Non-Certified Petitions •
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CANDIDATE PETITION � 1-11 e&wjll
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.
.
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 De- C ,4,Z04 zA- 12. A/it
on the Primary /General Election Ballot as a: [check/complete box, as applicable]
onpartisan ❑ No party affiliation ❑ _ Party candidate for the office of
cirti CO M l 7)/sTiale- 1V
(insert tit of office and include district, circuit, group, seat number, if applicable)
Date of Birth or Voter Registration Number Address
(MM /DD/YY)
/ o / — 32 /5/ 61 PZi,f ? IC Co-(' (
Cit County State Zip Code
p t-41-1/ cm(
Signature of Vot Date Signed (MM /DD/YY)
G ,A [t be c ompleted b Voter]
4 Rule 1S- 2.045, F.A.C. DS -DE 104 (Eff. 09111)
40
X (IWAUD 31
CAN DIDATE PETITION
Notes: - All information on this form becomes a public record upon receipt by the S upervisor of Elections.
- It is a crime to knowingly sign more than one petition for a candidate. [Section 104.185, Florida Statutes] r14
- If all requested information on this form is not completed, the form will not be valid as a Candidate Petition form.
1, 0 /016 //„ e'c /4 the undersigned, a registered voter
(print name as it appea on your voter information card)
in said state and county, petition to have the name of -De- c4Rrv1Ezj} (Z. ,/1 ART) .i
placed on the Primary /General Election Ballot as a: [check/complete box, as applicable]
[Nonpartisan ❑ No party affiliation ❑ Party candidate for the office of
0/7 o w
C4YV1 l S S / -- D /ST R-i L V
n - T
(insert titl of office and include district, circuit, group, seat number, if applicable)
Date of Birth or Voter Registration Number Address
(MM /DD/YY)
C - Yil 74, 6 / ,y 7-6, 2/ff
City County State Zip_Code
t/t1 / /�J4 / kbti- PhP /td - / 3
SI ur. •t toter Date Signed (MM /DDIYY)
/
il
fr ` [to be completed by Voter)
Rulk1S -2.0 ., F.A.C. ` / DS-DE 104 (Eft. 09/11)
• Y
/\ k)r
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.
~' t, / I 1 the undersigned, a registered voter
A,14• _ . S
(print n. - as it appears on your voter information card) 1
in said state and county, petition to have the name of Pie • c ,e t L�9 / \. X��ro" "
placed on the Primary /General Election Ballot as a: [check/complete box, as applicable]
[Nonpartisan ❑ No party affiliation ❑ Party candidate for the office of
17 c myy)I SS I0/6M -- 75(SY/Ller'2
(insert title of office and include district, circuit, group, seat number, if applicable)
Date of Birth or Voter Registration Number Address
(lW 7 - 10 / I Li
Vk le fl £ 1 a
City 6 0 C ounty State Zip Code e,
r _, pp. Sig a of V e �' Date Signed (MM /DD/YY)
V ' t 7411Plati ) . — — )ii
[to be com feted by Voter]
Rule 1S- 2.045, F.A.C. DS -DE 104 (Eff. 09/11)
1
1
X5C)
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, t� L ` e S' , ,, f - j1 f an a? 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 - C,.(R-n/674 g - rz
placed on the Primary /General Election Ballot as a: [check/complete box, as applicable]
Nonpartisan ❑ No party affiliation ❑ Party candidate for the office of
C 1 C043/1/// SS /pNe; Z -- D/STR-t c r
(insert title of office and include district, circuit, group, seat number, if applicable)
Date of Birth or Voter Registration Number Address
(M M /DD/YY)
J U 1-ehcA c, Pr v
City County State Zip Code
v.v. 11-e_c_cr.h Y f 0 c .. FL. � 3 LI 3
Signature of Date Signed (MM /DD/YY)
[to be completed by Voter]
2 / � i / Z -fl [ 4
Rule 1S- 2.045, F.A.C. DS -DE 104 (Eff. 09/11)