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Filing Papers Miscellaneous Cash Receipt CITY OF BOYNTON BEACH No. 9213 r °L �P TON Account No. 001-0000-159-10-00 $ 306.81 //5 , 213/4i Received of STRVRN B_ GRANT Address P.O. BOX 424 BOYNTON BEACH, FL 33425 For 1% FILING FEE TO RUN FOR MAYOR ON MARCH: 12, 2019 Dept. CITY CLERK'S OFFICE By Miscellaneous Cash Receipt Y °, 3 CITY OF BOYNTON BEACH NO. `,� ` O U L �P TON 6 Account No. 001-0000-369-10-00 $ ?5_nn y , 20/ Received of STEVEN B. GRANT Address F.O. BOX 424 BOYNTON BEACH, FL 33425 For CITY FILING FEE TO RUN FOR MAYOR ON MARCH 12, 2019 Dept. CITY CLERK'S OFFICE By RESIDENCY REQUIREMENTS I lie Zria-) candidate for r , P (Print Name) OytOr of the City (Mayor/Commissioner— District #) of Boynton Beach, have received, read and thr understand the residency requirements of Article II of the Charter of the City of Boynton Beach. 'Signature of Candidate) 0(/ te) _<c cr 2/15/18 S:\CC\WP\ELECTION\Year 2014\Information Packets\RESIDENCY REQUIREMENTS STATEMENT.doc FORM 1 STATEMENT OF 2018 Please print or type your name,mailing FINANCIAL INTERESTS FOR OFFICE USE ONLY: address,agency name,and position below: LAST NAME--FIRST NAME--MIDDLE NAME: GRANT -STEVEN - BENJAMIN MAILING ADDRESS: PO BOX 424 mm 7:: n ,- CITY ZIP: COUNTY: I BOYNTON BEACH 33425 PALM BEACH W -,-, NAME OF AGENCY: --0 n CITY OF BOYNTON BEACH =a NAME OF OFFICE OR POSITION HELD OR SOUGHT: MAYOR rn c- You are not limited to the space on the lines on this form.Attach additional sheets,if necessary. CHECK ONLY IF ® CANDIDATE OR fJ 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, 2018 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(must check one): COMPARATIVE (PERCENTAGE)THRESHOLDS OR J 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"nla") NAME OF SOURCE SOURCE'S DESCRIPTION OF THE SOURCE'S OF INCOME ADDRESS PRINCIPAL BUSINESS ACTIVITY STEVEN B. GRANT, ESQ 2501 SW 11th Ct Boynton Beach FL 33426 ATTORNEY STEVEN B. GRANT 136 NE 3rd Ave Boynton Beach,FL 33435 LANDLORD 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 17(4 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 136 NE 3rd Ave,Boynton Beach, FL 33435 located at the bottom of page 2. INSTRUCTIONS on who must file this form and how to fill it out begin on page 3. CE FORM 1-Effective:January 1,2019 (Continued on reverse side) PAGE 1 Incorporated by reference in Rule 34-8.202(1),F.A.C. PART D—INTANGIBLE PERSONAL PROPERTY[Stocks,bonds,certificates of deposit,etc.-See instructions] Of you have nothing to report,write"none"or"n/a") TYPE OF INTANGIBLE BUSINESS ENTITY TO WHICH THE PROPERTY RELATES n/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 n/a 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 n/a 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 PART G—TRAINING For elected municipal officers required to complete annual ethics training pursuant to section 112.3142,F.S. ® I CERTIFY THAT I HAVE COMPLETED THE REQUIRED TRAINING. IF ANY OF PARTS A THROUGH G 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 attorney Signature: in good standing with the Florida Bar prepared this form for you,he or 7---.7f,-Y,' she must complete the following statement: I, , 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. Date Signe : t //� CPA/Attomey Signature: 1(7 "/ Date Signed: FILING INSTRUCTIONS: If you were mailed the form by the Commission on Ethics or a County Candidates file this form together with their filing papers. Supervisor of Elections for your annual disclosure filing, return the MULTIPLE FILING UNNECESSARY:A candidate who files a Form form to that location. To determine what category your position falls 1 with a qualifying officer is not required to file with the Commission under,see page 3 of instructions. or Supervisor of Elections. Local officers/employees file with the Supervisor of Elections WHEN TO FILE:Initially, each local officer/employee,state officer, of the county in which they permanently reside. (If you do not permanentlyreside in Florida, file with the Supervisor of the countyand specified his or state employee must file within 30 days of the p date of his or her appointment or of the beginning of employment where your agency has its headquarters.)Form 1 filers who file with the Supervisor of Elections may file by mail or email. Contact your Appointees whoemust thatbe confirmedws by the daysSenate from must datete priorfh it Supervisor of Elections for the mailing address or email address to confirmation,omnt.even if is less than 30 from the of their use. Do not email your form to the ommission on Ethics, it will be appointment. returned. Candidates must file at the same time they file their qualifying State officers or specified state employees who file with the papers. Commission on Ethics may file by mail or email. To file by mail, Thereafter, file by July 1 following each calendar year in which they send the completed form to P.O. Drawer 15709, Tallahassee, FL hold their positions. 32317-5709; physical address: 325 John Knox Rd, Bldg E, Ste 200, Tallahassee, FL 32303. To file with the Commission by email, scan Finally,ngfile a finalm disclosure form (FormF 1F)F within(Final Statement days of your completed form and any attachments as a pdf(do not use any oleaving Financial Interests)office or es)doesnt. Fri li a CE Form 1F ig other format)and send it to CEForm1 @ieg.state.fl.us. Do not file by if ilerw inhiso does osi on onne the mfiler of filing a. Form 1 both mail and email.Choose only one filing method. Form 6s will not if the filer was in his or her position December 31,2018. be accepted via email. CE FORM 1-Effective:Januay 1,2019. PAGE 2 Incorporated by reference in Rule 34-8.202(11,F.A.C. CANDIDATE OATH — NONPARTISAN OFFICE "(' "4 (Do not use this form if a Judicial or School Board Candidate) i ' .leck box only if you are seeking to qualify as a 19 .Mi! —9 P l 2: SR write-in candidate: ❑ Write-in candidate OFFICE USE ONLY Candidate Oath (Section 99.021(1)(a),Florida Statutes) I, S7YI1 I �/�t✓I� (Print name above as you wish it to appear on the ballot If your last name consists of two or more names but has no hyphen, check box 0. (See page 2 - Compound Last Names). No change can be made after the end of qualifying. Although a write-in candidate's name is not printed on the ballot, the name must be printed above for oath purposes.) am a candidate for the nonpartisan office of A(kQ I Y (Office) (District#) ;I am a qualified elector of P4/M 0(tt C 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. Candidate's Florida Voter Registration Number(located on your voter Information card): 1 I) S 7�J y 7 Y G Phonetic spelling for audio ballot: Print name phonetically on the line below as you wish it to be pronounced on the audio ballot as may be used by persons with isabilities(see instructions on page 2 of this form):(Not applicable to write-in candidates.] 1Te_e-- Ver) nrG f 6 ) ek Ss'? q S��t/L�'i ./ IP') tg( fil✓t\ ("I Signature of Candidate Telephone Numb r Email Address i 3 felt c`� , ( &__ c/1.40 �e€c — s5 Add Address City State ZIP Code STATE OF FLORIDA , - �d/�' 41.4- I • �/� �_ Signature of No -ry Public COUNTY OF )1Ol..�1M �e ` Print,Type,or Stem, Commissioned Name o 'otary Public below Sworn to(or affirmed)and subscribed before me this °I 44: TAMMY L STANZIONE day of 1,y(._.<\�0.--j20 zc MY COMMISSION#FF213683 'ersonally Known.: _ or 'aimed Identification: 1: EXPIRES March 25.2019 44C1 398-0'53 noridallo:a yServiut.con, Type of Identification Produced: DS-DE 302NP(Rev.11/17) • Rule 1S-2.0001,F.A.C. '`4""OF F fc < t ,gip O ,,% .. y Palm Beach County qil V _ry A.OFPAr''" 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 27 signatures on the Nominating Petitions of STEVEN B. GRANT for MAYOR FOR THE CITY OF BOYTON BEACH 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 STEVEN B. GRANT is a registered voter in Precinct 7182, in the City of Boynton Beach, Florida. Signed, this the 18th day of December, 2018. ./e,A,001/rN , bh611,‘ SUSAN BUCHER --• , SUPERVISOR OF ELECTIONS c PALM BEACH COUNTY x -``_. c. (SEAL) ►v -T;_ -- C CITY OF BMJ YN TON BEACH APPOINTMENT OF CAMPAIGN TREASURER CITY CLEFS ('S OFFICE AND DESIGNATION OF CAMPAIGN DEPOSITORY • �� 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 1. CHECK APPROPRIATE BOX(ES): 0 Initial Filing of Form Re-filing to Change: ❑ Treasurer/Deputy ❑ Depository ❑ Office ❑ Party 2. Name of Candidate(in this order: First, Middle, Last) 3.Address(include post office box or street, city, state,zip Steven Benjamin Grant code) PO Box 424 4. Telephone 5. E-mail address Boynton Beach, FL 33425 (561 ) 880-5529 Steven@StevenBGrant.com 6. Office sought(include district, circuit, group number) 7. If a candidate for a nonpartisan office,check if Mayor, City of Boynton Beach applicable: ❑ 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. I have appointed the following person to act as my ® Campaign Treasurer ❑ Deputy Treasurer 10. Name of Treasurer or Deputy Treasurer Steven B Grant 11. Mailing Address 12. Telephone PO Box 424 ( 561 ) 880-5529 13. City 14. County 15.State 16.Zip Code 17. E-mail address Boynton Beach Palm Beach Florida 33425 Steven@StevenBGrant.com 18. I have designated the following bank as my ® Primary Depository ❑ Secondary Depository 19. Name of Bank 20.Address SunTrust Bank 315 S Federal Hwy 21. City 22. County 23. State 24. Zip Code Boynton Beach Palm Beach FL 33435 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 IN IT ARE TRUE. 25. Date 26. Sig ,to of Can idate August 9, 2017 . X 27. Treasurer's Acceptance of Appointment(fill in the blanks and check the appropriate block) I, Steven B. Grant , do hereby accept the appointment (Please Print or Type Name) designated above as: ® Campaign Treasurer • / �e•uty T easurer. August 9, 2017 X g Date ignature a of Campaign Treasurer or Deputy Treasurer DS-DE 9(Rev. 10/10) Rule 1S-2.0001, F.A.C. CITY OIDEEICX114§k3PAV STATEMENT OF CITY CLERc'S;OFFICE CANDIDATE 17 AUG -9 PHI: 30 (Section 106.023, F.S.) (Please print or type) 1, Steven B. Grant candidate for the office of Mayor, City of Boynton Beach have been provided access to read and understand the requirements of Chapter 106, Florida Statutes. s /3- ,/ 08/09/2017 Signature of Candidate 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)