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Filing Papers MATERIAL FOR CANDIDATES YOU HAVE INDICATED YOUR DESIRE TO BECOME A CANDIDATE; THEREFORE, I 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 INDICATING YOUR INTENT TO RUN 4. ✓ Residency Requirements (rc be filled out and returned to City Clerk) 5. _ ✓ Form DS - DE 84 Statement of Candidate & copy of Chapter 106, Florida Statutes (Must be Bled with Q ty Clerk within 10 days after filing Appointment of Campaign Treasurer - Intent ) 6. ✓ State of Florida Election Laws - Chapters 99, 105 & 106 (2012) 7. ✓ Guide to Sunshine Amendment & Code of Ethics for Public Officers and Employees , - - rn 8. � Directions for Posting Temporary Political Sign as W 7 9. ` City Commission District Map 1 : 10. Part I Charter, Article VII. Elections - City of Boynton Beach - 72 2 . r 11. Part II Code of Ordinances - Chapter 2 Administration, Article III. Elections ry 12. ✓ / Poll Watcher Form & FS 101.131 - "Watchers at Polls" 13. ✓ 2014 Public Campaign Financing Handbook 14. ✓/ Candidate Petition Handbook 15. Blank Campaign Report Summary Sheets, Contributions Sheets & Expenditures Sheets 16. i/ Petition Form - Candidate for Commissioner - TO BE FILLED OUT, CERTIFIED BY SUPERVISOR OF ELEC1 IONS AND RE 1 URNED TO CITY CLERK DURING QUALIFYING 17. ✓ Form 1 Statement of Financial Interests 2009 - TO BE FILLED OUT SIGNED & RE 1 URNED TO THE CITY CLERK DURING QUALIFYING 18. L&A TESTING NOTICE (SIGN AND RETJRN AT TIME OF QUALIFYING ) 19. ✓Loyalty Oath - Oath of Candidate (DS - DE 24B) TO BE RE 1 URNED TO CITY CLERK DURING QUALIFYING RECEIVED BYT) 2 tank" Signature Cam-' gth ' • R Gt-cLit) et M. Prainito, MMC ity Clerk 114/2013 3.47 PM S: \CC \WP \ELECTION \Year 2014 \Information Packets \MATERIAL FOR CANDATES doc 1 RESIDENCY REQUIREMENTS 0 r c) n r 1 "*i M 41 1 T h� CD rT RL I, c° , candidate for Print Na b c (i i (Print e) ' ) , � G. t 1Lt 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. --� (Sign_. reofC • e) 016 11/12/2013 12:31 PM S: \CC \WP \ELECTION \Year 2014 \Information Packets \RESIDENCY REQUIREMENTS STATEMENT.doc "I EIN..('c ? (''r.' APPOINTMENT OF CAMPAIGN TREASURER AND DESIGNATION OF CAMPAIGN 13 DEC -3 P11 4: 02 DEPOSITORY FOR CANDIDATES (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 if HECK 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 A (in � clude post office box or street, city, state, zip C C - cod 4 / )? 9 phone / 5 E -mail addre s 33 --- 66 / qc - /.3 42/bee,g/ VIP 0%. 44 16 1 0A) c 44 14# i 6. Office sought (include district, circuit, gr6up numb t) 1 7 If a candidate for a nonpartisan office, check if Di_57-iturg /S3`/0N applicable: t ❑ 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 El Write -In gl 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 piny Tr�� rer 11 Mailing Address ( / / r /� 12 Telephone 866 /dieliV 067 q , / a/)0 - //93 City ' •oun - 15 St 16 Zip Code 17 E -mail address P i ,,ifil . 1:.:12 i t'll Ift. ... Yi Me ' d. i e ,,f,' 18 have designated the following bank as my 0 Primary Depository ❑ Secon• -ry Dep• itory 19 a � of_ 6 /� 20 � � g s s� + --., ff-cti‘ 6 ,r� 21 Cit 2 o my 23_,Sta 2 C e ilh, 14 .1? UNDER PEN LTIES OF PERJURY, I DECLARE THAT I HAVE READ THE FOREGOING FORM FOR APPOINTMENT OF CAMPAIGN TREASURER AND DESIGNATION OF CAMPAIGN DEPOSITORY AND THAT THE FACTS STATED IN1 UE. 25-Date 26 Signature of - to ..--- . r re �� i /,/ ,� ' 27 Tre sure s Acc ance of Appointment�(fj L wine blanks and check the appropriate block) /4/9-c I, t "4 , do hereby accept the appointment (Please Print fr Type Name) . .. desi ated above as Er Campaign Treasurer Et._. ty T -- ?. ji; i C911 a Date - ignature of - mpaign Treasurer or Deputy Treasurer DS -DE 9 (Rev. 10/10) Rule 1S- 2.0001, F.A.C. 1- (1) 1 1— 1 - z co 0 w N co c - d W EC 0 Q 2 Q ct 0 0 2 0 N N r N co N N N N O 2 m O 0) M CO Cr) -J LL 0 W m Z 0 H Z 0 CO N CO m m CO 00 co N to wp t gli STATEMENT OF CANDIDATE 13 DEC 10 PM 12: 41 (Section 106.023, F.S.) (Please print or type) 1, candidate for the office of Ma7 (Silk/ �rV " have been provided access to read and understand the requirements of Chapter 106, Florida Statutes. r c7(j 4 1nr C- - • Ida - 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) OF p y Pcedal ` _ Palm Beach County Op pp�. m 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 41 signatures on the Candidate Petitions for MACK MCCRAY, City of Boynton Beach, Commissioner District II, 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 MACK MCCRAY is a registered voter in Precinct 7182, in the City of Boynton Beach, Florida. Signed, this the 15th, day of January, 2014. S N BUC ER SUPERVISOR OF ELECTIONS rn PALM BEACH COUNTY tv a (SEAL) Le - °' CANDIDATE PETITION Notes: - All information on this form becomes a public record upon receipt by the Supervisor of Elections -1t is a crime to knowingly sign more than one petition for a candidate [Section 104 185, Florida Statutes) 1 0 - If all requested information on this form is not completed, the form will not be valid as a Candidate Petition form. evl I, ' L- r✓ o f '__ So the undersigned, a registered voter ( (print name as it appears on your vo er information card),,, in said state and county, petition to have the name of ] U ]�ci_ tin ` c L ! �j `- placed o the Primary/General Election Ballot as a [check/complete box, as applicable] onpartlsan ❑ No party affiliation ❑ Party candidate for the office of LI (X 114 ak'i ii--5 onk-lz--- __1);_51'tuc - Tr -4.4-' (insert title of office and include district, circuit, group, seat number, if applicable) Date of Birth or Voter Registration Number Address (MMIDDIYY) j 1 W. 6 /6 C``- ti7--T" C un State Zip Code Atio_ 6 ti N i3 i- - 35'y.-C --- Signature of Voter Date Signed (MM /DD/YY) Ito be completed by Voter) • tai-- �_\ .z 2.__ / y /y Rule 1S- 2.046, F.A.C. OS-DE 104 (Eft. 09(11) — t ! DS:DE 104 (Eff. 09/11) CANDIDATE PETITION , / Notes: - All information on this form becomes a public record upon receipt by the Supervisor of Elections \/ `� - It is a crime to knowingly sign more than one petition for a candidate [Section 104 185, Florida Statutes] ," - If all requested information on this form is not completed, the form will not be valid as a Candidate Petition form. I, 0 i 4 I✓ , c_ k Alr G t ,, the undersigned, a registered voter (print n -me as it appears on your vote, r ir�fo rr�ation, -rd) n in said state and county, petition to have the name of w`\ ` `/�i t placed on a Pnmary/General Electron Ballot as a [check/complete box, as applicable] onpartisan ❑ No party affiliation ❑ , Party candidate for the office of L LO /14 155i i LL L T I - (insert title of office and include district, circuit, group, seat - number, if applicable) Date of Birth or Voter Registration Number Address (MMlDD/YY) /1 d-1 1 1 5 UP N, 5 - 41 7 5 - kz 4 "-" ( C• C n State Zip Code i24.,kc..tf - 5 66 1 1 OW ilq-Ure)(4-- FLt - 33 L(',-, Signature of Voter Date Signed (MM /DDIYY) n f to be completed by Voter] Y) l' . , c Rule 1S- 2.045, F .C. DS -DE 104 (EH. 09/11) CANDIDATE PETITION Notes: - All information on this form becomes a public record upon receipt by the Supervisor of Elections n ' - It is a crime to knowingly sign more than one petition for a candidate. [Section 104 185, Florida Statutes] uV - If all r: o uested information on this form is not completed, the form will not be valid as a Candidate Petition form. I, /. If , Plf / A— / the undersigned, a registered voter . (print na e as it - ;pears . your •ter informatiy / /' I J in said state and ccunty, petition to have the name of / /// A . , / L �� r placed on the Primary/General Election Ballot as a [check/complet. b• applic :ble) unpartisan ❑ No affiliation ❑ _ Party candidate for the office of Ak / ,,,, a 3 , ii€ it 7 ) L s ( insert title of office and includict, cir u , group, seat number, if applicable) Date of B' h or Voter Registrati n Number 1 Address Zlit (MM /DD // 7 � �C rP 4 (/ 3 /a ( Co St� Zip de � dti Signature of Voter Date Signed (MM /DD/YY) - _ KC.__ '115)/ [to be c plete 1Vot Rule 1S -2 046, F.A.C. DS - 104 (Eff. 09/11) CANDIDATE PETITION Notes: - All information on this form becomes a public record upon receipt by the Supervisor of Elections - It is a crime to knowingly sign more than one petition for a candidate [Section 104 185, Florida Statutes] \ )( - If all requested information on this form is not completed, the form will not be valid as a Candidate Petition form. I C Wh 1 U Z -r3 'L the undersigned, a registered voter ( name as it appears on your va(77 for abo rd) in said state d county, petition to have the name of I - 1 1 C (L placed the Primary/General Election Ballot as a [check/complete box, as applicable) Nonpartisan ❑ o party affiliation 0 Party candidate for the office of (-; 0- fkiN 63)Mj 7 0; (insert title of office and include district, circuit, group, seat' number, if applicable) Date of Birth or Voter Registration Number Address (MM /DDNY ) 11 ‘ -11. 3. q 6 5 15 i ,w, 54-' 64v- _ ,.., City , n CA4n 1 Stat Zip ode ?tee , t 6x-ii,'/( • Signature of Voter Date Signed (MMIDD/YY) '- to be completed by V Rule 1S- 2.045, F.A.C. DS -DE 104 (Eff. 09/11) CANDIDATE PETITION Notes: - All information on this form becomes a public record upon receipt by the Supervisor of Elections l -11 is a crime to knowingly sign more than one petition for a candidate [Section 104 185, Florida Statutes] v - If all requested information on this form is not completed, the form will not be valid as a Candidate Petition form. V I, 3-0 5 m a e& a g e -f the undersigned, a registered voter Y (print name as it appears on your vo�nforcard� 7 In said state and ounty, petition to have the name of placed on t Primary/General Election Ballot as a [check/complete box, as applicable] C_) onpartisan ❑ No party affiliation ❑ Party candidate for the office of ,` 6 6 £x,0/2-- - 3; 477,--e_.---1-- ----- (insert title of office and include district, circuit, group, seat number, if applicable) Date of Birth or Voter Regisstratiioon / Number A dress C� _ p . 3 N . kj, Ci f rA ittY 1'V\ State Zip 7:•d3r,.....------ V , Signature of Vote Date Signed ( d VYY) l � t /l � [to be completed by y Voter] U ( / / J /y G p 41'61 '4 Rule 1S•2.045, F.AC. DS -DE 104 (Eft 09/11) CANDIDATE PETITION Notes: - All information on this form becomes a public record upon receipt by the Supervisor of Elections - It is a crime to knowingly sign more than one petition for a candidate [Section 104 185, Florida Statutes] - If all requested information on this form is not completed, the form will not be valid as a Candidate Petition form. J c A4- K, ivtL the undersigned, a registered voter (print name as it appears on your voter irOrmationioard) in said state and county, petition to have the name of C NzA placed o he Primary/General Election Ballot as a [check/complete box, as applicable] onpartisan No party affiliation E3 Party candidate for the office of (\. 'N-(11 • C/0 WA; 71/ (insert title of oifice and include district, c it, group, seat number,lapplicable) Date of Birth or Voter Registration Number Address (MM/DD) 1 Piq city 7 State Zip C ' 6) 1 11\rigi\J ba-4—f ruflyhiv • atur Voter Date Signed (MM/DD/YY) cky [to be completed by Voter] 1 — Rule 1S-2.045, F A.C. D DE 104 (Eff. 09/11L CANDIDATE PETITION Notes: - All information on this form becomes a public record upon receipt by the Supervisor of Elections i - It is a crime to knowingly sign more than one petition for a candidate [Section 104 185, Florida Statutes] - If all requested information on this form is not completed, the form will not be valid as a Candidate Petition form. ; ' t ,/ i I, -Kg �'\r L.0 K' IX t • G,K the undersigned, a registered voter J V ( not name as l it appears on your voter informs o card) J in said state an county, petition to have the name of �A (\C6� �� JI v `' placed o e Primary/General Election Ballot as a [check/complete box, as applicable] unpartisan 0 No party affiliation El Party candidate for the office of C; C 0 tkl Al`i S r 11N- 7), S`C-W a' (insert title of office and include distnctrtircurt, group, seat number, if applicable) Date of Birth or Voter Registration Number Address Ai, ' I (MM /DDNY) 1! l II g l6 I I frV , 5 `J -- r/ � c . nt y + , State Zip Code 6 � r)v, Signature o�er [ be Signed ompleted by Voter] �4! __ ,Z _. .fs / / /1 Rule 15-2.045, F A C. DS -DE 104 (EN. 09/11) CANDIDATE PETITION Notes: - All information on this form becomes a public record upon receipt by the Supervisor of Elections -11 is a crime to knowingly sign more than one petition for a candidate [Section 104185, Florida Statutes] - If all requested information on this form is not completed, the form will not be valid as a Candidate Petition form. I, ? Z.. the undersigned, a registered voter ,� (print name as it spioears on your voter i format' card) in said state and county, petition to have the name of l� n C-g-A placed the Primary/General Election Ballot as a [check/complete box, as applicable] Nonpartisan ❑ No party affiliation ❑ Party candidate for the office of 0 .--t N./t-f CIO Rilk -.' 6 - 1LC- -- e - - 0-- (insert title of office and include district, circuit, group, seat number, if applicable) Date of Birth or Voter Registration Number Address ( 3, ---1 YY) f ,,, N.1,4/ 9 - ----=- - C. Co ty State Zip Code Signature of Voter Date Signed (MM /DD/YY) [to be completed by Voter] (SDa- `''N".e.,- `Z. \ —C4 — ( C( Rule 1S- 2.045, F A.C. DS -DE 104 (EH. 09/11) CANDIDATE PETITION Notes: - All information on this form becomes a public record upon receipt by the Supervisor of Elections - It is a crime to knowingly sign more than one petition for a candidate [Section 104185, Florida Statutes] - If all requested information on this form is not completed, the form will not be valid as a Candidate Petition form. I, l pJIA f the undersigned, a registered voter K (print name as it ap ears on your vote information card) in said stat; and county, petition to have the name of ! " ( - K ► 1 • c—RA y placed • the Primary/General Election Ballot as a [check/complete box, as applicable] ILIP, onpartisan ❑ No party affiliation ❑ Party candidate for the office of C �L -d fl P 65I d AILI_ `� — rki c—r (i s ert title of office and include district, circuit, group, seat number, if applicable) Date of Birth or Voter Registration Number Number Address / (MM /DDlYY) j `X / l I 3 7v, l`(/ � = - - -r( - - City 4 Con ■ State Zip Code 13 01f (44 ) Q-/I - C4 - ( FOltli\ rein\c-A- Signature of Voter Date Signed (MM /DD/YY) [to be completed by Voter] � C / —o 3 -/ Rule 1S- 2.046, F A.C. DS -DE 104 (Eff. 09/11) CANDIDATE PETITION Notes: - All information on this form becomes a public record upon receipt by the Supervisor of Elections - It is a crime to knowingly sign more than one petition for a candidate [Section 104185, Florida Statutes] - If all requested information on this form is not completed, the form will not be valid as a Candidate Petition form. k i k r I, c V n 1' : 1Al W , © ©,/,+- -p J the undersigned, a registered voter (print name as it appears on your voter information card) in said state and county, petition to have the name of I V l a sc fu(' e__ �__ A y place on the Primary/General Election Ballot as a [check/complete box, as applicable] Nonpartisan ❑ No party affiliation ❑ Party candidate for the office of Wl t `jrbA)0-- -- Dr SriziC (insert itle of office and include district, circuit, group, seat number, if applicable) Date of Birth or Voter Registration Number Address / , / U (MM /DD/YY) I l (4.1 /� p ( (U LTV E `t City County State Zip Code 6 L (INI - 1 6 fd -14C--)(4 A- 13L/1--cf( -FL- :3 Signature • f Voter Date Signed (MM /DD/YY) [to be complet d by Voter) y 4 L,r1_ L.::)Crc Rule 1S -2.0 ■•, F.A.C. DS -DE 104 (Eff. 09111) CANDIDATE PETITION Notes: - All information on this form becomes a public record upon receipt by the Supervisor of Elections l -1t is a crime to knowingly sign more than one petition for a candidate [Section 104 185, Florida Statutes] V - If all requested information on this form is not completed, the form will not be valid as a Candidate Petition form. I '.. 1, - ,, Ly ., -- D� , ) G L (-r--0/J the undersigned, a registered voter (print name as it appears on your voter information card) G �.Z in said state and county, petition to have the name of ( (A � cj placed on t e Pnmary/General Election Ballot as a [check/complete box, as applicable] onpartisan ❑ No party affiliation ❑ Party candidate for the office of Z.- t 6_ Ya(/� 55 ,` 6 NW � t 5.2L ( `ZC_ (insert title of office and include district, circuit, group, seat number, if applicable) Date of Birth or Voter Registration Number Address ((a C3 CCU � t7--- Ai, RI , , t - C County State Zip Code Ddro 7 PA-1-11-L f-569-e-{1 ILL 3 ( i i""S .- S e of Vot�,r Date Signed (MM /DD/YY) / _ [to be completed by Voter] R - .046, F.A.C. DS -DE 104 (EH. 09/11) CANDIDATE PETITION Notes: - All information on this form becomes a public record upon receipt by the Supervisor of Elections - It is a crime to knowingly sign more than one petition for a candidate [Section 104 185, Florida Statutes] 1.) - If all requested information on this form is not completed, the form will not be valid as a Candidate Petition form. ', r i, 6 �� L. [Uk (-L a ` - - J the undersigned, a registered voter u (print name as it appears on your voter information card) in said state and county, petition to have the name of (Lk 6- f ( (--- placed on the Primary/General Election Ballot as a [check/complete box, as applicable] unpartisan ❑ No party affiliation ❑ Party candidate for the office of C lt4( U 1 ilk 1 i O Ai Lt - j); 5 TT C- --_ (insert title of office and include district, circuit, group, seat number, if applicable) Date of Birth or Voter Registration Number Address �� �y �� r ,, / (MM /DD/YY) I ( 3c.00 it . RI c " ` L' J % vim (l v 4-cT /, County State Zip Code d U �To N rt—kt PA- Ln/1 A F L . 3 6(3. Signatur of Voter _ / Date Signed (MM /DD/YY) C u [to be cum eted b Voter] r 2 ( 13 l y' Rule 1S- 046, F.A.C. DS -DE 104 (Eff. 09/11) CANDIDATE PETITION Notes: - All information on this form becomes a public record upon receipt by the Supervisor of Elections - It is a crime to knowingly sign more than one petition for a candidate [Section 104 185, Florida Statutes] VV - If all requested information on this form is not completed, the form will not be valid as a Candidate Petition form. ri I, meQ 11)- `) f -i- the undersigned, a registered voter (print name as it appears on your v /t / 1 1 /c 1 r formatign card in said state and county, petition to have the name of 'III e, e32-45, placed the Primary/General Election Ballot as a. [check/complete box, as applicable] Nonpartisan ❑ o party a liation ❑ Party candidate for the office of Et. ,...i .b ilk 114 i _S ' ( 611)6 ; 511Z-I cr 0 --- (insert title of office and include district, circuit, group, seat number, if applicable) Date of Birth or Voter Registration Number Address 1 O (MMIDD/YY) i lq 1 tg c IV id / 02,- C piit: h State Zip Cod ‘ 6 0 riV fe10\T- , ,11A &Wk. V , 34 nv 6 Signature of Voter Date Signed (MM/DD/YY) [to be completed by Voter] ,..' 1A-Z16. ( - - - - A r Al./(71c— 1 / I, i /A (7 Rule 1S- 2.045, F.A.C. DS -DE 104 (Eff. 09/11) CANDIDATE PETITION Notes: - All information on this form becomes a public record upon receipt by the Supervisor of Elections -11 is a crime to knowingly sign more than one petition for a candidate [Section 104 185, Florida Statutes] 1 - If all requested information on this form is not completed, the form will not be valid as a Candidate Petition form. I, ,I IT REa- fr■ Q r ((i) . 1 - -T b e the undersigned, a registered voter I (print name as it appears on your vot r 1 formaard) �� in said state and county, petition to have the name of placed on the Primary/General Election Ballot as a [check/complete box, as applicable] onpartisan ❑ No party affiliation ❑ Party candidate for the office of 1 (insert title of office and include district, circuit, group, seat number, if applicable) Date of Birth or Voter Registration Number Address (MM /DD/YY) i �i� a G / / LOO} �, C 3 6J -(- -- City C my State Zip Code ' rirctii) t .....—(1o(4 V ril e).-c(9-...)(4 PC, 7,3e( '-- ig k tack ature of Voter 0 Date Signed (MM /DD/YY) `'� [to be co pleted y Voter] : l ' 1 L I► •r o f C A i L i" Rule 1S- 2.045, F.A.C. DS -DE 104 (EH. 09/11) CANDIDATE PETITION Notes: - All information on this form becomes a public record upon receipt by the Supervisor of Elections - It is a crime to knowingly sign more than one petition for a candidate [Section 104 185, Florida Statutes] - If all requested information on this form is not completed, the form will not be valid as a Candidate Petition form. I ) l ir f n,, Lvve_ /1 the undersigned, a registered voter (print name as it appears on your voter information, rd) l in said state and county, petition to have the name of A G (11 placed o he Primary/General Election Ballot as a [check/complete box, as applicable] Nonpartisan ❑ No arty affiliation ❑ Party candidate for the office of 6 Lw at ii , 0 Iva- 4( 6+7--< (insert title of office and include district, ci cult, group, seat number, if applicable) t Date f Birt or Voter Registration Number Address f Ig 3 g3 ( (q( / L( /0 N. wi s 3 _ T – f— ci ti j & Co • / / State Zip Code it-k-- ie\ 33y33 17 of Voter Date Signed (MM /DDIYY) [to be co plet by Voter] Rule 1S- 2.046, F A.C. /40.-4-4,. 7 DS -DE 104 (EH. 09/11) CANDIDATE PETITION Notes: - All information on this form becomes a public record upon receipt by the Supervisor of Elections - It is a crime to knowingly sign more than one petition for a candidate [Section 104185, Florida Statutes] - If all requested information on this form is not completed, the form will not be valid as a Candidate Petition form. I, C - 6-Trz -1 NE T the undersigned, a registered voter 1/ (print name as it appears on your voter information card) 77�� in said state and county, petition to have the name of I V I l ` �(~ 1 ' � C_ly placed on the Pnmary/General Election Ballot as a [check/complete box, as applicable] partisan ❑ No party affiliation ❑ Party candidate for the office of (insert title of office and include district, circuit, group, seat number, if applicable) Date of Birth or Voter Registration Number Address (MM/D,D/YY) , 1 LOO N, City ( '- C State Zip Code , rri -e go Signature of Voter Date Signed (MM /DDIYY) (14,6 [to/ c mpt d /Voter] o( tq . y Rule 1S- 2.045, F.A C. DS -DE 104 (Eff. 09/11) CANDIDATE PETITION Notes: - All information on this form becomes a public record upon receipt by the Supervisor of Elections - It is a crime to knowingly sign more than one petition for a candidate [Section 104 185, Florida Statutes] - If all requested information on this form is not completed, the form will not be valid as a Candidate Petition form. I, -----(72_pci IV __04--di--2'. __04--di--2'. the undersigned, a registered voter I (print name as it appears on your voter informatl� card) i �� in said state nd county, petition to have the name of , C' C PCC placed o he Primary/General Election Ballot as a [check/complete box, as applicable] unpartisan ❑ No party affiliation ❑ Party candidate for the office of (insert title of office and include distr cuit, group, seat number, if applicable) Date of Birth or Voter Registration Number Address P C / C u ty State Zip �j /J fix)`` rc Signature of Voter , Date igne (MM /DDIYY) [to be o p ted by Voter] Rule 1S•2.045, F A.C. DS -DE 104 (EN. 09/11) CANDIDATE PETITION Notes: - All information on this form becomes a public record upon receipt by the Supervisor of Elections - It is a crime to knowingly sign more than one petition for a candidate [Section 104 185, Florida Statutes] - If all requested information on this form is not completed, the form will not be valid as a Candidate Petition form. I, �� '1/ the undersigned, a registered voter / (pr(nt name as it apper on your v C inform i n card) 1 i1 in said state nd county, petition to have the name of - l f / en r Election Ballot as a [check/complete l placed the Primary G e al e [ ecWcomplete box, as applicable] unpartisan JJ II o party affiliation ❑ Party candidate for the office of X 1 1 41/6 x-51 bNe -- 1 5- 6 - (insert title of office and include district, circuit, group, seat number, if applicable) Date of Birth or Voter Registration Number Address /DD/ (MMYY) 1 \ , ✓ tr Ct c W41/1)- % "4'( -- ,,,, C c ty State Zip / code _ i , Sirature of V ter rvJ {� ` 6/ Date Signed (MM /DD/YY) t�J, � [to be co p/et by Vote / r) 7 J / , Rule 1S- 2.046, F.A.C. DS -DE 104 (EH. 09111) CANDIDATE PETITION Notes: - All information on this form becomes a public record upon receipt by the Supervisor of Elections - It is a crime to knowingly sign more than one petition for a candidate [Section 104 185, Florida Statutes] - If all requested information on this form is A is notcompleted, the form will not be valid as a Candidate Petition form. I ' L ' j 2 5 �n7 �.�`foVSFi 0 , the undersigned, a registered voter (print d ame as it appears on your vatiarnformati card) An in said st. e and county, petition to have the name of c cp1 place. •n the Primary/General Election Ballot as a [checx/complete box, as applicable] IS Nonpartisan ❑ o party affiliation ❑ psi / Party candidate for the office of d i A i < : 9 6 k — J - 7 ) \ 141 (insert title o '. ice and include district, circuit, group, seat number, if applicable) ^ Date of Birth or Voter Registration umber Address (MM /DD/YY) j l P•c 135 _!1 q (\) , i'o ` r 3 , ty , Stet Zip C de t 1 1 l\- i If t-1 itA i\.--' ., S natur Voter 1 Date (MM /DDIYY) / [to be competed b V er] / — Rule 1S- 2.046, F A.C. DS -DE 104 (Eff. 09/11) (MM /D /YY) ?-p d(� �-q ��v r t Ci / Col Sta Zi Code / V ___..- r 0 Signature of Voter Date Signed (MM /DD/YY) [to be completed b Voter) / , 1/ 17 (.-- C ( r ( 1 7 / Rule 1 - 2.046, F.A.C. DS -DE 104 (Eff 09/11) CANDIDATE PETITION Notes: - All information on this form becomes a public record upon receipt by the Supervisor of Elections - It is a crime to knowingly sign more than one petition for a candidate [Section 104185, Florida Statutes] J - If all requested information on this form is not completed, the form will not be valid as a Candidate Petition form. 1/ / 1 34 vy p _ G the undersigned, a registered voter (Orin t name as it app ars on your vo Y A - r formati ri card) I� ft-c4:____ � in said s to and county, petition to have th name of AA ( U-- ft) place on the Primary/General Election Ballot as a [check/complete box, as applicable] Nonpartisan ❑ o party affil' tion ❑ Party candidate for the office of 0.:1 (*A I “ --, DI 4 c-r r (insert title of office and include district, circuit, group, seat number, rf applicable) Date of Birth o Voter Registration Number /� Ache ; _ 1 (MM /DD/YY) 1 . 7 e �, 4. ,_, ti Ci�t n ^ State Zip Cod 3 Signature of Voter ( Date Signed (MM/DDIYY) 71 l) t-g 61- t I 6) 14- G , [to be completed by Voter) Rule 1S- 2.046, F A.C. DS -DE 104 (Eff. 09/11) CANDIDATE PETITION Notes: - All information on this form becomes a public record upon receipt by the Supervisor of Elections. - It is a crime to knowingly sign more than one petition for a candidate [Section 104 185, Florida Statutes] 1 - If all requested information on this form is not completed, the form will not be valid as a Candidate Petition form. II i I, OF 1 M17� the undersigned, a registered voter 0 (print name as it appears on your vot i ormation = r.) in said to and county, petition to have the name of ( /� 44 place-/ the Primary/General Election Ballot as a [check/complete box, as applicable] L% Nonpartisan ❑ No 1 arty affiliation ❑ Party candidate for the office of / 6)14/ G/Vel-- - Di \ 3fKi Cr 1--- .7 (insert title of office and include district, circuit, group, seat number, if applicable) Date of Birth or Voter Registration Numb Address (MM /DD/YY) 1 I d 4 1 � / n I--/ id e -- 9 5-7 ------ City . Cou State Zip Code / wi, Signatu e of Voter '--- r Date Signed (MM /DD/YY) t [to be complete y Voter) 1 ( Rule 1S- 2.046, P.A.C. DS -DE 104 (Eff. 09/11) CANDIDATE PETITION Notes: - All information on this form becomes a public record upon receipt by the Supervisor of Elections - It is a crime to knowingly sign more than one petition for a candidate [Section 104 185, Florida Statutes] - If all requested information on this form is not completed, the form will not be valid as a Candidate Petition form. I Ifi MEI:7-e_ y �� the undersigned, a registered voter (print na e as 1 a.pears on your vot i for atio rd w It - in said state and county, petition to have the name of � .A. O____IZALo placed,. the Primary/General Election Ballot as a [check/complete box, as applicable] Li onpartisan ❑ No party affiliation ❑ Party candidate for the office of 0 ,,,:l . ' , el--- i 1 l ` -iG ` - (insert title f o ce and include distn , ircuit, group, seat number, if applicable) Date of Birth or Voter Registration N mber Address A (MM /DDIYY) D Q I I 5 9d — +'J � f � L Cq,jy State Zip Co ilc . 1 s .? it4 ,/ Signature of Voter Date Signed (MM /DD/YY) i /i i i iii 4 % [to ile completed by Voter] - ( I. ( Rule 15- 2.046, F.A.C. DS -DE 104 (EH. 09/11) CANDIDATE PETITION Notes: - All information on this form becomes a public record upon receipt by the Supervisor of Elections -11 is a crime to knowingly sign more than one petition for a candidate [Section 104 185, Florida Statutes] - If all requested information on this form is not completed, the form will not be valid as a Candidate Petition form. \./ r I .M1 E` 1,E - _ C the undersigned, a registered voter (. int name as it appears on your v informa o card �J in said state an county, petition to have the name of 7 ic ,' � (" � placed o e Primary/General Election Ballot as a [check/complete box, as applicable] Nonpartisan ❑ No party affiliation ❑ Party candidate for the office of l flg 1 `lr 1, t "o Ne_12 -- --- l 5 tar / (insert ti le office and include district, circuit, group, seat number, if applicable) Date of Birth or Voter Registration Number Address cf (MM /DD/YY) L 1301o1P- �� 4 ( /" J - ti (9 N 5 4 6 C 1 Cit•4 Coun �j ,y State Z C�o t" i �l'_'' � � ✓114 ✓ s y t Signature of Voter Date Signed (MM/DD/YY) [to be completed by Voter] Rule 1S•2.046, F A.C. DS -DE 104 (Eff. 09/11) CANDIDATE PETITION Notes: - All information on this form becomes a public record upon receipt by the Supervisor of Elections ) - 11 is a crime to knowingly sign more than one petition for a candidate [Section 104 185, Florida Statutes] , - If all re, _ ested information on this form is not / completed, the form will not be valid as a Candidate Petition form. i / I, C � [ ( the undersigned, a registered voter i pn t name as it a•''ea on • , ur vot-r in o at d) in said state and county, petition to have the name of . if i•.AF- Jj • placed on the Primary/General Election Ballot as a [check/compl:te box, as appbcabte} p Nonpartisan ❑ No party affiliation ❑ Party candidate for the office of �r "Sp tle /t lt f o ice an m ct, clr t number, l Date of Birth or Voter Registration Number I Address (a.----- / / 1 /7/ /edi Ci C • S tate Z ip Code 33x?) -- # - Signature of Voter Date Signed (MM /DD/YY) .11---'C ' [to be co p/et&1,6y V ,v,1 Rule 1S•2.046, F.A C. DS-DE 104 CANDIDATE PETITION Notes: - All information on this form becomes a public record upon receipt by the Supervisor of Elections - It is a crime to knowingly sign more than one petition for a candidate [Section 104 185, Florida Statutes] - If all requeste' in irmation .n this f.rm is not completed, the form will not be valid as a Candidate Petition form. / , i (d (Jy' the undersigned, a registered voter (print nam= as it appears on •r • -r Int matron car �r d In said state and county, petition to have the name of `� / L Afv J placed on the Primary/General Election Ballot as a [check/complete box, as applicable] Nonpartisan ❑ No party, affi radon ■ . Party candidate for the office of X lir P ./ (ins rt title . o "ce and Include •istnct, circuit, grou •, seat number, If applicable Date of Birth or V. er - egistration Number Address (MMIDD z ij4�; I ,/ 1 . rmirm S� S3 Coe ----- i A ) .;) l i - '‘') Sig . ure of Voter Date Signed (MMIDD Y) [to be com efed by oted // Rule 1S- 2.046, F.A C. DS -DE 104 (Eff 09/11) CANDIDATE PETITION / Notes: - All information on this form becomes a public record upon receipt by the Supervisor of Elections V -11 is a crime to knowingly sign more than one petition for a candidate [Section 104 185, Florida Statutes] - If all requested 1 ormation on this form is not com,let: '/ e form will not be valid as a Candidate Petition form I ' !mil %/, r gt.;G / the undersigned, a registered voter (p ?lnt nam • as it appears o7our voter "ormatio in said state and county, petition to have the name of la, e � . . /9 . / placed on the Pnmary/General Election Ballot as a [check/complete box, as applicable] Nonpartisan ❑ No a a lliatlon Party candidate for the office of (l sert title of office am include district, circuit, group, seat Flu' um•er, 1 pp 'cable) Date of Birth or oter Registration Number Address (MMlDD/YY d y /9 sid 44%/ /(7 City County State Zip Code / ThiJ Sign re of Vot Date Signed (MMIDD/YY) [to be comp ted b Voter] c - -1 - - :,4.4.1-0.-- f)-7--4',/7.71L / i Rule 1S -2 046, F.A.C. � D -DE 104 (EH. 08111) CANDIDATE PETITION Notes: - All information on this form becomes a public record upon receipt by the Supervisor of Elections -11 is a crime to knowingly sign more than one petition for a candidate [Section 104 185, Florida Statutes] - If a reg ested informati • • n on this form is riot completed, the form will not be valyd as a Candidate Petition form r I, / / / I/ the undersigned, a registered voter / / iA., e (• int name as it apps - on your vo er Informati in rd) / �/ e in said state and county, petition to have the name of E if , 1 , � placed on the Primary/General Election Ballot as a (checWcompl:te box, as applicable] Nonpartisan ❑ No party aff ' -tion ❑ Party candidate for the office of e itle of office and include district, or . , glroup, seat number Date of Bi h or Voter Registr tion Number Address (MMI 7 7 7 �f r9. (772 l al, /trtd / — ity / c • ` / S t Z d`e/ Pk / . ! ` .4 tM � ! j 7` Signature f Voter l , Date Sig/YY) / [to be yf/otei f Rule 1S -2 046, F A.C. DS- E 104 (EN. 09111) CANDIDATE PETITION Notes: - All information on this form becomes a public record upon receipt by the Supervisor of Elections I 1 (-- - It is a crime to knowingly sign more than one petition for a candidate. [Section 104 185, Florida Statutes] ✓ 1 - If all reques. •d information on this form 's not completed, the form will not be valid as a Candidate Petition form. 1, ' I L ( / ' I� , the undersigned, a registered voter (print name as it appears on your voter mfor�- • <��.� '` in said state and ccun petition to have the name of placed on the Primary/General Election Ballot as a [c7ck/comp ate box, as applicable] Nonpartisan ❑ No pa . illation ❑ 6 Party candidate for the office of ( _ � w sert title of office and include distri , circuit, • roup, seat n • •er, if applicable) Date of Bi or Voter Registration Num er I Address /� /� /,, (MM /DD li. , c / (9 ! ,2 A ��(/' / ( r 7-7 ,/" Co Siata-- Zi Code ,.. K Signature of Voter Date Signed (MM /DD/YY) [to be comp) ed by ter] \.,,t----Q — ...- i Y 12 Rule 1S -2.846 F.A.C. DS -DE 04 (EH 09/11) CANDIDATE PETITION A l l Notes: - All information on this form becomes a public record upon receipt by the Supervisor of Elections -11 is a crime to knowingly sign more than one petition for a candidate [Section 104 185, Florida Statutes] - If all requested information on this form is not c.mp -ted, the form will not be valid as a Candidate Petition form. 1, the undersigned, a registered voter il IF (IF n ' I."- 's't appears on you vo - 'i . f•r -tio A ffl in said state and county, petition to have the name of ...lei placed on the Primary/General Election Ballot as a [check/complete box, as applicable] Nonpartisan ❑ No pa nation ❑ Party candidate for the office of (VIA I b) ith p/ insert title of office and Include di rcuit' rou seat n r if applicable) ( dist ci 9 P. PP ) Date of Birth or Voter Registrati n Number Address 3 j?'j,5 — (M ) : 7LJ0 ilt- ( 1 r ig2_ iY • o n liall Zip Code pipk 7 I I !t,Ml5 t Signature of Voter Date Signed (MM /DD/YY) / [to be co leted by Voter] %/� �� % / //0 Rule 1S- 2.046, F A C / DS- E 104 (Eff. 09/11) CANDIDATE PETITION Notes: - Al! information on this form becomes a public record upon receipt by the Supervisor of Elections -11 is a crime to knowingly sign more than one petition for a candidate [Section 104 185, Florida Statutes] - If all requeste• 'nfor, ation on this form is no completed, the form will not be valid as a Candidate Petition form )1 I, / ,� /� `� I �� , th- undersigned, a registered vote 1 (pnn nam- as it 'pears on your voter Information card /d 0 In said state and county, petition to have the name of // ( LLi/ placed on the Primary/General Election Ballot as a [check/complete box, as ap. icable] Nonpartisan ❑ No p affiliation ❑ Party candidate for the office of 7t/ / /fi (Insert tit of office and Includ Istrlct, circuit, group, eat number, If applicable) Date of Birttjh or Voter Registration Number I Address kali/ (MM/ i 3 ( / ii--/ai Al i / C ou , y Stag Zip Code Af 6, ,, , ,� i ✓ ., , Signat 're of Voter Date Signed MM /DD Y) ��.C� l�/i't-G� ,Q,,..�l,�L�i� Ito be comp! t 2 - t�1 • Rule 1S- 2.046, F A.C. D -DE 104 (Eff. 09/11) CANDIDATE PETITION Notes: - All information on this form becomes a public record upon receipt by the Supi?rvisor of Elections - It is a crime to knows g1y sign more than one petthoni for ac andidate (Section 104 185, Florida Statutes] I 1 f all r , uesl d info ation on his fors not completed, the form will not be valid as a Candidate Petition form 1 r I, 1 / V NJ the •dersigned, a registered voter V (print name as i appe won your voter info r • i� d) in said state and county, petition to have the name of iI ;l MI , � placed on the Primary/General Election Ballot as a [check/co plete box, as applicable] p Nonpartisan ❑ No part liation [2] . Party candidate for the office of iliS / ' ** 1-) //, (rose title of office and include district, circuit, group, seat num pplicable) Date of Birth r Vote Registration Number f Address (MMIDDI�Y .9-3 /10 / / f %h i .c_ ) 7(1/4) Cou State Code al A 111. II 1j� ( / W Signature of Voter 1 Date Signed (MM/ DIYY) J 111/9 7 Vt" r e [to be co p /eted Voter) Rule 1S•2.046 F.A.C. / , i 1 /,? , /#' DS- 1 4 (Eff. 09/11) CANDIDATE PETITION Notes: - All information on this form becomes a public record upon receipt by the Supervisor of Elections - It is a crime to knowingly sign more than one pe ition for a candidate [Section 104 185, Florida Statutes] - If all reques • • format'. on this form is in %ompleted, the form will not be valid as a Candidate Petition form. ) t i I, t / A the unders'•ned, a registered voter (• int'name as it - , p -ars o •Sr vo er inform/ �• rd) in said state and county, petition to have the name of 'I / ��� �� placed on the Primary/General Election Ballot as a [check/complete box, as applicable] unpartisan ❑ No party affiliation ❑ Party candidate for the office of 0 1 ( / SS // 1 ( Insert title of office a include • istrict, or fit,tro p, seat tuber, if applicable) Date Birth or Voter Registration Number 1 Address (M fli /(;),_ /7_ Ids 41, /,/ * 1 7,,,.,(., 7,,,,,,..1 Co Stag / Zip ode i AIM f/ Fkb Signature of Voter Date Signed (MM /DD/YY) [to be co Voter] at nifiat i2 2 'hAte,57u, / Rule 1S- 2.046, F A.C. DS -DE 104 (EH. 09111) CANDIDATE PETITION Notes: - All information on this form becomes a public record upon receipt by the Supervisor of Elections c i t i - It is a crime to knowingly sign more than one petition for a candidate [Section 104 185, Florida Statutes] - If al • ' ' • ed information on this orm is not completed, the form will not be valid as a Candidate Petition form. 1, the undersigned, a registered voter A • fl • ame •s •i' , 0 .. " your voter Infor A Z d) in said state and county, pe Rion to have the name of .. __ /l C C placed on the Primary/General Election Ballot as a [check/complete box, as applicable] Nonpartisan DN. rty affiliation ❑ Party candidate for the office of / I / - ill I (insert title of office and Include district, circuit, group, seat number, if applicable) Date Birth or Voter Region Number � Address (MM / / D/YY) 77? r ifiggpipu C un Stat� Z p odd c e 3 ,f-- Sign re of Voter �,,, Date Signed (MM /DD/YY) a f — [to be o b Voter] /d ? . /(/ Rule 1S- 2.045, F A C. / DS -DE 1164 (Eff. 09111) CANDIDATE PETITION Notes: - All information on this form becomes a public record upon receipt by the Supervisor of Elections , J - It is a crime to knowingly sign more than one petition for a candidate. [Section 104 185, Florida Statutes] 7 - If all requested information on this form is not completed, the form will not be valid as a Candidate Petition form. I, i , , i ,t eec- i J y \ 1 the undersigned, a registered voter (print name as it appears on your voter inform o card) / /e()- 1 in said state and county, petition to have the name of / placed on the Primary/General Election Ballot as a [check/co .fete b. , as applicable] ?onpartisan ❑ No party affiliation ❑ Party candidate for the office of � r i oT�f include distn , circus , group, seat num , i applicable) Date of Birth or Voter Registration Number I Address (MM/ / ,_, £d L1 A/W 3 . ./c1 S E City County State Zip Code 13 A -fi►,, lie,f,ti Ph i iy, 6 riot_ .33 435 Signature of Voter Date Signed (MM/DD/YY) [to be completed by Voter] Will:t f Clikt kik) ' i I 12. i i I Rule 1S -2 045, F.A.C. DS -DE 104 (Eff 09/11) i CANDIDATE PETITION Notes: - All information on this form becomes a public record upon receipt by the Supervisor of Elections - It is a crime to knowingly sign more than one petition for a candidate [Section 104 185, Florida Statutes] / - If all requested information on this form is not completed, the form will not be valid as a Candidate Petition form. v/ ti I, i / t/ h t j M on the undersigned, a registered voter (print name as it appear your voter i'•, ' ation -rd) in said state and county, petition to have the name of a4d ` / e_ ,L6 -, placed on the Primary/General Election Ballot as a [che. com• ete box, as applicable] E] Nonpartisan ❑ party affiliation ❑ e Party candidate for the office of t ' ll i Al v, ./ i # 1 (insert t itle of o ffice and in ude • l tact lrcult • 1 • seat number, if a livable ( PP ) Date of Birth or Voter Registration Number Addre s / (MM /DD/YY) C' • I State Zip Code B F , ' I� , rte Tity 14,444 �, l�3) Si . na ure of Voter Date Signed (MM /DD/YY) / / I , .. [to b e co plete by Voter) ? 1,- o' Rule 1S -2 046, F A C. DS -D 104 (EH. 09111) CANDIDATE PETITION Notes: - All information on this form becomes a public record upon receipt by the Supervisor of Elections -11 is a crime to knowingly sign more than one petition for a candidate [Section 104 185, Florida Statutes] 1 - If all req ested infor Lion on this f is not completed, the form will not be valid as a Candidate Petition form I, �� m,"5 the undersigned, a registered voter (print name as I appears on your voter infor In said state and county, petition to have the name of placed on the Primary/General Election Ballot as a [check/complet as applicable] Nonpartisan ❑ N arty affiliation ❑ Party candidate for the office of / / (/ (insert of off mclud Istflg, r ult group, se tuber, if applicable) Date of Bi h or Voter Registration Number 1 Addr ss ali � L,. ? ? % ; .. I' / C u ty S Zip Code .;1 33 Signature of Voter Date Signed (MM /DD/YY) Ard/14/461 [to be coin eted byoter] Rule 1S- 2.045, F A.C. DS -D 104 (Eff. 08/11) CANDIDATE PETITION Notes: - All information on this form becomes a public record upon receipt by the Supervisor of Elections / - It is a crime to knowingly sign more than one petition for a candidate [Section 104 185, Florida Statutes] 6 - If all requested formation .n this form is not completed, the form will not be valid as a Candidate Petition form. I .. the undersigned, a registered voter In r a e - r - •pears on yo v. er f✓ on car. in said state and county, petition to have the name of / / / C ' % aro, placed on the Primary/General Election Ballot as a [check/c•mple - box, as appl' Bale] n onpartisan El No p -rty affiliation ❑ Party candidate for the office of , ( IrM AI ' R ' (ins -rt title of office -nd mclu.. ,, stn ', cu , gr.up, number, if applicable) Date of Birth or Voter Registration Number I Address / MM/DD/YY -1 / itGl b l i w' 1 ! `- (AA2 - e A . / er ' MC i a _ & __/ Ail / 1-'1 53 .?C s-- Zip Code Signa re of Voter Signed (MM/ /YY) `,".�`'�' [to be co yleted of /� Ru e 15 -2 046, F.A C DS-DE 104 (EH. 09H1) CANDIDATE PETITION Notes: - All information on this form becomes a public record upon receipt by the Supervisor of Elections - It is a crime to knowingly sign more than one petition for a candidate. [Section 104185, Florida Statutes] - If all request' i ormation on this for 's not com•leted, the • will not be valid as a Candidate Petition form. '`f I, i K P IC / I t undersigned, a registered voter k. .' (print na as it7:pears on yourT:er in o ma o % :n `R .....- in said state and county, petition to have the name of placed on the Primary/General Election Ballot as a [check/complete box, as applicable) onpartisan ❑ No part - ffiliation ❑ Party candidate for the office of 5 s; WAY A (insert title of office and include distri , circuit, group, seat number, if applicable) Date of Birth or Voter Registration Number Address /� �� ( IDDIYY 1/ < 1G r / 7 ; , 4J S ty / State Zip Code 7.ita tp / 33V / . I -� f Signature of Voter Date Signed (MM /D NY) [to be co pleted b Voter] / - 40•- /j12764.e.k / /0 OWV Rule 1S -2 046, F A C. os -0E 104 (EN. 09!11) CANDIDATE PETITION Notes: - All information on this form becomes a public record upon receipt by the Supervisor of Elections - It is a crime to knowingly sign more than one petite. fora candidate. [Section 104 185, Florida Statutes) - If all re ested information on is fo m is o cr�leted, the form will not be valid as a Candidate Petition form -1‘ the undersigned, a registered voter i t‘./ (print name as t ap ears on your voter InformaUo " in said state and county, petition to have the name of �'./ /,� C/j� _ i %/✓ placed on the Primary/General Electron Ballot as a [check/complete box, as applicable] lanpartisan ❑ No party affiliation / ❑ / Party candidate for the office of i 4tS) 1 // insert title of�nd 1 ude 1 rl•t, circuit, group, seat number, if applicable) Date of Birth or Voter Registration Number Address (M11114)Dp/ /t2? /1/ ki ‘ ( **.g.'". / Co y / State Zip Code Mr Mt . rte.. .I.. �1 . 3 Signature of Voter Date Signed (MM /DDPYY) [to be co pleted by oter] Rule 1S -2 045, F.A C. DS -DE 104 (EN. 09111) CANDIDATE PETITION Notes: - All information on this form becomes a public record upon receipt by the Supervisor of Elections 11 { - It is a crime to knowingly sign more than one petition for a candidate [Section 104185, Florida Statutes] - If all requested information on this form is not completed the form will not be valid as a Candidate Petition form. I '` 12 -. w S the undersigned, a registered voter (print name as it appears on your voter inform on card) in said st to and county, petition to have the name of V \ a the placed n the Primary/General Election Ballot a s a [ c Wcom p lete box, as apphcable] ] Nonpartisan ❑ No party affiliation ❑ Party candidate for the office of (insert title of office and include district, circuit, group, seat number, if applicable) Date of Birth or Voter Registration Number Address j (MMIDD/YY) 1 P( C CO N'6 e — -&i Ci D u fxkeit 5��D c f �^ L Signature of Voter Date Signed (MM /DD/YY) [to be qmpleld by Voted Rule 1S- 2.046, F A.C. l DS -DE 104 (Eff. 09/11) CANDIDATE PETITION Notes: - All information on this form becomes a public record upon receipt by the Supervisor of Elections - It is a crime to knowingly sign more than one petition for a candidate [Section 104 185, Florida Statutes] ,), - If all requested information on this form is not completed, the form will not be valid as a Candidate Petition form. I ---"/ 6,7Ely# L j1 itt,14-YEkLs the undersigned, a registered voter (print name as it appears on your v informs i n card) n in said state and county, petition to have the name of / 111/( '9{1 placed o e Primary/General Election Ballot as a [check/complete box, as applicable) Nonpartisan ❑ N / o / party affiliation ❑ Party candidate for the office of �.� (insert title of office and include district, circuit, group, seat number, if applicable) Date of Birth or Voter Registration Number Address (MM /DD/YY) 1 r-� (2 g T iF0 N, 6 . 4.7./..,e'- 1 Ct C u S Zip Code tr i fri / 60-4 / .1 - • Signature of ter Date Signed (MM /DD/YY) [to be completed by Voter) Ru 144.046, F.A.C. DS -DE 104 (EH. 09/11) CANDIDATE PETITION 51" Notes: - All information on this form becomes a public record upon receipt by the Supervisor of Elections. -11 is a crime to knowingly sign more than one petition for a candidate [Section 104 185, Florida Statutes] - If all req ested inf+rma on on thi •rm i not . ompleted, the form will not be valid as a Candidate Petition form. 1 i . , / i WC liaAre / the undersigned, a registered voter (print =me as it a• • ars o your v• -r information A'. /� in said state and county, petition to have the name of placed on the Primary/General Election Ballot as a [check/complete ( .x, a • :pplicable] Nonpartisan ❑ No pa nation ❑ Party candidate for the office of 4 r.,, ( rtya K ( l ) i �uit group, seat number If a licable sert t� le of'bffice afitf� district, g p, pp ) Date of Bid or Voter Registration Number Address 7:1 e- l / Wi 1 ( .4 i ( ,.tY (ths. / State Zip Code , -- Pi "33 4 / 1. 3.J . Signature of Voter Date Signed (MMIDDIYY) to be co p/eted b ote , Arl(rtft4 Rule 1S -2 46, F.A.C. DS -DE 104 (Eff. 09 /11) The City of Boynton Beach City Clerk's Office 100 E BOYNTON BEACH BLVD ( r' BOYNTON BEACH FL 33435 (561) 742-6060 FAX: (561) 742 -6090 E -mail: prainitoj @bbfl.us 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 11, 2014 General Election will be held: Friday, February 21, 2014 © 3:00 p.m. Supervisor of Elections Warehouse 7835 Central Industrial Drive Riviera Beach, Florida RECEIPT of this no ice ' hereby documented: ,01 (;1 re Date R - ceived DETACH IF YOU AND /OR YOUR REPRESENTATIVE(S) plan(s) to attend the Logic & Accuracy (L&A) testing on Friday, February 21, 2014, please detach and return the lower portion of this notice to the City Clerk. Signature #Attending S: \CC \WP \ELECTION \Year 2014 \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 FORM 1 STATEMENT OF 2013 Please print or type your name, mailing FINANCIAL INTERESTS address, agency name, and position below FOR OFFICE USE ONLY: LAST NAME -- FIRST NAME -- MIDDLE NAME Mc Cray Mack MAILING ADDRESS , 806 North West 4th Street ra X11 1 -mot, CITY ZIP COUNTY -� Boynton Beach, Fl. 33435 Palm Beach NAME OF AGENCY 'z► City of Boynton Beach w NAME OF OFFICE OR POSITION HELD OR SOUGHT -- .. City Commissioner District II 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 (must check one) ❑ DECEMBER 31, 2013 OR ❑ SPECIFY TAX YEAR IF OTHER THAN THE CALENDAR YEAR MANNER OF CALCULATING REPORTABLE INTERESTS: FILERS HAVE 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 ❑ 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, write "none" or "n /a ") NAME OF SOURCE SOURCE'S DESCRIPTION OF THE SOURCE'S OF INCOME ADDRESS PRINCIPAL BUSINESS ACTIVITY Bob's Printing 1885 South West 4th Ave. E -7 Printing Mizell & Kurtz Funeral HRme th d b O tti 3 ire t Ft. Lauderdale, Florida 3331 1 LFD Embalmer — St. John Miscionary Baptist Church 900 North Seacres Blvd. I Boynton Beach, Florida 33435 Church 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] (If you have nothing to report, write "none" or "n /a ") FILING INSTRUCTIONS for when and where to file this form are located at the bottom of page 2. 304 North West 12th Avenuue Boynton Beach INSTRUCTIONS on who must file this form and how to fill it out 806 North West KU, Jr._ Blvd_ Boynton Beach, Florida begin on page 3. CE FORM 1 - Effective January 1 2014 (Continued on reverse side) PAGE 1 Adopted by reference in Rule 34 -8 202(1) F A C PART D — INTANGIBLE PERSONAL PROPERTY [Stocks, bonds, certificates of deposit, etc - See instructions] (If you have nothing to report, 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, write "none" or "n /a ") NAME OF CREDITOR ADDRESS OF CREDITOR PART F — INTERESTS IN SPECIFIED BUSINESSES [Ownership or positions in certain types of businesses - See instructions] (If you have nothing to report, write "none" or "n /a ") BUSINESS ENTITY # 1 BUSINESS ENTITY # 2 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 ❑ SIG Lideaa r- : DA E SIGNED re uir d : 40 ce ed pub'. ! s ntan icensed and r - •ter 473, or attor 1W good standing ' ith the Florida Bar prepared this form for you, he or she must complete the following stat: -nt , prepared the CE Form 1 in accordance with Section 112 3145, Florida Statutes, and the instructions to the form Upon my reasonable knowledge and belief, the disclosure herein is true and correct Signature Date FILING INSTRUCTIONS: WHAT TO FILE: WHERE TO FILE: WHEN TO FILE: After completing all parts of this form, including If you were mailed the form by the Commission Initially, each local officer /employee, state officer, signing and dating it, send back only the first on Ethics or a County Supervisor of Elections for and specified state employee must file within sheet (pages 1 and 2) for filing your annual disclosure filing, return the form to 30 days of the date of his or her appointment that location or of the beginning of employment Appointees If you have nothing to report in a particular Local officers /employees file with the who must be confirmed by the Senate must file section, you must write "none" or "n /a" in that Supervisor of Elections of the county in which they prior to confirmation, even if that is less than section(s) permanently reside (If you do not permanently 30 days from the date of their appointment reside in Florida, file with the Supervisor of the Candidates for publicly- elected local office must NOTE: county where your agency has its headquarters ) MULTIPLE FILING UNNECESSARY: file at the same time they file their qualifying State officers or specified state employees papers Generally, a person who has filed Form 1 for a file with the Commission on Ethics, PO Drawer calendar or fiscal year is not required to file a 15709, Tallahassee, FL 32317 -5709, physical Thereafter, local officers /employees, state second Form 1 for the same year However, a address 325 John Knox Road, Building E, Suite officers, and specified state employees are candidate who previously filed Form 1 because 200, Tallahassee, FL 32303 required to file by July 1st following each calendar of another public position must at least file a copy year in which they hold their positions of his or her original Form 1 when qualifying Candidates file this form together with their Finally, at the end of office or employment, each qualifying papers local officer /employee, state officer, and specified To determine what category your position falls state employee is required to file a final disclosure under, see the "Who Must File" Instructions on form (Form 1 F) within 60 days of leaving office or page 3 employment However, filing a CE Form 1F (Final Facsimiles will not be accepted. 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, 2013 CE FORM 1 - Effective January 1 2014 PAGE 2 Adopted by reference in Rule 34 -8 202(1), FA C Y CI r ) Y t' i u i :. i CANDIDATE OATH — : `' 11 E =1 r" ' ' NONPARTISAN OFFICE 14 FEB -4 PM 3: 16 (Not for use by Judicial or School Board Candidates) OFFICE USE ONLY OATH OF CANDIDATE / / 4 99 0 1, Fionda Statutes) I , i6 (//:—._ , (PLEASE PR T NAME AS YOU WISH IT TO N THE BA�� -- N E ; AY NOT BE�CHA ED E END O. . YI am a candidate for the nonpartisan office of 4 / A ` , (0 o- ) / (district #) I am a qualified elector of Il /� �� J 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 , . support the Constitution of the United States and the Constitution of the State of Florid- x Aropp,--- . � ..�► mi r33 /in ' A 6 Aca� ,n.� d i o Telephone Number Email Address i i � 5-4 Ai • , � 7 < v 4 3,w 3) Address C i S ziP Code Candidate's Florida Voter Registration Number (located on your voter 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 in u bons on page 2 of , i- form) 40 g-n STATE OF FLORIDA COUNTY OF PALM -- E'CRC}I Sworn to (or affirmed) and subscribed before me this a day of JQ.I1ctax , 20 lit Personally Known or � 1 ,. • _ la • PL Signa re of Notary Public Produced Identification - n ype, or Stamp Commissioned Name of Notary Public NOTARY PUBLIC -ST OF FLORIDA Type of Identification Produced ; Janet M. Prainito , Commission # EE028433 ,,11 s Expires: SEP. 22, 2014 JAMIE; 11lltU Al LAIN 111. nut,uury w, ua,.. DS -DE 25 (Rev. 5111) Rule 1S- 2.0001, F.A.C. \ T Y OA Miscellaneous Cash Receipt No. 5 2 6 7 0 CITY OF BOYNTON BEACH _ r 0 _ V r ON Account No. 001- 0000- 369 -10 -0X $ 222.57 Received of Mack McCray Address 806 NW 4th Street. Boynton Beach, FL 33435 For 1% State Assessment to run for Commissioner, District II Ow: OYBaNS seat in the March 11, 2014 GenerapleE �i Receipt not X 129646 Totai P.eent $222.57 Dept. City Clerk' s Office B Miscellaneous Cash Receipt No. 92669 CITY OF BOYNTON BEACH y _ �P 7-0 r4 Account No. 001-0000 - 369 - 10 — OD $ 25.00 1 -46 ,20r4 Received of Mack McCray Address 806 NW 4TH STREET, BOYNTON BRACH, FL 33435 For City Filing Fee - To run for Commissioner, District II on riper: RY82 March 11, 2014 Date. 1/28/14 R1 Receipt no: 129645 Taal tendered f25,1fq Total paynent $25.09 Dept. City Clerk's Office By