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Filing Papers Miscellaneous Cash Receipt 01 v CITY OF BOYNTON BEACH No. 771.18 A U ~ TO N 0 001-0000-369-10 Account No. a 259.26 2/i. 13 Received of Cliff Montross Address 109 SW 18th St Boynton Beacii t.,A 33426 For 1% state assessment fee for the mayor at large seat Oper: BY`B2IX5 for the March 12, 2013 Election Date: 2/12/13 81 . keceipt no: 147174 Total tendered $259.2G Dept. Cit Clerk By Stanzione a nt $259.26 Miscellaneous Cash Receipt ' Y ` CITY OF BOYNTON BEACH - -= No. c U ~ TON Account No. 001 -0000- 369 -10 -00 s 25.00 ,20 .L1 Received of Cliff Montross Address 109 SW 18 St Boynton Beach FL 33426 1 For city filing fee for the Mayor seat for March 12, 2013 %' Oper: BYB2IXS ' election Date: 2/12/13 81 Receipt no: 147175 Total tendered $3"5.68 Total a ®ent $25.86 Dept. City Clerk By 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 NAME -- FIRST NAME -- MIDDLE NAME : MAILING ADDRESS : y © 0, Sfit,? `F //% 57 • r -►� rsj CITY :V ZIP : COUNTY : � C� O ,� 2 rt R NAME OF AGENCY : cj rri NAME OF OFFICE OR POSITION HELD OR SOUGHT : 1 yb e P/A o 3 P ^ 1 , &47e You are not limited to the space/on the lines on is form. Attach additional sheets, if necessary. CHECK ONLY IF ❑ CANDIDATE OR ❑ NEW EMPLOYEE OR APPOINTEE * *'F* 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 (must 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: X ' 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 SOURCE'S OF INCOME ADDRESS .044- AyT PRINCIPAL BUSINESS ACTIVITY • N.) Silf7 )71%(5)0. z?` • G ,� . 26 NJ hilt., oC f9iuSio/'s1'-aspx2i5G�f r/ 4 C�rbyc,t?i✓Hr�ivi YCR izDA% R7V -si0>1 • / ?,/2 P�1,. x S77! hi,m) Ae 33'0 7"t� l Cep ,Sr. &/// S C ece/ /d' /5516 /4.61 L;t/ c•9 .� P%? 5 /A1 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 J6.4 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 109' Si l ; S /, 4/4s1i�1 , Gyf / ,5 ova,06 -S� .∎ie form are located at the bottom � / 1/ of page 2. fi4, 2 11 -1 ,/, �; ~ /'/ 7'54 /34 Z/D ;11 C 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 P 1#efrt p rigT e O&J, e-s$ 4/4 ,'pro,, 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 A(6 �� ADDRESS OF BUSINESS ENTITY f PRINCIPAL BUSINESS ACTIVITY POSITION HELD WITH ENTITY 1 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): 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 signina and datina 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 C 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 uali in To determine what category your position falls q fy g 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. rlArNr- The City of Boynton Beach ,-c v o,.. City Clerk's Office .' 100 E BOYNTON BEACH BLVD w - BOYNTON BEACH FL 33435 ; t-, (561) 742-6060 CO 7 -1 0 P FAX: (561) 742 -6090 —" N / 0 S. J Yj E -mail: prainitoj @bbfl.us www.boynton - beach.org --' C CaY 0 _il PU BLIC NOTICE "� p �rn Jr r'7 c�� 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: Sig ture 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 5: \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 _ ,, F ER 1 sc,,;eEM CANDIDATE OATH NONPARTISAN OFFICE v 2 AM/0: 04 (Not for use by Judicial or School Board Candidates) OFFICE USE ONLY OATH OF CANDIDATE (Section 99.021, Florida Statutes) I C4 /flit M,rnTRosS (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 AlFy0R • A $'c C) 18D74'4JY St d%, r4' (office) (district #) ; I am a qualified elector of �In 45 � 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. Sig ure /10,4-044/ f Candidate Telephone Number Email Address /09 sty /97n/ sT c/ Be yZ &, 7af& 33 yAG Address City State ZIP Code Candidate's Florida Voter Registration Number (located on your voter information card): 3142 * 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): C LI F r D "IODS STATE OF FLO A COUNTY OF 111- -! } i LJC I - 1- Sworn to (or affirmed) and subscribed before me this 11 day of /i&tAtf , 20 /3 . Personally Known: or G Signature of otary Public Produced Identification: Fk A.L. Prir4 Type�or sio�ed rla�e gj NQta4 Public ` ^►►� , / 4 , DEOKIE POONAI I Q Type of Identification Produced: /Cam ( 10 S r Z 4 - - Nk 1 r. Notary Public - State of • da \ / s .s • My Comm. Expires Sep ' 15 I ��o. �;: Commission # EE 1 : • DS -DE 25 (Rev. 5/11) Rule 15- 2.0001, F.A.C. INSTRUCTIONS: INSERTING PHONETIC SPELLING OF CANDIDATE'S NAME FOR AUDIO BALLOT Use the PRONUNCIATION KEY below to provide pronunciations for ambiguous first names and surnames. Capitalize STRESSED syllables, use lower case for unstressed syllables. Use dashes ( -) to separate syllables. You should also add any notes such as rhyming examples, silent letters, etc. Samples: PRONUNCIATION KEY Stressed Vowel Sounds NAME ON BALLOT PRONOUNCED AS EE (FEET) feet (FIT) M Mishaud mee -SHO (•d' is silent) E (BED) bed A (KAT) cat (KAD) cad Jahn HAHN (rhyme: fawn) AH (FAH -thur) father Beauprez boo -PRAT (rhyme: hooray) (PAHR) par AH (HAHT) hot (TAH- Maniscalco man- uh- SKAL -ko dee) toddy UH (FUHJ) fudge Tangipahoa TAN- ji- pah -H0 -uh (FLUHD) flood Monte Mahn -TAI UH ( CHUHRCH) church AW (FAWN) fawn Tanya TAWN -yuh (not TAN) U (FUL) full 00 (FOOD) food OU (FOUND) found O (FO) foe El (FEIT) fight Al (FAIT) fate 01 (FOIL) foil Y00 (FYOOR- ee -uhs) furious Unstressed Vowel Sounds uh (SO -fuh) sofa (FING- guhr) finger Certain Vowel Sounds with R AHR (PAHR) par ER (PER) pair IR (P1R) peer OR (POR) pour OOR (POOR) poor UHR (PUHR) purr Consonant Sounds B I (BED) bed TS (ITS) its (PITS - feeld) Pittsfield D (DET) debt TH (THEI) Thigh F (FED) fed TH (THEI) Thy G (GET) get ZH (A- zhuhr) azure (VI- zhuhn) vision H (HED) head Z (GOODZ) goods (HUH - buhz -tuhn) Hubbardston HW (HWICH) which J (JUNG) jug K (KAD) cad L (LAIM) lame M (MAT) mat N (NET) net NG (SING -uhr) singer P (PET) pet R (RED) red S (SET) set T (TEN) ten ✓ {VE Y (YET) yet W (WICH) witch CH (CHUCRCH) church SH I (SHEEP) sheep NOTE: T e ling officer. Page 2, DS -DE 25 (Rev. 5/11) Rule IS- 2.0001, F.A.C. •t p -0 s t de . ; go .. l�%%_ = Palm Beach County of PAS 240 SOUTH MILITARY TRAIL WEST PALM BEACH, FL 33415 POST OFFICE BOX 22309 WEST PALM BEACH, FL 33416 SUSAN BUCHER Supervisor of Elections 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 Cliff Montross submitted 40 petition signatures for the office of Mayor of the City of Boynton Beach. I further certify that 29 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 Cliff Montross is a registered voter in Precinct 3192, in the City of Boynton Beach, Florida. Signed, this the 8th day of February, 2013. -n < (7) rn _ r c3 r*z c) S AN BUCHER�`=� SUPERVISOR OF ELECTIONS = ,) PALM BEACH COUNTY 9 7 ,1c.i --rn (SEAL) NOMINATING PETITI c LE. 13 FEB 12 0110 : 0 14 We the undersigned, duly qualified voters of the CITY OF BOYNTON BEACH (Sec. 2 -42, City Code of Ordinances), do hereby nominate: 4/n" 114W /R oj1' f S. iv. ,8 %H. Bo 43 P4 . 33 Y2 4 to be a candidate for MAYOR AT -LARGE 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. ,� ►. ADDRESS "'A.!•Il1511/ v.n 5 rcr F 8 .1 1-53 - CO 1 r Lam_ , . N_ 1 _ k� N W ' A 0A _J610144C1 ��. I on 4 $Cl 33 4: 4 41 „200 0 . So P 1 it) / ,13 79 iN1 --SC) Kay ae ech 1-1 nag bA-01) s 1 4c., --4.41 I t a' KO 69 15(5 -9.4410t1' "t4A 7/ 5 4/ /I t B n&A'.•rC C 11 Vlvc 06.e 3v 3. 4 34tc. �� d�► J coy 5'(r jvw . �-i 33y0 l 4's 6 " ) . I WY Lfoz SG-> 3 ra s-r )3/g 33 � `1 w1&k T) oQ L1 15 e l" ter~ !16 ' L e - X2(1 � - Y) 1 3 ,76 yea do 10 I/Sir (94:," v r C 3 2—Al 0.Ay 1 Alre6C7 r efiLka/Ce/C- (4( - 3 4(d N E asM rpic 8 . • 13 FEB t 2 Al »: 04 NOMINATING PETITION We the undersigned, duly qualified voters of the CITY OF BOYNTON BEACH (Sec. 2-42, City Code of Ordinances), do hereby nominate: eivir /14twidtars ih 9 SWJ181H c'7 Bp yd71. &NA', / . ti to be a candidate for MAYOR AT -LARGE 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, 3 VP 4€_±1 ' • , ,,lo3q C 6 D• 3 'r a,iiillet. ' /-d... .�..� / & g, I''"g4 >J ./ Z 10/ 4SS' SW 3R,D NE 33 e ., c , 1 j . j a - M c� f .1. a_ 3393 " - -. t ont4kAD R4 frc 11 R II i (a 0 bir N' ,f, . • _ s t b - 8 (3 Si4) g J 33(11 4. CS � 7T4- 13 9 S6 QM 4 ve. 33 Y .S^ A \-c)or t Lo CI-La 1 cA- 3,3`4,7--L7 zsr_2t „ VS �t a7 3 ,ht.) / 35 �C / a�. u//a cam- 3r ter c,„....,, .' 1 3 og S w 3 Zi •►� � � �- i � � t �"G 1. � ,� C ac. , ♦ ��- C L � 1 �- r_ 4. „, , G r NOMINATING PETITION73 FEB 12 Alf 10: 04 We the undersigned, duly qualified voters of the CITY OF BOYNTON BEACH (Sec. 2-42, City Code of Ordinances), do hereby nominate: 24 + eZtif.r ;OP Ste. s.1 Jarrow ira4,f,�ir. J34' 6 to be a candidate for MAYOR AT -LARGE City of Boynton Beach, Palm Beach County, Florida, for the term: MARCH 2013 to MARCH 2016 pursuait to the Charter and Ordinances of said City. ijJJb , OeirS 020 rs'a g� oPtiumE KoarkarWEek &o SST ri►2 $14 33 l S' 4 X2.20 Rk S de 1 - 2-bt o yw 6 - c 4 b. e `lx(, GOAPA 47ihrie y/7 vd- t 1 ;_tro/ C) c. ! e cd s 0,isvaa 144 Amy 180Yeraiiti OPAciq Or eto , �% zA4,44-4•%-- ?f S,t, 47 � ` , 3 `( ..?)we nt, rroi 052- If1; 09 -1KJE 1711 a lv :;1 g OP)iz/ .d7/+�, 33 A ar C. Res /MD rA ! 6 6 I 1 Sow rri - rri co i N.) - t - - - c) r1 4 2Q) ittf/ 1;4- I, the undersigned, c 1 t c il O n i ROSS , 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 Mayor At -Large for the City of Boynton Beach, Florida. r -\ f,-; Sworn to and subscribed before me at Boynton Beach, Florida, this IA day of „ A.D. 20 /3 . • Received at the City Hall in Boynton Beach this /o1 day of de h/ LA_i , A.M. d 20 13 at 'q! 35 do r • . City Clerk CYJ ) f N _ 1 -- Sza \ shrdata \cc \wp \election\nominating petition doc CD C A