Second SOE Petition Submittance Form 07-30-2021OF
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Wendy Sartory link slJ,rl5a o Ei.C"CI'
Palm Beach county Supervisor of Elections 2021 JUL 30
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PETITIO',\SUBMITTAN'CE FORM
Name on Petition, Candidate, or Committee: 1 (116 l �n
Office Candidate is seeking:
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Number of Petitions Submitted: (Approx.1 142-
Name of person submitting petitions: �l
Address:
City, State, Zip Code:
Phone: 5'6/— Email:.���'
Signature: n
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Deputy's Initials:
Revised 04/2020
Date:
240 South Military Trail, West Palm Beach, FL 334151 Post Office Box 22309. West Palm Beach, FL 33416
Telephone: 561.656.62001 Fax Number: 561.656.6267