Intent to Run THE CITY OF BOYNTON BEACH
2026 CANDIDATE NOTICE OF INTENT TO RUN*
Candidate's Name: cnoz g District 2 _District 4
gAppointment of Campaign Treasurer and Designation of Campaign
Depository for Candidates (DS-DE 9) READ
_ Ensure Candidate signs Block 26
_ Ensure Campaign Treasurer or Deputy Treasurer signs acceptance MAY 2 7 2025
Ensure form is completely filled out
Note: Only one primary and one secondary depository can be designated City Clerk's Office
0 Appointment of Campaign Treasurer and Designation of Campaign n/GL,
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
Note: Only one primary and one secondary depository can be designated
Statement of Candidate (DS-DE 84)
I, V\d c-1,, , acknowledge receipt of printed copies of
the following:
• Qualifying Information
• 2025-2026 Calendar of Reporting Dates
• Florida Election Code
•.- Ca didate & paign Treasurer Handbook
Date: Vo?7/95
Signature
Comments:
Checked:( ( Reviewed: Date:0725
*Candidates acknowledge that if additional qualifications or residency proof requirements
are established after filing, they must comply by providing the required documentation
when requested. Failure to meet subsequently enacted qualification criteria may result in
disqualification or necessitate voluntary withdrawal from candidacy. By signing this
document, Candidates affirm their understanding of this continuing obligation to maintain
and demonstrate eligibility throughout the election process.
OFFICE USE ONLY
STATEMENT OF �pL�CD
CANDIDATE MAY 2 7 2025
(Section 106.023, F.S.)
(Please print or type) City Clerk's Office
Ae (7,7
candidate for the office of 9,2/SS, (#e r iril`i (/-�
have been provided access to read and understand the requirements of
Chapter 106, Florida Statutes.
7
"-61tii7Ly---/:
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Signa re of Cand Date
Each candidate must file a statement with the qualifying officer within 10 days after the
Appointment of Campaign Treasurer and Designation of Campaign Depository is filed. Willful
failure to file this form is a first degree misdemeanor and a civil violation of the Campaign
Financing Act which may result in a fine of up to $1 ,000, (ss. 106.19(1)(c), 106.265(1), Florida
Statutes).
DS-DE 84(05/11)
APPOINTMENT OF CAMPAIGN TREASURER IFOLIED
AND DESIGNATION OF CAMPAIGN
DEPOSITORY FOR CANDIDATES MAY 2 7 2025
(Section 106.021(1), F.S.)
(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):
et Initial Filing of Form ❑ Re-filing to Change: ❑Treasurer/Deputy ❑ Depository ❑ Office El Party
2. Name of Candidate(in this order: First, Middle, Last): 3.Addr ss (inclu a 7,,,or S eet, Ci , State, Zip Code):
(Please P'nt or Type Name) . le /U/
NAL /61 4( Cli/41-74li Cid 7/ i9 3K3)
4. Telephone: 5. Candidate's Voter Registratipn#: 6. Email Address:
of
//c3 notr uired foruau oses no /c % " 7
�� cl
( required 4 � 9p purposes) y�
4'M55I/J7
ce Sought(include district, cir uit, gro p, or seat#): 8. If a candidate f� • office,check the box
9
if applicable:
�4ti, �� ❑ pntend to run as a Write-In Candidate.
9. If a candidate for majun office,check the box and fill in the name of the party as applicable: I intend to run as a
❑ Write-In Candidate. ad No Party Affiliation Candidate. ❑ Party candidate.
10. I have appointed the following person to act as my: TA-Campaign Treasurer ❑ Deputy Treasurer
11. Name of Tresurer or De uty Treasurer: 12.Telephone: ' 13. Email Address:
,2?ac 4 e ��/ 3� .� ���� �U��
14. Mailin A dress City: 16. State: 17. Zip ode:
344/41/ _ S/Fe oA) �d r/
53v36
18. I have designated the following bank as my (check a6propriate box): titPrimary Depository [' Secondary Depository
19. Name of B / 20. Address: /7,ehe
hiv
4/4# m--
21. Ci 22., 'my / 23. Stat 24.' i lCpde;_.
3f/ry
) A-rii
i-7 7
UNDER P NALTIES OF PERJURY, I DECLARE THAT I HAVE READ THE FOREG. G FORM FOR THE APPOINTMENT OF THE
CAMPAIGN TREASURER AND DESIGNATION OF THE CAMPAIGN DEPOSITORY AND THAT THE"F CTS STATED IN IT ARE TRUE.
26. .Signature • .c.n i' e:
25. Date:And40.5 v / �/
,X1,----
27. Treasurer's Acceptance of Appointment(fill in the bl n s a d check th propriate box)
Pp P P
I, do hereby accept the appointment designated above as:
(Please Print or Type Name)
[' Campaign Treasurer. ❑ Deputy Treasurer.
28. Date: 0 � 1/4p 29. Sig aJ - •" •a •ign l�-U ,fror Deputy Treasurer
DS-DE 9(Rev.0 .0001,
F.A.C.