CANDATES.doc MATERIAL FOR CANDIDATES YOU HAVE INDICATED YOUR DESIRE TO BECOME A CANDIDATE; THEREFORE, WE HAND YOU THE FOLLOWING: 1. ✓ Qualifying Information & Municipal Election Schedule 2. Dates to Remember 3. ✓ Form DS -DE 9 Appointment of Campaign Treasurer and Designation of Campaign Depository for Candidates (8/03) — TO BE SIGNED AND RETURNED TO CITY CLERK 4. ` Residency Requirements (To be filled out and returned to City Clerk) 5. ✓ Form DS -DE 84 Statement of Candidate & copy of Chapter 106, Florida Statutes (Must be filed with City Clerk within 10 days after filing Appointment of Campaign Treasurer) 6. ` State of Florida Election Laws - Chapters 99, 105 & 106 (2012) 7. / Guide to Sunshine Amendment & Code of Ethics for Public Officers and Employees 8. ✓ Directions for Posting Temporary Political Sign 9. ` City Commission District Map 10. v Part I Charter, Article VII. Elections — City of Boynton Beach -I 11. 11. ' Part II Code of Ordinances — Chapter 2 Administration, Article III. Elections 12. Poll Watcher Form & FS 101.131 — "Watchers at Polls" co 13. ' Candidate Handbook for Candidates i 14. ✓ Blank Campaign Report Summary Sheets, Contributions Sheets & Expenditures Sheets 15. ✓ Petition Form - Candidate for Commissioner — TO BE FILLED OUT, CERTIFIED BY SUPERVISOR OF ELECTIONS AND RETURNED TO CITY CLERK DURING QUALIFYING 16. ✓ Form 1 Statement of Financial Interests 2009 — TO BE FILLED OUT, SIGNED & RETURNED TO THE CITY CLERK DURING QUALIFYING 17. L&A TESTING NOTICE (SIGN AND RETURN AT TIME OF QUALIFYING.) 18. Loyalty Oath - Oath of Candidate (DS -DE 24B)— TO BE RETURNED TO CITY CLERK DURING QUALIFYING RECEIVE BY Candi to • i na Ire Da Si nod � ` 1 01 Fka..,,...to et M. Prainito, MMC ty Clerk October 18, 2012 S \CC \WP \ELECTION \Year 2013 \MATERIAL FOR CANDATES.doc MATERIAL FOR CANDIDATES YOU HAVE INDICATED YOUR DESIRE TO BECOME A CANDIDATE; THEREFORE, WE HAND YOU THE FOLLOWING: 1. Qualifying Information & Municipal Election Schedule 2. ✓ Dates to Remember 3. ✓ Form DS -DE 9 Appointment of Campaign Treasurer and Designation of Campaign Depository for Candidates (8/03) — TO BE SIGNED AND RETURNED TO CITY CLERK 4. 4/ / Residency Requirements (To be filled out and returned to City Clerk) 5. /Form DS -DE 84 Statement of Candidate & copy of Chapter 106, Florida Statutes (Must be filed with City Clerk within 10 days after filing Appointment of Campaign Treasurer) 6. State of Florida Election Laws - Chapters 99, 105 & 106 (2012) 7. ✓ Guide to Sunshine Amendment & Code of Ethics for Public Officers and Employees 8. LZ Directions for Posting Temporary Political Sign 9. ✓ City Commission District Map rn 10. / Part I Charter, Article VII. Elections — City of Boynton Beach rw 11. ✓ Part II Code of Ordinances — Chapter 2 Administration, Article III. Elections 3 12. 1/ / Poll Watcher Form & FS 101.131 — "Watchers at Polls" _ -41e0 / 13. ✓ Candidate Handbook for Candidates 14. ✓ Blank Campaign Report Summary Sheets, Contributions Sheets & Expenditures Sheets 15. L / Petition Form - Candidate for Commissioner — TO BE FILLED OUT, CERTIFIED BY SUPERVISOR OF ELEL 110NS AND RETURNED TO CITY CLERK DURING QUALIFYING 16. ✓ Form 1 Statement of Financial Interests 2009 — TO BE FILLED OUT, SIGNED & RETURNED TO THE / CITY CLERK DURING QUALIFYING 17. ✓ L&A TESTING NOTICE (SIGN AND RETURN AT TIME OF QUALIFYING.) 18. ✓ Loyalty Oath - Oath of Candidate (DS -DE 24B)— TO BE RETURNED TO CITY CLERK DURING QUALIFYING RECEIVED BY: 43%; /c9 Candidate Signa r Date Signed il i ud : t . t t o Jan: M. Prainito, MMC Ci• Clerk October 18, 2012 S: \CC \WP \ELECTION \Year 2013 \MATERIAL FOR CANDATES doc MATERIAL FOR CANDID . TES YOU HAVE INDICATED YOUR DESIRE TO BECOME A CANDIDATE; THEREFORE, I HAND YOU THE ,• FOLLOWING: 1. / Qualifying Information & Municipal Election Schedule 2. ✓ Dates to Remember 3. ✓ Form DS -DE 9 Appointment of Campaign Treasurer and Designation of Campaign Depository for Candidates (8/03) - TO BE SIGNED AND RETURNED TO CITY CLERK INDICATING YOUR INTENT TO RUN. 4. Residency Requirements (To be filled out and returned to City Clerk) 5. Form DS - DE 84 Statement of Candidate & copy of Chapter 106, Florida Statutes (Must be filled with City Clerk within 10 days after filing Appointment of Campaign Treasurer - Intent ) 6. / State of Florida Election Laws - Chapters 99, 105 & 106 7. •/ Guide to Sunshine Amendment & Code of Ethics for Public Officers and Employees 8. Directions for Posting Temporary Political Sign 9. v City Map and District Maps 10. ./ Part I Charter, Article VII. Elections - City of Boynton Beach 11. i/ Part II Code of Ordinances - Chapter 2 Administration, Article III. Elections 12. Poll Watcher Form & FS 101.131 "Watchers at Polls 13. ✓ Public Campaign Financing Handbook 14. ✓ Candidate Petition Handbook 15. ./ Blank Campaign Report Summary Sheets, Contributions Sheets & Expenditures Sheets 16. ✓ Petition Form - Candidate for Commissioner - TO BE FILLED OUT, CERTIFIED BY SUPERVISOR OF ELECTIONS AND RETURNED TO CITY CLERK DURING QUALIFYING 17. Form 1 Statement of Financial Interests 2014 - TO BE FILLED OUT, SIGNED & RETURNED TO / THE CITY CLERK DURING QUALIFYING 18. ✓ L&A TESTING NOTICE (SIGN AND RETURN AT TIME OF QUALIFYING.) 19. ✓ Loyalty Oath - Oath of Candidate (DS - DE 24B) - TO BE RETURNED TO CITY CLERK DURING QUALIFYING RECEIVED BY: r Candidate Signature Date Signed eir _ anet M. Prainito, MMC - City Clerk 5/26/2015 3:33 PM S: \CC \WP \ELECTION \YEAR 2016 \Information Packets \MATERIAL FOR CANDATES.doc MATERIAL FOR CANDIDATES YOU HAVE INDICATED YOUR DESIRE TO BECOME A CANDIDATE; THEREFORE, I HAND YOU THE FOLLOWINGG: 1. +/ Qualifying Information & Municipal Election Schedule 2. / Dates to Remember 3. / Form DS -DE 9 Appointment of Campaign Treasurer and Designation of Campaign Depository for Candidates (8/03) - TO BE SIGNED AND RETURNED TO CITY CLERK INDICATING YOUR / INTENT TO RUN. 4. ✓ Residency Requirements (To be filled out and returned to City Clerk) 5. / Form DS - DE 84 Statement of Candidate & copy of Chapter 106, Florida Statutes (Must be filed with City Clerk within 10 days after filing Appointment of Campaign Treasurer - Intent ) 6. v State of Florida Election Laws - Chapters 99, 105 & 106 7. / Guide to Sunshine Amendment & Code of Ethics for Public Officers and Employees 8. V Directions for Posting Temporary Political Sign 9. ✓ City Map and District Maps 10. / Part I Charter, Article VII. Elections - City of Boynton Beach 11. 1/ Part II Code of Ordinances - Chapter 2 Administration, Article III. Elections 12. t/ Poll Watcher Form & FS 101.131 - "Watchers at Polls" 13. t/ Public Campaign Financing Handbook 14. ✓ Candidate Petition Handbook 15. t/ Blank Campaign Report Summary Sheets, Contributions Sheets & Expenditures Sheets 16. t/ Petition Form - Candidate for Commissioner - TO RE FILLED OUT, CERTIFIED BY SUPERVISOR / OF ELECTIONS AND RETURNED TO CITY CLERK DURING QUALIFYING 17. e/ Form 1 Statement of Financial Interests 2014 - TO BE FILLED OUT, SIGNED & RETURNED TO THE CITY CLERK DURING QUALIFYING 18. ✓ L&A TESTING NOTICE (SIGN AND RETURN AT TIME OF QUALIFYING.) 19. ✓ Loyalty Oath - Oath of Candidate (DS - DE 24B) - TO BE RETURNED TO CITY CLERK DURING QUALIFYING RECEIVED BY: N) (� s 4.. 1/ - Candidate S ature Date Signed i eta - • 1 d et M. Prainito, MMC Clerk 5/26/2015 3:33 PM S: \CC \WP \ELECTION \YEAR 2016 \Information Packets \MATERIAL FOR CANDATES.doc , ATERIAL FIRC ANII ) ATES YOU HAVE INDICATED YOUR DESIRE TO BECOME A CANDIDATE; THEREFORE, I HAND YOU THE • FOLLOWING: 1. Qualifying Information & Municipal Election Schedule' 2. Dates to Remember/ 3. (V Form DS -DE 9 Appointment of Campaign Treasurer and Designation of Campaign Depository for" Candidates (8/03) - TO -'E SIGNED AND RETURNED TO CITY CLERK INDICATING YOUR INTENT TO RUN. / 4. v Residency Requirements (To be filled out and returned to City Clerk)`' 5. Form DS - DE 84 Statement of Candidate & copy of Chapter 106, Florida Statutes (Must be filed with V / City Clerk within 10 days after filing Appointment of Campaign Treasurer - Intent ) 6. ✓ State of Florida Election Laws - Chapters 99, 105 & 106'' 7. j Guide to Sunshine Amendment & Code of Ethics for Public Officers and Employees / 8. ✓ Directions for Posting Temporary Political Sign'' 9. c/ City Map and District Maps" 10. / Part I Charter, Article VII. Elections - City of Boynton Beach' 11. j Part II Code of Ordinances - Chapter 2 Administration, Article III. Elections III 12. /, Poll Watcher Form & FS 101.131- "Watchers at Polls "r/ 13. - Public Campaign Financing Handbook 14. i/ Candidate Petition Handbook/ 15. t/ Blank Campaign Report Summary Sheets, Contributions Sheets & Expenditures Sheets'" 16. ✓ Petition Form - Candidate for Commissioner - TO BE FILLE`I OUT, CERTIFIED BY SUPERVISOR OF ELECTIONS AND RETURNED TO CITY CLERK DURING QUALIFYING 17. Form 1 Statement of Financial Interests 2014 - TO BE FILLED OUT, SIGNED & RETURNED TO' THE CITY CLERK DURING QUALIFYING 18. •. / L&A TESTING NOTICE (SIGN AND RETURN AT TIME OF QUALIFYING.) 19. / Loyalty Oath - Oath of Candidate (DS - DE 24B) - TO BE RETURNED TO CITY CLE'-:K DURING'" QUALIFYI ;G ip Er• , Y: /, ZA Ct, /d /2 ??// Candidate Signature Date Signed III Janet M. Prainito, MMC City Clerk 5/26/2015 3:33 PM S: \CC \WP \ELECTION \YEAR 2016 \Information Packets \MATERIAL FOR CANDATES.doc FOR el: 1 DATE / `> TIME�y f Veal PHONEb(..0 - I � ,Olt 1 s - CELL P)61 -1 1 'o9G�Ie 1 LI MESSAGE \N161 )1. L_ N TELEPHONED e fill 0 . 0 1Ni 1 , r4& / _ ."� D RETURNED YOUR CALL � - \- ` PLEASE CALL r -C)>` a�� 1 "TO a eL , ® WILL CALL AGAIN (L fl CAME TO SEE YOU am 0 WANTS TO SEE YOU SIGNED il m Con eCt. g ance oAdvi se . M " ency CSwner � - / � :� Office 561 =989 -7266 - Cell 561- 777 -2618 . �y ° Fax 5,61-244-3259 ToddJackso `n @connectmyinsurance.com" ,,, „, ..,I vaww.connecti nsuranceadvisors.com HOME AUTO CONDO - RENTERS - BOAT MOTORCYCLE COMMERCIAL : 1 i ATERIAL FO''• ; CAN MATES YOU HAVE INDICATED YOUR DESIRE TO BECOME A CANDIDATE; THEREFORE, I HAND YOU THE FOLLOWING: 1. r/ Qualifying Information & Municipal Election Schedule 2. � Dates to Remember 3. Form DS -DE 9 Appointment of Campaign Treasurer and Designation of Campaign Depository for Candidates (8/03) - TO BE SIGNED AND RETURNED TO CITY CLERK INDICATING YOUR INTENT TO RUN. 4. . Residency Requirements (To be filled out and returned to City Clerk) 5. ✓ Form DS - DE 84 Statement of Candidate & copy of Chapter 106, Florida Statutes (Must be filed with City Clerk within 10 days after filing Appointment of Campaign Treasurer - Intent ) 6. c/ / State of Florida Election Laws - Chapters 99, 105 & 106 7. - ' Guide to Sunshine Amendment & Code of Ethics for Public Officers and Employees 2 8. Directions for Posting Temporary Political oliti rri 9. L., City Map and District Maps mow. �-c 10. ✓ Part I Charter, Article VII. Elections - City of Boynton Beach cD • 11. ,/ Part II Code of Ordinances - Chapter 2 Administration, Article III. Elections -I' CA) rrt 12. V Poll Watcher Form & FS 101.131- "Watchers at Polls" 13. ' Public Campaign Financing Handbook 14. ,/ Candidate Petition Handbook 15. Blank Campaign Report Summary Sheets, Contributions Sheets & Expenditures Sheets 16. ✓ Petition Form - Candidate for Commissioner - TO BE FILLED OUT, CERTIFIED BY SUPERVISOR OF ELECTIONS AND RETURNED TO CITY CLERK DURING QUALIFYING 17. L/ Form 1 Statement of Financial Interests 2014 - TO DE FILLED OUT, SIGNED & RETURNED TO THE CITY CLERK DURING QUALIFYING 18. ✓ L&A TESTING NOTICE (SIGN AND RETURN AT TIME OF QUALIFYING.) 19. .7 Loyalty Oath - Oath of Candidate (DS - DE 24B) - TO BE RETURNED TO CITY CLERK DURING QUALIFYING RECEIVED B / r /f /'S Candidate Signaturr Date Signed ® 4 M. Prainito, IA MC Orret Clerk 5/26/2015 3:33 PM S: \CC \WP \ELECTION \YEAR 2016 \Information Packets \MATERIAL FOR CANDATES.doc • OUR PRECINCT'NUMBER Su Nuinero de Distrito Electoral 1 1 '3186 ; F OUR POLLING LOCATION Su Centro Electoral CONGRESS MIDDLE I' 101 S CONGRESS AVE BOYNTON BEACH ' • YOU ARE ELIGIBLE TO VOTE FOR A REPRESENTATIVE IN EACH DISTRICT LISTED % USTED PUEDE POR REPRESENTANTE DE CADA DISTRITO NOMBRADO US,CONGRESSi'. • STATE SENATE STATE HOUSE ',; 'Congreso EE:UU Senadpdel Estado CAmara de j6utados del Estad LLl J44 9U COUNTY;COMMISSION SCHOOL BOARD '? MUNICIPALITV Comisl6n del .Condado ' , Junta Escolar Municipalidir0 Ail non , ... 120215681 - _ n,r: mo d: � � ,NC/4o1oc; p �E 2/7/2014 9 �►�i VOTER INFORMATION CARD ® PALM BEACH COUNTY FLORID/ TARJETA ELECTORAL, CONDADO DE PALM BEACH FLORIDA REQ ISTRAT NU M : RE ©ISTRATION b�1TE F�AECINCT , aNum ION r» Ue idscii BER 1 donw Fe¢ha de Irtscrlpclon , Dlstr/to Electoral . 120215681 �� 0918/12 ..3186 JACKSON, 'WHL,LIAM TODD VELAIRE DR • BOYNTON•BEACH FL 33426 • • 01/31/1963 NPA• MATERIAL FOR CAN i'IDATES YOU HAVE INDICATED YOUR DESIRE TO BECOME A CANDIDATE; THEREFORE, I HAND YOU THE • FOLLOWING: 1. V Qualifying Information & Municipal Election Schedule 2. Dates to Remember 3. Form DS -DE 9 Appointment of Campaign Treasurer and Designation of Campaign Depository for Candidates (8/03) - TO BE SIGNED AND RETURNED TO CITY CLERK INDICATING YOUR ✓ INTENT TO RUN. 4. t/ Residency Requirements (To be filled out and returned to City Clerk) 5. / Form DS - DE 84 Statement of Candidate & copy of Chapter 106, Florida Statutes (Must be filed with City Clerk within 10 days after filing Appointment of Campaign Treasurer - Intent ) 6. State of Florida Election Laws - Chapters 99, 105 & 106 c> 7. j Guide to Sunshine Amendment & Code of Ethics for Public Officers and Employees n-c cp • < a 8. Directions for Posting Temporary Political Sign c � -r I n- 9. , City Map and District Maps 33-< v cn 10. Part I Charter, Article VII. Elections - City of Boynton Beach = ay C? -n ca • 11. Part II Code of Ordinances - Chapter 2 Administration, Article III. Elections — �n Co rn x 12. / PoII Watcher Form & FS 101.131- "Watchers at Polls" 13. / Public Campaign Financing Handbook 14. Candidate Petition Handbook 15. 1 Blank Campaign Report Summary Sheets, Contributions Sheets & Expenditures Sheets 16. / Petition Form - Candidate for Commissioner - TO BE FILLED OUT, CERTIFIED BY SUPERVISOR OF ELECTIONS AND RETURNED TO CITY CLERK DURING QUALIFYING 17. Form 1 Statement of Financial Interests 2014 - TO BE FILLED OUT, SIGNED & RETURNED TO THE CITY CLERK DURING QUALIFYING 18. ✓ L&A TESTING NOTICE (SIGN AND RETURN AT TIME OF QUALIFYING.) 19. (1 Loyalty Oath - Oath of Candidate (DS - DE 24B) - TO BE RETURNED TO CITY CLERK DURING QUALIFYING RECEIV \,D B I lit I \ M 20/5 Candid - is nature Date Signed ___ m 0 • _1_4 ill fp , , ) - „ : . 4- 1 et M. Prainito, MMC -- -ity Clerk 5/26/2015 3:33 PM S : \CC \WP \ELECTION \YEAR 2016 \Information Packets \MATERIAL FOR CANDATES.doc