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Shelton, Rebecca 08-22-24- Notice of Intent to Run THE CITY OF BOYNTON BEACH 2025 CANDIDATE NOTICE OF INTENT TO RUN E Candidate's Name: VItt)ta -51kU �ayor _District 1 _ District 3 Appointment of Campaign Treasurer and Designation of Campaign Depository for Candidates (DS-DE 9) _ Ensure Candidate signs Block 26 FILED _ Ensure Campaign Treasurer or Deputy Treasurer signs acceptance Ensure form is completely filled out Au3 2:2 2024 Note: Only one primary and one secondary depository can be designated CITY CLERK'S OFFICE Appointment of Campaign Treasurer and Designation of Campaign Depository for Candidates (DS-DE 9) _ Ensure Candidate signs Block 26 _ Ensure Campaign Treasurer or Deputy Treasurer signs acceptance _ Ensure form is completely filled out Not" Only one primary and one secondary depository can be designated Statement of andidate (DS-DE 84) gebeteA, NA , acknowledge receipt of printed copies of the following: • Qualifying Information • 2023-2025 Calendar of Reporting Dates • Florida Election Code • Candidate & 'n Treasurer Handbook Date: q121(2q Sign. ' e Comments: Checked: C-A4Q--- Reviewe Date: 7/6/0-/X?) APPOINTMENT OF CAMPAIGN TREASURER AND DESIGNATION OF CAMPAIGN FILED DEPOSITORY FOR CANDIDATES (Section 106.021(1), F.S.) Av3 2- 2024 (PLEASE PRINT OR TYPE) CITY CLERK'S OFFICE NOTE: This form must be on file with the filing officer before opening the campaign account. OFFICE USE ONLY 1.CHECK APPROPRIATE BOX(ES): 2 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 PO Box or Street, City, State, Zip Code): (Please Print or Type Name) 1R5-- 31/V 14. fl-VC EP `Sh eL m J 'Ny N-1- -Bea-l►, -fi- 5-54-3r 4. Telephone: 5. Candidate's Voter Registration#: 6. Email Address: 1 (90e l ) q v-I-0 2 J-- i i Z -S 130 1 re betectfbrIsorttyi rnckyOr DCS mad t (not required for qualifying purposes) torn 7.Office Sought(include district, circuit, group, or seat#): 8. If a candidate for a nonpartisan office, check the box if applicable: PA rtf 3a tea vl 1-, /L(- Or L ..1 iE CII intend to run as a Write-In Candidate. 9. Ifar a candidate for ptisan/office, check the box and fill in the name of the party as applicable: I intend to run as a ❑ Write-In Candidate. BNo Party Affiliation Candidate. ❑ Party candidate. 10. I have appointed the following person to act as my: 2 Campaign Treasurer ❑ Deputy Treasurer 11. Name of Treasurer or Deputy Treasurer: 12. Telephone: 13. Email Address: L15r IYIa,kk 641 ) o5-4 g I ton ac ale, s,t at ILow\ 14. Mailing Address: 15. City: 16. State: 17. Code: G12 36 Oak_ Ne., -Lb 1360:Retizm 33. I 18. I have designated the following bank as my (check appropriate box): NtTrimary Depository ❑ Secondary Depository 19. Name of Bank: 20. Address: *1---D BAIIK 5f$ E. Wool:8( - a 21. Cit)(::, 22. County: 23. State: 24. Zip Code: L YY 'o ati I L .?6,(04 Mak - 3 3 3c. UNDER PENALTIES OF PERJURY, I DECLARE THAT I HAVE READ THE FOREGOING FORM FOR THE APPOINTMENT OF THE CAMPAIGN TREASURER AND DESIGNATION OF THE CAMPAIGN DEPOSITORY AND THAT THE FACTS STATED IN IT ARE TRUE. 26. Signa re of Candidate: , 25. Date: �j r�- ' 7-4 v 27. Treasurer's Acceptance of Appointment(fill in the`blanks and check the appropriate box) I, IA 5Pr i Y 1 A-k f ' do hereby accept the appointment designated above as: (Please Print or Type Name) Campaign Treasurer. ❑ Deputy Treasurer. 29. Signa j re of Crp.-gn Treasi rer of Deputy Treasurer 28. Date: g,� � X ! , / DS-DE 9(Eff. 10/23) /� Rule 1S-2.001,F.A.C. APPOINTMENT OF CAMPAIGN TREASURER AND DESIGNATION OF CAMPAIGN �, DEPOSITORY FOR CANDIDATES F i L -" D (Section 106.021(1), F.S.) A.;3 2- 2024 (PLEASE PRINT OR TYPE) CITY CLERK'S OFFICE NOTE: This form must be on file with the filing officer before opening the campaign account. OFFICE USE ONLY 1. CHECK APPROPRIATE BOX(ES): 4 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 PO Box or Street, City, State, Zip Code): (Please Print or Type Name) e (5ki t /11/(-'"? 46atit, (11 I bo w � 3 Eby r►-f�► eaClq, - - 5 (/3 5-- 4. Telephone: 5. Candidate's Voter Registration#: 6. Email Address: ) / a 1/ 9-3°1 r- hey r � �i 9 ���- (not required for qualifying purposes) ( V "mi. O I A 7. Office Sought(include district, circuit, group, or seat#): 8. If a candidate for a ponoartisarl office, check the box EaPiicie:CAk. ayI intend to run as a Write-In Candidate. 9. If a candidate for partisan office, check the box and fill in the name of the party as applicable: I intend to run as a ❑ Write-In Candidate. No Party Affiliation Candidate. ❑ Party candidate. 10. I have appointed the following person to act as my: ❑ Campaign Treasurer %Deputy Treasurer 11. Name of Treasurer or Deputy Treasurer: 12. Telephone: 13. Email Address: ke & S1th — (5Le! ) 92-1 o) z-- z*14,1 h Drnaii.Um 14. Mailing Address: 15. City: 16. State: 17. Zip Code: ill;s (ski lIt- ae- A yiti Aa F`' 3331- 18. I have designated the following bank as my (check appropriate box):OPrimary Depository ❑ Secondary Depository 19. Name of Ban 20. Address: �"b 8aiile 57d t-. tdootzeJh " 0 21. Cit 22. County: 23. State: 24. Zi Code: City, PL /YL &_, <._ 3 3/3 UNDER PENALTIES OF PERJURY, I DECLARE THAT I HAVE READ THE FOREGOING FORM FOR THE APPOINTMENT OF THE CAMPAIGN TREASURER AND DESIGNATION OF THE CAMPAIGN DEPOSITORY AND THAT THE FACTS STATED IN IT ARE TRUE. 26. Signature of Candidate: 25. Date: g/).011 �� X27. Treasurer's Acceptance of Appointment(fill in the blanks and check the appropriate box) I, 12d (fj(ri, Ski-i-6-- do hereby accept the appointment designated above as: (Please Print or Type Name) ❑ Campaign Treasurer. eputy Treasurer. 29. Si nature of Campaign Treasurer of Deputy Treasurer 28. Date:' d_k/ 0 1X / DS-DE 9(Eff. 10/23) Rule 1S-2.001, F.A.C. OFFICE USE ONLY STATEMENT OF CANDIDATE FILED L D (Section 106.023, F.S.) .C3 2. 2024 (Please print or type) CITY r} ERK'S OFFICE 1, neibeolk- .$)I)CJ-T iry) candidate for the office of JbUj Y\ 0.6uyi have been provided access to read and understand the requirements of Chapter 106, Florida Statutes. X g2- -Ct Signature of Candidate ate Each candidate must file a statement with the qualifying officer within 10 days after the Appointment of Campaign Treasurer and Designation of Campaign Depository is filed. Willful failure to file this form is a first degree misdemeanor and a civil violation of the Campaign Financing Act which may result in a fine of up to $1,000, (ss. 106.19(1)(c), 106.265(1), Florida Statutes). DS-DE 84(05/11) I