HomeMy WebLinkAboutElliott, Robert Qualifying Packet - 2020 08 24 ,� .. CITY OF WINTER SPRINGS, FLORIDA
o "^� 2020 GENERAL MUNICIPAL ELECTION li::`OIi:tM
FORM IMUST BE
PROVII DIED TO T11IE'::.
TII""'ll"'T 1TTDIItCAII!:I II . Ili` I6II Iil)IICT OINII II fIITf I II° IICT I CITY CII..i::.RK DURING
Q UAI...IFYIkNG
Date 1 fume
NAME:
)- - Ir2eviewStarted
The following iinforr-nation is(provided to you to assist in your campaign for Public Office;however,please note the docunnents
In this packet of materials are not intended to be a complete digest of Florida's Election I...aws.
rr IS°Youp IRESIPO1NSIII31111.IlTYTO READ AMID U, HIDE RSTANID T'11-11E LII...ECTION CODE Alt ID COMPILY W11T11 All...II...AIPIIN...II ABII...IE
IREQU I IRII:::III II:INTS
The appplicant accepting this document and the attachments should initial after each section as it is reviewed
QUALIFYING DOCUMENTS
The documents in this sectlorr are due to the City CYerklDesignee no later than 72:00 p.rn.on the last class of Qualifying 1,11hich is
Friday,August 28,2-020.
"Appointment of Campaign Treasurer and Designation of Campaign [Depository for Candidates" [DS-DE 91
"Statement of Candidate"[DS.DE.84d
11 "Affidavit of Qualified Voter Status and Clay Pesidency"
"Application for Office and Election Assessment"(WITH a check drawn from campaign account'for'the Application Fee
2
AND the applicable 1%Assessment OR"Nodce of Undue Burden")
:3 "Notice of Testing Tabulating Equipment"
4 "Notice of Political Campaign Advertisements/Signs" QUAII...Ili:--Y11ING E::DOCU KIEN'T'S
S "Schedule of Campaign Finance Peport'ing Periods/Duce Dates" WITI1 AN*AS"1rE'IRIISIK Imes"f'
S "Notice of Access to Campaign Finance Forms" BE COMIPIi...IE:::TIE:::If.:D IIIN IFirzoIN">r'
"Candidate Petition" OF 1111F CITY
*Candidate Oath Gli...EIRK/IDESIIGINEE:DU PING,.
"Notice to Federal Government Employees(If applicable) QUAL]EY]MO
.
'1:::orrn U"-".Statement of Financial Interests 2019"
Accepted:
STA'rE OF FII...OIR11DA 11 Nlf:::OIRIMAriioiN
l he Florida Election Code,Chapter 97 -108,Florida.Statutes [08/2019,) (includes Chapter 106 which addresses Political
Advertising and Disclaimers,etc.
"Candidate and Campaign.i.reasurer Handbook"(10/a/2019) (Which includes"Chapter 12 Political Advertising"and
"Chapter 13:Other Disclaimers"
"Electioneering Communications Organization !-Handbook"
State of Florida Election Information Contacts
Accepted :
II�� � f1� ��"�w��
Revised 07/27/2020 I
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QUAIII 1II 1/IPw";
NAME: JI" i',.6^�z s �Y"I :�,� � ., ,,.0 I,,,,,. pI��,:ag
CAMPAIGN FINANCE/ELECTRONIC FILING INFORMATION
"Contributions Returned"[DS-DE-2]
Envelopes of Checks/Receipts(2)
Accepted:
.................� `SIT._
CITYOF WINTER SPRINGS INFORMATION
m M'City of Winter Springs 2019 District Map
Accepted: } "°
w,
MISCELLANEOUSINFORMATION
"Statement of Ethical Campaign Practices"(From the Seminole County Supervisor of Elections
"Foreign nationals"-from the Federal Election Commission(6/23/2017)
Legal References for Qualifying Documents
Accepted: � Y�.�
NOTE: The Candidate SHOULD NOT close out their Campaign Bank Account before they are invoiced and payment is made
to the Seminole County Supervisor of Elections for verification of Petition signatures
The following signature area is to be signed upon receiving the 2020 Election Qualifying Packet,including the above referenced
documents
.m
a", have on this date received the forms and information
Name of Candidate(Print or Type)
noted on these two(2)pages,and agree that I will read all of the Election Qualifying packet materials that have been provided to
me;and understand that it is my responsibility to comply with all Laws as they apply to the 2020 Election.
Signature Date
r
�, i r� .��.�� i I
zip
__..
Street�rtdress af:Cv Code
State of Florida
CountyofpVr1C i Vv �1r
Sworn to(or affirmed)and subscribed before me by means of hysical presence or_onlline notarization]
'L° t
f a.
this dd ].� '(�rC day of
by '„V k..PH` V ��k �'�' II� W �" �"'"�"�� Personally known:
(Print name ofperson making statement)
t�
Al
Type of Identification produced "" Signature of Notary Public-State ofF/orida
Revised 07/27/2020 11 ( C 11 RIVED
L�I� pi�U�'
Notary Public State of Florda
Christian D GLan J %!%
My Commission GG 913234
MOO
I EV Expires 09/15/2023
f2P1 A" al
u CITY OF WINTER SPRINGS,FLORIDA I
2020 GENERAL MUNICIPAL ELECTION FOlRlal
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l��A�YCAVIT( QI,IAllllll;� �'"0T[T 7?S7AT11.'3AlN1., R RRII t:a�°,I Ili-:f6.:G 1:
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CII� 11 11 11 �11 11' 11 IIC1 RII II Il k "'i V V .i..�II III II li II II II` C11Y Cl 6:,',:IiRK DI.IPING,,
_.. .. ✓ QUALIFYING
o V--r' do hereby state that I seek election to the City
of Winter Springs' R 1i✓,, +"' r"' f ai N41 u�r:R,C lalu. „"N,) a four(4)year term
.crprrlirl u��rr, IdliuU°IIrP Rlrre+ ~d Iki PIu�9 Clil�a
., :✓>, ,<a 7^,_, ...,.�._. ..,..m
in the election to be held in the City of Winter Springs,Florida on Tuesday,November 3,2020.1 further swear or affirm:
(1.) 1 am a qualified voter in the City of Winter Springs
(2.) My legal place of residence is: S 'r L 3
�- C7
.. ..... c!' �' e,J� W £�.mm.� ... �.�.w...
(3.) Length of time of residency in the City of Winter Springs is:
(4.) Length of time of residency in Winter Springs District: is R„.T.
N I am attaching two(2)documents,one to be a Florida Driver's License,as verification of my residency in the
City of Winter Springs.The second document is: V O-P" F e
G � t
✓PG,rI� ,,r,rC ..„�, J,r„ rrrr
State of Florida
Countyof :u✓ o-
Sworn to(or affirmed)and subscribed be+ore me by means off 4physical presence or_onlline notarization)
� �6�
this day of p„�("ry a °� 2020
d
by � w�,,",�✓r, fr�J /°� /p t0� 1�^" Personally known: OR Produced Identification
(Print name ofperson making statement) ., o
Type of Identification produced Signature of Notary Public-State of Florida
Notary FullI State of Florida
Christian D Gowan
g My Commission GG 913234
orw Expires 09115l2023
all! 111111
FOR OFFICE USE ONLY
Copy of Florida Driver's License provided for Item(5)
t
r .,4 D¢ (5)
Other documentation �i p rp, ro,����
r„ provided for Item pp i a4 V g d Revised 07/27/2020
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s""
CITY OF WINTER SPRINGS, FLORIDA
oT 2020 GENERAL MUNICIPAL ELECTION °111'1'd'1
mr� ,ae l
toss � I�PZ.JCA TK 1V FCW( ICE'
aGoov,Ece`' I..IIIIV� TTIIa1Vll.11.11ll:lf
.. AND f LEC TY ,: .,5SA4 .' T,.
1'.m:ER111Ilw
3IZOVII[)El)TO 1IIII
f I " 1 CT IITY Cil EI K DIMING
.- QUALIFYING
I, o stpzr 1� � I 0 r-T do hereby state that I am a registered and qualified Elector of the
,.. . ...m. ..
I ,;
City of Winter Springs;and I am applying for the Office of
a+:ply� Dia,tirfc OI isla 0 t 1 I�I:ic I i 0i:1 a four(4)year term,in the Election to be held
in the City of Winter Springs, Florida on Tuesday, November 3,2020.
1 further agree to pay the following Qualifying Fee AND applicable Election Assessment
QUALIFYING FEE:$150.00 AND THE BELOW ELECTION ASSESSMENT
ELECTION ASSESSMENT-COM MISSION ER:$120.00
Each Commissioner receives:$1,000.00 per month
$1000.00 x 12 months=$12,000.00 annually
The 1%Assessment amounts to:$120.00
NOTE: "Any person seeking to qualify for nomination or election to a municipal office who is unable to paythe
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." [99.093 (2) Florida Statutes]
Pursuant to F.S.99.093(2),candidates who are unable to pay the election assessment without imposing an undue burden on
their personal resources or resources otherwise available to them shall upon written certification of such inability given
under oath to the city clerk be exempted from paying the election assessment. Any candidate exempt from the election
assessment shall also be exempt from the city's qualifying fee.
FOR OFFICE USE ONLY
APPLICATION FEE:Campaign Account Check in the amount of$150.00 attached
(Check should be made payable to the City of Winter Springs) Check#
AN Qi
1%ASSESSMENT-Commissioner:Campaign Account Check in the amount of$120.00 attached
(Check should be made payable to the City of Winter Springs) Check# T..
OR,IF APPLICABLE
DCom feted"Notice of Undue Burden"Attached
P R`E E I oq r11 f'+ D
Revised 07/27/2020
a
r 1P.-Iz ,E r.Ji "P".°ll
a"TR^ CITY OF WINTER SPRINGS,FLORIDA
2020 GENERAL MUNICIPAL ELECTION FRM
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tiC®a.`vE a ���7 'F TABUL..��'�%�11��' '�r �'U1PA �... 14F 011I II�IIw��+US 11I I3II II:'�
PIu"0VIIII)II:II") M IIII°I
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NOTICE
Please accept this notice that the tabulating equipment to be utilized in the City of Winter Springs,Florida's 2020
General Municipal Election will be tested on:
DATE: Friday,October 9,2020
TIME:10:00 a.m.
The aforementioned test will be held at:
THE OFFICE OF THE SUPERVISOR OF ELECTIONS FOR SEMINOLE COUNTY
1500 East Airport Boulevard,Sanford, Florida,32773
(407)585-VOTE[8683]
city of winter springs
Municipal Elections Offcal/Designee
Revised 07/27/2020
AUG % U//,U
r,iiil 'r� c i i Oy ,Ir!NrG�iS
,i El
...... CITY OF WINTER SPRINGS, FLORIDA
k
2020 GENERAL MUNICIPAL ELECTION FORMf
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s� i III ' lI i f O i ICIE
i US COMP LE,I
k�:OPM MUS1 IBIG..
i`)P0v0I.)`IC 0 I IV II I:
I I ' 'fIi�Y C : R i" iSSII � III 0Y CLERK 1: u11N :
f' UAL RIV:��,"1llIC::G
Please find the following documents/information/references related to Political Campaign Advertisements/Signs
in this Notice:
Copies related to Political campaign Advertisment/Signs attached:
(1) Copy of Florida Statutes 106.1435
(2) Copy of Winter Springs Signage Information (Chapter 16,City of Winter Springs Code of Ordinances)
Information/References related to Political Campaign Advertisements/Signs:
(3) "The Florida Election Code,Chapters 97-106, Florida Statutes" -August 2019 (included in Qualifying Packet)
(4) "Candidate and Campaign Treasurer Handbook" - Revised 10/03/2019 (Which included information from
"Chapter 12: Political Advertising"and "Chapter 13:Other Disclaimers") [Included in Qualifying Packet]
ACKNOWLEDGMENT
k1 L j c.)9-.1' do hereby acknowledge on this date of
II I l le r lI rr:i4 dwx=l 01
.,u..
AU Q11�T 1 �'; 2020 with my signature below that I received a copy of
Florida Statutes 106.1435 and a copy of Chapter 16 from the City of Winter Springs'Code of Ordinances,and with my
signature affixed below, I understand that it is MY responsibility as a Candidate for Elected Office to comply with all laws,
specially as related to Political Campaign Advertisements/Signs.Also with my signature affixed below, I acknowledge that I
will comply with all laws related to Disclaimers as explained/noted in "The Florida Election Code Chapters 97-106, Florida
Statutes"and-the"Candidate and Campaign Treasurer Handbook."
................... ......... .. �?402 O
FOR OFFICE USE ONLY
Attachment:Copy of Florida Statutes 106.1435
f,
RECEVIIIED
Attachment:Chapter 16 from the City of Winter Springs Code of Ordinances
Al ,�,` t 2HTj
Revised 07/27/2020 1'11 CF"Vkll°all Hk
\WF..
CITY OF WINTER SPRINGS,FLORIDA
z "M 2020 GENERAL MUNICIPAL ELECTION pll l F
4� 95 �i � �f l..ICA TIONF OFFICF
tiG Ew ,� 1111 DVS COMPL II
Dsu �. ,, r�U'U"'1 II II I,U<II)U�II'��IIIING
Iiu "IC"`UIIIII' II::' II 'IIIIIf.'""II III I °: II UI,' ICIIIImQ V'° VII
SCHEDULE
DURING/AFTER QUALIFYING*,THE FOLLOWING CAMPAIGN FINANCE REPORTS ARE DUE:
Report Due Date.October 9,2020
-shall contain information regarding all previously unreported contributions and expenditures from October 1,2020-
October 2,2020
Report Due Date.,October 73,2020
-shall contain information regarding all previously unreported contributions and expenditures from September 1,2020-
September 30,2020
Report Due Date.,October 23,2020
-shall contain information regarding all previously unreported contributions and expenditures from October 3,2020-
October 16,2020
Report Due Date.,October30,2020
-shall contain information regarding all previously unreported contributions and expenditures from October 17,2020-
October 29,2020.
A Final Report shall be filed 90 days after the General Election-on or before February 7,2027
-shall contain information regarding all previously unreported contributions and expenditures from October 30,2020-
February 1,2021
*For Unopposed Candidates
Report Due Date.November 27,,2020
-shall contain information regarding all previously unreported contributions and expenditures from August 1,2020-
November 27,2020
ACKNOWLEDGMENT
I, p���-T ►"i. C L L-I-a�T'd— do hereby acknowledge that on this date of
A (,>! /�5"F 37- 1 2020 with my signature below that I received a written
"Schedule of Campaign Finance Reporting Periods/Due Dates"(as noted above on this form).
I , rJ14
Revised 07 27 2020 0
JI i 1(,,,,C,_OF I i-Hr!CITY �L.t 1"l
®rsYq° CITY OF WINTER SPRINGS, FLORIDA
o 2020 GENERAL MUNICIPAL ELECTION i`�III'II
P.
QweNOTKI 17
Villo � � �
� >ros� �� Tlll.fl ll �� IIw�@ il�"i- 'n
FOR111A I LII
�'T "��If" If"�fl SS� 01 : III' II IIIi l' II CT i�l�'"�III. Ill ll,�� 11 a u���.�1" II III II�! II n 111 III III CiTlU f EP TO
�UFI�NG
II III
NOTICE
Please note that Campaign Finance forms are available at the following State of Florida Website address:
� //elc>,...rr,vlorl�.9ar.er�
AND/OR
through the Seminole County Supervisor of Elections Office when using their"Online Treasure Reporting System."and/or
may be requested through the City of Winter Springs' Municipal Elections Official/City Clerk/Designee.
ACKNOWLEDGMENT
u
®i a®,— . do hereby acknowledge that on this date of
....,,.... .u_. .............
...........
.........
ldh,.,rir r,1 'u Cli 1,i
2020 with my signature below that I am to comply with the
provisions of Section 2-97.Winter Springs Code,which states,"All Candidates for elected office in the City of Winter Springs
shall electronically file their campaign treasurer's reports required by state law utilizing the Seminole County Supervisor of
Elections Off•ice's electronic filing system.The electronic filing deadline for a completed campaign report shall be the same as
the deadline established by law for filing an original paper copy of the report with the City's filing officer."
!I'!ill ii16i 1 ii !ill iiii;ligimilligul i 11:1glill-!III ll lil I lll�ii ill,11 li ill ill
Revised 07/27/2020
RECEIVED
rev°C,)F VA',° t w
v ..,.i.., C�w..,,,e°,,E H"K
CAN DI DATE PETITION M 7
FOR
•All information on this form becomes a public record upon receipt by the Supervisor of Elections
it is a crime to knowinglysign more than one petition for a candidate.[Section 70,9U85 Florida Statutes) THIS COMPLETED
quested information:Eel
toform is not completed,the form ud/1 not be valid as a Candidate Petition Form.
FORM MUST BE
r1 the undersigned, aregistered PROVIDED TO THE
(Please pant name as R or•<our voter information card) l CITY CLERK DURING
voter in said state and county,petition to have the name of QUALIFYING
placed on the General Election Ballot as a[check/complete box,as applicable] 7
® Nonpartisan N/A No party affiliation N/A Not Applicable Party
Candidate for the Office of
City of Winter Springs-City Commission District Fire
(Please insert the title of office and include District,Circuit,Group,Seat Number,if applicable)
Birth OR Voter Re �
Date of g iistration Number
Address
(Ml WY)
w
Ci Fst—at—e --1 iZip Code
Cou ty
ir r� ° errn+nt�h - I3�
o be com I ted b V �
Signatu e of Voter Date Signed(MM/DD
r8 ter
$�l 9Da
Rule 1S-2.045,F.A.C.
CANDIDATE
b. T VII rn-iON FORM
*AII information on this form becomes a public record upon receipt by the Supervisor of Elections
It is a crime to knowinglyslgn more than one petition for a candidate.[Section 704.785 Florida Statutes] THIS COMPLETED
.If all requested information on this form is not completed,the form rdll not be valid as a Candidate Petition Form.
FORM MUST BE
"""" �� w � m < the undersigned, a registered PROVIDED TO THE
(Pleas nt name as it appears on your voter information card) CITY CLERK DURING
voter in said state and county,petition to have the name of 1�(y (C i QUALIFYING
placed on the General Election Ballot as a[check/complete box,as applicable]
A N Applicable Nonpartisan N/A party / otA livable Party
Candidate for theOffice of
City of Winter Springs-City Commission District Five
(Please insert the title of Office and include District,Circuit,Group,Seat Number,if applicable)
Date of Birth OR Voter Registration Number Address
State 'zip Code
city � County
Signature of Voter
"'^ FDate Sigrl(MM/DDtA1NM�
e completed by Vote �el
S-2A. FA
Rule'I '. wWW
I` C IE 119,
loss
;,v I�Vi vd PP'
. .
sm,
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CANDIDATE PETITION FORM 7M
.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 1"785 Florida statutesj
/fall requested information on this form is not completed,the form will not be vaild as a Candidate Petition Form. THIS COMPLETED
� t
e FORM MUST BE
( @ the undersigned, a registered PROVIDED TO THE
(Please print nar a as it appearson your vo.er information card} l ,t1� CITY CLERK DURING
voter in said state and county,petition to have the name of ' p i���� i d ,5 QUALIFYING
laced on the General Election Ballot as a [check/complete box,as allcable]
Nonpartisan N/A No party affiliation N/A Not Applicable Party
Candidate for the Office of
City of Winter Springs-City Commission District Five
(Please insert the title of Office and include District,Circuit,Group,Seat Number,if applicable)
Date of Birth OR Voter Re istration Number Address
(M M/DDAIM)
City County State Zip Code
I,
2a
Signature of Voter � �� � a ». — Date Signed(MM/DD/YWY]
(w. fro be completed by voter]
ule 15-2.045,F.A.0
CANDIDATEI°TION FORM 7 15-i`
*rill Information can this firm becomes a frublic record upon receipt icy the super vi ar of Elections
a mFfell eeque tedinformate'on on M form is not cornpierrrdcrvathe forennw Xndate.Bw valid as a Cass Florida el d e Peu tie n sForm, T 1lS COMPILE)ED
�X If'ORM MU BE
6 (Uala ro�1,1- .as rt appears,ere on�� � t ] the&Rndell;90. n d, Bt registered
_ . _ PROVIDED TO THE
U p y o4trinformatbncard
G 11 l Y Cl....ERK DURING
voted"nn said state and county,petlt.'uorn to have the narl�ne of � 6� �r ��Q � `a� ¢ UAI...VII'ZYING
IP�aced orh the GenerM Meol:lon Boot.as a[checlk/<-,ol-oplete box,as applicable]
Nonpartisan 114/K1 Nopantyaffifiatlon N/A 1 Not Applicable Party
Candidate for'the Office,of
City of Winter,Sprin s City Commission District Five
�_.(Please insert the we of office and pncnude Uistdrt.,Clrcult,Group,Seat Nuuut ben,W appkable)
Irate rf Birth P,:m valer Mra iler tritrn Naurnk:aer Address�, �
(MM/DD/`F' VYl
...� � o
Gt Caar.sncy � NA-1
I—LI-1
p Code
e i
� W
.,
ignature of Voter Date Siguta:d(WHIM/I"rD/1JW6
i'rea be completed by Voter]
Rule1S-2045,FAC.
J f 4 0 [,I�
6SV I I+:of CJI 'llifei € iT v �:i-i f,l^�
CANDIDATE PETITION
�' .FORM 7
'All information on this form becomes a public record upon receipt by the Supervisor ofElections
-It is a-crime to knowfnglysign more than one petition for a candidate.[Section 704.785 Florida Statutes)
'/fall requested information on this form is not completed,the form will not be valid as a Candidate Petition FormI. THIS COMPLETED
FORM MUST BE
pp appears yourdx.2�.I..,,w the undersi ned, a re istered PROVIDED TO THE
voter in said state and county,petition ���/L ��t DCITY CLE IF DURING(Please print name as It appea yo `,
' to have the name of T � ' ,.-.._. QUALIFYING
placed on the General Election Ballot as a[check/complete box,as appiicable]
® Nonpartisan N/A No party affiliation N/A Not Applicable party
Candidate for the Office of
_City of Winter Springs-City Commission District Five
Please insert of Office and include 11z( t the title District Circuit,Group,Seat Number,if applicable)
Date of Birth OR Voter Registration Number Address
g
City Coun State Zip Code
I
Signature ofVoter Date Signed(MM/DD/YYYY)
iTo be completed by V ter)
L C
Rule1S-2045,F.A,
q FORM 7
'All information on this fair becomes a public record upon receipt by the Supervisor of Elections
'!t is a crime to knowinglysign more than one petition fora candidate.[Section 104.78S Florida Statutes]
'!fall requested information on this form Is not completed,the corm will not be valid as a Candidate Petition Form THIS COMPLETED
the undersigned, aregistered FORM MUST BE
I, (Please print name as i<appea PROVIDED TO THE
petition to have the name of card)rs on your voter Information
��� .,� �,���� CITY CLERK DURING
voter In said state and county,P .....-.�.� .. .- QUALIFYING
placed on the General Election Ballot as a[check/complete box,as applicable]
xNonpartisan N/A No party affiliation Not Applicable Party
Candidate for the Office of
City of Winter Springs-City Commission District Five
(please insert the title of Office and include District,Circuir,Group,Seat Number,if applicable)
Date of Birth OR Voter Registration Number Address
(MM/DDF�Y i*I
City Stahl Zif
Coun f ode
Signature of voter Date Signed(MM/DDM'YY)
(To be completed by Voter]
Rule 1S-2A45,FAC
l l "y'O ��olVe'Yhf� ' Y.ifJl :,y
'ANDH[.,,)A F E F)E I ITION C Fopm 7
on IhIs'roj'mi becorneas a public'moordarson receipt by the Supondsorog'Elections
crime to knoin,,ngysi�7n mor&than onepetWon fof a candidage.[Section 104.W5 F'htfida Slatuiesy
T11-flS COMPILIET"IE11")
11� dinfo,�vrion on th'.'S'farrm not rompheted,Me form will not be vailty as a Candidale f4nrirlon Fornz
f::0MA MUST Bf
Liao undersigned, a registered
it
Pleasr/print iinan as it a.I ears on v voter infoR rnaflon cairdp
tv r" ,� Ci I Y C11 El:Z1K DUPiNG
ave the r-�arrie of
'V
voter�n said state and cow ty,petrtion to h
QUAII U�YiNG
p1laced or)the GeneiraW Election Baillot as a j,c1hec1k/coirnp*te box,as applicalble]
Nonpartisan �E:E/AD INo party afflHatcn IFN/A NotAppIlicable
Party
Candidate fog the Of of
City of Winter!'.5pirings•..City Coimrnissuon["Astda Rive
iPiease Insert the tMe of OffiRce and ndude DlstHct,CiMUR,Group,Seat Number,if ajppflcable)
Date of Birth 01r,'Voter Pegisvation IMutirnber Address
WW'DWYMO
X� ley
Cltyr,7,7, u /1 couaa
..........................................
signature \,lot r Date Signed QMM/r..),D/YYYVj
i Fa be corner ts.d b .,oterj
,
7�
CANDIDATE PETITION r7
on m��,ikwn he�:vmes a P�,116�mci::Wd Lipoo rvcso'qki�'1hu&Jpvav1b1:v ofax::Mq'rs
h5 a cik?w to irrm 0 Man ore pefinon rvr a a:vndkm' �Svvth:n 10,q,MoAlbph:h3 f.IatWdsl
Ifall iequosted Informatio"on thIs form A;nor L corrrp�vted,the forra wWr7ct be vadl(d as a t��mW�gc/Vwhm fbim -Q HS P IiA'OlAA JS 11LETEID
A i
�W5 the undersigned, a registered 0 4n — -
P.as--�Pri r name as it appears.n Ay..1,2:ot�-.--rinfo r�;--n card) 'LEPK DUlliflIN G
voter in said state and county,petition to have the name of ITo)ioetA JAU NG
placed on the General Election Ballot as a [check/complete box,as applicable)
X J
Nonpartisan No party affiliation Not Applicable Party
Candidate for the Office of
City of Winter Springs-City Commission District Five
(Please insert the title of office and include District,Circuit,Group,Seat Number,if applicable)
Date of Birth OR Voter Registration Number Address
(MM/DD/YYYY)
I Fbre--s�-
City County Fst—.te---1 iZip Code
-70 a'
Signati. of Vo Da te Si g ned(M M/D D/YYYY)
[To be completed try,Voter]
Pule IS-2.045,FA.0
MIG 2, �I/ 200'J
Y o V')IN
oF�:wk F OF
CANDIDATE PETITION FOPIN4 1117
..............
::vn�Ms fk:iw�beconiesapaWk n:"cod:,,rivn rn ci:*�t ku,9he�4,�pei,v?scvr W 06:::Uons
Q k50 C halTOncnm rvito �rU: ofi tesl& M
be vaj'fi:.�as a R'&�On:f�i:knvr� l HIS(��UVIII:N 11:�:::�ED
1,411JS1 11311:::
the undersigned, a registered ill-ill
111)(ears on your voter informationcard)
U1 P l N G
y voter in said state and count ,petitio C 11 E�!Z 11<
n to have the name of e,I-,+ QUAll
placed on the General Election Ballot as a[check/complete box,as applicable]
X Nonpartisan No party affiliation N/A — Not Applicable Party
Candidate for the Office of
City of Winter Springs-City Commission District Five
(Please insertthe title of Office and include District,Circuit,Group,Seat Number,if applicable)
Date of Birth OR Voter Registration Number Address
(MM/DD)"Y -Y)
City County I State Zip Code
eucv, t�
T19-11ature ofvotgr Date Signed(MM/DDAYW)
[ro be completed by voter]
P 0 >1
CANDIDATE PETITION l:opivi 1117
'41,Wcn-nnwfon on ehis tvirn becomwE D ptdtwc?fxo r upon rece(pt by Me Superosw ofElocnions
a)s a ewirte,to Ogn mme than one pvriibn h7r a vvodhe�t te Isectbn M Uab Flcrn 2 Srannew,7
ffafl htri"bnrllVon an thl's Fbirn irnot"o'rnp�utcd the A!wm be qv AW as a carx w P�0'9111on rcvo T 111 flS Mkff)l ETE11l)
the undersigned, a registered V!�0PM NIUS 11,311:
i)WOVIIDEII�),TO T'11 111;'
(Please print name as I appears on your voter information card)
EPIK 11)UPING
voter in said state and county,petition to have the name of QUAII l I Y11 IN G
placed on the General Election Ballot as a [check/complete box,as applicable]
X Nonpartisan N/A No party affiliation EN/A7--] Not Applicable I..Party
Candidate for the Office of
City of Winter Springs-City Commission District Five
(Please insert the title of Office and include District,circuit,Group,Seat Number,if applicable)
Date of Birth OR Voter Registration Number Address
(MM/DDA-YW)
Z5
City County fStat. Zip Code
J
ISignature of Voter ....... Date signed(M M/DD"
[Tmp Vy oterb781
.2
P
Pule IS-2.04S,F.A.C.
j"
—R—111' 4' "FE.
1',�T FI:R E),P,J:"41 C'"z
11 F C y C f E
III II)A-l"ERE-F-1- - 1 FOPM lre
.All o"rnururex'sarRar n rrry thh;fon7r Wsecowyms ra jrub a°reccv'wd„farrss ya:a;a afyr dtp Qdse Fu�aos'vAvor o R:la;:«:`Ra'bnz:
Al ac is a sa.crime up6rsRrsrssrs a arya ryy�s RR�A�smorA��rae i y an one s�«�y'wpezft or foa a candidate. a n tl`ion 7040 18.5 7 toddy P�atute-
« aroirnwr'rpsuorbewra;ldasaaawudidale Petition 1orsrn.
r��rrl:u«�>eun.uai«� 'q:�°dC aQP"naJQ".R fl4'.�Irna�;rfl rdi rt.F�"��8a'Pr:l"RaR�'� P
s it appears your votei[
�Pi
voter reren a ilr.�.>�ra:t•aarenr r"daRarrnPrr aaRtM1o�retarn IYn:nnd Iwa Ir ar q fl kd ;" �m✓� » WX. . �. �"IITY CJII_�I14<D��MN
. state slim "
QUALIFYING
placed on tlhie General B ct.liran IIBa3fllot as at r hec,k/cornpllllel e box,as p m ova lWe
rJa»nlpzarai",,<arn IIs���A Ilafanraral�'f,y allu0uratliaa�ny �d� Not Aplplla':aY:aflSr Pare'a;,Y
aMaarndlla',ate for the Office of
lit'y of Winter Springs-City Caaat'nn°n6ssiort District Hve
QII=�1ysa�¢ Vosse.rt.q:ki«xRuitBa:^syrd,aYrie,earr„na�But¢reueadu C:711su4�uca',C,,:reu°c,uuiA,C,rasual�r.°�a.usaPw'usynaGDmyuufi,apvirwk0a.aufnllrs)
Date of Birth()ld'2&"raver Paer or tu`•sfl'lirar'o Nu.urnQ;er Address
a,"
flr"unf/Ext/w° y)
City County State Zip Code
r
,Signature of Voter Date Signed(MM/DD/YYYY)
[To be completed by Voter]
Pule1S-2.045 Frr„u.':':. ,✓'
y CANDIDATE PETITION
IC`o ICfi V
"AllMform&Vwq On triads roar°a brcomet adaubilc re-cord upon r cerpt r;Ar'adte Sqf.a;rnrdscv RsfEkcr/cns
It Is a crime to drsre-avwr?g1j,,sfgn n,,cro tha.ru one d eVVora Few a eaaxd"ra^Ct, /' a'r^r er 104305 Florida. afi%ra»qJ
Cf e7 xequmssanp"drvrorrr otivn an d'faas forsrr Is not cornr"IetcH,Mr,fbm'7 nvffl not be,uramc v a r'4,mcdtoa1a I'.samQPbon Form 1"7MS COMM.E11ED
FOP
fl r
MUST NII:
the a "rrs"ynea , a rausilwlre� PROVIDED TO k"
pi u n nn as utarPeua on,yoi rroC°l
« I r aPYaP aVoter a : county, i In t Ir rerfl
2u fl Vq
plIaR a l the rr �R " iRn nllls [ l -fl rru box,a upPok b e]raonlpaardsan / No party afffflatuon Not. Paalrty,
Can6daalte For the Office of
ty of llnt r Springs-Oty Corxnlrrnlissii rn II'Astlruc't.N::iIV
QPlease insert the title of Office and onciude IDi Nt C Orou it,Group,Seat Number,uR apw;Ncabllle)
.............
,ate us„'Bn Gslp`w o er IRr g stu-atioiii Nasrnlraer A.ddiress
CMM/D1 z/M"w'"y
"ry
V" n
City rwant RaR ZipC aria
-70
Signature u/Voter _ Date Siignea`!QIa m/C~aY'1/yyyyj
[.10 be«.a p y Voteri
r'iry a owu:�.
Ru'Ie 15-.Of451�F.A.C.
a iV i
C) -,Cl..
C-A TE PETIIF'101144
f,
N D I DA 17 F!ORM
'Ad in fiermatkw on tlr�!q fc,I"n becv"nes a pu&ir recoid upon eecelpt Ay I he Supeiv(s'or ofj,-.M,^z I ions
U Av a crime to knovvingtysgn rr"W'&tha'r�'o?,,p petw6an for a car�dkfate,9�scfhin�04-785 F)or'eda EY,atugeg] T11 flS COMPLETED
a re -il
V ali rCq"J35t&d yA'�YmE,?,ion cpT th!r fon'n, ,-r,,r(,cornplsw d,the form wilf nct be qlaPd ru,a Csindal, -�Fiefffk.v benz
FORIM MUST IBE
A—It �jv�f�,j ffie unders greed, a registered PPOMDED'm T11 l 11i
�Nease pdra narne as ft appears on your voter info:rirnat�on card'
voter In sa�d State arid county,petition to have the inaime of
QLJAl UYING
Oaced on the Gene iiall Ellecteon lBalllot as a J.Checlk/corriplete box,as apjpllicaUe�
X P,Ponpartisan ETl No pWiy affifiation / Not Apiplicatfle Party
Candlidate for the Office of
City of Winter Spirings-Clay Coriw-Hsslon 113M., rilct FIve-a
fl[Pleas'e insert the title of Offoe and indude L:)istrim cimUit,Group,Seat Number,if applicable]
Data of EMi'th 01Q Voteir Regis iranon N ury-ilber Address
kAIM/11DID/YYYY)
921 Ckokeahtrlry
City State Zip Code
w tvk-rw 708
Signature of Voter Date signed(M M/DD"
[To be completed by Voter]
, w : CANDIDATE PETITION FOPM 17
a cph ne to kno t,Ogb 5,pYhMWP tflilir ane pivtOon fnr a zwndddata j5et:tron 104,765FO?hya'Raturev
ffA'r roaiton on th&Awn 1w not comp)j^tr'C4�c r�aX M, be vaird as a t�ndka'Yte PoUtbr 7)w d^n IHS C."OMPLETED
1, --Lw—k0LY%A':L cy, the undersigned, a registered F011!VA MUSI BE
(Please print name as it appears on your voter information card) 11!)ROVIDEI
-1" Y C1 1Xmil,c
voter in said state and county,pet�ition to have the name of OM— c
placed on the General Election Ballot as a [check/complete box,as applicable]
Nonpartisan No party affiliation FN/A Not Applicable Party
Candidate for the office of
City of Winter Springs-City Commission District Five
(Please insert the title of Office and include District,Circuit,Group,Seat Number,if applicable)
....................
Date of Birth OR Voter Registration Number Address
(MM/DDA'YYY)
City County State Zip Code
\/J;r%+4,v- S r i vo Sewn,n ale FL 31-700
Signatw."of ,ter Date signed(MM/DD/YYYY)
V/
[To be completed by Voter]
I Ru le 1S-2.045,F.A.C.
Ril,
UG 2
....................
CANDIDATE PETITION 11011:ZIIA 111,7
......................
on Uwh;ku-17?beco),ries a puldst:recvd,V riacclipi bb,Phe nipSPv&Vr i::4 E'Wr&bw
h ::Icwfne ev hin:mhu:0,s�gn nxwo Mon one jvv�!Mbn kv a cwnem::We S� ;rliodp 1476AR5)dlarum :4B1W1aSj
0 cw ghk hw•M 4�nw! t'p��r�lorm biddi ni:::9 be va6W as a Ge, I�&M(cin 1 vr.rjq �HIS CON111111-1�ETEI[)
the undersigned, a registered
P ROV 1 D E D M 11 E
(Please print name as it appears'r i your voter information card)
l IIY 0,11�1�DLIMNC
voter in said state and county,petition to have the name of IS QUN 111�7YI11141c'
placed on the General Election Ballot as a [check/complete box,as applicable]
X Nonpartisan E_N/A I No party affiliation [N/A Not Applicable Party
Candidate for the office of
City of Winter Springs-City Commission District Five
(Please insert the title of Office and include District,Circuit,Group,Seat Number,if applicable)
..........
Date of Birth OR Voter Registration Number Address
(MM/DDNYYY)
T�r,-e4�r c-eAe-
3—ty County State Zip Code
--.a.
-D\ 3.:2 70
Signature of Voter Date Signed(MM/DD")
7o be completed by voter]
f
Rule I S-2.045,F.A.C.
.....................
CAN DI DATE PETITION FoRm 7
(S�Pvbvn PO4M50cirkM Statuhss'l
Of reizueven,Oh:rrnaviwt,iin m4s kmrn,rs tn::,i:czvnpkt&4r„Mv re,nn�'vffi not fic va6fdavv t-wx:46&We AgN06n kirn THIS COMPLETED
El the undersigned, a registered FORM MUST BE
(Please print name as it appears conyour voter information card) PRCMDED TO THE
voter in said state and county,petition to have the name of 42,A.,, CITY CLERK DUNG
QUAUFYNG
placed on the General Election Ballot as a [check/complete box,as applicable]
X Nonpartisan No party affiliation E/A= Not Applicable Party
Candidate for the Office of
City of Winter Springs-City Commission District Five
(Please insert the title of office and include District,Circuit,Group,Seat Number,if applicable)
,Date of Birth OR Voter Registration Number Address
(M M/D DtYYW) f 0 10 f7o re-S + Cirr— lz
. ............. e city zipc.
W F-
Signature of Voter Date Signed(MM/DotYYYY)
[To be completed by Voter]
Rule IS-2.045,F.A.C.
vu 77
",,,UG 2 4
T
...............--.-..........
u14rE PIETI ria�q
CAN D I DA w7
F Z�
AN infoienation on this Awn becomes a pubfir record a. raceiptlWdyc Supendsof of Flections
It hi a"iff I" *W?y 5,tg 'e th'5, 5
'e ""'o ","— '111m,to,,a andidele ISecti...104 11.3.,Flo,ida S.'tatu'c/
11'ali on thLs fc.,rrn is not completed,the ocwn?11011noX be vaildars a Candidate iN�261ion Fe.vj'M THMCOWrLE'i'IED
FORM MUST'BE
the Undersigned, a registered
PIROVID
i[Please jorint nagne as it aplitears onyour voter information carr.o CITY CLEW DURING
vote� in said state and county, petffion to K�avt.-�thie nanne of
oin the Generzil Election Ballor as a(chedk/coirnplleTe box,as apl-)Iicalble�
Not ApIpIllicable I q l'ty
iq;(r f-rtiqt r 1q/A NoIllw-tyaffiliation
t:r:aproc cc.raga for the Office of
(:.IIty of Winter Springs-City Commlission Dlistrla Flve
(Plpase our seirt the tide ofoffice and irwk.Ae District,C.Ircuit,Group,Seat Nuryfl,,)ev,ifajppliceule)
Date,of Birth OP Voter IRegistration INuirrber At*.Jress
ILL fl�3 C �
V
City Zip Code
"14 04- S 17 el
....................... F.................................
Signatwe&Vcter (Date Slqwd QIvU IAJDIDIYYYYj
I becornpleted byVoier1
Pule M 2,045�RA,C.
CANDIDATE PETITION Fopm 7
Ail;f7fornictirn on jlMs f6rrrp becomes a put-'k:rccord upon tvcetpi b''v i°W'Sqpc't Wds L'I of Elertions
Ift fs a cdrry to knovvingly rLgn morc than cru,petWon Nr a civnd/dala ')idp"';tatUtr'.q]�r10��716j'n 70�'ffaft requirsted H NrOM70 v'rrvv an i taf 7 forna eT nor.completed,the rw rr)o"iflnot be,valla,F's a CC1)r)1d&Te'Peritrion Fom'4 T11H,11S COM11311 ETED
the undersigned, a reglstered III MUST IBIS
I, P1P0Vl1I'.:)ET.')TO THE
,,0 n a rn e�as��r��4pasr. .'ft appeart;on your rare it information card)
�Plpase pr " �
voter in sald state and county, j3e2@tion to have the inarne cyf ?jL6)!X- "lV M (-l'TN'CLEPK DURING
placed trim the Geneirall Election 11::laIlllolr.as a[dheck/coirn et ple b s ox,a appilic:able] QUAk IFYIIING
No party affflador, Not Applicable 13airty
Candidate for the Office of
0ty of Winter Springs-Uty Commission 1311suict IFive
@Please linsert Ohre title ofWce and 1nclude District,Clirculit,Group,Seat Number,lfapjpltcable]
Date of Birth oR voter Registration Number EAddres..S
(MM/DDNYYY)
071 L I-c 9
City Unty state Zip Code
C, S
signature of Voter Date signed(M A/D DNYYY)
[To be completed by voter]
RU IS-2.04�i
;iU2
R E C FE a I
AIJ6 2 !0�",,,`,[J'
r�q�V,1H,4VER E',f"Rfl'JGS
2
()F THE Cl?"Y
CANDIIII ��� IIII m IIII 'T __ .......
Ail 0hrar i"ar;n'cin an LW'r Y9ra-M it r.Vf1 rr^w,7 PUbik RACcen,y upon roc rani fryr the,Su)P nd'O of r 1!:.1,i,tbr?S
r ra r:",rarr e lra Jrnowt in g! 9 one l� b �d'��rva p,�r^ :✓dary!0 l6',*`�!J.cgktu,�W.���,rlutc,51
f._ll rr.lrr f �'rrr arr: r ll r on fter icd,x i irrnot c�„^,ror r,ejod,the forrrvo ual0 nrrafl on ANmYd ak a Candtdato Ppbnwa^^«r 7l:rr»r HISCOW',11 E1111.1)
ee nntname�si�it o the undersigned, a registered
I' EII EI
PI
P. on your ormationcard) "a��� � PIK DU L.�
id state and county,petition to have the name of �je�a � �t��'
Voter In said 19 II '"' i i ill IIiVIIV
placed on the General Election Ballot as a [check/complete box,as applicable]
XNonpartisan N/q No party affiliation N/A Not Applicable Party
Candidate for the Office of
City of Winter Springs-City Commission District Five
(Please insert the title of Office and include District,Circuit,Group,Seat Number,if applicable)
Date of Birth OR Voter Registration Number Address
(M M/DDMW)
LCLY)e--
City County State 1 Zip Code
W
Signature of Voter Date Signed(MM/DD/yyYy)
[To be completed by Voter]
Rule15-2.045,.F.A.C.
ma CANDIDATE PETITION M,r m
�`«4tP rr'wr'rar,,r�,r[r"«rr Tarr 1'/�ida i"nrrd"a orrerr�iram a gacrl+ld dw:rCar�u"urf�r'al'a r�.�^.ra rp ;r;°t,her:tw,r�r„ad�sarr r+d'f'arr.�a:atr�nr�r*r
*/a f.,a C1r P ne to dcrao^rongb"w�r+yrr€w^rroee arr.,an tare&,araVr ion fol a rar x4ft€r,wC^+ir"erCon 70.1"1 d 0r rgra.aSeat r.rdmasa
r llrr r v r v gri'rrarrraPc2 o r;P Barg"u h"7,fl tra r fa.;wrails� ., w "awrr,diegl d r,llddrnrr lrrr1 1a R R gn�P(( III"
r dg � l:aary r � the undersigned, a registered I FO iI II\40.�M IV�IC~�
'Vq A::'M. If 0 I H
(Please print name as it appears on your voter information card) �q af.ry cii.EPIK DIUM114G
voter in said state and county,petition to have the name of o�Q��4 1-l i P)TT Qg yAll..11i"YllNG
placed on the General Election Ballot as a [check/complete box,as applicable]
X Nonpartisan N/A No party affiliation [N/A Not Applicable Party
Candidate for the Office of
City of Winter Springs-City Commission District Five
(Please insert the title of Office and include District,Circuit,Group,Seat Number,if applicable)
Date of Birth OR Voter Registration Number Address
tdC 'fM d In Zip Code
Si natur ' ,? [To be oma➢i Vt Vd IbypV ter^t]i -.... _. ..
g :Or i [:+�nLeS1 1,le
Voter)
r �r3
(Rule 15-2.0 .A.
A,r 1 j, 2'/1,");,1
a If fr„tC°\+glleHER l i tldC 7u
€,YI I ICE C)F 6+1b, fw41
1��)ETITIQlq 17
AlUirfAwmaron on ehio0 tart becon7es a pubficrermdupon rvcolpl bYehc Ripenisor of F ecrivns
mhrw to noiwinglyso�n rnoterhan onopolUjon fm a randh*71a jSPcUrn 7CW,.?R5 Floficyb Stalufts,,
1fa'1M7Ue6ffi'4J M�rWMakOrM an M&ftvp�d'y nov complotvcl,Uw Mrrn Wflnof be vwld 4sa Candhl�7!c I Mftion Foxi rrl 14 01S COI'Al:ILE 11 B[
k) FORM INIUST BE
' \Cc" the undersigned, a registered Nf .[�)OKA TO U I iE
(Please mint name as it appears on your voter information card)
,,f 1:RIK Dtfl:flt�4G 2 , 01"i(CU
voter in said state and county,petition to have the name of 'Ok7egA M . V i
_�\, 0
placed on the General Election Ballot as a [check/complete box,as applicable] -- QUALWY Iit�G,
X Nonpartisan N/A No party affiliation =N/A Not Applicable Party
Candidate for the Office of
City of Winter Springs-City Commission District Five
(Please insert the title of Office and include District,Circuit,Group,Seat Number,if applicable)
Date of Birth OR Voter Registration Number dress
(MM/DDA-YW) W &Orle &)Jcke ck-'V-
Fity-- County State Zip Code
SLIM i Vk D R-
Signature of Voter Date signed(MM/DD/YY"
[To be completed by Voter]
� �� a�
Rule
CANDIDATE PETITION FORM 7
*An infDroryabon on this form inacoynes a pubfic cecc,d upon receipt by theSupervisof of Flactlons
H js a critne to knowiinplys,p�qz u r)u.n e Man one petedon for a candidate,f5ection 70-.785 r1of Ida Statutes]
flfP'afbas* d, A t oi U e fcrrn�:.s�tcorn�,leted,the forrn wX not be vadd'a�7 a Candidate Pardtfon Form, I M COM PL E71ED
FORM MUS"r BE
the uindeirs�gnedj, a registered PIROW)EID TO T'l IE
s il ap pearson yourvot,r i'riformaflon card)
OTY CLEPIK DURING
voter un said statE! and courity,1peti o have the name of --K2,q1oe-o-AA Im,1,2-- QUAUFY11ING
p1laced oin the GeneraU 11.Aecdon Baflot as a[checklcornp ete box,as appficalble]
...........
tionipairtHsain NSA No party affiliat0on Not Aqppficable Party
Candidate for the Office of
City ofWiinteir Springs -City Comimlissilon [:Astrict Nve
pPllease insert ilt,ectie of office and'indude DistiricL,Circuit,Group,Seat Nurnber,ffapp ficable)
Data of Birth 01P.Voter Registration Number Address
-LL
C't lCounty Fs—,A 1 Zip Code 17
7,
Signatur el 1a Date Signed(M M/DD/YYYY)
[To be compl.t1d by-), .1
A
.................
Rule1S- 4,, F.A.C.
C
IIII IIII NII°°° """ "� NIN° n" mIII NNE m"."
°" H infsmN ara'onx on ahis fonrra berc:onaaras as t:aadbftc necoraf adpton a-eceipt f�py ffra i42mY or nrs"kSieC1.e w?s
It a:a crane.to ffna5 d'sra,rfD+ra'fffrn nwrraa:dfd x a rar>p:vetf8da°rda for a candtdate%I ea Lion 10438 r p Raark a it:af erd"d q.
"�6..a th"T,""f j" completed,the fr.,,ra'a will aaof be V aafow a s a'�"aa auctr a e f^evl wy A't d rrn. ��^aM
6 �n9,D
wu�"f�IMla���»r Gk)
PltC�RM I �
rrN"5d7Rt4sMR rrosa Y.�u f'�raaard fvdN rc ^. a
rya ��d"»�r a � �-""�' ,� � pad t:P�nr, a.urnrff�i �If'fuf�cfa s It��i^sC.r�rr!ar� .��a"Illi"�IPPD'TC I�BE
0.n2:at:t..0 Ilta fi:a�llt ..,laalLdu -�h"tl4�G:&.DG.kIPtlt "a�,pa�,. w ',` anyrc9v41=)d¢ ,wli,µ7_P"1aiaar iGi a'na'.reau`a:f)
c0 IIr.Ea c Iarin a ` a o R �~
tr ' uullShc�n� a � ��„„ ,. .m_, f�l'�f"a�"("A,f~: �f�O~�fBufIING
ilarne
QUALlIdylNG
p1lac°ed¢'n they Geru��vM Elect n I a"tBllot as a [arheck/cornllpdete Irox„as aplipiur,,aUe]
a- = or, N/A -- . I Vf:pt�wfD�Pllica~ble Pal y I+Va:alrul.nar4�i_raae R^�/�' Ira �'a"al"0: affd�¢aiC -
C`;an6daste for the C)ffilce of
Cli'ty or Winter Sli irio°'nos City Commission Ui'striict Five
(PIease iinseirt.a",,dtIe of 0 f ice a ii d'inc1.u a e D st ric t,C`:ir(.g V"Coy oulia..S eat I14urrrullser,if tulppfa'c ablel
II::7a7 cwt V'.lia't 1,'fp tenter Ilfc a iist.ravoin Number A J(hes s
I11"4M/Dr)ry t^F'w)
D.irrr County Istate f ip'n Caa¢fs
✓"r
L,
Signatuureof1�oter DAte Signed(lalAIDwV'D/WY)
� °�..,,. •�� mm � r�; e,��' ...�"; ,a ,,,� "°' frnau�aonrurwOcree:Wlaytwl
Rule 15-2.045,FA.C.
CANDIDATE PETITION fOMA
rA,fbn na u:'u:,,r,"r W r'ud°S J16 r, l oecwr+r..,a dw,irrrs?6tf far c�c,)r^:s"a,tra d ro ru:or P,4S,t�,°:rvc
r'p ai rn4:wif,n aWwwnna ou��,a f�frd n wfn is n r+�r>da irop?eg the fa orra uw" rn° rCt"+aj r f�4kd du
rr r a Yc Ad tiu as gt ron rrwi rd s' 't, i
.l.
suYno'rnarYo,i^ ac aa,faarlr�rril i"wuaW�reJcu,�am�,ra�, n,ad',vartsf'aimtdA,rrra�r�n"��,,�+r.�w�a`r. ��.,.il�i I f�w�dl'.m I
'd'fa�, N'�w.r..wP���'"7,L' � III 'I'F�
(easenot name as it P p c, a oY� the undersigned, a registered
' nyourvoter information card) l"/rr:n"N/lll fl'rll:)"'I I lI f I� . I
'�ob��,$ , �1 ` _ eCl f :ltl N/If'll'
voter in said state and county,petition to have the name of 1� t (j�' l�r� q pl��atii lll'^'u�„qu kaw�
placed on the General Election Ballot as a[check/complete box,as applicable]
oNonpartisan N/A No party affiliation N/A 1 Not Applicable Party
Candidate for the Office of
City of Winter Springs-City Commission District Five
(Please insert the title of Office and include District,Circuit,Group,Seat Number,if applicable)
Date of Birth OR voter Registration Number Address
(MM/DD/"r"i tv P� ck
ElCity �' Count State Zip Code
...... _................--__m ..........
Signature ofVote r ,,.
...„.„, Date Signed(MM/DD/WVV)
LT C�,'edbyV,ter]
o be com
Rule 1S-2.04.,;F.A.C.
�Gd Iiarrl,ou Wa-m7 .°,,,. �'� awu�mw r" ��/"
AU 0 le„ a Z I2 0
j y r,,TE Iw i I RII'f
l..If,!s rI4i._C'[1 y t:":I f K
FORM 7
CAN D I P E"F F 0
cofdapan eeced7t bj,,the Superimioe ofL ctions
*it h,a ceime to knoiivkaq6,sigjrP mcm flown one rwaftion An a Candidate[Spctlon 70 W5 I kvfda Statutes]
ft-a,11 requevtod mforrnathm on OW.5 frnm ir not complered,the Awn ovf/not be vaild. as a randidate Petition Fbrlyy, Tf CIS COMIPLETED
J- 36vvl�li�/L"4 the unders�gned, a reglistered MRIM Ill BE
110 f R'�OUD TH VED"i-0 `E
�Nease pHnt nanne as it appears oinRink)II11natk lcard�
�-,k �t, CITY CILIERK ENJIMING
voter lin said state a nd county,p etitiori Lo have the narne of ��ge,0 QUAILIFY0410i
p1laced cin thie Gen ma IE.1lec.flon 11-30ot as a[check/cornplete box,as aploficalbIle]
X monipairtlsan Nolpairtyafflifadon /:A:--I Not Appilicable Party
Candlidate foir the Office of
Clity of Winter SIll- CIty Corymmilssiorl toilet II:':ye,
Unalease uns;ert the bitle of Office aru:i' nclude District,CIITUit,Group,Seat Nuirnber,ut,31.')jpficable�
Emte of Birth OP Voter Peglsltiiatlon INLJIIrnlber Addiress
�Mim/�)11-)/Yyyy°
to
�
City "Ounty Z i p Code
v ` ,
Slginatuuira^aapnAna e i Date Sig ned(M MIDEVYYYY�
�"Gb lie coirn [a to 94 V t
64 go
Pule IS-2.045,F.A.C.
CANDIDATE PETITION 7
'All Wormation cq this Awni becamea a pubAc mcmd upon ee�ce0pt by the Supeimor cfEiectjons
it is a cr#ne to knowdrygly sogn rwre then one pethko foi a candldate^[Secdon 10,rt 185 f lorida stattites)
vrm is not comftletod,the fofm weill not be vaild as a ran dkeateZetitirdn 1.:vrm, T1 HS C011AIPLE."IFE.I.)
FORM MUST BIE;'
the undeirsigined, a regilstered
PRCMDED'ro"rHE
(li �.-.,�pirinLrmiiieasitapp,arsori,yok� v Ler�nfoirrnaVonc
voteir in saidstate aind county, petlition to have the narne of
QUM IFYING
jpk'aced on the Generai Election 13allot as as [check/comlil box,as applicalbIle]
Nonpartisan = No pairty affilla6oin Eq=//k=-I- Not Appiicalblle Pa arty
Candidate for the Office of
01ty, of Winter Spidings-City Coimmission ENstda IFive
(Please unserq the title ol'Office and 6nclude Dlslrict,Circuft,GrOL4D,Seat Number,if applllcable�
Date of Birth OR Voter Registratlon Number Addiress
—'r
C—)
clby U r, .............
7�; MpCode
LIJ
................... .
2 ... .....
S;nature cif',loter oate SicK,ied 0AM/E)D/YY1N)
[To be cornpiet,d by Voterl
. ..............
Rule Is
J,.G 2
7-YO! 'AMN`E1 pq,,; GS
I p(::�!:.(:�,r, Grp �-, 'r,, (,,,I E R,1,/,'
ETTION
CAN DI 7
'All adbrma6un up Uwe lurm becolnes a paxbkd derord Upon rilt wA21 bY the supavviscrofElect4ons
I t 1ra cArre to, nwfe 0an onepet1wd-, cand"dwe,P&ctkyn 704 786 1 4w&Y F Statuld'SY
m�ghis form&n,:ag cennplet15d,the foprr rvlfna�bc,vai)Wag a randidb:le Nthiorp i onm, THIM GOMll°'a9 JIllTED
FORIA IIIAUS' II II
1, the undersigned, a registered 11:>11:�OVII DIII::D TO 11 a ff
(Please print name as it appears on your voter information card)
voter in said state and county,petition to have the name of C��`YCLERIIK' 113UIRIIIING,
placed on the General Election Ballot as a [check/complete box,as applicable) QUAILlII 'Y'lNG
Nonpartisan E:NKl No party affiliation Not Applicable Party
Candidate for the Office of
City of Winter Springs-City Commission District Five
(Please insert the title of Office and include District,Circuit,Group,Seat Number,ifapplicable)
Date of Birth OR Voter Registration Number Address
(MM/DD/YYYY ov
;L7
ty CountState
Ci Zi
Code
JA)j 3.2-748
Signature Date Signed(MM/DD/YYYY)
[To be completed by Vo ter,
k,u le IS-2.04S,FA.C. .......... .............
CAN DI DATEPEBTION
IFOWA7
A If infoi mz t dun an k hIs rw rn beram r's a pl"'b lie 70crd?d v'rwn rr ccl I bje the,Supe ry sc r of F-*,CNC,,s..F
It 11,a crhm'.�to knovIng(.y 5 rj ry-we"Man ons,pet/tion 1c),a cz'nWdate.f5ection 704.7625 Fiorhaez SIBI utes']
,if U Cn on 111' f rhe star ni, 711-iM COMP 11 ETED
"S FORM MUST IBIE
11, the uindersigried, a reg�stered PROWDEID 7`0 THIE
iPllease print name as ft appews on your voteii�nforrnation cawd� CRY CI-EPK DUMNG
Voter ln said state and county,1petlition to have the narne of
QUALPING
pV,iaced on the Geneirall If lection IBaallllot as a [chieck/complete lbox,as ajpplicalble)
Nonpartisan No paqy affillation Not,AppHcalblle l�::�a r l�y
E=x EED
Can6da:te for the Office of
City of Winter Springs-City Commissioin Distirlict Five
iPlease tlnsen the title of Office and iincWde DMrlct,Omuft,GmUp,Seat Number,Gfapplicat.:,Ie)
................
[Date of Birth OIR Voter Peg stiratio in Nu rnbeii Add ess I
(MM/DF.)/YYYY)
5 nty Zip Code
Sig DAL'4� ter Date Signed(MM/DDAIYW)
LS [To be completed by Voter]
Pule IS-2.045,F.A.-
777""
0 F F
CANDIDATEPuITION FORM 7
.AN Information on this form becomes a public record upon receipt by the Supervisor of Elections
�It is a crime to knowinglysign more than one petition for a candidate.[Section 704.785 Florida Statutes] THIS COMPLETED
*If all requested information on this form is not completed the form will not be valid as a Candidate Petition Form.
FORM MUST BE
the undersigned, a registered PROVIDED TO THE
� -
(Please print name as it appears on your voter information card) CITY CLERK DURING
voter in sai
d state and county,petition to have the name of "" wD �� 0 " QUALIFYING
placed on the General Election Ballot as a[check/complete box,as applicable]
1 X Nonpartisan N/q No party affiliation N/A Not Applicable Party
Candidate for the Office of
City of Winter Springs-City Commission District Five
{p- se insert the title of office and include District, ,Circuit,Group,Seat Number,if applicable)
-
Date of Birth OR Voter Registration Number Address �j y� L r�
(MM/DDNYYY) VAI< f /� J f E79/
....... _� - -- State Zip Code
FYI
...Signature of rater
Date Signed(MWDD/YYYY)
[To be completed by Voter)
Rule 15-2.045,F,+a. �
Co CANDIDATE PETITION M 7 FORM
*All information on this form becomes a public record upon receipt by the supervisor of Elections
.It is a crime to knowinglys/gn more than one peddon fora candidate.[section 704185 Florida Statutes]
'If all requested information on this form is not completed,the form will not be valid as a�ndidate Petition Form. THIS COMPLETED
FORM MUST BE
the undersigned, a registered PROVIDED TO THE
® - �`
(Please print name as it appears on your voter information card) _ CITY CLERK DURING
voter In said state and
county,petition to have the name of E „ ®*k-- QUALIFYING
placed on the General Election Ballot as a[check/complete box,as applicable]
No a affiliation N Not Applicable Party
'If( Nonpartisan N Candidate for the Office of
A� �
City of Winter Springs-City Commission District Five
P i the title of office and include District,Circuit Group,
(Please e up,Seat Number,if applicable)
Date of Birth OR Voter Registration Number Address
(MM/DD/YYYY)
�... ..��a . _
CityCounty State Zip Code
,.,,��� _�_�_ __...
Si nature of Vo[er Date signed(MM/DD/YYYY)
g
[To be completed by voter]
Rule 1S-2A45,FAC.
rya" P �tY ,t:IiSr S
f 1 °a.%pv': r^SnV.,i�.4R
CANDIDATE PETITION 1117
.All dMormadon or)tjds form bpeomes a publk record upon rerelpt by the SupaiWsor afElkecdons
*fr&a cdme to irnowbingeys®qn more than one pee.&Ior;fof a candidaa: ISection?04,7d35 Florida Statutes]- ' ro , ge �e 11M�'OISR CO MMUPS11.I 7.....E.....I.D
/rp Itlhe uirider'Mgnedtanreoyistredif-affrequestec isdAn- ation n msfrm notmpfetd Me tb�vnv/ w .
PIROVII'.)ED"TO THE
Nvmepv1nt measitapppausorikourvq.ateriTif;T I rT) CITY CLEPIK DUMING
voter 4-�sa�d state and co�jnty,peddon to Ihave the rtaryie of 0�9 QUAI IFYING
p aced on the General Dec-bon Baik.:A.as a[!check/cornp ete box,as
Nonpartisan =q/A Nopar�yafflliadoin HE= Not AppficakAe Party
Candidate for d"m Office of
City of Mmer S11prongs-City CommIlisloin DWAct.Five
(Please insert the tMe of Office and Mclude IDist,not,Clircu!t,Group.Seat.Nurnber,Uf ajr.)r,.wRcabiP)
T)_aLeWI1iro oPvaver Reg is_"aW_n'-Number Address
(MMADD/YYYY,
0t couS Y N it Stfite� Zip Qjde
, w d/tc
-
Stgnatune_of'Voter Date Spgjwd gMIIAIDD"
[To be co 4_f p-te hyVotOj
7
e7
Pule IS-2.045,RAC,
CANDIDATE PEI ITION
*AW informarAw on this form bacomes a publir rarard qraon recelpt by the..15upervi3or of Elerdarm.,
n d..a crkne to knoimng6,s4-va maie rhan one pedfion for a candidate.[Sardan 704.,M5 Florida Staluteqj
If an on thj.s rurryp i..zc not complprpd,the foun w,11inot be vd.-mild as a camridare Petition;-:brrn. THIS COMPLETED
I L61 I 1:'-"ORM MU.rST 11311::�
the unders�gned, a reg�stered 11:31ROVIDED TO TIAE
(Mease prhbt narne as at appears on your voter infbrvnadcn carm. CIW C11 ERK IDU PING
voter in saW!:.;tw,'.e and ciourity pedtion w tnave the narne of QUAI IF
jpUaced on the General Uection IBa9Vat as a Ichecktromplete box,as appkablej
Nonpardsan Nopartyaffiiabon ±_ INot AprAic-aWe Party
Can6date-for the ofte tlf
City of,Winter Springs City Commisem District Five
..........
(Please insem the We of Offiv.-.'e and hadude Nst.Arft,Ckcuft.Group,Seat UqujynliDer,if applicable)
Address
11 Date of Birth OR Voter Reostradon N urnbey
pip f
W� Fr)-res-4 0 ...........
C!
4:a Code
7 03
ME
Date Signed(IMMJE)D"�
[ro be complete d" IDY V
.............
UelS- 045,PAC.
rr
CE57—Er.1�r........
2 4
crry(0v
CANDIDATE PETITION FORM
'All information on this form becomes a public record upon receipt by the Supervisor of Elections
'it is a crime to knowingysign more than one petition for a candidate.[Section 704.W Florida Statutes] THIS COMPLETED
6 if all requested information on this form is not compl-I the form will not be vaild as a Candidate petition Form.
FORM MUST BE
I, ��tZ�L�� R�1�LC the undersigned, a registered
ITM PROVIDED TO THE
(Please print name aurc appears onyour voter information card) jP.2 1�60 CITY CLERK DURING
voter in said state and county,petition to have the name of p QUALIFYING
placed on the General Election Ballot as a[checWcomplete box,as applicable]
Nonpartisan N/A No party affiliation N/A Not Applicable Party
Candidate for the Office of
City of Winter Springs-City Commission District Five
(Please insert the title of office and include District,Circuit Group,Seat Number,� �e)-
• i - p, if applicable)
Date of Birth OR Voter Registration Number Address
(MM/DD/YYYY)
City No�
2 State Zip Code
Si nature of voter Date Signed(M M/DDM YY}
g jro be completed by Voter)
Rule 1 F.A.C.
CAN DI DATE PETITION FORM 7
°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 704.W Florida Statutes] THIS COMPLETED
•/fall req a red information on th form of completed,the form v✓it not be vaild as a Candidate Petition Form.
FORM MUST BE
( a the undersigned, a registered PROVIDED TO THE
�- (Please print name as it appears onyour voter information card) - CITY CLERK DURING
voter in said state and county,petition to have the name of Ck>p QUALIFYING
placed on the General Election Ballot as a[check/complete box,as applicable]
Nonpartisan N/Candidate for the ONo party affiliationffice ofA Not Applicable Party mm..
City of Winter Springs-City Commission District Five
(Please insert the title of office and include District,Circuit,Group,Seat Number,if applicable)
Date of Birth OR Voter Pegistr tion Number Address
(MM/DD/YYY1) a t o o O>!v i wee'
CitCou state Zip code
w f�i'j
�s
Signature f d7 ate rDiateLS igned(MM/DD/YYYY)
s completed by Voter]
Pule IS-2-0 d AC. Iwo
RECEIVED
4")kT"°v t7I VV11 dilFIR S:4:uhJGS.
CANDIDATE 0 FORM 117
.Aflinkmenadon on this,as becornes as),xibfir reconlupai reve;pf by the Supeivisod,of FIC,'cgioos it 8a� ftne trknobiwkq1jv sIgn more,than one perffinn fm a canffidata�"se ct(on 704.78SFkylida Statutesl
tdadd
xx anrl'A nus COMPLAD ED
FIROIRMA MLISI If E
the undersigned, a ireg�steved OVHNEDI'011-11E
PR
.��e pdint name as ft appears on your voteir inrorrr-r.ftion caiid�
C11TY C.,'LIERK 11"w w
III u,
voter in sald State aind County,l to have-the narl-�e of
QUALAPYING
sparred oni the Geineu all IDection Ballot as a [check/corripliete l as appficabiell
=X . Nlonparfisain =N/A Nolpartyafflilladon Fl9—/A ] Not Aplipficalble Party
CancHdate for the Office of
City of Wiintt.%r S11prilirigs-0ty Cohn w-nilssion INIstrilct,
(FIevsv nsert theUde of(AfIce and hiclude D�stdct,OrcW. ,Grouj.),Seat 114uirnl,,'weir,it ajpjpflcalble�
IDate of Bl�tlq OP Voter Req�stwlion i1qurnber Addi,ess
im r.)Jy'1(Yy� 0:
Zip Code,
V k V
S'ugnariare of "stet' Data Slgned iM YjDD/YYYY)
fic te q.)1ete(V'.)yVo1'er1
7P(.,�i�
CANDIDATE PETITION FOPIA 7
'Aflh)/blpiailhn on Mis fejrr?bocomes,rpubh,c recon,"upon,
Ft 45 a cfIrne au knmWr�g13"S`-qn nwle than on4�'�WrirVbn tw a candxiara 15eclInn 104,�65 Florida StatwesI
*Irallmqupslec"'inrormo?1cf,0)�?this A"vm�Fnot compAyted,the tfm wl#�n')t bp vulldaz a :7vr��cWa PeMliun rwm THM CCHAP11,11i, ED
1170[W Mus� BE
the undersigned, a registered Di!�'
(Please print name as it appears on your voter Information card) 0MIDED TO il�iE
voter in said state and county,petition to have the name of C11Y C11�EIRX DUMNO
placed on the General Election Ballot as a [check/complete box,as applicable] QUiU.i11iiYflNG
Nonpartisan F
No party affiliation N/A Not Applicable
Party
Candidate for the Office of
I City of Winter Springs-City Commission District Five
(Please insert the title of Office and include District,Circuit,Group,Seat Number,if applicable)
Date of Birth OR voter Registration Number Address
M MID D/YYYY,,,,,,/,
........................
...........
—71
C;,tuy County IState Zip Code
Signature—.f Voter Date Signed(M M/DD"
(To be completed ,y voter)
Pule IS 2A45.F.A.C.
A
AUG �2' 4 2020
1Y F" Vvl'�'TF
1winhivrnation on I hf!,,ftwin&,cornes a pubAc rowid JIpon receipt ty Ow&1j2rrVAor Of L/ections
It T4 a cyinw tv*novdekg1y!;4gn rnorr than onepatition to a r.wnrPrJae.c JS6.ollon 104,786 0--&Wda 51,01uros,)
ffafl neq(testeel information on this forrn is' m d,O.nor coplotew`curvy v�"Of n 9 br. vffrya ct"l�a nolf4afe PeVe.ion 4-curn 111 i1S COMi")ILE'11 EID
0�:M MUSTBE
2
PIPOVIIDI:�33 11'0'ru H'�
the undersigned, a registered
(Please print name as it appears on your voter information card)
--L_L-
voter in said state and county,petition to have the name of F 11,10;1
placed on the General Election Ballot as a[check/complete box,as applicable] QUAl H:YMG
EI=X Nonpartisan N/A ' No party affiliation EE= Not Applicable Party
Candidate for the Office of
City of Winter Springs-City Commission District Five
(Please insert the title of office and include District,Circuit,Group,Seat Number,if applicable)
Date of Birth OR voter Registration Number Address
(M M/DDAYYY)
rr
city County st ZiP
a.....
Signature of Voter Date Signed(M M/DDA^Ml
[To be completed by UP
Rule 15-2.W4S,FA C.
q'21mit",
CANDIDATE PETITION 17
fSdrrtion 104,Pas
cry dd��farsn i�';nGtCe'?nPktFc4 Ow fbm7 �wfdas'a I l 11 lS MAPLE]Elll
the undersigned, a registered E FORIA MUS11 11:
(Please prfnt name as it appears on your voter information card)
voter in said state and county,petition to have the name of E 1 617"t— 0 IIY C11 ERIK DUI!d 1114G
placed on the General Election Ballot as a[checkicomplete box,as applicable] QUAll flIllY34G
X Nonpartisan No party affiliation N/A Not Applicable Party
Candidate for the Office of
City of Winter Springs-City Commission District Five
(Please insert the title of Office and include District,circuit,Group,Seat Number,if applicable)
Date of Birth OR Voter Registration Number Address
(MM/DD/YWY)
q,2 i�
city County Fst—.t.-7 ZipCode
Signature of Voter Date Signed(M MIDDIYYYY)
[To becompieted by'voter]
0
--—--------—
LRuleIS-2.045,FA4,",
4 2
IY(�F' V o rq
PIC'i� ()F rHE, Cl
CE CANDIDA-FE, PE I I I 10�lq
11.70RIA 7'
'Afi it pforrnation on th&form beconw4s a rwbfic recoidupon iecenpt bY thei;upeivisot afrIecuan,&
if is as crifne t.r.)knc."Wng1),slgn more than anepeudon for a candich'Up.15ece9an 104,185 FlorrdaSgaf.ureiq THIS COMPLETED
trap ghifetrm 1E norce'unpleted,the Awn wil(not be vaild as a Candidatv PleVdon Fb,n',.
Y1, the ljnders�gined, a ret..J�StE�[`Ed FORM MUST,BE
PROV0EIDTO THE
Please print name as it appears on your voter information card)
voter�n said state a nd county,jpc.�titiori to aave the inarine of -Il 'cr LIP QUL11IFYNGp�aced on the General Eleclkxn BaHot as a Checlk/coirnplete box,as ajpjpficalbleN
Non1paitisan No party y affifiatron E=L-.Not ApplicalNe Pairty
Candidate for the(3ffice of
Uty of,Wkiteir Spings..0ty Corywrdssion Ustrirt Hve
lllease hisert.the Ufle ofOffilce and include 0:)istr1ok" f'AJ[rojjp, eir,if ajal,"uIlcabley
t PJLAJ[T�r,
Diate of 113hrth 0111,Vateii lPe� Address giFtratioin Nurnbei
flr
12
City ounty State P Z�� C o d=e
Y evo
p �c
e
Sig' tur a ti'rVoter Date signed(mm/DDA^m)
[To be completed by Voter]
L/ mow,
1Rule )45,FAC.
CANDIDATE PETITION FOPM 17
All irdbimation an this,,Norm becomes a public record upon receipt by the Superinsor off..'Jections
It Is a criene to knawing y sign nowe than ona petition foi a camolidate.[Section 104,WS r1odda. statutes,
ffal�i�asted Wor ation on mit form is not romple,ted,the form"01 not be vadd as a Candidwe Potidon Fbem. rlfflS COMP11 ETF.::D 1, M MU5T BE
li�l* 0 the uirlders�gred, a reg�stered FOR
P lease print na ime as nt a ppea rs on you r voter i nfor�na don card} PPOVDED T'O'Tl 0E
: 111qG
_j OTY C1 ERK DUR
voter in salid state and county,petkion to have the name of QuAll WYNG
1placed din the Generall ERecfloini�::falllot as a jcheclk/coirnp�ete box,as applicable]
oinpartlsan N opartyaffiflatim) EH �01A[Ir;�Hcabk, �Ipwt y
............. N ..............................I I
Canddate for the Office of
Oty of Winter Splings..0I y Comirnissilon[DistiNct Flirte
tPiease J nsert the btle of Of ice an d hid ude District,0 v cu ft,Croup,Sea t N u rn ber,ff afapfica We
Date of Birth Ort Voter Reqistradain rJurnber Address
�MM/D[)"Y�
...................
Citt Zip
Signature I 11 I 11 I'll of� ter Date Signed(MM/DD/YYYY)
[To be completed lb,//Toter]
u a.IS-2.045,F.A.
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F t C' E oF-"'i lit,,crr(r LEFQIIK
CANDIDATE OATH —
NONPARTISAN OFFICE pp
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(Do not use this form if a Judicial or School Board Candidate) ���^V��i�Nr� '��1l�u���� �„"���t��l�
Check box only if you are seeking to qualify as a AUG `' 4 Jl[J lJ
write-in candidate:
❑ Write-in candidate
OFFICE USE ONLY
Candidate Oath
(Section 99.021(1)(a), Florida Statutes)
(Print name above as you wish it to appear on the ballot. if your last name consists of two or more names buthas no
hyphen, check box ❑. (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 ����% m ° #
..m..... .__ Office (District........
I am a qualified elector of e a��' o 1 v 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
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 information card):
9 ( Y )
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 disabilities(see instructions on page 2 of this form):[Not applicable to write-in candidates.]
Signature of Candidate Telephone Number Email Address
..e�
Address 6 �pF ( I u
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ess City / State, ZIP Code
STATE OF FLORIDA Signature of Notary< P g ubllc
COUNTY OF ` ��1 b ��E Print,Type,or Stamp Commissioned Name of Notary Public below:
Sworn to(or affirmed)and subscribed before me this,
+ V OuL Notary Public State of Fonda
day of �"��,' a w 20 f�.�" Christian D Gowan
Vj
My Commission GG 913234
Personally Know: or Produced Identification: p� ExPiros 09/15l2023
Type of Identification Produced: __. J L ,,,:;;� � L
DS-DE 302NP(Rev. 11117) Rule 1S-2.0001,F.A.C.
FORM 1 STATEMENT OF 2019
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
Elliott Robert Miles
MAILING ADDRESS:
925 Chokecherry Court
CITY: ZIP: COUNTY
Winter Springs 32708 Seminole
NAME OF AGENCY: t FE 0 !111
NAME OF OFFICE OR POSITION HELD OR SOUGHT
City of Winter Springs City Commissioner
'I Mph<,
CHECK ONLY IF ✓❑ CANDIDATE OR ❑ NEW EMPLOYEE OR APPOINTEE
**** THIS SECTION MUST BE COMPLETED ****
DISCLOSURE PERIOD:
THIS STATEMENT REFLECTS YOUR FINANCIAL INTERESTS FOR CALENDAR YEAR ENDING DECEMBER 31, 2019.
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 R1 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
Enurance Insurance Services 650 Davis St,San Francisco,CA 94111 PP&C Insurance
Fidelity Investments 100 Magellan Way,Covington,KY 41015 Pension
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
n/a
PART`C--REAL PROPERTY TY [Land,buildings owned by the reporting person-See instructions] You are not limited to the space on the
(If you have nothing to report,write"none"or"nla") lines on this form.Attach additional
sheets,if necessary.
_. ... .............
FILING INSTRUCTIONS for when
[n/a and where to file this form are
~~ 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 9,2020 (Continued on eevenne alde) 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]
(If you have nothing to report,write"none"or"nva")
TYPE OF INTANGIBLE BUSINESS ENTITY TO WHICH THE PROPERTY RELATES
Bank Account Navy Federal Credit Union
401K TD Ameritrade
PART E—LIABILITIES [Major debts-See instructions]
(if you have nothing to report,write"none"or"n/a")
NAME OF CREDITOR ADDRESS OF CREDITOR
............ . .............�.
Quicken Loans Mortgage Company 1050 Woodward Ave,Detroit,MI 48226
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"nia")
BUSINESS ENTITY#1 BUSINESS ENTITY#2
NAME OF BUSINESS ENTITY
ADDRESS OF BUSINESS ENTITY n/a
PRINCIPAL BUSINESS ACTIVITY
POSITION HELD WITH ENTITY
I OWN MORE THAN A 5%INTEREST IN THE BUSINESS — AA7777�
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 CONTIN�UED ON A SEPANA"I`E SHEET PLEASE CHECK MERE
T F_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
she must complete the following statement:
I,Form 1_n accordance
ord Prepared the CE
instructions to the form.Upon
112.3145, Florida Statutes,and the
my reasonable knowledge and belief,the
disclosure herein is true and correct.
Date Signed:
CPA/Attorney Signature: ..
8/13/2020
.............. ........ .w� .
' Date Signed:
FI CTIONS•
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
in
under, see page 3 of instructions.
form to that location. determine what category your position falls 1 with a qualifying officer is not required to file with the Commission
' or Supervisor of Elections.
i
of the county in which they permanently reside. (If you do not
Local officersemployees file with the Supervisor of Elections WHEN TO FILE:Initially, each local officer/employee, state officer,
and specified state employee must file within 30 days of the
permanently reside in Florida, file with the Supervisor of the county date of his or her appointment or of the beginning of employment.
where your agency has its headquarters.) Form 1 filers who file with Appointees who must be confirmed by the Senate must file prior to
the Supervisor of Elections may file by mail or email. Contact your confirmation, even if that is less than 30 days from the date of their
Supervisor of Elections for the mailing address or email address to appointment.
use. .Do nq$mrmmfoml to the Commgp,,ort Ethics�it will,_be
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, Finally, file a final disclosure form (Form 1F) within 60 days of
Tallahassee, FL 32303. To file with the Commission by email, scan leaving office or employment. Filing a CE Form 1F(Final Statement
your completed form and any attachments as a s a(do not use any of Financial Interests)does�relieve the filer of filing a CE Form 1
other format), send it t le by both
mail an e.fl.us and retain a copy if the filer was in his or her position on December 31,2019.
for your records. Do not file by both mail and email.Choose only one
filing method. Form 6s will not be accepted via email.
CE FORM 1-Effective:January 1,2020. PAGE 2
Incorporated by reference in Rule 34-8.202(1),F.A.C.
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:
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Print Name of Candidate: