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Filing Papers r . -- tv° . - APPOINTMENT OF CAMPAIGN TREASURER AND DESIGNATION OF CAMPAIGN = c> - DEPOSITORY FOR CANDIDATES w co (Section 106.021(1), F.S.) ,y:... co rn E, (PLEASE PRINT OR TYPE) s NOTE: This form must be on file with the qualifying officer before opening the campaign account. OFFICE USE ONLY 1. CHECK APPROPRIATE BOX(ES): ❑ Initial Filing of Form Re- filing to Change: 0 Treasurer /Deputy ❑ Depository ❑ Office p Party 2. Name of Candidate (in this order: First, Middle, Last) 3. Address (include post office box or street, city, state, zip /)� O c ode) 4. Telephone 5. E -mail address ( Vet ) 900-011S CI @i ; f. c 9 y fr,/ev. .6 i R 33 c3.5 1 6. Office sought (include district, circuit, group number) 7. If a candidate for a nonpartisan office, check if // applicable: vin ilSi �ia 3 0 My intent is to run as a Write -In candidate. 8. If a candidate for a partisan office, check block and fill in name of party as applicable: My intent is to run as a ❑ Write -In ❑ No Party Affiliation ® Party candidate. 9.1 have appointed the following person to act as my Z Campaign Treasurer 0 Deputy Treasurer i0. Name of Treasurer or Deputy Treasurer (,�n3 -61.9. 1-v.0 3 go 11. Mailing Address 12. Telephone ice 1 f E 02,6 a ( SW'/ ) T 0 ' 8 c 13. City 14. County 15. State 16. Zip Code 17. E -mail address gD L- ped .,.,,. fpm A( 33V35 d ,l uJ X04,/ 18.1 have designated the following bank as my [S Primary Depository El Secondary E7epository 19. Na lAidIS U g � 20. Address t' ( / / 21. City 22. County y ty 23. State 24. Zip Code UNDER PENALTIES 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 STATE) IN IT ARE TRUE. 25. Date 26. Signature of C •' lib 420 il X „ten r 27. Treasu Acceptance of Appointment (fill in the blan . and check the appropriate block) I, (f1 r/. 4-a.- L 9ud k~,41 j , do hereby accept the appointment (Please Print or Type Name) iesignated above as: 0 Campaign Treasurer ❑ Deputy Tre- -:i rer. I('( 211r9/ S X f1l Date Signature of ' ampaign Treasurer or Deputy Treasurer DS -DE 9 (Rev. 10/10) Rule 1S- 2.0001, F.A.C. PPOINTMENT OF CAMPAIGN TREASURER CITY qF BflYUT N BEACH CITY -BFt'S OFFICE AND DESIGNATION OF CAMPAIGN 15 NOV -6 PH 14: 32 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 e ECK APPROPRIATE BOX(ES): Initial Filing of Form Re- filing to Change: ❑ Treasurer /Deputy ❑ Depository ❑ Office ❑ Party 2. ame of Candidate (in this order: First, Middle, Last) 3. Address (include post office box or street, city, state, zip code) C 01/NR LOUIS VoHLUs ICI SL a8 6- t 4. Telephone 5. E -mail address (%1 ) `lop-W(1s dromelkstyva. %I . cvM ejoyNTvN 6E1461-1 , FL 33 '135 6. Office sought.(includedistrict, circuit, group number) : 7. If a candidate for a nonpartisan office, check if . = 3 - ` applicable: //�� C -1 COwtwia SSI tin 01 3 ❑ 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. • X have appointed the following, person to act as my Campaign. Treasurer 0 Deputy Treasurer 10. Name of Treasurer or Deputy Treasurer C1-eiS IN1 LOW GH6GV.4 11. Mailing Address 12. Telephone 1 (0l SEa - C1 ' (so )9OD 8'S 13. City 14. County 15. State 16. Zip Code 17. E -mail address QOYArrON &iicfr P4c,M S e4c lH fL 334(15 GI rorvte 14.s 0 1 its f . 49 18. I have designated the following bank as my Primary Depository ❑ Secondfry Depository 19. Name of Bank 20. Address £A-A1k OF A-picalcici mi AL F60b441. Hwv 21. City 22. County 23. State 24. Zip Code ,AOYnrroN £bi?cH Pfc,M County ,, W fL 33(f35 UNDER PENALTIES 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 I IT ARE TRUE. 25. Date 26. Signature of C!;- -J II (NO fc1oiS X illeaff , 27. Treasurer's Acceptance of Appointment (fill in the b -nks and check the appropriate block) i, ektiztfrimiti Loos / VHt/ US , do hereby accept the appointment (Please Print or Type Name) •signated above as: F1 Campaign Treasurer 0 Deputy p-asu - r. X �ile (I l 0(, 11015 IL�►A l ate Signature EV - mpaign Treasurer or Deputy Treasurer DS -DE 9 (Rev. 10/10) Rule 1S- 2.0001, F.A.C. ® RESIDENCY REQUIREMENTS C , !i?f s7aJk 1 . komo .( lc , candidate for (Print Name) im i; c v;, n o r , 3 of the City ( ayor /Commissioner — District #) Beach, have received, read and understand, the residency requirements of Article II of the Charter of the City of Boynton Beach. (Signature of andidate Cf®/ Dat) cD •c c-, -Tr • • r" cn Q, to Fin • a 11/12/2013 12:31 PM S: \CC \WP \ELECTION \Year 2014 \Information Packets \RESIDENCY REQUIREMENTS STATEMENT.doc OFFICE USE ONLY STATEMENT OF III CANDIDATE (Section 106.023, F.S.) (Please print or type) I, Zile/ S?7/V/1 //' I P/ c ' m,n candidate for the office of ,.ISio71er Dis r, 3 ; have been provided access to read and understand the requirements of C , Chapter 106, Florida Statutes. ca -` � rr crt x `o - cr. --t - r co a m Ill N., rri,.--., . _, ir Ar. d er,,,, J r. , ..... _ - _: I 11/P 6/ - r Signa re of Candidate ate 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) 114467385 LOUIS ROMELUS, CHRISTINA NPA 7190 161 SE 28TH CT BOYNTON BEACH FL 33435 6/23/1988 B F 7/12/2006 11/6/2012 5619004845 22 co m m m m ti ti rn co co • ,i FORM 1 STATEMENT OF 201 Please print or type your name, mailing FINANCIAL INTERESTS FOR OFFIEy: address, agency name, and position below: I C h7 LAST NAME -- FIRST NAM MIDDLE NAME : O UI M CIOMAM . ....:..., MAILING ADDRESS : (4- "'s3 u j _._t 11 p)F CITY : ZIP : COUNTY : 'r, -' Pi £ c yin) & i c// 33435 19r L' ti z NAME OF AGENCY : NAME OF OFFICE OR POSITION HELD OR SOUGHT : Er)MAl hilt p/Ue 1) fp f I (77" S 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 (glust check one): ®/ DECEMBER 31, 2014 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 19 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 SOURCES DESCRIPTION OF THE SOURCE'S OF INCOME ADDRESS PRINCIPAL BUSINESS ACTIVITY 4/1.4 Amy pi ,c 49c(eq— g2. (Diva tESS Ave LIKE- I,1RTI+( R CoiL &CUAu(ur -I try ( =iovCri t' /P(IJ Jrle . rote Peale -CS Pc »cF (ow ng.o, NC, iEC -EComm ulcAr ibAlr 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 Oil+ 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 '� I r ' located at the bottom of page 2. ! 1 / A., G� �, this T for�m a how to f Il must out j yvr 1� 1(p / sc �() C7 6tG� c/ K3 r begin on page 3. CE FORM 1 - Effective: January 1, 2015 (Continued on reverse side) PAGE 1 Adopted by reference in Rule 34- 8.202(1), F.A.C. i 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 A PART E — LIABILITIES [Major debts - See instructions] • (If you have nothing to report, write "none" or "n /a ") • NAME OF CREDITOR ADDRESS OF CREDITOR 9/1111b /LII / ,9• fiat LuJr idio,M /A) /Ti, D6 /9f®6 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 Ai1/49 AJ /,9-' 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 OF FILER: CPA or ATTORNEY SIGNATURE ONLY If a certified public accountant licensed under Chapter 473, or Signature: attorney in good standing with the Florida Bar prepared this form for you, he or she must complete the following statement: A � I, prepared zit 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. Date Signed: CPA/Attorney Signature: II/ 9/ C Date Signed: 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, retum 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.) file at the same time they file their qualifying .. MULTIPLE FILING UNNECESSARY: papers. State officers or specified state employees A candidate who previously filed Form 1 because Thereafter, local officers /employees, state file with the Commission on Ethics, PO. Drawer of another public position must at least file a copy 15709, Tallahassee, FL 32317 -5709; physical officers, and specified state employees are of his or her original Form 1 when qualifying. A address: 325 John Knox Road, Building E, Suite required to file by July 1st following each calendar candidate who files a Form 1 with a qualifying 200, Tallahassee, FL 32303. year in which they hold their positions. officer is not required to file with the Commission Finally, at the end of office or employment, each or Supervisor of Elections. Candidate file this form together with their local officer /employee, state officer, and specified qualifying papers. state employee is required to file a final disclosure To determine what category your position falls form (Form 1 F) within 60 days of leaving office or under, see the 'Who Must File" Instructions on employment. However, filing a CE Form 1F (Final page 3. Statement of Financial Interests) does not relieve Facsimiles will not be accepted, the filer of filing a CE Form 1 if he or she was in their position on December 31, 2014. CE FORM 1 - Effective: January 1, 2015. PAGE 2 Adopted by reference in Rule 34- 8.202(1), F.A.C. r . Misce llaneous Cash Receipt.. `;� Y e �� No. 1 CITY OF BOYNTON BEACH - u , ~ TO N 8 Account No. 001-0000-369-10-00 $ 25.00 f 1 ) ,.20 Received of C istinaa Louis Roia61 i Address 161 SE 38 CT, B0YNTON BEACH, FL 33435 I OFD' E[IXE For City Filing Fee to run for Coomi t ' 7 - 5igiq-E5 ,F4.nflh 115,:" a Total D M P L", $ - I c. on March 15. 2016. . . De pt. City Clerk's Office : sy r M ., tom ;.,, -- - M Cash Receipt � °° CITY OF BOYNTON BEACH ----- = No ' : ' ~ T ON Account No. 001' 0000 369 ®10 -00 $ 222.57 ,. 20 Received of Christina Louis n e1us Address 161 SE 28 CT, BOYNTON BEACH, FL 33435 For 1% State Assessment to un-fo {ei 1 c o g e �� � �r `� t on March 15 a 2016. Total u_, r �? 7 , i ' . Dept. City Clerk's Offi g 1 r CITY OF BOYNTON BEACH CANDIDATE OATH - CITY CLERK'S OFFICE NONPARTISAN OFFICE 15 NOV 12 PIH 3 13 (Not for use by Judicial or School Board Candidates) OFFICE USE ONLY OATH OF CANDIDATE (Section koHEz 99021, Florida Statutes) i fr /fr/Ah q L- J (PLEASE PRINT NAME AS YO O AP ON THE BALLOT * — NAME MAY NOT BE CHANGED AFTER THE END OF QUALIFYING) am a candidate for the nonpartisan office of BDOtijl Ai d6C-> / 6 (o, fMsf1D/V6g , 3 (office) (district #) ; I am a qualified elector of ,4 t L1 f 6,? f 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. ' 1 4 X %iS ($ ?oo - tiff CL leptieLtire 001 Sig . ure of Candidate Telephone Number Email Address Address City State ZIP Code Candidate's Florida Voter Registration Number (located on your voter information card): )it/473,525 * 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): Hris — Mb - /Wit, m y o STATE OF FLORIDA COUNTY OF Palms BeAC4 Sworn to (or affirmed) and subscribed before me this 1 a day of N OVe Yt6eR , 20 155 . Personally Known: or % • et nature of Notary Public Produced Identification: • rint, Type, or Stamp Commissioned Name of Notary Public Type of Identification Produced: ; ►y I JANET M. PRAINITO *. i* :*. MY COMMISSION # FF 142411 =rj..(�:a€ EXPIRES: September 22, 2018 bt/ Rondnd Thru Notary Public Underwriters CIA DS -DE 25 (Rev. 5/11) Rule 1S- 2.0001, F.A.C. Tai -, City of Boy a ton ; ,e th -� ' �� City Clerk's Office 100 E BOYNTON BEACH BLVD ` 3 -- BOYNTON BEACH FL 33435 ;c: �� ? (561) 742 -6060 c ®' t `' %' FAX (561) 742 -6090 -- i �'�To;; E -mail: prainitoj @bbfl.us r.) , www.boynton- beach.org — a c 711: c w PUBLIC NOTICE TO: CANDIDATES, POLITICAL PA'• TIES � OTHERS NOTICE IS HEREBY GIVEN that the Logic z Accuracy (L&A) testing of the voting equipment to be used in the March 15, 2016 General Election will be held: Wednesday, February 24, 2016 @ 10:00 a.m. Supervisor of Elections Warehouse 7835 Central I dustrial Drive Riviera Beach, Florida RECEIPT of this notice is hereby documented: A AI 4 „ P Sign `ure Date Received DETACH IF YOU Ai '';D /OR YOUR REPRESENTATIVE(S) plan(s) to attend the Logic & Accuracy (L&A) testing on Wednesday, February 24, 2015 © 10:00 a.m., please detach and return the lower ortion of this notice to the City Clerk. p �/ Signature #Attending S: \CC \WP \ELECTION \YEAR 2016 \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 OF Feh4 ( Palm Beach County 240 SOUTH MILITARY TRAIL WEST PALM BEACH, FL 33415 POST OFFICE BOX 22309 WEST PALM BEACH, FL 3341S SUSAN BUCHER Supervisor of Elections TELEPHONE: (561) 858 -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 27 signatures on the Nominating Petitions of CHRISTINA ROMELUS for BOYNTON BEACH CITY COMMISSIONER, DISTRICT 3 are registered electors within the municipal limits of the City of Boynton Beach, according to the registration records on file in this office. This is to further certify that CHRISTINA LOUIS ROMELUS is a registered voter in Precinct 7190, in the City of Boynton Beach, Florida. c- � C` : ' Signed, this the 10th day of November, 2015. c .a: c - , mca , 4 • . a Ma cri SUSAN BONER c ' a SUPERVISOR OF ELECTIONS PALM BEACH COUNTY hi (SEAL)- • 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, e-C R O c 4 _ T the undersigned, a registered voter (print name as it appears on your voter information card) ? county, petition to have the name of (2-it � 1�h� � ,( � in said state and coun placed on the Primary/General Election Ballot as a: [check/complete box, as applicable] p Nonpartisan ❑ No party affiliation ❑ Party candidate for the office of c [M &S[?)n€r i S G 7t 3 (insert title of office and include district, circuit, group, seat number, if applicable) Date of Birth or Voter Registration Number Address (MM /DD/YY) 3 2M NaL3 Po-r4- 10/05119 City County State Zip Code 6 C r liA 4-6/k- iS Q i 'ff 3 i Signature of Voter Date Signed (MM /DD/YY) [to be comple ed by Voter] ` _____ /1/7/ Rule 1S -2.0 C. DS -DE 104 (Eff. 09/11) Qr` t , tea' 1-, LO in 6..L. C CD Cr ,� u - `su I. Li E Z 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, 60MAi 'C the undersigned, a registered voter (print name as it appears on your voter infor ation card) in said state and county, petition to have the name of L r Ma V� 'll ( At on the Primary/General Election Ballot as a: [check/complete box, as applicable] El No party affiliation ❑ Party candidate for the office of C_CDPA-kv‘I A5r-vo-r ,boy d (insert title of office and include district, circuit, group, seat number, if applicable) Date of Birth or Voter Registration Number Address (MM /DD/YY) OCT /3 /9_,S /7) 7 cJ C CP 0,2A C. /' oo?- Ci ✓ Coun State. Zip Code 6 1 /) 47 1 8 c// 1,/v erg-44 /�� • 33/3 Signature of Voter Date Signed (MM /DD/YY) 1 � [to be comp! ted b Voter] 9 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 Statut sJ - If all requested information on this form is not completed, the fonn will not be valid as a Candidate Peti ' n r lift • the undersigned, a r egistered voter 1,✓� 1 f�e fie tr o t-/ (print name as it appears on your voter info ation card) in said state and county, petition to have the name of n��lnsa ic . e placed on the Primary/General Election Ballot as a: [check/complete box, as applicable] P Nonpartisan ❑ No party affiliation 0 Party candidate for the office of (s I _ I c+ 3 (insert title of office and include district, circuit, group, seat number, if applicable) Date of Birth or Voter Registration Number Address (MMIDD/YY) 'Of.— i-f t s `� l � 9 $ 1-Z7 Coce /Z-7 City County State Zip Code �a f ` G 'Z 4j 33 c F �S� Signature of Voter Date Signed (MM /DDIYY) [to be completed by Voter] //- l° ` is E DS-DE 104 ff. 09/11) Rule 1S -2.045 F.A.C. S 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 Statut J - If all requested information on this form is not completed, the form will not be valid as a Candidate Petite n ! ,r. I, � % t £� , I I , / O p the undersigned, a iegi e • voter (print name as it appears on your voter information card) in said state and county, petition to have the name of CAA v)]1,.(3— r placed on the Primary/General Election Ballot as a: [check/complete box, as applicable] c gi 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 ( M 1 I 16 24e- Gra t n5 CwCCe-- Cit County State Zip Code Sclr, Pea m teach F t 55435 Sign ur - of Voter I Date Signed (MM /DD/YY) , [to be completed by Voter] r is Rule 1S -2.1 / , -.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. /Le". - It is a crime to knowingly sign more than one petition for a candidate. [Section 104.185, Florida Statu - If all requested information on this form is not completed, the form will not be valid as a Candidate Peti 'on f c► ` U v the undersigned, a gistered voter (print name as it appears on your voter infor ation card) in said state and county, petition to have the name of lh(151 R eqS placed on the Prima /General Election Ballot as a: [check/complete box, as applicable] P Primary/General L P PP l Nonpartisan ❑ No party affiliation ❑ Party candidate for the office of (insert title of office and include dis rict, circuit, group, seat number, if applicable) - Date of Birth or Voter Registration Number Address (MM /DD 3 -3--/ 19y 5e 2 -? ��� City County State Zip Code 01 (1/ °d 6 /) ?1v FL_ 35g3s-- Signature of Vo er Date Signed (MM /DD/YY) [to be completed by Voter] — Rule 18- 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 fo I ' Mai Anon G rnP tsso the undersigned, a re Este e voter 5 (print name as it appears on your voter information card) in said state and county, petition to have the name of C " n� 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 ltrivx ■••%. (5 3 1\2.7.12.1-- (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 1/041/e8 2� Zv SE 2nd S-}- . L&jm\� , �V v` City County State Zip Code r,\-we) Beck, PB C 33435 Signature of Voter Date Signed (MM /DD/YY) Lai .611.3\ryN.11... [to be completed by Voter] II /Icy / l am Rule 1S- 2.045, F.A. 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 fob I, ArA CUld G r 0 i; !1 . 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 a n i nt• a- 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 isAs , 4- ' f- 3 (insert title of office and include district, circuit, group, seat number, if applicable) Date of Birth or Voter Registration Number Address (MM /DD/YY6 ... 6(0 - 1(0 - ' qn 14( Se ek C City County State Zip Code i . , r`► PoSW ee i R, 39 Signad of Vo ir Date Signed (MM /DD/YY) [to be om leted by Voter] it i 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 Petitio o I, � T o (1) • (2_e � � the undersigned, a reg a vo e (print ame as it appears on your voter information card) Rn in said state and county, petition to have the name of ( ki' w�_ r , placed on the Primary/General Election Ballot as a: [check/complete box, as applicable] Nonpartisan El No party affiliation ❑ Party candidate for the office of 6 ,1 %A. AN 1 / 1 `• b 114 2 (insert title of office and include district, circuit, group, seat number, if applicable) Date of Birth or Voter Registration Number Address (MM /DD/YY) 05 i21,1 •( 3 t 5e R , City C unty State Zip Code b 6 14 tks..i-- VOI.ak titrrEj il 3N) jr Signature of Voter Date Signed (MM /DD/YY) [to be completed by Voter] ....A.—stk. . t i AO I LI Rule 1S- 2.045, F.A.C. DS-DE 104 (Eff. 09/11) CANDIDATE PETITION Notes: - All information on this fonn 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 a es] - If all requested information on this form is not completed, the form will not be valid as a Candidate titi I, S e tr e A a- (1.--,-,,,,.-,.(7._ the undersigned, a registered voter (print name as it appears on your voter information card) r in said state and county, petition to have the name of C P 1`> 4`►AP. 0 - placed on the Primary/General Election Ballot as a: [check/complete box, as applicable] Nonpartisan ❑ No party affiliation ❑ Party candidate for the office of b 4,-F 3 / r Ci isert title of office and include district, circuit, group, seat number, if applicable) Date of Birth or Voter Registration Number Address (MM/DD1Ylf) � n 5 5 .� '' o <)- 4'� L �� ``c 1 fJ `F'Ul City n County State Zip Code ,..--- ,...-& Signature f Voter Date Signed (MM /DD/YY) [to be completed by Voter] i / LeAft_ g &eilL al//d /15 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 for • 1 ` ,, ; . the undersigned, a registered voter (print name as it app -ars on your voter in tion ca d) in said state and county, petition to have the name of V ` ri (1144n t Ji, l placed on the Primary/General Election Ballot as a: [check/complete box, as applicable] tigNonpartisan ❑ No party affiliation ❑ Party candidate for the office of C0 ] l 3 (insert title of office and include 'strict, circuit, group, seat number, if applicable) ( , g p, pp cable) Date of Birth or Voter Registration Number Address (MM /DD/YY) City County State Zip Code Tae (F9-eA rn 33 S Sig lure of Voter + Date Signed (MM /DD/YY) - 1 [to be completed by Voter] , Cdi- r �, , �, ( l 0 I l 4 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. [Seddon 104.185, Florida Statutes] _ - If all requested information on this form is not completed, the form will not be valid as a Candidate Petition fo . ,... I, �11 ((�� (( the undersigned, a registered voter I�IIC:rldi 01J kGOA (print name as it appears on your voter infor ation card) in said state and county, petition to have the name of IA tAl placed on the Primary/General Election Ballot as a: [check/complete box, as applicable] 0 Nonpartisan ❑ No party affiliation ❑ Party candidate for the office of C ONA-iv%, ,,, Stir Nwfc...4— .....,. (insert title of office and include district, circuit, group, seat number, if applicable) Date of Birth or Voter Registration Number Address (MM /DD/YY) 0 K/22/g2 12.E 5t 2? 0 - . City County State Zip Code Y h +aA 1becCIe. Z_ItiA. Te04.4 FL 33q35 Signature of Voter Date Signed (MM /DD/YY) [to be completed by Voted 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 rm. ) I, \ e 6 4 , rc..- the undersigned, a registered voter (print name as it appears on your voter infor tion card) in said state and county, petition to have the name of / rvgt. garoeL! / placed on the Primary/General Election Ballot as a: [check/comp ete box, as applicable] Nonpartisan p No party affiliation ❑ Party candidate for the office of ( S i p ..(-- 1) 8 'c + 3 (insert title of office and include district, circuit, group, seat number, if applicable) Date of Birth or Voter Registration Number Address (MM /DD/YY) k Tb ' ' G nc . City County State Zip Code 4 »L te/ 7a? 144 J /.1 . . q S34/3 2s - Signat e of Voter Date Signed (MM /DD/YY) 40/ L [to co plet d by Voter] Ruler F.A.C. F.A.. ! DS -DE 104 (Eff. 09111) L 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 for 1, era the undersigned, a registered voter (print name s 't appears on you vv ter information card) in said state and county, petition to have the name of r���� placed on the Primary/General Election Ballot as a: [check/complete box, as applicable] [ ‘onpartisan ❑ No party affiliation ❑ Party candidate for the office of (owl t/tek iS P n 3 (insert title of office and include district, circuit, group, seat number, if applicable) Date of Birth or Voter Rgistration Number Address ^� � (MM /DD/YY) /24 /5F SE L(� ( + City /I County State Zip Code 339 Signature of Vo -r / Date Signe (MM /DD/YY) [to be com fete by Voter] k _ :/ /I ( /S Rule 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, the undersigned, a registe ed voter qr Ce,r.. Lee k d m,e(AIS print name as it appears on your voter information card) in said state and county, petition to have the name of Grn rJS I �J oM c:(n� placed on the Primary/General Election Ballot as a: [check/complete box, as applicable] lonpartisan ❑ No party affiliation ❑ Party candidate for the office of OM ci))1A,9 0 j3 _ (insert tit e of office and include district, circuit, group, seat number, if applicable) Date of Birth or Voter Registration Number Address (MM /DD/YY) 7 r / -iqs- 10 SG Z9* City County State Zip Code y S Signature of Voter / Date Signed (MM /DD/YY) [to be completed by Voter] - G Rule 1S- 2.045, 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. - 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 for I, ,s,e,` �Ar1 the undersigned, a registered v to er (print name as it appears on your voter infor 'on card) • in said state and county, petition to have the name of J ,/ ) s1 , 4111 - placed on the Primary/General Election Ballot as a: [check/complete box, as applicable] Nonpartisan ❑ No party affiliation ❑ Party candidate for the office of D7 DA 1) (insert itle of office and include district, circuit, group, seat number, if applicable) Date of Birth or Voter Registration Number Address p 1 (MM /DD/YY) � 2 `7 v z. �` t d � 1 u_ O City County State Zip Code Signature of Voter Date Signed (MM /DD/YY) [to be completed by Voter] IVA 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 f . h � � the undersigned, a regist red voter (print name as it appe -. s on your voter info 91 tion card) in said state and county, petition to have the name of f '-1'. 2 DinelAAS placed on the Primary/General Election Ballot as a: [check/complete box, as applicable] Nonpartisan ❑ No party affiliation ❑ Party candidate for the office of ( cJi'r D1 3 (insert title of office and include district, circuit, group, seat number, if applicable) Date of Birth or Vot Registration Number Address (MM /DD/YY) 10.2V 7 - 706y 4 4 y City County State Zip Code dCPJ &qdi &/ , cJ �Gm _321/34 Signatu of Voter Date Si ned (MM /DD/YY) [to be ..mp ted by Voter] .1114A -16.11 /; 7 is- Rule 1S- 2.045, .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 for . .30nCAJVhan Can e Jr the undersigned, a registered voter (print name as it appears on your voter informati n card) in said state and county, petition to have the name of informati i7Ameild placed on the Primary/General Election Ballot as a: [check/complete box, as applicable] Nonpartisan ❑ No party affiliation ❑ Party candidate for the office of (owi , )Jj»yw( AIt 3 (insert title of office and include district, circuit, group, seat number, if applicable) Date of Birth or Voter Registration Number Address 10/i) ' 7 074 r►'); b i r y Dr City County State Zip Code Y 40 n (6 eat h a (rn beac cL Signatur, .f Voter Date Signed (MM /DD/YY) � t� [to be comp) ted by Voter] 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] / 1 - If all requested information on this form is not completed, the form will not be valid as a Candidate Petition form 1, f ( -( the undersigned, a registered voter (print name as it ap ears on your voter i .. ormatidn card) in said state and county, petition to have the name of J j . 0Mel,A S placed on the Primary/General Election Ballot as a: [check/complete box, as applicable] [ F Nonpartisan ❑ No party affiliation ❑ Party candidate for the office of \mM t S S [lV:C 0 -ad 3 (insert title of office and include district, circuit, group, seat number, if applicable) Date of Birth or Voter Registration Number Address (MM /DD ) City County State Zip Code Lam' ?caw` V 3433 Signature of Voter Date Signed (MM /DD/YY) [to be com leted by Voter] 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, / } the undersigned, a registered voter (print name as it a pears on your voter inform ' n card in said state and county, petition to have the name of placed on the Primary/General Election Ballot as a: [check/comple a box, as applicable] Nonpartisan D No party affiliation ❑ Party candidate for the office of (/ainfkl /94e- Da 3 (insert title of office and include district, circuit, group, seat number, if applicable) Date of Birth or Voter Registration Number Address (MM /DD/YY) /(7 — c� 4 _' / ` I � s5 4 4.2 ./ s/ City County State Zip Code .n. ov7 4e c4 1 124 F C 3 3 Vol- 6 Signature of Voter Date Signed (MM /DD/YY) [to be completed by Voter] Rule 1S- 2.045, F.A.C. DS -DE 104 (Eff. 09111) • • • 1 CANDIDATE PETITION t 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, '� the undersigned, a registered voter %7 (print name as it ap'ears on your voter info mation in said state and county, /// ty, petition to have the name of �� it �� placed on the Primary/General Election Ballot as a: [check/complete box, as applicable] Nonpartisan ❑ No party affiliation I3 L o r -i Party candidate for the office of 6714 (insert title of office and include district, circuit, group, seat number, if applicable) Date of Birth or Voter Registration Number Address (MM /DD/YY) 07 10 9� City e vei County State /� Zip Code /4741:4,7 5/:?‘" Signature o , • er . � Date Signed (MM /DD/YY) / [to be completed Voter] Rule 1S- 2.045, .A.C. -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 for . I, Ill , the undersigned, a registered voter (print name as "t ppears on your voter inform ard) Wevwdui in said state and county, petition to have the name of 6� - placed on the Primary/General Election Ballot as a: [check/complete box, as applicable] ❑ No party affiliation El Party candidate for the office of jlallonpartisan (ertebtat tY cliSiter Il { 3 (insert title of office and include district, circuit, group, seat number, if applicable) Date of Birth or Voter Registration Number Address City County State Zip Code o n c . W �rn . Q.� FL ag 3 5 Signature of Voter a Date Signed (MM /DD/YY) I [ to be completed by Voter] II/ oat 2015 Rule 1S- 2.045, F.A.C. DS -DE 104 (Eff. 09/11) • CANDIDATE PETITION e / 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 f m . 1, f Y ► tttCht ( \lltc e the undersigned, a registered voter (print name as it appears 1 your voter infor tion card in said state and county, petition to have the name of h j am. , v '.L placed on the Primary/General Election Ballot as a: [check/complete box, as applicable] [Nonpartisan ❑ No party affiliation ❑ f Party candidate for the office of e rolvivi..0 A.72-e-r n (insert title of office and include district, circuit, group, seat number, if applicable) Date of Birth or Voter Registration Number Address D C I1 5 5E a 8` ' City County State Zip Code ' 1(:5 r'),, C- ?CdA r n. 3)CGC h F1-- 634 Si • nature of Vot / >r Date Signed (MM /DD/YY) l . / 7 [to be completed by Vo er] 1 /ti / _ 1'1 --c1 -- t 4n Rule 1S- 2.045, F.A.C. DS -DE 104 (Eff. 09/11) CANDIDATE PETITION ( 1 7 p(e. 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. Cr co 4'1 the undersigned, a registered voter (print name appears on your voter info tion card) 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] Nonpartisan No party affiliation ❑ Party candidate for the office of (10-kmia;S5/17Kg-r- 0($ (insert title of office and include district, circuit, group, seat number, if applicable) Date of Birth or Voter Regi tration Number Address (MM /DD/YY ) 3 S , I > �� : 7 0 City County p State Zip Code -Pm. /*/ 573 Signature of V7 e 7 - Date Signed (MM /DD/YY) l / [ ] 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. p - 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 1 °IJ Q the undersigned, a registered voter (pri name as it appears o our voter infor ation card) in said state and county, petition to have the nab of (14 giOwidisar placed on the Primary/General Election Ballot as a: [check/complete box, as applicable] Nonpartisan ❑ No party affiliation ❑ Party candidate for the office of EfAvt sit / s(17 Ad 3 (insert title of office and include district, circuit, group, seat number, if applicable) Date of Birth or Voter Registration Number Address (MM /DD/YY) O,� / // / .6 2 11E2_, ;30 -- City County 9 State Zip Code 6 e /g©n i //9 -zii FL. 33 , /,35 Signature of Voter Date Signed (MM /DDIYY) Z [to be co leted by Voter] r /i 7// Rule 1S- 2.045, F.A.C. DS -DE 104 (Eff. 09/11) CANDIDATE PETITION V 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 for . 1, L rry/) ( 6O I ?P the undersigned, a registered voter (print name as it appears on your voter info do card) il in said state and county, petition to have the name of Pf. WavvaLAA placed on the Primary/General Election Ballot as a: [check/comp ete box, as applicable] )Z ❑ No party affiliation ❑ Party candidate for the office of c.W i9f (inse title of office and include distr ct, circuit, rou , seat number, if applicable) 9 P PP ) Date of Birth or Vot r Regis ration Number Address //�� r � (MM /Y /DDY) '70) cif di /4 v� / Vi {� E 0 r 6 t City Zj / y// � (1`JJC Co , 4 t r i g 1� cb2 State Zip Code 3,3 93 Signature of of r Z Date Signed (MM /DD/YY) ,./7" C /37 [to be competed by oter] hl 5 i 0 1 Rule 1S- 2.045, F.A.C. / DS -DE 104 Eff. 09/11 l 09/11) CANDIDATE PETITION V 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. 1, (" lv d the undersigned, a registered voter (print name as it appears on your voter inf ation card) in said state and county, petition to have the name of 4 placed on the Primary/General Election Ballot as a: [check/complete box, as applicable] [ Nonpartisan ❑ No party affiliation ❑ Party candidate for the office of e ffirvIAA t (- hx 7 (insert title of office and include distric , circuit, group, seat number, if applicable) Date of Birth or Voter Registration Number Address n (MM /DD/YY) 0 / 0 `f r / (q I —) 1 se 0A Ave__ City n County (� Stat � Zip Code '� _ vo I,LPAC Q / I ( 33 (f3C Signat re of Voter Date Signed (MM /DD/YY) [to be completed by Voter] Rule 1S -2. 5, A.A.c. DS -DE 104 (Eff. 09/11) • I _J V/ 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. 1, i t W /� I , kg A i n4 _ ! J the undersigned, a registered voter print name as it appears on your voter inf ation c ) in said state and county, petition to have the name of n � < � 7 A..9 placed on the Primary/General Election Ballot as a: [check/complete box, as applicable] Nonpartisan ❑ No party affiliation EK iJ I o I , Of/ Party candidate for the office of ((nit 6.V/ < d/gt (C. 3 ert title of office and include district, circuit, group, seat number, if applicable) Date of Birth or Voter Registration Number Address \ (MM /DD/YY) / CouuTy Stat Zip Code C 7 Signer e of Voter Date Signed (MM /DDIYY) d s i ' / ` _ �( i L [to be com leted y Voter] �.. Lam� Lli t /4 // /s ----- Rule 1S- 2.045, F.A.C. DS -DE 104 (Eff. 09/11)