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Filing Papers COREY kgAV 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 witn 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. 4 ,Z 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. ✓ 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 Ct 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 OF QUALIFYING.) 18. ✓ Loyalty Oath - Oath of Candidate (DS - DE 24B) TO BE RE i URNED TO CITY CLERK DURING QUALIFYING RECEIVED BY: { /$/' (Hate Signature Date Signed 4111 .=1 11 . PtorlIKL‘k et M. Prainito, MMC ' ity Clerk October 18, 2012 S: \CC \WP\ELECTION \Year 2013\MATERIAL FOR CANDATES.doc 1:n/ TRICE APPOINTMENT OF CAMPAIGN TREASURER ' i r ICE A DEPOSITORY T FOR CANDIDATES SN 1 3 JAN ~9 AM s ' 00 (Section 106.021(1), F.S.) (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 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 CORY BRIAN KRAVIT code) 4210 KEY LIME BLVD., BOYNTON BEACH, FL 4. Telephone 5. E -mail address 33436 (561 ) 893 -0042 6. Office sought (include district, circuit, group number) 7. If a candidate for a nonpartisan office, check if CITY COMMISSIONER - DISTRICT IV applicable: ID 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 ❑ No Party Affiliation ❑ Party candidate. 9. I have appointed the following person to act as my © Campaign Treasurer ❑ Deputy Treasurer 10. Name of Treasurer or Deputy Treasurer LARRY ELLMAN 11. Mailing Address 12. Telephone 2505 PRINCETON COURT ( 954 ) 629 -6712 13. City 14. County 15. State 16. Zip Code 17. E -mail address WESTON BROWARD FL 33327 LTEPROCONSULTING@AOL.COM 18. I have designated the following bank as my © Primary Depository ❑ Secondary Depository 19. Name of Bank 20. Address WELLS FARGO 5131 CONGRESS AVE. 21. City 22. County 23. State 24. Zip Code BOCA RATON PALM BEACH FL 33487 UNDER PENALTIES OF PERJURY, 1 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 /8/ I 3 x 27 Treasurer's Acceptance of Appointment (1 in the blanks and check the appropriate block) 1 a e r)f 111 ' , do hereby accept the appointment (Please Print or Type Name) designated above as in Campaign Treasurer ❑ Deputy Treasurer. 1 / Date Signature of Campaign Treasurer or Deputy Treasurer DS -DE 9 (Rev. 10!10) Rule 1S- 2.0001, F.A.C. 4 { RESIDENCY REQUIREMENTS w --t � s • -rr rY k ' , candidate for (Print Name) Co- 7/,- -1 ∎5S o/ c -- of the City „c (Mayor /Commissioner — District #) S.,, , , Beach, have received, read and understand the residency requirements of Article 11 of the Charter of the City of Boynton Beach. ature of Candidate) (Date) 9/27/2012 11:03 AM S: \CC \WP \ELECTION \Year 2013 \RESIDENCY REQUIREMENTS STATEMENT.doc ° i f YCC-`S 041 Y;,LACH STATEMENT OF , = arc CANDIDATE 13 JAPE -9 AM 9: 00 (Section 106.023, F.S.) (Please print or type) 1, CORY KRAVIT , candidate for the office of C. �y 66 - rM , SS 0 ■ / D, i ]f, < f -V J- - , have been provided access to read and understand the requirements of Chapter 106, Florida Statutes. X " _ _ / 1 g /?3 Signature of Candidate 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) °'t Y °'� Miscellaneous Cash Receipt n CITY OF BOYNTON BEACH NO. �+�� � = r 0 U 4. 5" rO N 0 Account No. OO1- 0000 - 369 -10 -00 • $ 222.57 '-// 1 ,20 Received of CORY RRAVIT Address 4210 REY LIMB BLVD., BOYNTON BEACH, FL 33436 For 1% State Assessment Fee for the District IV Commission 6 p seat for the March 12, 2013 elect, 111 F,_ pr t . '�a�ai t flexed 14 et ' T ta TI t • $ Dept City Clerk' Office By 1 A r► _% FORM 1 STATEMENT OF 2012 Please print or type your name, mailing 1 FINANCIAL INTERESTS I address, agency name, and position below: FOR OFFICE USE ONLY: LAST NAME -- FIRST NAME -- MIDDLE NAME : 4 V; — Co/ /y $1e, `t-, MAILING ADDRESS : 4z» )< fT� Soy - 0 {Y�-■ 3 ;4 ?6 l-/ 11 4 co CITY : ZIP : COUNTY : NAME OF AGENCY : NAME OF OFFICE R POSITION HELD OR SOUGHT : tt You are not limited to the sp e on the lines on this form. Attach additional sheets, if necessary. CHECK ONLY IF CANDIDATE OR ❑ 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(mu check one): �J' DECEMBER 31, 2012 OR ❑ 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, WHI ARE USUALLY BASED ON PERCENTAGE VALUES (see inst uc •ns for further details). CHECK THE ONE YOU ARE USING: 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, you must write "none" or "n /a ") NAME OF SOURCE SOURCE'S DESCRIPTION OF THE SOURCES OF INCOME ADDRESS PRINCIPAL BUSINESS ACTIVITY �uZ3� ti `f� �c e M . 5i 136,'x. g li-4" /�• (.4v r , '^'t 4 10 A t- Ara i fc. v41 ,Inc . Inc . I I Hob-e ro:, s .,Q IFD ' rcti; 4t4am, 1 �, �O^tt 140 )4.11; f)LCL 1 i (iss -I ft -JO ,Ir 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 f M.5 } i Assoc, (05 - 5n; + f 3 /v9. ta.c\,„ ett ft-+I CI( - rfc P., Lt4yr, tsE -itts )40 4-, q o is C., « hi„). #! /of ( rinc 3f - 1 ovy►cr.J tlss' 1-4o .- ( PART C -- REAL PROPERTY [Land, buildings owned by the reporting person - See instructions] FILING INSTRUCTIONS for (If you have nothing to report, you must write "none" or "n /a ") when and where to file this CW64 7c,.,71 Id VV:0 �CYn -- "A � -6' I j 33s/ 3 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 - Effective: January 1. 2013. Refer to Rule 34- 8.202(1), F.A.C. (Continued on reverse side) PAGE 1 PART D — INTANGIBLE PERSONAL PROPERTY [Stocks, bonds, certificates of deposit, etc. - See instructions] (If you have nothing to report, you must write "none" or "n /a ") SEA- TYPE OF INTANGIBLE BUSINESS BUSINESS ENTITY TO WHICH THE PROPERTY RELATES -)- �..L E � � � Awl" / r ' }-? ck PART E — LIABILITIES [Major debts - See instructions] (If you have nothing to report, you must write "none" or "n /a ") NAME OF CREDITOR ADDRESS OF CREDITOR i ,�t 7i s fi-r7r) e- �y�yT� P v o,� b4o 4:5 / T( 757 G /4 kt 5 �. ,,�— C-�� s 1 �.6a�c 740 , /it.Jdel 5 PART F — INTERESTS IN SPECIFIED BUSINESSES [Ownership or positions in certain types of businesses - See instructions] (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 J 1,4 ADDRESS OF BUSINESS ENTITY I �/ PRINCIPAL BUSINESS ACTIVITY POSITION HELD WITH ENTITY I OWN MORE THAN A 5% INTEREST IN THE BUSINESS NATURE OF MY OWNERSHIP INTEREST IF ANY OF PARTS A THROUGH F ARE CONTINUED ON A SEPARATE SHEET, PLEASE CHECK HERE ❑ SIGNATURE (require • F DATE SIGNED (required): Z//o//3 �_- FILING INSTRUCTIONS: WHAT TO FILE: WHERE TO FILE: WHEN TO FILE: After completing all parts of this form, If you were mailed the form by the Commission Initially, each local officer /employee, including signing and dating it send back on Ethics or a County Supervisor of Elections state officer, and specified state employee only the first sheet (pages 1 and 2) for filing. for your annual disclosure filing, return the must file within 30 days of the date of form to that location. his or her appointment or of the beginning If nothin ou have report of employment. by th Appointees who t must be t y nothing to p ort i n a particular Local officers /employees file with the fi fil section, you must write "none" or "n /a" in that Supervisor of Elections of the county in cononfirmationrmed e ena e mus e prior to , even if that is less than 30 c section(s). which they permanently reside. (If you do not days from the date of their appointment. permanently reside in Florida, file with the y NOTE: Supervisor of the county where your agency Candidates for publicly - elected local office MULTIPLE FILING UNNECESSARY: has its headquarters.) must file at the same time they file their Generally, a person who has filed Form 1 State officers or specified state employees qualifying papers. for a calendar or fiscal year is not required file with the Commission on Ethics, P.O. Thereafter, local officers /employees, state to file a second Form 1 for the same year. Drawer 15709, Tallahassee, FL 32317 -5709. officers, and specified state employees However, a candidate who previously filed required to file by July 1st following Form 1 because of another public position C file this form together with their e ach calendar year in which they hold their must at least file a copy of his or her original qualifying papers. positions. Form 1 when qualifying. To determine what category your position falls Finally, at the end of office or employment, under, see the "Who Must File" Instructions on each local officer /employee, state officer, and page 3. specified state employee is required to file a final disclosure form (Form 1 F) within 60 days Facsimiles will not be accepted. of leaving office or employment. However, filing a CE Form 1F (Final Statement of Financial Interests) does not relieve the filer of filing a CE Form 1 if he or she was in their position on December 31, 2012. PAGE 2 "IF B:) rN I oN BEACH CANDIDATE OATH — NONPARTISAN OFFICE 13 fEB H AM 8: 34 (Not for use by Judicial or School Board Candidates) OFFICE USE ONLY OATH OF CANDIDATE (Section 99 021, Florida Statutes) 1, Cory k✓Av, *1 (PLEASE PRINT NAME AS YOU WISH IT TO APPEAR ON THE BALLOT * -- NAME MAY NOT BE CHANGED AFTER THE END OF QUALIFYING) am a candidate for the nonpartisan office of C' 47 Co e ✓ (office) (district #) , I am a qualified elector of P4 1 Pr f to c , County, Florida, (circuit #) (group or seat #) 1 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 (5 511( - 6 - 04 Co✓yKy- t,41 C�aj." --• Signature of Candidate Telephone Number Email Address 4? I0 ke L, Mt R1()) ' 1 9 07 , 1 /0*, 131,c 303l Address City State ZIP Code Candidate's Florida Voter Registration Number (located on your voter information card) 1 \ 1 gi7 4 1 Please print name phonetically on the line below as you wish it to be pronounced on the audio ballot for persons with disabilities (see instructions on page 2 of this form) STATE OF FLORIDA COUNTY OF 1 1 .%1 get. Sworn to (or affirmed) and subscribed before me this /1 day of _ , 2013 �. Personally Known or —. AU •�� ture of Notary Public Produced Identification t, Type, or Stamp Commissioned Name of Notary Public Type of Identification Produced DS -DE 25 (Rev 5/11) Rule 1S- 2.0001, F.A.C. ' dd VOTER CARD • PALM BEACH COUNTY, FLORIDA o, ••�: TARJETA ELECTORAL, CONDADO DE PALM BEACH, FLORIDA REGISTRATION NUMBER REGISTRATION DATE PRECINCT Numero de Inscripcion Fecha de Inscripcion Distrito Electoral 111876477 06-17 -2002 3164 KRAVIT, CORY B 4210 KEY LIME BLVD BOYNTON BEACH FI, 33436 Signature of V • - Firma • - • tante 05/26/1980 RE] rOL C HERE DCBLE AQUI ' OUR PRECINCT NUMBER Su Numero de Distrito Electoral 3164 YOUR POLLING LOCATION Su Centro Electoral CITRUS COVE ELEMENTARY 8400 LAWRENCE RD BOYNTON BEACH YOU ARE ELIGIBLE TO VOTE FOR A REPRESENTATIVE IN EACH DISTRICT LISTED USTED PUEDE VOTAR POR UN REPRESENTATVE DE CADA DISTRITO NOMBRADO US CONGRESS STATE SENATE STATE HOUSE Congreso de los EE UU Senado del Estado Camara de Diputados del Estad 22 34 90 COUNTY COMMISSION SCHOOL BOARD MUNICIPALITY Comislon del Condado Junta Escolar Munlcfpaldad 3 4 BB REGISTRATION NO ► 111876477 • NUMERO DE INSCRIPCh SUSAN BUCHER • SUPERVISOR OF ELECTIONS / SUPERVISOR DE ELECCIONE ,cfc. F UGAL S � u Palm Beach County OF PAS 240 SOUTH MILITARY TRAIL WEST PALM BEACH, FL 33415 POST OFFICE BOX 22309 WEST PALM BEACH, FL 23416 SUSAN BUCHER Supervisor of Elections TELEPHONE [581) 656 -6200 FAX NUMBER C561) 656 -6287 WEBSITE www pbcelections org CERTIFICATION I, SUSAN BUCHER, SUPERVISOR OF ELECTIONS, for Palm Beach County, Florida, do hereby certify that Cory Kravit submitted 30 petition signatures for the office of Boynton Beach City Commission, District IV. I further certify that 25 of those signatures are registered electors in the City of Boynton Beach, according to the registration records on file in this office. This is to further certify that Cory B. Kravit is a registered voter in Precinct 3164, in the City of Boynton Beach, Florida. Signed, this the 30th day of January, 2013. SAN BUCHER SUPERVISOR OF ELECTIONS PALM BEACH COUNTY co c- er rn (SEAL) °? ;lap rn, 1 ' _....U∎ 4 vrfeCE NOMINATING PETITIOI 3 FEB 11 AM 8: 34 We the undersigned, duly qualified voters of the CITY OF BOYNTON BEACH (Sec. 2 -42, City Code of Ordinances), do hereby nominate: c r y K ,I,,'4_ to be a candidate for COMMISSIONER — DISTRICT IV, City of Boynton Beach, Palm Beach County, Florida, for the term: MARCH 2013 to MARCH 2014 pursuant to the Charter and Ordinances of said City. - SIGNATURE ADDRESS -` 1 CM i � liA / t;fr �'1 k I,; ; l- 4 ( �� F U( boa ((0 / V 3yS ,S - �L t t hi RP 3313 � l , . _ `' 5. k v Y� W S 4147 life y71 emeA,FI Z6 i d i Pi 4* `' i ' ' ' 600 14 IA a 1/5- A1',' � y a��ik 41 gC ,fir4itt.-4(5 3'591 li vt I/.i ���.. 3N56 f ri , Q� � t iti } , 2 °5 VVC(1 (111,�, ' i1g/d 301peicii a eik,l pgy i.A9 ikificH2,f I (1 Z �,-,%� ) ' i n z o S / c' J ) . ✓1 M dpi /r? j�r--�, j3c ) , -1 _' `y_ 3 iNj S' 6 t * 4 3 V( 1 /T 3:3 36 <.i (9- 1 -14)) S -- v lily 13 - c i D, ,3 oyi� l �8 cf, f-� ,/ ' r /,, /y �c v -:- ja: -I .A * Ye/ S 1 r,... -k etii BJhh 4�e.,kPL3 /1,,n/ 1., „i . tD , r 1 s, /I 7'; , . ,, J L f � , . z ,_ ” _ '1'f cs+ --- ` / �� �.rr % f ��L u' 'fi / VOW ' i _ i ilA / 43KA ?AV 1 b M ii-A ibt-fikoi33 M LLI //3gtf pitw . i.'D ,1 ON ' 33 q ■ u " k,v05 9 /�.�az ei G , D, / A is Lt, r) : 3 ?3C v . / 3 I / J 3 .6' 7r;' ''✓ 1 ''l� ) 6''',/' 1 ; , ' /- s L/3 6 i, '''t,i, c t 1 6„4„ ' It - ----, v2, t , ,,a �t .. i \- ,;, \ k,. . h , , rZ At 31, Sl 8 , r, 1 l� � ,ik4 we /i S'iys A. - .. ' !.&:. ! .. ,, ... e g9ff Ho/writ/it' � i� /71 ,F IIMI itii l - / 1 i -7= -A r\-11- P "� l 10 1 (4 7 L �c • �' � ;3$34 &'` A T -,� --_ � l 7 k ✓, ,I- ¢ Z to K c �' ma �� �-, � - rx,A, 531.34 -7 i Act �`f r �n �f Li I C no v r4 l / c, d ill yy►.titoki l,ERc4 33436 I 7io -5 2 74h Ter,, 13 33 it/LIA/ ! I K-e. 61a' �7���r�ta.. ��,c C, 33 Y,1� l'aLUI i I 'y 6)vd, • ; 4S\ c \ 34 rc :�� ( C c J Z-1 Ci �3 r.. CJI C V ) - acs -*; z I, the undersigned, CAD R [L-F) AV iT , 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 COAMi 56icnef- 1)iSrp,ic - TV Ma for the City of Boynton Beach, Florida. Sworn to and subscribed before me at Boynton Beach, Florida, this / 1 day of Y Q A.D. 20 / 3 . ( 9.-x-44At)Yn .� Received at the City Hall in Boynton Beach this / 1 day of ✓ A.M. 20/3 at 8: 50 02-411-t)W) . A ... (-_, ., - -_ , . t ) City Clerk Sit c")- Y �Q z rn S \CC \WP \ELECTION \Nominating Petition - Special Election doc