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Filing Papers OFFICE USE ONLY STATEMENT OF CANDIDATE (Section 106.023, F.S.) (Please print or type) < 1\) PPLL v ( 2 f e-P -- rtr _, candidate for the office of goykyro L) f3C =4 CE-f Crth1 COnityn57o ge ; - have been provided access to read and understand the requirements of a r - ur , '�'o Chapter 106, Florida Statutes. ��` Qx rrit L x /S/ /3 Signature of Candidate te 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) PPOINTMENT OF CAMPAIGN TREASURER AND DESIGNATION OF CAMPAIGN 1 / OF Se Y DEPOSITORY FOR CANDIDATES (Section 106 021(1), F.S.) «�{ �'LfR F tE (PLEASE PRINT OR TYPE) i3 FEB `7 ull 4: 09 NOTE: This form must be on file with the qualifying officer before opening the campaign account. OFFICE USE ONLY V IECK 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 code) ke ki 14 LL llO S.C.3 c- ' 2? i;v -. 4 Telephone 5 E -mail address T3a►" nl ioJ 73G)4C1-1 ( 5 - 6( ) 732 AVli9- F2,41 , 33435` 6 Office sought (include district, circuit, group number) 7. If a candidate for a nonpartisan office, check if U aZI, CIT: T '. CbYhM l SS It Ogg, applicable: --- o - T C1. dF Glot/.OT61 ( 86404 ❑ 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 I have appointed the following person to act as my Campaign Treasurer ❑ Deputy Treasurer u Name of Treasurer or Deputy Treasurer 4</- ;k/ i i- 1 AL.L. 11 Mailing Address 12 Telephone G 10 5. G . 3 a° AVG . l eYK)ro&) 135fica FL 3.34- (s&( )732-9+26 13 City 14 County 15 State 16 Zip Code 17. E -mail address 18 I have designated the following bank as my X Primary Depository ❑ Secondary Depository 19. Name of Bank 20 Address &AA* d gm cle) cr4-- 571 L 4-S - i - IIOLs21 G 1+ Po aI) 21 City 22 County 23 State 24 Zip Code 136 t354c Poqc.`n l 3 � ,9 C-J FLb 2 rare . 3 � 1-3 UNDER PENALTIES OF PERJURY, I DECLARE THAT 1 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 Signat of andidd- /g/ / 3 x -,.� C . 27 Treasurer's Acceptance of Appointment (fill in the blanks and check the appropriate block) I, ( ' N /1 A 1_1__ , do hereby accept the appointment (Please Print or Type Name) 'signated above as Campaign Treasurer ❑ Deputy Treasurer I Q. /.5/ /3 C � , Date Signature of Campaign Treasurer or Deputy Treasurer DS -DE 9 (Rev. 10/10) Rule 1S- 2.0001, F.A.C. RESIDENCY REQUIREMENTS ke t3 1-kPLL , candidate for (Print Name) t ,S t7 L G7' 311 - of the City (Mayor /Commissioner — District #) Beach, have received, read and understand the residency requirements of Article II of the Charter of the City of Boynton Beach. 944 . (Signature of Candidate) (Da ) w' z m - "ca .-, r'w rvt ■ o ac's "N) x _ `l* up 9/27/2012 11:03 AM S: \CC \WP \ELECTION \Year 2013 \RESIDENCY REQUIREMENTS STATEMENT.doc Miscellaneous Cash Receipt °' '� NO. r CITY OF BOYNTON BEACH 7 TON 001 - 0000 - 369 -10 -00 • Account No. $ 25.00 2 -12 , 20 13 Received of Ken Hall Address 110 SW 3 Ave, Boynton Beach FL 33435 For City filing fee for the commission district III seat ' (per: BYB2RS' Jr the march 12, 2013 election Date: 612/13131 Receipt no: 147cm41 Tut tendered. Off Dept. City Clerk's Off By St $25• Ete Miscellaneous Cash Receipt Y ° q CITY OF BOYNTON BEACH No, .L� 001 - 0000 - 369 -10 -00 ti T O N 4, Account No. $ 222.57 2/12 13 - Ken Hall Received of Address 110 SW 3 Ave, Boynton Beat -h Fl 31435 For I% State Assessmefh fee for the commission di strict III Oper: B02Ra Beat for the march 12, 20134elerfiA4e: 2/2/13K Receipt no: 14723'3 "Mal tendered $222.$7 Total paveent Dept. City Clerk Off B T. Stanzione 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 �M� -FIRST NAME �DDLE NAME MAI ING ADDRESS : W � _4 VY &\C _ CITY : ZIP : COUNTY : : -.r FLJ.11))0 X3433 PrALtm J /4Ct- u,=: NAVE OF AGENCY : ri CO rT7 AME OF OFFICE OR POSITION HELD OR SOUGHT : N ,D 1-1 `h LAT' ( h1 rmSSa-lN - ■ �.. 1 Z You are not limited to the space 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 ( ust check one): 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, WHICH ARE USUALLY BASED ON PERCENTAGE VALUES (see instructions for further details). CHECK THE ONE YOU ARE USING: ❑ COMPARATIVE (PERCENTAGE) THRESHOLDS OR A 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 - p, `B-Z DESCRIPTION OF THE SOURCES OF INCOME ADDRESS 3344 l) PRINCIPAL BUSINESS ACTIVITY ph/ [ = .! eiR 4 AktiZ al,A . 731(13 - 50i11--- - .1 OJ 1D . `?G scow F 3 06 Govt ,, q Cf/a A-hvvc c g vu, l e X , ( � Souza - , )-1QO w(tZ -R6 ,- a w n U. QS 1 7 ?'7 Co l, dt413 4- i T i (ks-1 s /A V »t O( 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 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 L / /P 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 ") TYPE OF INTANGIBLE BUSINESS ENTITY TO WHICH THE PROPERTY RELATES 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 1,.: L-L$ 1‘00 1L e r'tl Y 13(hwao fief/. 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 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 IF ANY OF PARTS A THROUGH F ARE CONTINUED ON A SEPARATE SHEET, PLEASE CHECK HERE ❑ SIGNATURE (required): DATE SIGNED (required): 474:,' LC. G E C /) f r 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 you have nothing to report in a particular Local officers /employees file with the of employment. Appointees who must be section, you must write "none" or "n /a" in that Supervisor of Elections of the county in confirmed by the Senate must file prior to section(s). which they permanently reside. (If you do not confirmation, even if that is less than 30 permanently reside in Florida, file with the days from the date of their appointment. 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 are required to file by July 1st following Form 1 because of another public position Candidate file this form together with their each 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. The City of Boynton Beach r7 < City Clerk's Office r —*' 100 E BOYNTON BEACH BLVD c73 BOYNTON BEACH FL 33435 AZ (561) 742 -6060 FAX: (561) 742 -6090 = p3r. E -mail: prainitoi @bbfl.us t � � www.boynton- beach.org v n7 as 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 12, 2013 General & Special Elections will be held: Friday, February 22, 2013 © 3:00 p.m. Supervisor of Elections Warehouse 7835 Central Industrial Drive Riviera Beach, Florida RECEIPT of this notice is hereby documented: - ("7 /3 Signature Date Received DETACH IF YOU AND /OR YOUR REPRESENTATIVE(S) plan(s) to attend the Logic & Accuracy (L&A) testing on Friday, February 22, 2013, please detach and return the lower portion of this notice to the City Clerk. Signature #Attending S: \CC \WP \ELECTION \Year 2013 \INFORMATION PACKETS \L&A Testing Public Notice - For Candidate's Signature.doc Catch a Wave, Catch a Fish, Catch Your Breath - Breeze Into Boynton Beach America's Gateway to the Gulfstream �c �,�`,NICH GEAR H CANDIDATE OATH — A1/1 II: 32 NONPARTISAN OFFICE 13 FEB 2 (Not for use by Judicial or School Board Candidates) OFFICE USE ONLY OATH OF CANDIDATE (Section 99 021, Florida Statutes) I , - E HA L L. (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 1 A;1CACI C L `( e O 11m L(s T (office) I (district #) , I am a qualified elector of L, f'l C *CT'i County, Florida, (circuit #) (group or seat #) I 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 X y ( 56i ) 732- Signature of Candidate Telephone Number Email Address 1‘0 S, C. 3 AVE BOYA rA) 13G41/ F d u l D4 �'74 - Address City State Z Code Ca nd id ate's Florida Voter Registration Number (located on yo r vote information card) * 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 CH Sworn to (or affirmed) and subscribed before me this Ia day of Februar , 20 / . Personally Known `' o r �� - " ' 1 • 1 ature of Notary Public Produced Identification int, Type, or Stamp Commissioned Name of Notary Public NOTARY PUBLIC - STATE OF FLORIDA Type of Identification Produced Janet M. Prainito •• �,," •- Commission # EE028433 Expires SEP. 22, 2014 J ig) ' ' • mr ann'niNG Cfl..INC. DS -DE 25 (Rev. 5/11) Rule 1S- 2.0001, F.A.C. NTY CF LICY`TCH "EACH 13 FEB 12 AM II: NOMINATING PETITION " 2 AN 5• 02 , We the undersigned, duly qualified voters of the CITY OF BOYNTON BEACH (Sec. 2 -4 , City Code of Ordinances), do hereby nominate: 4< ALL 712 -g426 SC - E BACK roe PERS»N f#L EI1STo2'/ — to be a candidate for COMMISSIONER – DISTRICT III, City of Boynton Beach, Palm Beach County, Florida, for the term: MARCH 2013 to MARCH 2016 pursuant to the Charter and Ordinances of said City. w P' iwr" --IP pLEJ 5 1 YouQ. WsWn Rs srowN oft) Yool . voreQ RG--6tsTPr lor0 ei'RD 9 , SIGNATURE ADDRESS - ,----, t --- .) (U° Ct) Agt 62 I t.\ k*3.st-c-e ,- ■ 3L13c 4.10 - v L . 411 1J._.. g ��G mac), koi ., ,-,e,,,c, 4 .SD__sv(----- ,,k - , -. 6.-,,d, ,//7 7/ , i;,,,,„),,t.. if- ,,,,,,-- ).3 3J3-e-/35--- 1 / -. = ire AN". z _ /A0 3 1 AVE - Bo 'J Q F 3343 ,p '� _ _ = _ ., ��� L//d S tJ. � .y ✓E BA 33 23 5 I I , . r / % ✓, I % I M S1J, � U e i� 33 q3�" 0 ..a4, govstAtA, 136. Iw Ind r v ...6 , t3 3 "a� 1-1V2. £ .Fttlepiai �y,' ' f Rt. 3 1 t,),1 4- M . di : : dy . - - 1 M ' L ,tr r. ^'`‘ c ', L, � 1 ,, r r , cr ( t t NOMINATING PETITION 7A , ;F _- i 2 API 5: 02 :: f. FL We the undersigned, duly qualified voters of the CITY OF BOYNTON BEACH (Sec. 2 -42, City Code of Ordinances), do hereby nominate: I< 1 N 40....s. 712 SCE BACK FOR ReesbNptt t41 SrcNY to be a candidate for COMMISSIONER — DISTRICT III, City of Boynton Beach, Palm Beach County, Florida, for the term: MARCH 2013 to MARCH 2016 IT ! pursuant to the Charter and Ordinances of said City. --P PLE J5- . nal YOUR. N9mE 145 swownl CO Voo . VO ER R ISTRrf77o&J CiTRp •4- SIGNATURE ADDRESS SL-L'S r1N A. y "�34it / ,,JuA ii1-144, %■, ( c,,,.. , le , k, a)1,, ' - --- y- - - p �L J !74 of eil 4 (4S w lam/ 3.75.,.t 7 Ori 4krt 4. / r 4111,.. �� / 7�iv l -'t�:x [ . , �-s k> /--- j 7 4 - 21 ' S 6?-lizeit./ &emit-iv aid , ..skt'(.= - gi -- -V ...site ) 513Smac /4=- 7 Z/-- C \ '"Ara....... 11_ _41 . — - . , , ._" ' 0 -I ,- - ^ ( . -.. e. �i. //L t _ 41.6 i _A 'Y.' ' 3116 Jt Ale. /47,%? B 331<5.5" im/ / W MIER / d / /10 S a) C— ida fiV�s j),_. i■ a ka i ? ' 3 I iii 'S n:'3_ _ U / Cr' — ti 3 31'7 1 v" �-)$' art 00 ' 33 J —_ ) -- �V1 Ca "7 r9 S 10.19 - ttp0- 3 r r _ 4 �,1SJJ / ) NOMINATING PETITION ,� lr' . -- , : ,, § 5: 02 We the undersigned, duly qualified voters of the CITY OF BOYNTON BEACH (kec.'2 City Code of Ordinances), do hereby nominate: 1‹...tki / /-/4 7� 2- x'42 6 --b. SCE HACK Pak PcRSM$t E41sro2' to be a candidate for COMMISSIONER — DISTRICT III, City of Boynton Beach, Palm Beach County, Florida, for the term: MARCH 2013 to MARCH 2016 pursuant tok the Charter and Ordinances of said City. -- IP' PLCJS . 5Ig4 YOUR. M9/17E s 5 c) Vco VCTER TP1 l7c J eaRD SIGNATURE ADDRESS l" /A_3 - 1---- Fr - / l'i •- i -- . 2 ) (t' , _, � ,, ! � �> , _ . , r-- / / .J l� L Ki."- f �, / , . L v_-../..c.. � h_ ■ Q.0. x - CI-0%0 . Ai L St 4 ro 1 .. r 0 n A- `1'6 4/e3 G _ .e ..�., . , F r, , ;: 4 (_ / / - (i . , 5 c , (--L? /4 L G /3(i'l c ,'S aci)c� Li 9 St- t- bie i U' 3335 0 _, ' v /r r W e4 d L - es 2- Silo e Ae 1 iie_ M-33Y5 10 Y a `- /14 /) CI S t '- 57 5 /3, `(3 3Y3 • a.:1„ ` 1 6ctivb.,........../1 Ai ' 7 .' i i,,, a5 . • , - 74-AA-4-e-z<_ . / 6 0 ,534/35 NOMINATING PETITION „ .;;..rL We the undersigned, duly qualified voters of the CITY OF BOYNTON BEACH (Sec. 2 -' City Code of Ordinances), do hereby nominate: Ke. • ALL 71 2 - c'42 SCE BACk roe. PCRZA M 457NY to be a candidate for COMMISSIONER — DISTRICT III, City of Boynton Beach, Palm Beach County, Florida, for the term: MARCH 2013 to MARCH 2016 pursuant to the Charter and Ordinances of said City. -- PLCA5 . 51 YooR. N ?mE ,s st/avi o& YovR. vamp R tsrPm"lolJ CARD lw— SIGNATURE ADDRESS /00--V4,4 . j 3C(2' 5 S a 1,cL.e bat F c,,, 3 43 I, the undersigned, Ke.M 10.,11 , 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 Commissioner — District III for the City of Boynton Beach, Florida. / z /� )2 a Sworn to and subscribed before me at Boynton Beach, Florida, this /9 day of A.D. 20 1.3 . Received at the City Hall in Boynton Beach this f6 day of `T 20 /3 at !� 011 1, • City Clerk