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HomeMy WebLinkAboutWentzell, Christopher Application for Mayor - 2021 03 31 RECEIVED MAR 31 2021 CITY OF NTER SPRINGS CITY OF /INTER SPRINGS, FLORIDA OFFICE OF THE CITY CLERK QUALIFYING APPLICATION FOR APPOINTMENTTO MAYOR SEAT THE ORIGINAL QUALIFYING APPLICATION AND ALL OTHER DOCUMENTS MUST COMPLETED WITH ORIGINAL SIGNATURESAND MUST BE FILED IN THE CITYCLERI"S OFFICE BYHOON ON THURSDAY,APR,& 1,0021 Qualified candidates may attach a resume, references, recommendations, or other such docur entation that the(--a(i idaLe i`liesir es to h ve the CitCC�mit- issi0r1 CJP15€(jE'f before making an appointment to fill the unexpired term of the Office of Mayor. The Mayor serves on the governing body of the City subject to the duties and responsibilities specified in the City Charter. Please be aware that documents submitted to the City are public records available for inspection to the extent allowed by Chapter 119, Florida Statutes. Please complete the following in the space provided: A. GENERAL f }_e 1. Name: ('Inn'56pYiW—ey zt l- 2. Home Address: J10 . ,Y Sa 01YVN 1Y Wi Spriyicp F1 N-709 3. Occupation: - 4. Telephone (cell): ZC3L1(a Telephone (other): 5. Email: CQ UYP_n+7_e-ll 0 kCJMQ.+1 , COM B. ELIGIBILITY The information provided in this section is for purposes of determining whether you are eligible to serve on the City Commission: Ia. Are you duly registered to vote in Seminole County: (Y),- (N)_ lb. Are you duly registered to vote in the City of Winter Springs? (Y).X— (N). 2a. Do you live within the City limits of Winter Springs: (Y)) (N)_ 2b. What district do you reside in? (1)_ (2)____ (3)-X- (4)_ (5)_ 2c. How long (years and/or months) have you resided in the district.selected in 2b? 2d. How long (years and/or months) have you resided, iti the City? 3. Have you ever been convicted or found guilty, regardless of adj4dication, of a felony in anyjurisdiction?Any plea of nolo contendere (no contest) shall betonsidered a conviction for purposes of this question. (Y)_ (N)X- Rr=cF_iVED MAR 312021 CITY OF WINTER SPRINGS OFP�CP 4a. r"F r-JTY CLERK a. Do you presently serve on any other City of Winter Springs board or committee? (Y)_ (N)x_ 4b. Please list each: S. Do you have any private or personal interests which might conflict with serving the City's interests, if you were to be appointed to serve on this board or committee? (Y)_ (N)_)L 6. Ali persons applying for .3 City Commission Spat must voluntarily consent to n standard criminal background check before being appoiW-ed. -Do you voiui­,tarilly consent to having a standard 'background check being performed on you by the City of Winter Springs? (Y)� (N)_ 6a. Are you related to a City of Winter Springs Commission member by blood, adoption, or marriage? (Y)_ (N)$-- 6b. If yes to 6a, please provide relation: 7. 1 have read the attached information detailing the duties and powers of the Mayor and the Rules and Procedures of the City Commission. (Y))(— (N)— NOTE: The City of Winter Springs'City Commission has requested and encourages you to submit: 1) A brief Bio (to include background infbrmatior,,,information related to any applicable qualifications and current/previous community service) 2) Information related to whyyou would be a good candidate to fill this open Mayor Seat YOU HEREBY REPRESENT TO THE CITY OF WINTER SP'RINGS UNDER PENALTIES OF PERJURYTHATTHE INFORMATION PROVIDED HEREIN IS TRUE AND ACCURATE TO THE BEST OF YOUR KNOWLEDGE AND THE CITY OF WINTER SPRINGS HAS THE RIGHT TO RELY ON THAT INFORMATION. YOU HEREBY ACKNOWLEDGE THE' EXISTENCE OF THE CODE OF ETHICS FOR PUBLIC OFFICERS, AND THE FLORIDA SUNSHINE LAW, WHICH MAY PERTAIN TO YOU IF YOU ARE APPOINTED TO SERVE AS MAYOR. I F APPOI NTED IT IS YOUR SOLE OBLIGATION AND DUTY TO COMPLY WITH SUCH LAWS. Signature: Date: Please return to: City of Winter Springs The Office of the City Clerk 1126 East State Road 434 Winter Springs, Florida 32708 2199 THE ORIGINAL QUALIFWNC APPLICATION AND ALL OTWP DOCUMENTS MUST BE COMPLETED WITH ORIGINAL.51GI%L4TURE.5ANDMUST BgA7LEDIN THE CITYCLEWS OFFICE BY )VON ON y _1L 1, 2��j` FAtb&RE To. TIMELY FILE AN APRIL APPLICATION MA Y RESUL T IN YOUR APPLICA TION NOT L*WG CONSIDERED BY THE CITYCOMMISSION. P.ECEIVED MAR CITY OF WINTER SPRINGS,FLORIDA CITY R S 2021 MAYOR APPOINTMENT OFFIck- b THE K —7* fi OTERSTATUSAND THIS COMPLETED AFFIDA V1 T OF QUALIFIED V FORM MUST BE Q0 C17YAND DISTRICT RESIDENCY PROVIDED TO THE CITY CLERK NO OFFICE OF THE MAYOR LATER THAN NOON ON THURSDAY, APRIL 1,2021 doh,-�reby state that 1-�--ek to tl).�City Mame oF Candidate(Print or TN/Pe) of Winter Springs' mayor of the city of Winter Springs to complete a four(4)year term previously held by Mayor Charles Lacey for the city of Winter Springs,Florida.I further swear or affirm: (1.) I am a qualified voter in the City of Winter Springs (2) My legal place of residence is: W (,;Qr))Iy)c,Springs kAlAesSprims El Street AoVres.T-J city j State zip code (3.) Length of time of residency in the Ciiy of Winter Springs is: (4.) 1 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: Signature Date bf% F1 —3Z70E 5treetAdclress jity j State zip Code State of Florida Countyof f L-'\Z jj,-J Swam to(or affirmed)and subscribed before me bymeans off-Cphisicalpresence or—onfline notarizationj this l J day of V .,029- by C,{/'1 Personally known: OR Produced Identification (Print r7hme ofperson making statement) TYLER TAYLOR g J @� V\�,-4;-, H—P&O fr GG 279898 Type 6f1dentification produced g* aio or XP- 'ES:'November 27,2022 is Underwriter FOR OFFICE USE ONLY Copy of Florida Driver's License Provided for Item(5) Other documentation provided for Item(5) Revised 03/23/2021 There are several key qualities that 1 possess that would be advantageous for filling the position of Mayor. My work as a teacher has provided me with extensive experience in managing different visions, perspectives, and personalities as we work together to achieve a goal. I am able to provide effective guidance to my students and colleagues alike to ensure that outcomes are successful. I am comfortable with a diverse array of people and am skilled at making people feel respected and heard. My longevity with my school demonstrates the level of commitment and dedication that I would likewise demonstrate towards the Winter Springs community. Being a teacher also requires great organization and attention to details. Multiple levels of planning occur, from an overarching structure of how to cover the standards throughout the year to the day-to-day organization of each lesson, similarly to how a town has an overall vision that they are working to achieve while also managing individual projects and events. Despite that level of planning, however, flexibility is still necessary to ensure success. Sometime a well-planned lesson flops in a group of students, and it is necessary to make on-the spot adjustments in order to be effective. Other times, unexpected events may arise like special schedules or testing days that alter the plans. Being able to manage these changes easily and effectively will prove a valuable skill when issues arise while working towards the success of the city as mayor. But most of all, I feel like I would be an excel as mayor due to my passion for the community of Winter Springs. Since buying my house here in 2019, 1 have developed a deep level of appreciation for what Winter Springs has to offer its residents. It has a small town, connected feel similar to my upbringing in a small town in upstate New York. The safety and amenities available make it an incredible place to raise my daughter. We love going to the various parks and supporting local businesses and restaurants and have been impressed by the city events like the Movie in the Parks and the holiday lights in Central Winds Park. I am excited about the possibility to work towards continuing the great traditions of the community and ensure it remains a great place to live. RECiavrm MAR 3 . 2021 CITY OF WINTER SPRINGS OFFICE OF THE CITY C:l FRK I am an OCPS teacher, spending my entire 14 year tenure at the same Title I school working to make a difference for our students. During that time, I have taken on leadership roles at my job, helping to organize and plan school events such as beautification day, literacy night, and math and science night. I was also elected by my fellow staff members to the Faculty Advisory Committee, of which I am co-chair, and serve as the Professional Learning Community Lead for 8th grade social studies. My mentorship roles include assisting new teachers in order to increase their efficacy as well as providing guidance and modeling for students in collegiate teacher preparation programs. I have a master's degree in educational leadership, which has given me insight in how to manage organizations effectively. Outside of the school setting, I also volunteer at my church, serving on the school board and participating in church workdays. At my daughter's softball games for Winter Springs Babe Ruth, I assist the team with scorekeeping. I have also helped with hurricane relief efforts, filling boxes of food to send to Puerto Rico. Since I moved into the Winter Springs community just months prior to the pandemic, I have not had the opportunity to become as involved as I would like in the community, but I look forward to increasing my participation in the future. RECIENVF-D MAR 3 . 2021 CITY OF VVINTE*F �z, ,,-y CLERII,RINGS OFFICE OF THE C- Florida .-L.., i yM�TL�elr:. ?GSl�3Q?iiE1C 6r��i'"cCE "; rs. is7Cfi�'SA?LIP�iCC iaR �� e11j1�S;~R�P!g1N65;;�32798�QAB .uaip limamm16—ts-8'-00' t2 nex e%c make 5 zm RECEIVED MAR 3 , ZOZI CITY OF WINTER SPRINGS OFFICE OF THP CITY CLERK CITY OF WINTER SPRINGS • Charges i e - o UE UTILITY BILLINGall UP a- MON 7-61 TUE-FR18-5 1126 E STATE ROAD 434 SERVICE ADDRESS 1009 SAPLING DR �. ff r X PHONE:407-327-6996 I'�g g - .� r .f : ° Inco 1959 FAX:407-327-4753 - PENALTIES $0.00 EMERGENCY:407.327-2669 Y � r • UTILITYBILLSOWINTERSPRINGSFL.ORG W W W.W INTERSPRINGSFL.ORGtUB PAYMENTS -$260.00 CURRENT CHARGES $139.37 07/21/2020 TOTAL DUE BAL.15,Ndt BreakdownCharges Water Base $6.14 MONTHLY (NATER USAGE Water Usage $45.29 (in gallons) Water Tax $5.14. 25000 Sewer Base $12.06 Se er Usa Stormwater Base $5.50 12500 Solid Waste Base $18.10 TOTAL CURRENT CHARGES $139.377 ',;_ 0 141i M W = M Sean this code to make DCl OCT 10 NOV 8 DEC 10 JAN 10 FE9 11 MAR 13APR 14MAY 12 JUN 12 F. a payment With your smartphone today! Meter Reading. - > r TQ Days -�'M'' t F`" e' € 'W,�t04'r. '�' °",I-�� 9 ,. 0 _ _ a s A _ w _. _�� ,. m 5112/20 6/12/20 31 77317937 2357960 . 2380000 22040 c }rte..e'`�vp''r �?i's!i ��.c"�f'�� -f�'��t�S ,`�rF�-,FF.ti Sz x='Airirrrirs.°f" ='�c`�r,!.`3��F.•. 0 0 �• O M d0 N M 0 K w G ��i�`�����3�r� 1J�'P.,�... _~:. � -.a'"� r� ,..y 0 -� � f • • . _ 7!�O �L � a • a i These are difficult times and for some staying `' EaR Cole:'°' = -cads current with their utility bill is a challenge. Self-Pay by Website eservices.winterspringsfl.org Payment extensions and installment plan r beak's well 0% arrangements can be made. Call our - customer service group for the options. Self Pay by Phone 407-327-5991 N x N ......................... Please detach and return the bottom portion with your payment(Make Checks Payable to City 0f Winter Springs] Summary of • Charges DUE ACCOUNT NUMBER 17728-002 CITY OF WINTER SPRINGS SERVICE ADDRESS 1009 SAPLING DR 1126 E STATE ROAD 434 WINTER SPRINGS,FL 32708-2715 PAST DUE CHARGES ,$0.00. - CURRENT CHARGES, $139.37 07/2112020 Return Service Requested TOTAL DUE r.i _ i..• # 000001191 I=0001 = 1191 1 AV 0.386 CITY OF WINTER SPRINGS UTILITY BILLING CHRISTOPHER WENTZELL —� 1009 SAPLING DR 1126 E STATE ROAD 434 WINTER SPRINGS FL 32708-4006 WINTER SPRINGS, FL 32708-2715 00000000000017728002200000050493 CITY OF WINTER SPRINGS 111111 IIIA IIII 111111 VIII VIII VIII VIII VIII I I II IIII OFF.CF OP"IF�aT..CLERK l NOM I NATION PETITION All informa tiOn on tilis form becomes a public record upon receipt by th e Supervisor OfElectiOns THIS COMPLETED '!t isa crime to knowingly sign more than one petition fora candidate.[Section 704.785FIorida Statutes] FORM MUST BE (fall requested information on this form isnotcompleted the form willnotbe vaildasa Candidate Petition Form. PROVIDED TO THE the undersigned, a registered CITY CLERK NO (Please print name as it appears on your voter information card) 1 LATER THAN NOON voter of the City of Winter Springs,nominate f Yid G�'l�C� wavy e-v ON THURSDAY, 1R DAY to complete the unexpired term of Office of Mayor of Winter Springs recently vacated by former Mayor Lacey. 021 � /� y� (MM/DD/YYYY) , I J 1E \.c 1J� tate Cit Zip Code II I City �ounty �i 32. D Date Signed(MM/DD/YYYY) Signature of Voter !' [To be completed by voter] 313012-1 Rule 1S-2.045,F.A.C. -- I4~ NOMINATION PETITION `All information on this form becomes public record upon receipt by the Supervisor of Elections THIS COMPLETED 'It is crime to knowing/ysign more than one petition fora candidate./Section 704.785 Florida Statutes] FORM MUST B E ]fall requested information on this form is not completed,the form will not be vaild as a Candidate Petition Form. PROVIDED TO THE the undersigned, a registered CITY CLERK NO (Please print name as it appears on your voter information card)�r „C,,, LATER THAN NOON i voter of the City of Winter Springs,nominate c ikY n4o lve_ — ON THURSDAY, �o complete the unexpired term of Office of Mayor of Winter Springs recently vacated by former Mayor Lacey. APRIL 1,2021 PP,Voler Rc "tin,t, mbei I l,�I�r ss (M M/DD]YYYY) 11061 Iq 7 _ /00© Sao i✓t City [ountytate jZipCode 0 S'->C'l>'1 c S�l'�]i✓lCJ�t' ( �� I 3Z70F Signature of voter Date Signed(MM/DD/YWY) [To be completed by Voter] (Rule 1S-2.045,F.A.C. RECEIVED MAR 312021 CITY OF WINTER SPRINGS OFFICE OF THE CITY CLERK NOMINATION PETITION 'All information on this form becomes a public recordupon receipt by the Supervisor ofElections THIS COMPLETED *ltisa crime to knowinglysign more than onepetition fora candidate.(Section 704.785Florida Statutes) *lfallreq estedi formadononthisfor is not completed,the form will not be vaildasa Candidate Petition Form. FORM MUST BE PROVIDED TO THE I, the undersigned, a registered CITY CLERK T (Please print nam%e as it spears on your voter i ornatio®n card) i_ LATER THAN NOON voter of the City of Winter Springs,nominate u4c...V\�Zt.O� ON THURSDAY, to complete the unexpired term of Office of Mayor of Winter Springs recentlyvacated byformer Mayor APRIL 1,2021 Lacey. Date of Birth OR Voter Registration Number Address —Au2 Uco- City ounty tate Zip Code Signature of V Date Signed(MM/DD/YYYY) [To be completed by Voter] r -7 j 24D2.j Rule 1S-2.045,F.A.C. NOMINATION PETITION *A//information on tl)is form becomes a public record upon receipt by the Supervisor ofElections THIS COMPLETED *It is crime to knowingTysign more than one petition fora candidate.[Section 704.785Florida Statutes] *lfallre uestedinform ojonthisformisnotcompleted,theformwillnotbevaildasaCandidatePetitionForm. FORM MUST BE lk the undersigned, a registered PROVIDED K THE � CITY CLERK NO I (Please print name as Trappears on your voter information card) LATER THAN NOON voter of the City of Winter Springs,nominate C krts��""o nCr tuCni,-e1 j ON THURSDAY, to complete the unexpired term of Office of Mayor of Winter Springs recentlyvacated byformer Mayor APRIL 1,2021 Lacey. Date of Birth OR Voter Registration Number Address (MM/DD/WVY) Viol It' �I ��d G�W�Jei�00 �2IQ��� r City r [ountyftate Zip Code J!? - 70 Signature of Voter Date Signed(MM/DD/YYYY) (To be completed by Voter] 02/0 1/ lily I i Rule 1S-2.045,FA�Y- MAR 312021 CITY OF WINTER SPRINGS OFFICE OF THE CITY CLERK NOMINATION PETITION ` "Alllnfbrmation on thisform becomes a public record upon receipt by the Supervisor of Elections THIS COMPLETED 'It isa crime to knowinglvsign more than one petition fora candidate.(Section 704.785Florida Statutes) '/failrequestedinformation onthisformisnotcompleted,theformwillnotbevaildasaCandidate Petition Form. FORM MUST BE PROVIDED TO THE � r1� G' 17[�0i�,4�,4iV the undersigned, a registered CITY CLERK NO (Please print name as it appears on your voter information card) LATER THAN NOON voter of the City of Winter Springs,nominate �`v wce7+zel ON THURSDAY, to complete the unexpired term of Office of Mayor of Winter Springs recentlyvacated byformer Mayor APRIL 1,2021 Lacey. Date of Birth OR Voter Registration Number Address ,J (MM/DDM'YY) `I�07 .,�' //L,6 City [ounty f [tate Zip Code Sig nature• oter (Date Signed(MM/DDAWY) I [To be completed by Voter] 1 Rule lS-2. 5,F.A.C. NOMINATION PETITION xAll information On this form becomes a public record upon receipt by the Supervisor ofElections THIS COMPLETED *It is a crime to knowinglvsign more than one petition for a candidate.[Section 704.785 Florida Statutes] FORM MUST BE "!fall requested information on this form is not completed,the form will notbe vaildas a Candidate Petition Form. PROVIDED TO THE Ln C C 6ee�Af l the undersigned, a registered CITY CLERK NO (Please print name as it appears on your voter information carrd))j_ LLLATER THAN NOON voter of the City of Winter Springs,nominate ��` j �{�(z��l ON THURSDAY, to complete the unexpired term of Office of Mayor of Winter Springs recentlyvacated byformer Mayor APRIL 1,2021 Lacey. Date of Birth OR Voter Registration Number Address g (MM/DD/YWV) /007 S�W-6, ! "I City [ounty70- p tate Zipde signature of Voter Date Signed(MM/DD/YWY) Fro be completed by Vater] Rule 1S-2.045,F .. RF-c"EIVIED MAR 312021 CITY OF WINTER SPRINGS OFFICE OF THE CITY CLERK NOMINATION PETITION ,, ` *All information on this form becomes a public record upon receipt by the Supervisor ofElections THIS COMPLETED *It is crime to knowinglvsign more than one petition fora candidate.[Section 704.735Flonda Statutes) 'lfallrequestedinfor ationo this ormisn tcomplete th orrnwillnotbevaildasaCandidatePetitionForm. FORM MUST BE 'k. 11F, I, !-)C"'N-1 1 e r, bins — - the undersigned, a registered PROVIDED TO THE CITY CLERK NO (Please print name as it appears on your voter information card) �kri's�,,,pl ��fze!l LATER THAN NOON voter of the City of Winter Springs,nominate "h'�`'G/ ON THURSDAY, to complete the unexpired term of Office of Mayor of Winter Springs recentlyvacated byformer Mayor APRIL 1,2021 Lacey. Date of Birth OR Voter Registration Number Address (MM/DD/YYW) gity , ZipCode Wi o, e '��^I losmt 06f( X01?( Signal:- o Voter Date Signed(MM/DD[YYW) [To be comp) ted by Verj Lor--4/I Rule 1S-2.045,F.A.C. t NOMINATION PETITION *All information on this form becomes a public record upon receipt by the Supervisor ofElections THIS COMPLETED 'It is a crime to knowinglysign more than one petition fora candidate.[Section 704.135 Florida Statutes) •lfa0request dinformation n this form is not completed,the form will not be vailclas a Candidate Petition Form. FORM MUST BE I, L PROVIDED the undersigned, a registered CITY CLERK THE NO Please print n e as it appears on your 120er inform:-tion card) LATER THAN NOON voter of the City of Winter Springs,nominate' ON THURSDAY, to complete the unexpired term of Office of Mayor of Winter Spring recently vacated by former Mayor APRIL 1,2021 Lacey. C,�Y1So �, y U� iz�ll Date of Birth OR Voter Registration Number Address (MM/DD/YY" / ofo�xyl/ `1 !f� eR . jot 7'� 0 Y City ount tate Zip Code lel- Signature of Voter Date Signed(MM/DD/YYYY) ]To be completed by Voter] Rule 1 -2.045,F.A.C. RECEIVED MAR 312021 CITY OF WINTER SPRINGS OFFICE OF THE CITY CLERK NOMINATION PETITION *Ailinformation on this form becomes a public record upon receipt by the Supervisor ofElections THIS COMPLETED *Itisa crime to knowinglysign more than one petition fora candidate.(Section 704.05FIorida Statutes) 'IfaH requested information on this form is not completed,the form will not be vaild as a Candidate Petition Form. FORM MUST BE the undersigned, a registered PROVIDED TO THECITY CLERK NO (Please print name as it appears on your voter information card) �r.Y'i`�, LATER THAN NOON voter of the City of Winter Springs,nominate p� 1 � �1( ON THURSDAY, to complete the unexpired term of Office of Mayor of Winter Springs recentlyvacated byformer Mayor APRIL 1,2021 Lacey. !Date of Birth OR Voter Registration Number Address t ] /" a (MM/DID" )I LAp l�� �1 V ct �l� �, Cityounty [tate Zip ode W 1"A,pin [ Y� Signature of Voter Date Signed(M /W M/DDVY) ITo be completed by Voter] 31act IaoaI Rule IS-2.045,F.A.C. NOM I NATION PETITION 'All information on this form becomes a public record upon receipt by the Supervisor of Elections THIS COMPLETED ,It isa crime to knowinglysign more than one petition fora candidate.(Section 704.735Floride Statutes) ,If all requested information on this form is not completed,the form will not be vaild as a Candidate Petition Form. FORM MUST BE PROVIDEDTHE the undersigned, a registered CITY CLERK NO (Please print name as it appears on your voter information card) LATER THAN NOON /' voter of the City of Winter Springs,nominate �•r11--46P1--1 LkkAtrzel? ON THURSDAY, to complete the unexpired term of Office of Mayor of Winter Springs recently vacated by former Mayor APRIL 1,2021 Lacey. Date of Birth OR Voter Registration Number Address ��/�(f�r \�S City, �./ aunty tate Zip Code s �� P I Sig •re.t Voter Date Signed(MM/DDAWY) ]To be complet d by Voter] r Rule 1s- :045,F.A.C. RIF-CF-IVED MAR 312021 CITY OF WINTER SPRINGS OFFICE OF THE CITY CLERIC (` NOMINATION PETITION "ll information or)this form becomes a publicrecord upon receipt by the Supervisor ofElections THIS COMPLETED *It is crime to knowinglysign more than one petition fora candidate.[section 704.785Florida Statutes) FORM MUST BE */fall requested information on this form is not completed,the form will not be vaild as a Candidate Petition Form. PROVIDED TO THE f l yap Akx the undersigned, a registered CITY CLERK NO $ (Please print name as it appears on your voter informationcard) LATER THAN NOON voter of the City of Winter Springs,nominate an'skok-er tucy*en ON THURSDAY, to complete the unexpired term of Office of Mayor of Winter Springs recently vacated byformer Mayor APRIL 1,2021 Lacey. i Date of Birth OR Voter Registration Number Address .City [ounty t e Zip Code r _ Sig nature of Voter Date Signed(MM/DD/YYYY) ]To be completed by Voter] 03 JY7 Rule 1 2.045,F.A.0 NOMINATION PETITION ublicrecorduponreceiptbytheSupervisorofElections THIS COMPLETED *A!linformationonthisformbecomesap *It is crime to knowinglysign more than one petition fora candidate.[section 704.185 Florida Statutes] FORM MUST BE *lfallrequested information onthisformisnotcompletedtheformwillnotbevaildasacandidate Petition Form. PROVIDED TO THE a the undersigned, a registered CIN CLERK NO I E (Please print name as it appears on your voter information card) LATER THAN NOON LtJ�nl�zet l ON THURSDAY, voter of the City of Winter Springs,nominate APRIL 1,2021 to complete the unexpired term of Office of Mayor of Winter Springs recently vacated by former Mayor Lacey. X REGISTERED AT DIFFERENT ADDRESS Date of Birth OR Voter Registration Number Address (MM/DDNYYY) c0 tate i p Code City w� , f,n(93 �ounty � `� ®`G "mss ! Date Signed(MM/DD/YYYY) Signature of V er / [To be completed by Voter] i!f Rule 1S-2.045,F.A.C. -_— RECEIVED MAR 312021 CITY OF WINTER SPRINGS OFFICE OF THE CITY CLERK NOMINATION PETITION (:: . *All information on this form becomes a public record upon receipt by theSupervisorofElections THIS COMPLETED *It is a crime to knowinglvsign more than one petition fora candidate.[Section 704.785Flonda Statutes) *Ifall requested information onthisformisnotcompletedtheformwillnotbevaildasaCandidate Petition Form. FORM MUST BE � x PROVIDED TO THE I, �A _ the undersigned, a registered CITY CLERK NO (Please print na a as it appears on your voter information card) LATER THAN NOON voter of the City of Winter Springs,nominate 6,lArMopt--e� �ua&+.Zeli ON THURSDAY, to complete the unexpired term of Office of Mayor of Winter Springs recentlyvacated byformer Mayor APRIL 1,2021 Lacey. Date of Birth OR Voter Registration Number Address (MM/DD 1`?12- qw"Ar+(;�� r`z .2ci I� City [ounty �� tate Zip Code LA lfc, Signature of Voter ry Date Signed(MM/DD/YYVY) 1 (r b lipleted by voter] � l2-1 Rule 1S-2.0WFAI5, . Kl'-��k NOMINATION PETITION x *AllinformationonthisformbecomesepublicrecorduponreceiptbytheSupervisorofElection THIS COMPLETED 'It isa crime to knowinglysign more than one petition fora candidate.[Section 704.785 Florida Statutes) */fallr� ueste 'Tformationo /isfrmisnotcompleted,theformwillnotbevaildasaCandidatePetitionForm. FORM MUST BE PROVIDED TO THE the undersigned, a registered CITY CLERK NO (Please print name sit appears on y r voter information{caarrd) LATER THAN NOON voter of the City c Winte prings,nominate C�,ris�o O ei'' ujem e-i( ON THURSDAY, to complete the unexpired term of Office of Mayor of Winter Springs recentlyvacated byformer Mayor APRIL 1,2021 Lacey. Date of Birth OR Voter Registration Number Address (MM/DD/Y" '22 1 City 'ta�atte Zip Code i [ounty �lllll�K. I- L. Signature of V Date Signed(MM/DD/YYYY) Fo be compl ted by Vo r] �2 Rule ls-2.045,F.A.C. MAR 312021 CITY OF WINTER SPRINGS OFFICE OF THE CITY CLERK k NOMINATION PETITION 'All information on this form becomes a public record upon receipt by the Supervisor of Elections `Itisa crime to knowingiysign more than one petition fora candidate.(Section 704.785 Florida Statutes) '7faorequestedinformationonthis form isnot completed,theformwillnotbevai/dasaCandida tepetitionForm. THIS COMPLETED MUST BED the undersigned, a registered VIDED TO THE (Please print name as it ppears on your voter information card) TY CLERK NO voter of the City of Winter Springs,nominate THAN NOON l.��rttzel' THURSDAY, to complete the unexpired term of Office of Mayor of Winter Springs recently vacated by former MayorLacey. PRIL 1,2021 EDter Registration Number Address /1gs 15zco sraewick �, Rnty Q � � tate L Zip Code Signatu r f Voter Date signed(MM/DDAI.(w) [To be completed by voter] (� Rule 15-2.045,F.A.C. ,v\ 03 �/ 7 OZ {' NOMINATION PETITION *All information on this form becomes e public record upon receipt by the Supervisor of Elections `ltisa crime to knowinglysign more than one petition fora candidate(Section]04.785F/nrida Statutes] THIS COMPLETED "7fallrequested information on this form isnot tccomp`le�t`eed tthhe form willnotbe vaildasa Candidate Petition Form. FORM MUST BE I' LITO6A anZ�� the undersigned, a registered PROVIDED TO THE (Please print name as it appears on your voter information card) CITY CLERK NO voter of the City of Winter Springs, nominate LATER THAN NOON � eHfZ�1/ ON THURSDAY, to complete the unexpired term of Office of Mayor of Winter Springs recently vacated by former Mayor APRIL 1,2021 Lacey. Date of Birth OR Voter Registration Number Address//�� (� (MM/DD" O' l rhe 5p rl' 3dl- /p city r t [ounty - t( ��j�/ N rI(('N\ tate Zip Code Signature of Voter Signed(MM/DDA'Y y) [To be completed by voter] iPule 1S-2.045,F.A.C. DATE MISSING RECEIVIED LIAR 312021 CITY OF VONTER SPRINGS OFFICE OF THE CITY CLERK NOMINATION PETITION 'All information on this form becomes a public record upon receipt by the Supervisor of Elections THIS COMPLETED *It is crime to knowing/ysign more than one petition fora candidate.(Section 704785FIorida 5tatutesl *lfallreAque_stedinformation onthis form isnot completed,theformwill not bevaildasaCandida tePetition Form. FORM MUST BE —[ I, /_ tU_k j I the undersigned, a registered PROVIDED TO THE CITY CLERK NO (Please print name as it appears on your voter information card) LATER THAN NOON voter of the City of Winter Springs,nominate ��MjS - ON THURSDAY, o complete the unexpired term of Office of Mayor of Winter Springs recently vacated by former Mayor Lacey. APRIL 1,2021 Daic,of Bir^ C' ''v^er n;ai ..J.on:' .^.t,c P,ddr.. (M M/D DAWY) 07 1-7 /00 Ci [ountytate Zip Code Signature of Voter Date Signed(MM/DD/VYYY) (To lb^e�completed by Voter] Rule 1S-...:4S,F PtECEIVED MAR 312021 CITY OF VNNTER SPRINGS OFFICE OF THE.CITY CLERK CITY OF WINTER SPRINGS 2021 MAYOR APPOINTMENT RE C IS,VVE D OATH OF CANDIDATE OFFICE OF THE MAYOR 'Al/persons who noworhereafterare emplowdb yor who now or hereafter are on the payroll of the su e:sr depajvna-is and egencies, bdivisior d.,str c vi ta rie�.or an y fx-i the free publicschoolsystem of the state or countle4 orinstitudons of higher learning,and all candidates for public office,are required to take an oath before anyperson dulyauthor&ed to take acknowledgements ofinstruments far public record in the state-ff[87605 17)Florida statutes) "Arlyperson seeking to qualifyforpublic office who fails or refuses to file the oath required by this act shall be held to have failed to qualifyas a candidate forpublic office,and the name ofsuch person shall not be printed on the ballot as a qualified candidate."1876 07 Florida Statutes) 1, (' a.ef Lj)-evT�MP—\ k , a citizen of the State of Florida and of the United States of America, and a candidate for public office, do hereby solemnly swear or affirm that I will support the Constitution of the United States and of the State of Florida. Signature of Appointee Street Address sena ,city Stale Zip Code C, STATE OF FLOPIDA COUNTY OF--1->-�'-v Sworn to (or affirmed) and subscribed before m- by means of{_'physical presence or—onlline notarization} this- - k -,�cdayof aC-,,- !LL-- 2021 by C- L)e,(4:ze, Personalk/ knO\A/ ) OP Producedldontific,:Itlon Type of Identification produced �3,lue-I, Signature of Notary Public - State of Florida TYLER TAYLOR My COMMISSION#GG 279898 zz EXPIRES:November 27,2022 - PubiieundeNOters Bonded That No'P rM MAR 3 . 2021 TER SPRINGS F THE - CI;jO OFFICE CV ,ITY CLERK RECEIVED MAR 3 , iu'iL CITY OF WINTER SPRINGS OFFICE OF THE CITY CLERK �����������/����. mnw�~~=-~��~ `~ --�-- M&Q 3 12921 CITY OF WKNTEP SPPINGS c"'r° woa Or*.CuurTHE CITY G��m� ��� ���������������T OATH OF CANDIDATE OFFICE OF THE MAYOP "�ach oandidate.vvheche/ a party candidate.a candidate with no partyafD|iadun'ur a vv/itc:-in candidate, in order to qualify for nomination or election to any office other than a judicial office as defined in chapter lO5.shall take and subscribe to on 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 toqua|ify—" [99.02] (1)(o) Florida Statutes] STATE DFFLOQIDA COUNTYOF "Before me,an officer authorized to administer oaths, personally appeared /Please Print&bmeAs You'Wish It ToAppearmotymecordsFor This Appointment) to me well known,who, being sworn,says that he or she is candidate for the office of Mayor;that he or she is a qualified elector of the City of Winter Springs,Seminole County, Florida;that heorshe 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.876.05-876.1,0, Florida Statutes;that he or she has qualifie(A 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 ofAppointee Street Address City State Zip Code 57' �� / Svvorntoand subscribed before rnethis dayuf 2021,at Seminole County, Florida. " _ _ -- ------ (Signature and Tit le of Office�,Xclministeripq.Oath) My Comminion GG 913234 NOP Expims OWISM023