HomeMy WebLinkAbout2010 08 09 Consent 205 Proposed Qualifying Documents COMMISSION AGENDA
Informational
Consent X
ITEM 205 Public Hearings
Regular
'Ir
August 9, 2010 `A`-
Regular Meeting Mgr. / i
Authorization
REQUEST:
The City Clerk requests that the City Commission review the proposed Qualifying
documents in this Agenda Item along with the general information regarding some
of the details and dates pertaining to the November 2, 2010 Winter Springs
General Municipal Election.
SYNOPSIS:
2010 is an Election year for the City of Winter Springs with a General Municipal
Election being held on November 2, 2010 (in conjunction with Seminole County.)
As in previous Election years, the City Commission has asked to review the
Qualifying documents, thus the documents in this Agenda Item are most of the
official City generated forms that will become part of the City's Qualifying
Packets. Additionally, this Agenda Item provides the City Commission with some
of the details about the upcoming General Municipal Election being held on
November 2, 2010.
CONSIDERATIONS:
Previously, the City Clerk had been asked to provide the City Commission with a
preview of the proposed City generated documents that will become part of the
City's Qualifying Packets. The current City Commission has also asked to be
provided with a copy of the proposed City generated Qualifying documents for
their review.
CITY OF WINTER SPRINGS, FLORIDA
CITY COMMISSION
REGULAR MEETING - AUGUST 9, 2010
CONSENT AGENDA ITEM "205"
PAGE 2 OF 4
Prior to the completion of this Agenda Item, these proposed City generated
Qualifying documents were forwarded to City Attorney Anthony A. Garganese's
Office; and Attorney Kim Kopp has reviewed the attached City generated
Qualifying documents.
DATE OF GENERAL MUNICIPAL ELECTION:
"The regular election of mayor and commissioners shall be held at the time
provided for in Section 8.01 of this Charter." [per the Charter, Section 4.03.]
The next General Municipal Election will be held on Tuesday, November 2, 2010
[as outlined in Section 8.01.1.
"The mayor shall issue a proclamation calling the municipal elections provided
for in this article and at least sixty (60) days prior thereto." [per Chapter 2 of the
Code of Ordinances, Section 2.82.].
TERM LIMITS:
"The mayor shall be limited to three (3) consecutive full terms of office.
Commission members shall be limited to three (3) consecutive full terms of
office. The mayor or any commission member who has served three (3)
consecutive full terms of office after having been out of office for a period of one
(1) year, shall be eligible for election to successive three (3) consecutive full terms
of office; provided however, this limitation shall not prohibit a person who has
served three (3) consecutive full terms of office as mayor from qualifying and
being elected as a commission member; nor shall this limitation prohibit a person
who has served three (3) consecutive full terms of office as a commission member
from qualifying and being elected as mayor of the city." [per the Charter, Section
4.03. (c)].
TERM OF OFFICE:
"All elections shall be for four -year terms of office." [per the Charter, Section
4.03.].
The Term of Office will expire this year for the following Seats:
• Mayor (currently held by the Honorable John F. Bush)
• City Commission Seat Two (currently held by the Honorable Rick
Brown)
• City Commission Seat Four (currently held by the Honorable Sally
McGinnis)
MUNICIPAL ELECTIONS OFFICER:
"The city clerk is hereby designated the supervisor of elections for the city." [per
Chapter 2 of the Code of Ordinances, Section 2.81.].
CITY OF WINTER SPRINGS, FLORIDA
CITY COMMISSION
REGULAR MEETING - AUGUST 9, 2010
CONSENT AGENDA ITEM "205"
PAGE 3 OF 4
As our next General Municipal Election is being held in conjunction with
Seminole County, the Supervisor of Elections for Seminole County, Mr. Michael
Ertel and his staff will be taking care of many of the details for this Election.
QUALIFYING:
The period for qualifying runs "during regular business hours any time after 12:00
noon on the first filing date, which shall be seventy -one (71) calendar days prior
to the municipal election, but not later than 12:00 noon on the sixty- seventh (67)
calendar day prior to the municipal election. In the event, the first or last filing
date falls on a Saturday, Sunday, or legal holiday, then the subject filing date shall
be rescheduled to the next regular business day." [per Chapter 2 of the Code of
Ordinances, Section 2.87.1.
For the November 2, 2010 General Municipal Election - the Qualifying Period
runs from Noon on Monday, August 23, 2010 until Noon on Friday, August 27,
2010.
The names of the Candidates that qualify for the November 2, 2010 City of
Winter Springs General Municipal Election will be forwarded to the Supervisor of
Elections for Seminole County, prior to the end of business on Friday, August 27,
2010.
The City Clerk requests the City Commission review this Agenda Item for
information regarding some of the details and dates pertaining to the November 2,
2010 General Municipal Election, along with the documents included in this
Agenda Item which are the official forms that will become part of the City's
Qualifying Packets.
FISCAL IMPACT:
There is no Fiscal Impact to be considered with the approval of this Agenda Item.
COMMUNICATION EFFORTS:
The attachments in this Agenda Item have been sent to the City Attorney's Office for
their review and any changes they have suggested, have been made; along with any
scrivener's errors during /after their review. Additionally, this Agenda Item has been
distributed to the Mayor and City Commission, City Manager, and City Attorney; placed
in Press Packets; placed in the Lobby binder; and will be available on the City's Website,
LaserFiche, and the City's Server.
CITY OF WINTER SPRINGS, FLORIDA
CITY COMMISSION
REGULAR MEETING - AUGUST 9, 2010
CONSENT AGENDA ITEM "205"
PAGE 4 OF 4
After the approval of this Agenda Item and prior to the 2010 Qualifying period, the City
Clerk will notify all individuals who have opened up a Campaign Account for the 2010
Winter Springs General Municipal Election; along with any individuals who have asked
for preliminary documents related to the 2010 Winter Springs General Municipal
Election — as to when Qualifying Packets will be available.
RECOMMENDATION:
The City Commission is requested to approve the information in this Agenda Item
along with the proposed Qualifying documents presented under "Attachments ".
ATTACHMENTS:
Forms generated by the City of Winter Springs that will become part of the
November 2, 2010 Winter Springs General Municipal Election Qualifying
Packets, (but not limited to):
• "1- Affidavit Of Acceptance"
• "2 - Affidavit Of Residency — City"
• "3 - Affidavit Of Residency — District"
• "4 - Application For Office"
• "5 - Election Assessment"
• "6 - Oath Of Candidate"
• "7 - Loyalty Oath"
• "8 - Notice Of Testing Of Tabulating Equipment"
• "9 - Notice Of Political Campaign Advertisements /Signs
Supplement"
• "10 - Schedule of Campaign Finance Reporting Periods /Due
Dates'
• "11 - Petition"
• "Notice To Federal Government Employees"
• "Notice Of Undue Burden"
C ORVO NTER s CITY OF WINTER SPRINGS, FLORIDA
'� 2010 GENERAL MUNICIPAL ELECTION
1 - AFFIDAVIT OF ACCEPTANCE Page 1 of 4
orated MAYOR — CITY COMMISSION SEAT TWO /SEAT FOUR
1959
p' Circle W hich Applies To Candidacy
NOTE: The information provided to you in this packet, and the documents listed on this sheet, are provided to you
to assist you in your campaign for Elective Office, however, the documents in this packet of materials are not
intended to be a complete digest of the Elections Laws. IT IS YOUR RESPONSIBILITY TO READ AND
UNDERSTAND THE ELECTION CODE AND COMPLY WITH ALL APPLICABLE REQUIREMENTS.
The Applicant accepting this document and the attachments, and the City Clerk/Designee
providing these documents, should each initial by each item (in each block) as reviewed:
Time Review Began Time Review Concluded
, Qualifying Documents: (The documents in this section are due to the City Clerk/Designee
Q o a` 6 9)9 no later than 12:00 Noon on the last day of Qualifying - Friday, August 27, 2010)
I I I I "Appointment Of Campaign Treasurer And Designation Of Campaign Depository Fo . : 'dates" [DS -DE -9]
I I I I "Statement Of Candidate" [DS -DE 84]
I I 1 - "Affidavit Of Acceptance"
(Must be completed/signed in front of the City Clerk/I • - - - . 111
I I I 12 - "Affidavit Of Residency - City"
(Must be completed /signed in fry ' 1 i ` k /.1 -ignee I URIN THE QUALIFYING PERIOD).
13 - "Affidavit Of Res'r - . i
. - C. i s ' . , ' Se: Only)
(Must be corn.. •/sig / o .�` the Ci To lerk/Designee DURING THE QUALIFYING PERIOD).
MN ' "A icat • I • f' c- (With heck drawn from Campaign Account) or [ "Notice of Undue Burden "]
Era -" ; ,, . n j . sess t" (With Check drawn from Campaign Account) or [ "Notice of Undue Burden "]
Mg _A 6 'Oat ;if Candidate"
Mr (Must be completed /signed in front of the City Clerk/Designee DURING THE QUALIFYING PERIOD).
17- "Loyalty Oath"
(Must be completed /signed in front of the City Clerk/Designee DURING THE QUALIFYING PERIOD).
18 - "Notice Of Testing Of Tabulating Equipment"
1 9 - "Notice Of Political Campaign Advertisements /Signs Supplement"
1 10 - "Schedule Of Campaign Finance Reporting Periods /Due Dates"
I I 11 - Petition
I I I "Notice to Federal Government Employees"
"Form 1" - "Statement Of Financial Interests 2009"
I I I DS -DE 105 - "Candidate Name Pronunciation Request"
Initials/Date: (ApplicantiCCO)
/
■
c� • "`' -TER CITY OF WINTER SPRINGS, FLORIDA
2010 GENERAL MUNICIPAL ELECTION
3 1 - AFFIDAVIT OFACCEPTANCE Page 2 of 4
�LORIOp'
cc, State of Florida - Information:
I I "The Election Laws" - October 2009 [Chapters 97, 98, 99, 100, 101, 102, 103, 104, 105 and 106]
(i.e. "Florida Election Code ")
"The Election Laws" - "Highlighted" (October 2009)
"Chapter 2010 -167" (May 28, 2010)
"Candidate and Campaign Treasurer Handbook" - July 2010 (Which includes "Chapte ' olitical
Advertising" and "Chapter 14 Other Disclaimers ")
"2010 Public Campaign Financing Handbook"
"Electioneering Communications Organization Handbook" - J 201
"State of Florida Election Information/Contacts"
Individual Florida Statutes (Related to s.`a' a alifyin_ ' orm of particular interest):
99.012 Florida Statutes ( "Res i, i ; '.`. n ‘ ua 6 ali . i g for public office ")
99.021 Florida Statu o o , r id. - oa'
99.093 Flori • atut: nic. : candi.: s; e ection assessment ")
100.3 , Fl • . at e "Con • t of municipal elections ")
t 13 ' lo • ' e r, "Watchers at " olls
p )
1. /9 a Sta ies ( "Testing of tabulating equipment ")
11 t .02 hr a Statutes ( "Campaign treasurers; deputies; primary and secondary depositories ")
11 :.023 Florida Statutes ( "Statement of candidate ")
106.07 ( "Reports; certification and filing ")
106.09 ( "Cash contributions and contribution by cashier's checks ")
106.1435 Florida Statutes ( "Usage and removal of political campaign advertisements ")
106.1439 Florida Statutes ( "Electioneering communications; disclaimers ")
Department of State Memorandum (dated June 3, 2010)
106.147 Florida Statutes ( "Telephone solicitation; disclosure requirements; prohibitions; exemptions...")
106.1475 Florida Statutes ( "Telephone solicitation; registered agent requirements; penalty")
106.15 Florida Statutes ( "Certain acts prohibited ")
876.05 Florida Statutes ( "Public employees; oath ")
876.07 Florida Statutes ( "Oath as prerequisite to qualification for public office ")
876.09 Florida Statutes ( "Scope of law ")
876.10 Florida Statutes ( "False oath; penalty")
State of Florida - Division of Elections Campaign Finance Information:
"Notice of Access to Campaign Finance Forms"
"Contributions Returned" [DS -DE 2] [Florida Statutes 106.07 (4)(b)]
Courtesy Receipts Envelope
Initials/Date: (Applicant/CCO)
C .4 TE R
R s CITY OF WINTER SPRINGS, FLORIDA
2010 GENERAL MUNICIPAL ELECTION
� 1- AFFIDAVIT OFACCEPTA1VCE Page 3 of 4
RVD
�J s
t , Q a �''' / Electronic Filing Information
I City of Winter Springs Ordinance Number 2009 -09 (also noted in Chapter 2 of the ' , ter
Springs' Code of Ordinances)
I I I I Letter from the Winter Springs City Clerk to "Candidates for El - ted 0 ' S - • le onic ; ling
of Campaign Finance Reports)
I I I "Online Treasurer Reporting System" (Guider 1- s fo . ectro k F> • I Ca 1 : ' O inance
Reports) from the Seminole County Su . e ; AL , 1: ions
VII
Miscellaneous Inform . t 1 0
V.
- . it Ca i . aign Practices"
"Guide to the . ' shine • 1, e t , . `Cod: • f Et s for Public Officers and Employees" (2010)
"Florid o lunit od- •
w 1,3 Q .lifyin .ai :. Finance eport Due Dates" (Revised 07/01/10)
mi _m, . ; _ : Lion s - . 03
IIIIN IM' "S em ∎ • ical Campaign Practices" (from the Seminole County Supervisor of Elections)
ME ' • Guide & Florida Voter Registration Application" (from the Seminole County Supervisor
a� :, of Elections)
City Information:
"Charter" of the City Of Winter Springs
"Chapter 2 - Administration" from the City Of Winter Springs Code of Ordinances
City of Winter Springs Ordinance Number 2008 -16 (also noted in Chapter 2 of the City of Winter
Springs' Code of Ordinances)
I I I I City of Winter Springs Ordinance Number 2009 -14 (also noted in Chapter 2 of the City of Winter
Springs' Code of Ordinances)
2010 General Municipal Election "Information"
City of Winter Springs 2010 District Map
City of Winter Springs' "Employee/Payroll Forms"
Initials/Date (ApplicantlCCO)
/
4�N s CITY OF WINTER SPRINGS, FLORIDA
44 41t. 2010 GENERAL MUNICIPAL ELECTION
1- AFFIDAVIT OF ACCEPTANCE Page4of4
V IncorporiaM l tii
•PLORIDP
The following signature area is to be signed upon receiving the 2010 Election Qualifying packet ' . i, di t I. .. , • e
referenced documents:
D. ii% joy il
I, have on this date received the fo - ' ati. 1, n. o i . e -
Name of Candidate Please Print or Type)
YPe)
four (4) pages, in addition to any other Election mat .t •, ve ; io , , received from the Office of the
Cis for Winter S rin s; an ee the I re. of th= :lecti. ack t mater 1
ty p g, p e ate a s that have been provided to me;
and I also agree that ' is m spons i to c Imply w • t all L aws as they apply to the 2010 Election.
\IN) Signature of Candidate
Street Address
City State Zip Code
Date
STATE OF FLORIDA
COUNTY OF
1 Sworn to (or affirmed) and subscribed, under penalties of perjury, before me this
day of , 201 , by
(Print Name of Person Making Statement)
Notary Public - State of Florida
Signature of Notary Public
(SEAL)
(Print Name of Notary Public)
Produced OR Personally
Identification Known
Type of Identification Produced
Initials/Date: (Applicant/CCO)
Revised 08/03/10 /
CITY OF WINTER SPRINGS, FLORIDA
- 2010 GENERAL MUNICIPAL ELECTION
2 - AFFIDAVIT OF RESIDENCY - CITY
"40 OP'
MAYOR - CITY COMMISSION SEAT TWO /SEAT FOUR
Circle Which Applies To Candidacy
"Each candidate seeking the office of city commissioner or mayor of any other elective office of the city shall have resided in the city one (1)
year prior to the time of qualifying." 12 -87. Code of Ordinances, City of Winter Springs
do hereby state that I seek nomination to the City of Winter
Name of Candidate (Please Print or Type)
Springs as Mayor - City Commission Seat Two /Seat Four - a four (4) year term, in the Electit e h 1
Circle Seat Which Applies To Candidacy
in the City of Winter Springs, Florida, on Tuesday, November 2, 2010. I, fu ., - . e
(1) My legal place of residence is:
Street Ad. State Zio Code
(2) Length of time of residency in the City of "'ter :s is:
(3) I am attaching the following do t •t ent( r fic: t of m ngth of residency in the City of Winter
Springs. The do . r ent
r �
Signature of Candidate
Street Address
City State Zip Code
STATE OF FLORIDA Date
COUNTY OF
Sworn to (or affirmed) and subscribed, under penalties of perjury, before me this
day of , 201 , by
(Print Name of Person Making Statement)
Notary Public - State of Florida
Signature of Notary Public
(SEAL)
(Print Name of Notary Public)
Produced OR Personally
Identification Known
Type of Identification Produced _
Initials/Date: (ApplicantJCCO)
/
FOR OFFICE USE ONLY
Documentation Provided For Item (3).
Revised 07/29/10
�„roweR CITY OF WINTER SPRINGS, FLORIDA
2010 GENERAL MUNICIPAL ELECTION
u t 3 - AFFIDAVIT OF RESIDENCY - DISTRICT
A"LORIDp' CITY COMMISSION SEAT TWO /SEAT FOUR
Circle Which Applies To Candidacy
"Each candidate seeking the office of city commissioner shall be a resident of a designated commission district as established by ordinance and shall
have resided in the designated commission district six (6) months prior to the time of qualifying." [2 -87. Code of Ordinances, City of Winter Springs]
I, do hereby state that I seek nomination to th i in
Name of Candidate (Please Print or Type)
Springs City Commission - Seat Two /Seat Four - a four (4) year term • SIMI' ec ' t e h
Circle Seat Which Applies To Candidacy
in the City of Winter Springs, Florida, on Tuesday, ■ • � ,e ►• 1 to tha .
(1) My legal place of residence is: 11
1111 1 A . s s Citv State Zio Code
(2) Length of time of re • • ncy . Ci nter rings is:
(3) Length o i'm= •1 - is • cy r , of the City of Winter Springs is:
(4) 1 at attac t' fol s g : •cument(s) as verification of my length of residency in this District
and he • o ' inter Springs. The document is:
Signature of Candidate
Street Address
City State Zip Code
STATE OF FLORIDA Date
COUNTY OF
Sworn to (or affirmed) and subscribed, under penalties of perjury, before me this
day of , 201 , by .
(Print Name of Person Making Statement)
Notary Public - State of Florida
Signature of Notary Public
(SEAL)
(Print Name of Notary Public)
Produced OR Personally
Identification Known
Type of Identification Produced
Initials/Date; (Applicant/CCO)
/
* * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * *
FOR OFFICE USE ONLY
Documentation 4
Provided For Item (4).
I 1 c)
Revised 07/29/10
i-
•t�‘N CITY OF WINTER SPRINGS, FLORIDA
4�. 2010 GENERAL MUNICIPAL ELECTION
u 4 - APPLICATION FOR OFFICE
` t.&O ` % MAYOR - CITY COMMISSION SEAT TWO /SEAT FOUR
Circle Which Applies To Candidacy
"All candidates for offices in municipal elections shall be registered and qualified electors of the city at the time of their qualifying as a candidate
with the city clerk and shall file qualifying papers in accordance with state statutes and pay the qualifying fee and election assessment provided for in
section 2 -88. Such application shall be filed and the qualifying fee paid during regular business hours any time after 12:00 noon on the fir
filing date, which shall be seventy-one (71) calendar days prior to the municipal election, but not later than 12:00 noon on the sixty
calendar day prior to the municipal election." 12 -87. Code of Ordinances, City of Winter Springs'
"All candidates for city commission and mayor, qualifying as provided in this Code, shall pay a qualifyin . fee of o un do
($150.00). The qualifying fee and the election assessment shall be paid to the city clerk and be pa' • • th , rk int • • e g fund o
12 -88. (a) Code of Ordinances, City of Winter Springs
"Pursuant to F.S. 99.093 (2), candidates who are unable to pay the election a .• t it 1 t imposin_ . • un • • • den on their personal resources
or resources otherwise available to them shall upon written certif • • • su h
i i i t
I ' gi e under o. t to the c • clerk be exempted from
paying the election assessment. Any candidate exempt fro!, the • e s ss • t als • • • • rom the city's qualifying fee."
12 -88. (b) Code of Ordinances, City of Winter Sprin o il'
1, a ` l do hereby state that I am a registered and qualified Elector of the
lb C. to ( . t M ype)
City of . : prings; and am applying for the office of Mayor - City Commission Seat Two /Seat Four,
Circle Which Applies To Candidacy
a four (4) year term, in the Election to be held in the City of Winter Springs, Florida, on Tuesday,
November 2, 2010. I further agree to pay the following Qualifying Fee:
QUALIFYING FEE: $150.00
Signature of Candidate
Date Document Signed
Initials/Date (Applicant/CCO)
/
* * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * *
FOR OFFICE USE ONLY
Campaign Account Check in the amount of $150.00 attached (Check should be made payable to
the "City of Winter Springs ")
or, if applicable
Completed "Notice of Undue Burden" Attached
Revised 07/29/10
���NTER CITY OF WINTER SPRINGS, FLORIDA
2010 GENERAL MUNICIPAL ELECTION
1""le S - ELECTION ASSESSMENT
D� LORI
MAYOR - CITY COMMISSION SEAT TWO /SEAT FOUR
Circle Which Applies To Candidacy
"Each person seeking to qualify for nomination or election to a municipal office shall pay, at the time of qualifying for office, an election
assessment. The election assessment shall be an amount equal to 1 percent of the annual salary of the office sought."
199.093 (1) Florida Statutes1
"Any person seeking to qualify for nomination or election to a municipal office who is unable to pay the election assess . t • out imp •
an undue burden on personal resources or on resources otherwise available to him or her shall, upon written certificati of h '
given under oath to the qualifying officer, be exempt from paying the election assessment." 199.093 (2 Flor a • tatute•
I, do hereb to t 1 t a istere d q : led Elector of the
Name of Candidate (Please Print or Type)
City of Winter Springs; and am ap g fo t' ce ayor ity "ommission Seat Two /Seat Four
Circle Which Applies To Candidacy
- a four (4) year rm r .le ► , Cti011ie els 1 the City of Winter Springs, Florida, on Tuesday,
Novemb , 201 I 4h- . .e :o pay the following applicable Election Assessment:
ELECTION ASSESSMENT - MAYOR: $144.00
The Mayor Receives: $1,200.00 per month
$1,200.00 x 12 months = $14,400.00 annually
The 1% Assessment amounts to: $144.00
OR
ELECTION ASSESSMENT - COMMISSIONER: $120.00
Each Commissioner Receives: $1,000.00 per month
$1,000.00 x 12 months = $12,000.00 annually
The 1% Assessment amounts to: $120.00
Signature of Candidate
Date Document Signed
Initials/Date: (Applicant/CCO)
/
FOR OFFICE USE ONLY
For Office of Mayor - Campaign Account Check in the amount of $144.00 attached (Check
should be made payable to the "City of Winter Springs ")
or
For Office of Commissioner - Campaign Account Check in the amount of $120.00 attached
(Check should be made payable to the "City of Winter Springs ")
or, 1 applicable
Completed "Notice of Undue Burden" Attached
Revised 07/29/10
. ,4 1 11 R CITY OF WINTER SPRINGS, FLORIDA
"w 2010 GENERAL MUNICIPAL ELECTION
u t ro.paa,� 6 - OATH OF CANDIDATE
1959
.4 "kotztvP MAYOR - CITY COMMISSION SEAT TWO /SEAT FOUR
Circle Which Applies To Candidacy
"Each candidate, whether a party candidate, a candidate with no party affiliation, or a write -in candidate, in order to qualify for nomination
or election to any office other than a judicial office as defined in chapter 105 or a federal office, shall take and subscribe to an oath or affirmation
in writing. A printed copy of the oath or affirmation shall be furnished to the candidate by the officer before whom such candidate
seeks to qualify and shall be substantially in the following form:" 199.021 (1) (a) Florida Statutes'
STATE OF FLORIDA
COUNTY OF 0 °..0
"Before me, an officer authorized to administer oaths, ■ o y : d
I, app
name as yo ' sh it to ear on the ballot)
wn s
to me well o o in ays that he or she is a candidate for the offs
g y office of
Mayor - C i t ission Seat Two /Seat Four that he or she is a qualified elector of
Circle Which Applies To Candidacy
County, Florida; that he or she is qualified under the Constitution and the laws of Florida to hold the office to which
he or she desires to be nominated or elected; that he or she has taken the oath required by ss. 876.05- 876.10, Florida
Statutes; that he or she has qualified for no other public office in the state, the term of which office or any part thereof
runs concurrent with that of the office he or she seeks; and that he or she has resigned from any office from which he
or she is required to resign pursuant to s. 99.012, Florida Statutes ."
Signature of Candidate
Street Address
City State Zip Code
Sworn to and subscribed before me this day of , 201 ,
at Seminole County, Florida.
(Signature and Title of Officer Administering Oath)
Initials/Date: (Applicant/CCO)
Revised 07/29/10 /
�•N�NTER CITY OF WINTER SPRINGS, FLORIDA
0 2010 GENERAL MUNICIPAL ELECTION
t
�n,�d� 7- LOYALTY OATH
]959
'P�oRtvP MAYOR - CITY COMMISSION SEAT TWO /SEAT FOUR
Circle Which Applies To Candidacy
All persons who now or hereafter are employed by or who now or hereafter are on the payroll of the state, or any of its departments and
agencies, subdivisions, counties, cities, school boards and districts of the free public school system of the state or counties, or institutions o '' A,t
learning, and all candidates for public office, except candidates for federal office, are required to take an oath before any person t ut ,1 . ed to
take acknowledgements of instruments for public record in the state..." 1876.05 (1) Florida Statutes]
"Any person seeking to qualify for public office who fails or refuses to file the oath required by this act shall b ■ • I to h+ : fail d ; . ualify
candidate for public office, and the name of such person shall not be printed on the ballot as a quill' I ' I • . at 876.1 Flor , , Statutes] .ki "l,
111 1 iz; ; S S ; - • ' . rida and of the United States
Name of Candidate (Please Pri or Type)
0
of America, and being emplo - by cr fic and a recipient of public funds
as such e oyee ,t of - • • t • eby e ear or affirm that I will support the Constitution of the
United Stat nd o e `'e o orida."
Signature of Candidate
Street Address
City State Zip Code
STATE OF FLORIDA
COUNTY OF
Sworn to (or affirmed) and subscribed, under penalties of perjury, before me this
day of , 201 , by .
(Print Name of Person Making Statement)
Notary Public - State of Florida
Signature of Notary Public
(SEAL)
(Print Name of Notary Public)
Produced OR Personally
Identification Known
Type of Identification Produced
Initials/Date: (Applicant/CCO)
Revised 07/29/10 /
ri-4,147-e. CITY OF WINTER SPRINGS, FLORIDA
2010 GENERAL MUNICIPAL ELECTION
8 - NOTICE OF TESTING OF TABULATING EQUIPMENT
Incorporated 59
'ctoR►o� MAYOR - CITY COMMISSION SEAT TWO /SEAT FOUR
Circle Which Applies To Candidacy
"On any day not more than 10 days prior to the commencement of early voting as provided in s. 101.657, the supervisor of elections shall
have the automatic tabulating equipment publicly tested to ascertain that the equipment will correctly count the votes cast for all
offices and on all measures. If the ballots to be used at the polling place on election day are not available at the time of the testing,
the supervisor may conduct an additional test not more than 10 days before election day. Public notice of the time and place of t
test shall be given at least 48 hours prior thereto by publication once in one or more newspapers of general circulation in t
county or, if there is no newspaper of general circulation in the county, by posting the notice in at least four conspicuo p1 in
the county. The supervisor or the municipal elections official may, at the time of qualifying, give written notic ' the tam' , d / ., I -
of the public preelection test to each candidate qualifying with that office and obtain a signed receip o as b: giv - ,
]101.5612 (2) Florida Statutes]
Please accept this Notice that th . .ulat , e ' a to be lize in the City of Winter Springs, Florida's
2010 General 0 u ► .1 1 do III . - t ed on:
\143
DATE: FRIDAY, OCTOBER 8, 2010
TIME: 10:00 A.M.
The aforemen toned test will be held at:
THE OFFICE OF THE SUPERVISOR OF ELECTIONS FOR SEMINOLE COUNTY
1500 EAST AIRPORT BOULEVARD, SANFORD, FLORIDA
(407) 708 -7700
City of Winter Springs
Qualifying Officer/Designee
Initials/Date: (Applican/ICCO)
/
* * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * *
RECEIPT
1 , do hereby acknowledge that on this
Name of Candidate (Please Print or Type)
date of , 201 , I received written Notice (as noted above /on this form) of
the date, time, and location related to the "Testing of Tabulating Equipment ".
Signature of Candidate
Date Document Signed
Revised 07/22/10
r CITY OF WINTER SPRINGS, FLORIDA
2010 GENERAL MUNICIPAL ELECTION
u 9 - NOTICE OF POLITICAL CAMPAIGN ' 195 ADVERTISEMENTS /SIGNS SUPPLEMENT
�LORI
MAYOR - CITY COMMISSION SEAT TWO /SEAT FOUR
Circle Which Applies To Candidacy
"The officer before whom a candidate qualifies for office shall notify the candidate, in writing, of the provisions in this section.
1106.1435 (4) Florida Statutes
NOTICE
Please find the following documents /information/references related • ' 6:1 'gn v • e • •nts /Sign,
in this Notice:
Copies related to Political Campaign Advertise i a ed.
(1) Copy of Florida Statutes 106.1435
(2) Copy of City of Winter Spri ! ' "tem." SI . 1 . [poli • •al signs]" pamphlet
•I
Information/R • • re l■ el • d t 1 6: mpaign Advertisements /Signs:
(3) Cit t 'tf Wi :r `,. in Id • of Ordinances Chapter 16 Signs and Advertising (Available on the
City of 'e, ter ` • inl We, to or by contacting the City Clerk/Designee)
(4) "The i. • • • aws ' - October 2009 [Chapters 97, 98, 99, 100, 101, 102, 103, 104, 105 and 106]
(i.e. "Florida lection Code ") [Included in Qualifying packet]
(5) "Candidate and Campaign Treasurer Handbook" - July 2010 (Which includes "Chapter 13
Political Advertising" and "Disclaimer" Information) [Included in Qualifying packet]
Initials/Date. (ApplicantiCCO)
/
* * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * *
ACKNOWLEDGEMENT
I, do hereby acknowledge that on this date
Name of Candidate (Please Print or Type)
of , 201 , I received a copy of Florida Statutes 106.1435 and with my
signature affixed below, I understand that it is MY responsibility as a Candidate for Elected Office to
comply with all Laws, especially as related to Political Campaign Advertisements /Signs. Also with my
signature below, I acknowledge that I will comply with all Laws related to Political Sign Disclaimers as
explained /noted in "The Election Laws" and the "Candidate and Campaign Treasurer Handbook ".
Signature of Candidate
Date Document Signed
Revised 07/29/10
"Kre 4% CITY OF WINTER SPRINGS, FLORIDA
- 2010 GENERAL MUNICIPAL ELECTION
10 - SCHEDULE OF CAMPAIGN FINANCE
09 REPORTING PERIODS/DUE DATES
FLORIOp'
MAYOR - CITY COMMISSION SEAT TWO /SEAT FOUR
Circle Which Applies To Candidacy
"The filing officer shall provide each candidate with a schedule designating the beginning and end of reporting periods as we
the corresponding designated due dates."
1106.07 (1) (e) Florida Statutes]
"Any candidate or political committee failing to file a report on the designated due date shall be - I T ne.
1106.07 (8) (a) Florida Statutes]
S 1
AFTER QUALIFYING, THE FO • 1 WI ' • ' GN FI CE REPORTS ARE DUE:
Report Due Bat • • S: I be 7, 2 'Sikh
- shall co 1 : in in ' • , a k n -,2_ , in:.. 1 pre .usly unreported contributions and expenditures from
July 1, 20 1 - Sep • b- ' 0, ! 1,
Report Due ■ ' % ctober 1, 2010
- shall contain information regarding all previously unreported contributions and expenditures from
September 11, 2010 September 24, 2010
Report Due Date: October 15, 2010
- shall contain information regarding all previously unreported contributions and expenditures from
September 25, 2010 - October 8, 2010
Report Due Date: October 29, 2010
- shall contain information regarding all previously unreported contributions and expenditures from
October 9, 2010 - October 28, 2010
A Final Report shall be filed 90 days after the General Election - on or before January 31, 2011.
Initials/Date (Applicant/CCO)
/
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ACKNOWLEDGEMENT
1, do hereby acknowledge a that on this
g
Name of Candidate (Please Print or Type)
date of , 201 , I received a written "Schedule Of Campaign Finance Reporting
Periods /Due Dates (as noted above /on this form).
Signature of Candidate
Date Document Signed
Revised 07/29/10
s CITY OF WINTER SPRINGS, FLORIDA
2010 GENERAL MUNICIPAL ELECTION
11- PETITION
``ORt *
MAYOR - CITY COMMISSION SEAT TWO /SEAT FOUR
Circle Which Applies To Candidacy
"Each candidate seeking the office of city commissioner or mayor or any other elective office of the city shall file a petition signed by fifteen (15)
registered voters of the city with the city clerk." [2-87. Code of Ordinances, City of Winter Springs]
I, do hereby state that I seek nomination to the City of •
Name of Candidate (Please Print or Type)
Springs Mayor - City Commission Seat Two /Seat Four, a four (4) year term • ' e - ctio o b d
Circle Seat Which Applies To Candidacy
in the City of Winter Springs, Florida, on Tuesday, November 2, 1 u h - r state t:
(1) My legal place of residence is:
0
treet • .. • ss City State Zio Code
(2) Length of time of residence in th Pe of n - pr ;
(3) City of Winte p , Ret tere l 1� es No
Date
Signature of Candidate
Street Address
( n% State Zip Code
* * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * *
We, the undersigned qualified Electors, residing in the City of Winter Springs, Florida, nominate:
for the City of Winter Springs' Office of
Name of Candidate (Please Print or Type)
Mayor - City Commission Seat Two /Seat Four:
Circle Seat Which Applies To Candidacy
(1)
(Please Print or Type Name) Signature Date Petition Signed County
Street Address City State Zip Code Voter Registration Number OR Date Of Birth
(2)
(Please Print or Type Name) Signature Date Petition Signed County
Street Address City State Zip Code Voter Registration Number OR Date Of Birth
Initials/Date: (Applicant/CCO)
/
4.0sTeR N. CITY OF WINTER SPRINGS, FLORIDA
2010 GENERAL MUNICIPAL ELECTION
P Il - PETITION
ORtoP'
I NAME OF CANDIDATE: Page 2 of 5
Name of Candidate (Please Print or Type)
(3)
(Please Print or Type Name) Signature Date Petition Signed County
Street Address City State Zip Code Voter Registration Number OR Date Of Birth
(4)
(Please Print or Type Name) Signature Date Petition Signed County
Street Address City State Zip Code Voter Registra . ■ r OR Date 1
(....----\
(5)
(Please Print or Type Name) Signature *at: 1 'lion Signe V County
Street Address c::, VII tate ode Voter Registration Number OR Date Of Birth
( Oh. l ik
(Please Print X 11 Signature Date Petition Signed County
Street • .. ss '` City State Zip Code Voter Registration Number OR Date Of Birth
(
(Please Print or Type Name) Signature Date Petition Signed County
Street Address City State Zip Code Voter Registration Number OR Date Of Birth
(
(Please Print or Type Name) Signature Date Petition Signed County
Street Address City State Zip Code Voter Registration Number OR Date Of Birth
(9)
(Please Print or Type Name) Signature Date Petition Signed County
Street Address City State Zip Code Voter Registration Number OR Date Of Birth
Initials/Date: (Applicant/CCO)
1
I
( -, r r`NTER CITY OF WINTER SPRINGS, FLORIDA
"'�� 2010 GENERAL MUNICIPAL ELECTION
11- PETITION
\ORIOp'
NAME OF CANDIDATE: Page 3 of 5
Name of Candidate (Please Print or Type)
(10)
(Please Print or Type Name) Signature Date Petition Signed County
—aft illeil
Street Address City State Zip Code Vot R Al um.D': h
(11)
I
(Please Print or Type Name) Signature C\il .n Si: `c ounty
• Street Address > Voter Registration Number OR Date Of Birth
(
ii.p.,,
`e ' Signature Date Petition Signed County
11 r
St I ddr • City State Zip Code Voter Registration Number OR Date Of Birth
(13)
(Please Print or Type Name) Signature Date Petition Signed County
Street Address City State Zip Code Voter Registration Number OR Date Of Birth
(14)
(Please Print or Type Name) Signature Date Petition Signed County
Street Address City State Zip Code Voter Registration Number OR Date Of Birth
(15)
(Please Print or Type Name) Signature Date Petition Signed County
Street Address City State Zip Code Voter Registration Number OR Date Of Birth
(16)
(Please Print or Type Name) Signature Date Petition Signed County
Street Address City State Zip Code Voter Registration Number OR Date Of Birth
Initials/Date: (ApplicantlCCO)
r
d
� �xN'z� CITY OF WINTER SPRINGS, FLORIDA
c. 2010 GENERAL MUNICIPAL ELECTION
0 11- PETITION
� tn�i�
\ LOR►O �
NAME OF CANDIDATE: Page 4 of 5
Name of Candidate (Please Print or Type)
(17)
(Please Print or Type Name) Signature Date Petition Signed County
Street Address City State Zip Code Voter Registration Number OR Date Of Birth
(18)
(Please Print or Type Name) Signature Date Petition Signed County
Street Address City State Zip Code Voter • ' .., . Number O'� I e Of 1111 (19) —. —
(Please Print or Type Name) Signature gat Petitio ed County , .
I IIM
Street Address Q 1 .,,, , 't lite Zip. Voter Registration Number OR Date Of Birth
( A 111
` (Ple. Il I � Signature Date Petition Signed County
t A l s r City State Zip Code Voter Registration Number OR Date Of Birth
(21)
(Please Print or Type Name) Signature Date Petition Signed County
Street Address City State Zip Code Voter Registration Number OR Date Of Birth
(22)
(Please Print or Type Name) Signature Date Petition Signed County
Street Address City State Zip Code Voter Registration Number OR Date Of Birth
(23)
(Please Print or Type Name) Signature Date Petition Signed County
Street Address City State Zip Code Voter Registration Number OR Date Of Birth
Initials/Date: (Applicant/CCO)
/
1
c.,---- CITY OF WINTER SPRINGS, FLORIDA
itt i 2010 GENERAL MUNICIPAL ELECTION
P t� 11- PETITION
\tORIOP'
NAME OF CANDIDATE: Page 5 of 5
Name of Candidate (Please Print or Type)
(24)
(Please Print or Type Name) Signature Date Petition Signed County
Street Address City State Zip Code Voter Registration Number OR Date Of Birth
(25)
(Please Print or Type Name) Signature Date Petition Signed County
Street Address City State Zip Code Voter Registration Number OR Date Of Birth
(26)
(Please Print or Type Name) Signature Date Petition Signed Coun
.■I/0 (A
Street Address City State Zip Code V. R: ,. ation Num. 9 R Date e , irth
(27) 27 NA 'n MP/ (Please Print or Type Name) Signat ^ Cate Si:' County
t
Street Address Voter Registration Number OR Date Of Birth 0 1119 N
(28) ....
e ' Signature Date Petition Signed County
'E• r St 1 ddre' — City State Zip Code Voter Registration Number OR Date Of Birth
(29)
(Please Print or Type Name) Signature Date Petition Signed County
Street Address City State Zip Code Voter Registration Number OR Date Of Birth
(30)
(Please Print or Type Name) Signature Date Petition Signed County
Street Address City State Zip Code Voter Registration Number OR Date Of Birth
Initials/Date: (Applicant/CCO)
Revised 07/29/10 /
CITY OF WINTER SPRINGS, FLORIDA
QUALIFICATION REQUIREMENTS FOR OFFICE OF
THE MAYOR AND CITY COMMISSIONER
NOTICE TO FEDERAL GOVERNMENT EMPLOYEES
As a courtesy, the City of Winter Springs hereby advises Federal Government employees
that in some instances, Federal Government employees are not permitted under the Hatch Act to
run for elected office. See 5 U.S.C. § 7321 et seq.
If you are a Federal Government employee, you should consult your employer or attorney
to determine that you are permitted to run for the office of Mayor or City Commissioner in the
City of Winter Springs, Florida before executing qualification papers to run for said office.
By executing the qualification papers for the office of Mayor or City Commissioner, you
will be representing that you are duly qualified to run for elected office including, but not limited
to, compliance with the Hatch Act.
Acknowledgment:
Print Name of Candidate:
•
Initials /Date. (Applicant /CCO)
`NT ER CITY OF WINTER SPRINGS, FLORIDA
d 2010 GENERAL MUNICIPAL ELECTION
LT)
it& t NOTICE OF UNDUE BURDEN
rcorpoj�M9 /
&oR% MAYOR - CITY COMMISSION SEAT TWO /SEAT FOUR
Circle Which Applies To Candidacy
"Any person seeking to qualify for nomination or election to a municipal office who is unable to pay the election assessment without imposing
an undue burden on personal resources or on resources otherwise available to him or her shall, upon written certification of such inability
given under oath to the qualifying officer, be exempt from paying the election assessment." X99.093 (2) Florida Statutes
"Pursuant to F.S. 99.093(2), candidates who are unable to pay the election assessment without imposing an undue burd on it person , esource
or resources otherwise available to them shall upon written certification of such inability given under oath t city cI be - , aft . fr t 1
paying the election assessment. Any candidate exempt from the election assessment shall also be ex • •: . . m 1 • ity's . alif n_ fee."
[2 -88. (b) Code of Ordinances, City of Winter Springs
0
I er: 11) : that :.1 n • ) he City of Winter Springs,
1t�i h'
Name of Candidate (Please Print or Type)
Florida Mayor - City Co i ission t T at Fo - a four (4) year term, in the Election to be held
. • Whi• • •,.plies fcCan '
in the Ci .T of Wi \ -1 ` o ' k I rid on T day, November 2, 2010. I, further state that: by affixing my
signature o - .w, I . re, • sting that this Notice of "Undue Burden" be filed in lieu of the Qualifying Fee and the
1% Election • - sment, as the Qualifying Fee /Election Assessment would impose "an undue burden
on personal resources or on resources otherwise available ".
Signature of Candidate
Street Address
City State Zip Code
STATE OF FLORIDA
COUNTY OF Date
Sworn to (or affirmed) and subscribed, under penalties of perjury, before me this
day of , 201 , by .
(Print Name of Person Making Statement)
Notary Public - State of Florida
Signature of Notary Public
(SEAL)
(Print Name of Notary Public)
Produced OR Personally
Identification Known
Type of Identification Produced
Initials/Date: (Applicant/CCO)
Revised 07/29/10 /