Filing Papers
TO:
MATERIAL FOR CANDIDATES
S-I-e.lleN Holz..m AN
DATE: ~ -0"" -t)'l
YOU HAVE INDICATED YOUR DESIRE TO BECOME A CANDIDATE; THEREFORE, WE HAND YOU THE FOLLOWING:
1.
2.
3.
4.
5.
6.
7.
8.
9.
Poll Watcher Form & FS 101.131 - "Watchers at Polls"
/2010 Election Dates to Remember
./
d
../
10.
./
./
/'
./
/
./
/'
2010 Qualifying Information & Municipal Election Schedule
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
Form OS-DE 84 Statement of Candidate (Must be filed within 10 days after filing Campaign Treasurer
Appointment) (8/03)
State of Florida Election Laws - Chapters 99, 105 & 106 (09/05)
Guide to Sunshine Amendment & Code of Ethics for Public Officers and Employees
Directions for Posting Temporary Political Sign
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12.
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Part I Charter, Article VII. Elections - City of Boynton Beach
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Part II Code of Ordinances - Chapter 2 Administration, Article III. Elections
Blank Campaign Report Summary Sheets, Contributions Sheets & Expenditures Sheets
June 2008 Candidate Handbook for Candidates
Petition Form - Candidate for Commissioner - TO BE FILLED OUT, CERTIFIED BY SUPERVISOR OF
ELECTIONS AND RETURNED TO CITY CLERK DURING QUALIFYING
15. Form 1 Statement of Financial Interests 2009 - TO BE FILLED OUT, SIGNED & RETURNED TO THE
CITY CLERK DURING QUALIFYING
16. / L&A TESTING NOTICE (SIGN AND RETURN AT TIME OF QUALIFYING.)
17. Loyalty Oath - Oath of Candidate (DS-DE 24B)- TO BE RETURNED TO CITY CLERK DURING
QUALIFYING
18.
/
Statement of Residency Requirements & Article II of City Charter - TO BE SIGNED AND RETURNED
TO CITY CLERK
/2- 7 0;;-
Date Sig ned
Candidate Signature
I
Janet M. Prainito, City Clerk
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July 6, 2009
s:\CC\WP\ElECTION\Year 201O\MATERIAl FOR CANDATES.doc
STATE OF FLORIDA
APPOINTMENT OF CAMPAIGN TREASURER
AND DESIGNATION OF CAMPAIGN
DEPOSITORY FOR CANDIDATES
(Section 106.021(1), F.S.)
OFFICE USE ONLY
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I have appointed the following person to act as my
4. Name of Treasurer or Deputy Treasurer
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Campaign Treasurer's Acceptance of Appointment
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, do hereby accept the appointment as
% Campaign Treasurer 0 Deputy Treasurer for the campaign of SUVleh Hp I~..c~
who is seeking nomination or election as a candidate to the office of
(Party)
COI4I.A;.s.slnAJI?J \)i~,.(..-t-.......3.
UNDER PENALTIES OF PERJURY, , DECLARE THAT I HAVE READ THE FOREGOING CAMPAIGN TREASURER'S
ACCEPTANCE OF APPOINTMENT AND THAT THE FACTS STATED ARE TRUE.
12-7 -09
Date
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surer or Deputy Treasurer
OS-DE 9 (Rev. 01/08)
RESIDENCY REQUIREMENTS
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OFFICE USE ONLY
STATEMENT OF
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Each candidate must file a statement with the qualifying officer within 10 days after the
Appointment Df Campaign Treasurer and Designation of Campaign DepDsitory is filed. Willful
failure to file this form is a first degree misdemeanor and a civil viDlation of the Campaign
Financing Act which may result in a fine of up to $1,000, (ss. 106.19(1 )(e), 106.265(1), Florida
Statutes).
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APPOINTMENT OF CfJ MPAIGN TREASURER
AND DESIGNAT ON OF CAMPAIGN
DEPOSITORY fClR CAi~DIDA TES
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206 West Ocean Ave Boynton Beach FL 33435
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Boynton Beach Commission District #3
[8] Carr'Palg:l Trt:~':HIJrel 0 Deput\.. Trp.8SYt:'1
,1 Ndfl1e ')! Tr"'a'-"Ht" 'r Dep't!V -, :eClsurel
Steven Hoizman
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206 West Ocean Ave
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Campaign Treasurer's Acceptance of Appointment
Steven Holzrnan
(k i-,e~I'h\.. .'1' ''';..'' ',nt;, ;j~'i> :intn":~(lt as
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d:1UJrJ3H:.' f;,1 tnt' :lffice Of
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Boynton 3eac!1 Commission District ft.3
12-10-~ 009
UNDER PENALTIES OF PERJURY, I DECLARE THAT I HAVE BE1I'D THE FOREGOING CAMPAIGN TREASURER'S
ACCEPTANCE OF APPOINTMENT AND TyA'T THE FACTS STAT A RUE
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I Srqlvltlllfc' nf Campaign' reasure: or Uenu'(., r--;-p',1surer
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CITY OF ~OYNTON BEACH 0 CITY OF BOYNTON BEACH
*** CUSTO"ER RECEIPT *** IH *** CUSTOMER RECEIPT ***
Oper: JACKSOHZ Type: OC Drawer: 1 .&:: o era JACKSONZ Type: DC Drawer: 1
Date: 2/88/18 81 Receipt no: 137485 0 D~te; 2/88/18 81 Receipt no: 137487
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Description QuantitQ Amount Q.) ~4scriPtion "ISC~LtA~~~~S INCO"E_~01unt
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W4 MISCELLANEO S INCOME-B8l J::l
1.80 $236.78 1.00 $25.0~
Trans nUllbe-r: 4281796 0 hans nUllber: 428170
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G/L account number: J::l fill account numbe,.:
~ 00100803691800 )oj 00109093691000
.Q. .&:: Tender detail 'a ~ T ende"r detai 1
Q):t 0 CK CHECK 193 $236.78 1 J::l 192 $25.90
~ IH 0 CK CHECK
~ T ota! tende"red ~~ ;... $25.01l
~~ $236.78 0 co Total tendered
i Total paYlent Q s::: $2S.1l0
c $236.78 Q Total pay lent
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BZ ~ THANK YOU FOR YOUR PROMPT PAYMENT BZ I Q.) THANK yOU FOR YOUR PROMPT PAYMENT
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FORM 1
STATEMENT OF
FINANCIAL INTERESTS
2009
Please print ~r type your name, mailing
address, agency name, and position below:
c.
FOR OFFICE
USE ONLY:
ID Code
CITY:
ID No.
Conf. Code
P. Req. Code
3
You are not limited to the space on the lines on this form. Attach additional sheets, if necessary.
CHECK ONLY IF
CANDIDATE OR
o NEW EMPLOYEE OR APPOINTEE
**BOTH PARTS OF THIS SECTION MUST BE COMPLETED**
DISCLOSURE PERIOD:
THIS STATEMENT REFLECTS YOUR FINANCIAL INTERESTS FOR THE PRECEDING TAX YEAR, WHETHER BASED ON A CALENDAR YEAR OR ON
A FISCAL YEAR. PLEASE STATE BELOW WHETHER THIS STATEMENT IS FOR THE PRECEDING TAX YEAR ENDING EITHER (check one):
-1 DECEMBER 31, 2009 OR 0 SPECIFY TAX YEAR IF OTHER THAN THE CALENDAR YEAR:
MANNER OF CALCULATING REPORTABLE INTERESTS:
THE LEGISLATURE ALLOWS FILERS THE OPTION OF USING REPORTING THRESHOLDS THAT ARE ABSOLUTE DOLLAR VALUES, WHICH
REQUIRES FEWER CALCULATIONS, OR USING COMPARATIVE THRESHOLDS, WHICH ARE USUALLY BASED ON PERCENTAGE VALUES (see
instructions for further details). PLEASE STATE BELOW WHETHER THIS STATEMENT REFLECTS EITHER (check one):
o COMPARATIVE (PERCENTAGE) THRESHOLDS OR 0 DOLLAR VALUE THRESHOLDS
PART A - PRIMARY SOURCES OF INCOME [Major sources of income to the reporting person]
(If you have nothing to report, you must write "none" or "n/a")
/ 01:;'
PART B -- SECONDARY SOURCES OF INCOME [Major customers, clients, and other sources of income to businesses owned by the reporting person]
(If you have nothing to report, you must write "none" or "n/a")
NAME OF NAME OF MAJOR SOURCES ADDRESS PRINCIPAL BUSINESS
BUSINESS ENTITY OF BUSINESS' INCOME OF SOURCE ACTIVITY OF SOURCE
PART C -- REAL PROPERTY [Land, buildings owned by the reporting person]
(If you have nothing to report, you must write "none" or "n/a")
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.
OTHER FORMS you may need
to file are described on page 6.
CE FORM 1 - Eft. 112010
(Continued on reverse side)
PAGE 1
1111,
LOYALTY OATH
OFFICE USE ONLY
(Sections 876.05-876.10, Florida Statutes)
NON-PARTISAN OFFICE
STATE OF FLORIDA
COUNTY OF ~
First Name
~ (LiA, .
Middle~mellnitial
~ L 1:. MIA/V)
I,
S~e;\I€Jn
Last Name
a citizen of the State of Florida and of the United States of America, and being [a candidate for public office] do
hereby solemnly swear or affirm that I will support the Constitution of the United States and of the State of Florida.
Important: If elected, a candidate must retake the loyalty oath as specified in s. 876.05, Florida Statutes, and that oath shall be
filed with the records of the governing official or employing governmental agency prior to the approval of payment of salary,
expenses, or other compensation.
I,
OATH OF CANDIDATE
(Section 99.021, Florida Statutes)
&l~Vf:N HVL-Z::MAN
(PLEASE PRINT NAME AS YOU WISH IT TO APPEAR ON THE BALLOT -- NAME MAY NOT BE CHANGED AFTER THE END OF QUALIFYING)
I
3
am a candidate for the non-partisan office of
; I am a qualified elector of
~ (office)
(k V'v\ (2ea (~
(district)
County, Florida;
(circuit) (group)
I am qualified under the Constitution and the Laws of Florida to hold the office to which I desire to be nominated or
elected; by executing this form, I have taken the oath required by ss. 876.05-876.10, Florida Statutes; I have
qualified for no her public office in the state, the term of which office or any part thereof runs concurrent with the
office I see' an I have res' ned om any office from which I am required to resign pursuant to Section 99.012,
Florida St u
~
) State
ZIP Code
Produced Identification:
ign ure of Notary Public - State of Florida
! Prin Type, or Stamp Commissioned Name of Notary Public
'\...
OTARY PUBLlC.STATE OF FLORIDA
'"'''' J M P . .
,l:\~\ anet . ramI to
\'!1II.i Commission # DD592173
...,.....' Expires: SEP. 05,2010
BONIl!ill THRlJ ATIA"iTIC 1l0NDING CO., L"iC.
day of
Sworn to (or affirmed) and subscribed before me this 8
Personally Known:
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Type of Identification Produced:
OS-DE 25 (Rev. 11/09)
I1I1
The City of Boynton Beach
City Clerk's Office
100 E BOYNTON BEACH BLVD
BOYNTON BEACH FL 33435
(561) 742-6060
FAX: (561) 742-6090
www.boynton-beach.org
PUBLIC NOTICE
TO: CANDIDATES, POLITICAL PARTIES AND OTHERS
NOTICE IS HEREBY GIVEN that the Logic & Accuracy (L&A) testing of the
voting equipment to be used in the March 9, 2010 General Election will be
held:
Friday, February 19, 2010 at 3:00 p.m.
Supervisor of Elections Office
240 South Military Trail
West Palm Beach, FL 33415
RECEIPT of this notice is hereby documented:
/ -" l, '-i..r /0
Date Received
-----------------------------------------------------
-----------------------------------------------------
(Detach)
IF YOU AND/OR YOUR REPRESENTATIVE(S) planes) to attend the logic & Accuracy
(l&A) testing on Friday, February 19, 2010, please detach and return the lower portion
of this notice to the City Clerk.
Signature
Number Attending
9/9/2009 9:06 AM
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Palm Beach County
SUSAN BUCHER
Supervisor of Elections
240 SOUTH MILITARY TRAIL
WEST PALM BEACH, FL 33415
POST OFFICE BOX 22308
WEST PALM BEACH. FL 33416
TELEPHONE: (561) 656-6200
FAX NUMBER: (561) 656-6287
WEBSITE: www.pbcelections.org
CERTIFICATION
I, SUSAN BUCHER, SUPERVISOR OF ELECTIONS, for Palm Beach County, Florida, do
hereby certify that the 30 signatures on the Nominating Petition for CITY COMMISSION,
DISTRICT NO.3 of STEVEN HOLZMAN 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 STEVEN C. HOLZMAN is a registered voter in Precinct 7128,
in the City of Boynton Beach, Florida.
Signed, this the 29th day of January, 2010.
~~
, .. .
SUSAN BUCHER
SUPERVISOR OF ELECTIONS
PALM BEACH COUNTY
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PART D - INTANGIBLE PERSONAL PROPERTY [Stocks, bonds, certificates of deposit, ete 1
(If you have nothing to report, you must write "none" or "n/a")
TYPE OF INTANGIBLE
BUSINESS ENTITY TO WHICH THE PROPERTY RELA':-ES
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PART E - LIABILITIES [Major debts]
(If you have nothing to report, you must write "none" or "n/a")
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NAME OF CREDITOR v l"" ~
I I
ADDRESS OF CREDITOR
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PART F - INTERESTS IN SPECIFIED BUSINESSES [Ownership or positions in certain types of businesses]
(If you have nothing to report, you must write "none" or "n/a")
BUSINESS ENTITY # 1 BUSINESS ENTITY # 2
BUSINESS ENTITY # 3
~
NAME OF BUSINESS ENTITY
ADDRESS OF BUSINESS ENTITY
PRINCIPAL BUSINESS ACTIVITY
POSITION HELD WITH ENTITY
I OWN MORE THAN A 5%
INTEREST IN THE BUSINESS
NATURE OF MY
OWNERSHIP INTEREST
ROUGH F ARE CONTINUED ON A SEPARATE SHEET, PI.,EA,SE CHECK HERE 0
DATE SIGNED (required):
SIGNATURE (required):
0/0
FILING INSTRUCTIONS:
WHERE TO FILE:
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.
Local officers/employees file with the Supervisor
of Elections of the county in which they perma'
nently reside. (If you do not permanently reside
in Florida, file with the Supervisor of the county
where your agency has its headquarters.)
State officers or specified state employees
file with the Commission on Ethics, P.O. Drawer
15709. Tallahassee, FL 32317-5709; physical
address: 3600 Maclay Boulevard, South, Suite
201. Tallahassee, FL 32312.
Candidates file this form together with their
qualifying papers.
To determine what category your position
falls under. see the "Who Must File" Instructions
on page 3.
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 employ-
ment. 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 for publicly-elected local oftice
must file at the same time they file their
qualifying papers.
Thereafter, local officers/employees. state
officers, and specified state employees are
required to file by July 1 st following each
calendar year in which they hold their posi-
tions.
WHAT TO FILE:
After completing all parts of this form, including
signing and dating it, send back only the first
sheet (pages 1 and 2) for filing.
If you have nothing to report in a particular
section, you must write "none" or "n/a" in that
section(s).
Facsimiles will not be accepted.
NOTE:
MULTIPLE FILING UNNECESSARY:
Generally, a person who has filed Form 1 for a
calendar or fiscal year is not required to file a
second Form 1 for the sarne year. However, a
candidate who previously filed Form 1 because
of another public position must at least file a copy
of his or her original Form 1 when qualifying.
Finally, at the end of oftice or employment,
each local officer/employee, state officer, and
specified state employee is required to file a
final disclosure form (Form 1 F) within 60 days
of leaving office or employment
PAGE 2
CE FORM 1 - Eft. 1/2010
NOMINATING PETITION
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We the undersigned, duly qualified voters of the CITY OF BOYNTON BEACH, do
hereby nominate:
~-Le "Je V\
\-\6 \ LJ-V\.~
to be a candidate for City Commission, DISTRICT NO.3 City of Boynton Beach,
Palm Beach County, Florida, for the term:
MARCH 2010
to
MARCH 2013
pursuant to the Charter and Ordinances of said City.
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ADDRESS
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I, the undersigned,
Ste\/e.n HOL-ZMA '"
, do solemnly swear
(or affirm) that I am duly qualified to hold office under the Charter and Ordinances of the
City of Boynton Beach, Florida, and I do hereby accept the foregoing nomination as a
candidate for the office of City Commissioner for the City of Boynton Beach, Florida.
/27 --; ~f--
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Sworn to and subscribed before me at Boynton Beach, Florida, this !J
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day of ']0 t>u Uta A.D. 201 V
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Received at the City Hall in Boynton Beach this L day of ..jt!~
201(,) at 1,.':3 A.M.
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Janet M. Prainito, CMC
" City Clerk
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SICCIWPIELECTIONIYear 201 OIDistrict 31PETITION . Nominating Petition. DISTRICT 3 doc
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CERTIFICATE OF ELECTION
CITY OF BOYNTON BEACH, FLORIDA
THIS IS TO CERTIFY THAT STEVEN HOLZMAN was, on the 9th day of March,
2010, duly elected to Public Office from the said City of Boynton Beach, for the
three-year term of Commissioner - District 3 beginning March 16, 2010 through
March, 2013.
WITNESS my hand and the corporate seal of said City of Boynton Beach, this
16th day of March, 2010.
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S:\CC\WP\ELECTION\year 2010 Candidates\District 3\Steven Holzman\certificate of election. doc
OATH OF OFFICE
I, STEVEN HOLZMAN, DO SOLEMNLY SWEAR OR AFFIRM THAT I WILL SUPPORT,
PROTECT AND DEFEND THE CONSTITUTION AND GOVERNMENT OF THE UNITED
STATES, THE STATE OF FLORIDA AND THE CITY OF BOYNTON BEACH; THAT I AM DULY
QUALIFIED TO HOLD OFFICE UNDER THE CONSTITUTION AND LAWS OF THE STATE
AND THE CITY OF BOYNTON BEACH; AND THAT I WILL WELL AND FAITHFULLY
PERFORM THE DUTIES OF CITY COMMISSIONER OF THE CITY OF BOYNTON BEACH,
FLO~DA. jP_ $r
DATED this 16TH day of March, 2010
-
STATE OF FLORIDA )
COUNTY OF PALM BEACH )
) 55.:
The foregoing instrument was acknowledged before me this 16th day of March,
2010 by Steven Holzman. He is personally known to me or has produced
as identification.
~Yn.P~
l!!!;jRY PUBLIC
Janet M. Prainito
Print or Type Name
My Commission Expires: 09/05/2010 Commission No.
DD592173
NOTARY PUBLlC-ST/uE OF FLORlDA
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