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HomeMy WebLinkAboutParsons III, Howard - Application for Office of the Mayor - 2021 03 31 wn-CEIV ED MAR 312021 CITY OF WNTER sPRINGS CITY OF WINTER SPRINGS, FLORIDA OFFICE OF THE CITY CLERK QUALIFYING APPLICATION FOR APPOINTMENT TO MAYOR SEAT THE ORIGINAL QUALIFYING APPLICATION AND ALL OTHER DOCUMENTS MUST COMPLETED WITH ORIGINAL SIGNATURESAND MUSTBE FILED IN THE CITYCLERI'S OFFICE BYNOON ON THURSDAY,APRIL 1,2027 Qualified candidates may attach a resume, references, recommendations, or other such documentation that the candidate desires to have the City Commission consider 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 J 1. Name: JAX'P 2 P�xsp�ts 2. Home Address:) � 'a- 3. 3. Occupation: ^- klgf rr�- 4. Telephone (cell): 4- 3V5- Telephone (other): 5. Email: R�5©n[ B. ELIGIBILITY The information provided in this section is for purposes of determining whether you are eligible to serve on the City Commission: la. 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) (N)_ 2a. Do you live within the City limits of Winter Springs: (Y))C (N)_ 2b. What district do you reside in? (1)_ (2)_ (3)_(4)_ (5))C 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 in the City? 3. Have you ever been convicted or found guilty, regardless of adjudication, of a felony in any jurisdiction?Any plea of nolo contendere (no contest)shall be considered a conviction for purposes of this question. (Y)_ (N)_ RECEIVED MAR 312021 CITY OF VVINTER SPRINGS OFFICE OF THE CITY CLERK 4a. Do you presently serve on any other City of Winter Springs board or committee? (Y)— (N),t- 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)- 6. All persons applying for a City Commission Seat must voluntarily consent to a standard criminal background check before being appointed. Do you voluntarily 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 information, information related to any applicable qualifications and current/previous community service) 2) Information related to why you would be a good candidate to fill this open Mayor Seat YOU HEREBY RE PRESENT TO THE CITY OF WINTER SPRINGS UNDER PENALTI ES OF PERJURY THAT THE INFORMATION PROVI DED HEREIN IS TRUE AND ACCURATE TO THE BEST OF YOUR KNOWLEDGE AND THE CITY OF WINTER SPRINGS HAS THE RIGHTTO RELY ONTHAT 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. IF APPOINTED IT IS YOUR SOLE OBLIGATION AND DUTY TO COMPLY WITH SUCH LAWS. Signature: Date: z� Please return to: City of Winter Springs The Office of the City Clerk 1126 East State Road 434 Winter Springs, Florida 32708 2799 THE ORIGINAL QUALIFYING APPLICATION AND ALL OTHER DOCUMENTS MUST BE COMPLETED WITH ORIGINAL SIGNA 77JRE.5 AND MUSTBE FILED IN THE CITY CLERICS OFFICE BY NOON ON THURSDAY, APRIL 7, 2027 FAILURE TO TIMELY FILE AN APPLICATION MA YRESUL TIN YOUPAPPLIC4 TION NOT BEING CONSIDERED BY THE CITYCOMMISSION. Revised 3/23/2021 I!I,ECEIVED MAR 3 1 26Z I XtATE,V CITY OF WINTER SPRINGS,FLORIDA CITY OF WN, OFFICE OF VHCITY C;1-04K <- 2021 MAYOR APPOINTMENT Z 0 AFFIDAVITOFQUALIFIED VOTERSTATUSAND THIS COMPLETED FORM MUST BE Q..-CIO CITYAND DISTRICTI?ESIDENCY PROVIDED TO THE CITY CLERK NO OFFICE OF THE MAYOR LATER THAN NOON ON THURSDAY, APRIL 1,2021 do hereby state that I seek appointment to the City Name of Candidate(Print or Type) 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.) 1 am a qualified voter in the City of Winter Springs (2.) My legal place of residence is: 1,4,7 ]�, U 9,,-,, C StreetAddress City state zip Code (3.) Length of time of residency in the City 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.se.cond,clocument is: 13, Signature D6 to 3-1 StreetAddress city State zip code State of Florida Countyof Ej4A I Al 0 Lf- Sworn to(or affirmed)and subscribed before me by means off--jkphysical presence or—onfline notarization] 2 1 rj- -4*7-1 this day of plarth - — by /A C, ,d po-el a rQ Personally known: OR Produced Identification (Print name o/person making statement) fL 06'vea Lt'ce oe- Type of/dentiRcation produced Signature of Notary Public-State of Florida -400 0Q. Notary public SU"ft of:F:1wda Christian D Gowan State y Commission n G9 1V Expires 091�' �eV 16 0 F , . My Commission GG 913234 Expires 0911512023 FOR OFFICE USE ONLY Copy of Florida Driver's License provided for Item(5) Other documentation V,,7-LrA. t?66/S-rlt AIV-o A) provided for Item(5) Revised 03/23/2021 Raw-MmVIED CITY OF WINTER SPRINGS MAR 31 2021 2021 MAYOR APPOINTMENT CITY OF WINTER SPRINGS OFFICE OF THE CITY CLERK OATH OF CANDIDATE OFFICE OF THE MAYOR "All persons who now or hereafter are employed byor who now or hereafterare on the payroll ofthe state,or any ofits departments and agencies subdivisions counties cities,school boards and districts of the free public school system of the state or counties,or institutions ofhigher learning,and all candidates forpublic offrce,are required to take an oath before anyperson dulyauthorized to take acknowledgements ofinstruments for public record in the state-"[876.05(1)Florida Statutes) "Anyperson seeking to qualifyfor public office who fails or refuses to file the oath required by this act shall be held to have failed to qualifyas a candidate for public office,and the name ofsuch person shall not be printed on the ballot asa qualified candidate."[876.07F/orida Statutes] I,_ -r,�a, a 0 1A1?S--f - 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 r= // Signature of Appointee 1t1(9 c_41,16 pcl?ZZ-r Da. n Street Address City State Zip Code RECEIVED MAR 31 20zl STATE {]FFLORIDA CITY oFvwmrsnSPRINGS OFFICE opTHE CITY CLERK COUNTYOF_��_____ Sworn to (or affirmed) �n� subscribed before me by means of{ physical presence ' � � \� or ||i t riza1ionithis3115-�/�----' day of_ ' � . 2021 by Personally known__DRProduced Identification ____' Type ofIdentification produced Flarl 4c, azp ,2 Notary Pubhe State of FWda Cfth Christian D Gowan fft,= MY,commissim GG 913234 Signature ofNotary Public - State ofFlorida E�, 04 EXPirft 011015=23 D����A����In&���0�� CITY OF WINTER SPRINGS MAR 3 12021 2021 MAYOR APPOINTMENT CITY orvwwre*SPRINGS OFFICE nFTHE CITY CLERK OATH OF CANDIDATE OFFICE OF THE MAYOR "Each candidate,whether a party candidate,a candidate with no party affiliation,or a write-in candidate,in order to qualify for nomination or election to any office other than ajudicial office as defined inchapter l05.shall take and subscribe tuanoath oraffirmation inwriting. /\printed copy of the oath or affirmation shall be furnished to the candidate by the officer before whom such candidate seeks toqua|i0/'^[99.021 (l)(a} Florida Statutes] STATE 0FFLORIDA COUNTY OF "Before an officer authorized to administer oaths,personally appeared (Please Print Name AsYou Wish xToAppearmotyPecordsFor This Appointment) to me well known,who,being sworn,says that he or she is a candidate for the office of Mayor;that he or she is a qualified elector of the City of Winter Springs,Seminole County,Florida;that he or she is qualified under the Constitution and the laws of Florida to hold the office to which he or she desires to be nominated or elected;that he or she has taken the oath required by ss.876.05-876.10,Florida Statutes;that he or she has qualified for no other public office in the state,the term of which office or any part thereof runs concurrent with that ofthe office heorshe seeks;and that heorshe 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 Sworn toand subscribed before me this —' ' day of ��.2021.at Seminole County, Florida. (Signature and Title of Officer Administering Oath) Notary Pubbc State of Flonda My Cornmission GG 913234 Expires 09/1.5/2023 Not N EE I � 1-10-E-CEIVED MAR 31 ZOZ1 CITY OF WINTER SPRINGS OFFICE OF THE CITY CLERK rh „ 3wsn Florida., LICENSE '�VOTi+R�R43li� RY s. ��� L - f W9 Cr,C7K&CHEOR Wi�i CSR SPRINGS, 32ifl�-iW ' ;,�; l9241998Q , M FIFE OY7SVH[, HOWARD RUSSELL PARSONS 1049 cHOKECHERRY DR 059 WINTER SPRINGS Nov/ 4/ WS 2 ftW Covenant Church $00 Tuskawitia Road 2 Winter Springs FL 32708 28 Ma r110J2020 1,07658901 1ant 25119" 7 Being born and raised just outside of D.C. I was afforded opportunities to pay taxes, sit in traffic and shovel snow. That time in Virginia also allowed the realization of how much I enjoyed Florida while visiting family here. In 1992 1 made a move to Winter Springs but Northern Virginia managed to pull me back after about one year. In 1997 1 moved to Winter Springs and haven't thought twice about moving back! Fast forward a few years and I'm proud to say that my wife and I have been blessed to raise our three children in Winter Springs. All three of our children have attended Winter Springs schools and all three were told the same exact story of how their father went to Indian Trails the first year it was open! They get tired of that story. Not only did my wife and I get to raise three amazing children but we also attended college while working full time. With three children, it was important that we forged bonds with our community and especially school leaders by volunteering through different organizations. I was not only a Den Leader but also the Cub Master in my son's Cub Scout Pack for years with my wife holding positions in the Pack and my daughters volunteering. As a family we were heavily involved in Girl Scouts (yes, I was a Girl Scout assistant leader) and had the privilege to give back to our community. We helped coach soccer and enjoyed many weekends on Red Bug's grassy fields for practice and games. Winter Springs has provided my wife and I the opportunity to not only have a place that we are proud to call home but to also make incredible memories while raising three amazing children. We couldn't imagine calling any other place home. Respectfully, RECEIVED Howard Parsons MAR 312021 CITY OF WINTER SPRINGS OFFICE OF THE CITY CLERK There are many attributes that make a person a good candidate for Mayor but ultimately it comes down to passion. Rules and regulations can be learned. When people have lived and grown in a city, they have something to gain and something to lose. When people have lived, grown and are raising a family in that same city, they have everything to gain and everything to lose. The decisions become far more serious because they impact the citizens. Those citizens are my family. Currently, my father and I run a home inspection business that has been growing since 2006. I am also currently assisting the Department of Children and Families during the Covid crisis. Prior work experience includes construction, automotive and management. I am a self-starter that can also work well on a team with classes in communication and negotiation. My application for the position of Mayor comes with no political alliances or debts. I am pro Winter Springs and pro responsible growth. I am extremely passionate about Winter Springs as Winter Springs is not only our home but has also given us so much. As an everyday citizen of Winter Springs, I understand what we are looking for now and for the future of our city. The role the Mayor plays within Winter Springs is an important one that provides our citizens direction, leadership and confidence. Living in Winter Springs, raising children in Winter Springs and being apart of our community, I believe that I can become an important part of the Winter Springs team that can assist in reuniting the city. RECEIVED Respectfully, MAR 312021 Howard Parsons CITY OF WINTER SPRINGS OFFICE OF THE CITY Ci..F-RK Q7. NOMINATION PETITION Allinformation on this forrn becom as a public record upon receipt by the Supervisor ofElections THIS COMPLETED *It is a crime to knowinglysign more than one petition for a candidate.[Section 704.785 Florida Statutes) IfaH requested information on this form is not completed,theform,will not be valldas a Candidate Petition Form. FORM MUST BE PROVIDED TO THE � Pti � �.� �tr1 the undersigned, a registered CITY CLERK NO (Please print name as it appears on your voter inform}tion rd) LATER THAN NOON voter of the City of Winter Springs,nominate ,jam fie*;' �-- 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 Vater Registration Number Address (MM/DD" d 7 2 tq 7 q 9-16 City [ounty ! tate (�j/( Zip Code 132— Signature of Voter Date Signed(MM[DD[YYYY) rro be completed by Voter] Rule 15-2.045,FAC. MAR 312a2 X11 Y h)a, fi rpRINGS dr P, `tri U— K r L NOM I NATION PETITION 'Ad information on this form becomes a public record upon receipt by the Supervisor of Elections THIS COMPLETED 'It is a crime to knowinglysign more than one petition for a candidate.[section 704.785 Florida Statutes] *Ifall requested information on this form is not completed,the form will not be vaild as a Candidate Petition Form. FORM MUST BE PROVIDED TO THE the undersigned, a registered CITY CLERK NO (Please print name as it appears on i LATER THAN NOON jur voter information card) voter of the City of Winter Springs,nominate 14WAgb R- PAA40A1V 7V7 ON THURSDAY, io complete the unexpired term of Office of Mayor of Winter Springs recently vacated by former Mayor Lacey. APRIL 1,2021 Date of Birth OR Voter Registration Number Address (MM/DD/YYYY) �2-n 1qf5-t Ci ty Dunt y tate Zip Code Vt3i(\kU �)O(� Ll I I 3Y�D,5 II li;� Signature of Voter Date signed(MM/DQA-yW) [To be completed by voter] '313b 11f,124 Pule 1S-2. ,F.A.C. 4 -. 2 NOM I NATION PETITION *AH information on this form becomes a public record upon receipt bythe Supervisor ofElections THIS COMPLETED 'It is a crime to knowinglysign more than one petition for a candidate.[Section 704.785 Florida Statutes] *lfallrequested information on this form is not completed,the form vvill not be vaild as a Candidate Petition Form. FORM MUST BE Mage 14Y 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 ON THURSDAY, 1- j1117 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" Oq/0 city [ounty rate I lZi p Code 297 Signature of Voter Date Signed(lvlM/DDAYW) [rc,be completed by Voter] PuKw�2.o4s,F.A.C. MAR 312021 CITY OF VONTEP-SPRINGS OFFICE OF THE CITY CLERK E NOM I NATION PETITION `Ad information on this form becomes a public record upon receipt by the Supervisor of Flections THIS COMPLETED 'Itisacrimetoknowingtvsignmorethanonepetitionforacandidate.[section704,785FloridaStatutes] FORM MUST BE "!fall requested information on this form is not completed,the form will not be valid as a Candidate Petition Form. PROVIDED TO THE 1w (,-�� 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 1-41a*A (�Ala-At ON THURSDAY, o complete the unexpired term of Office of Mayor of Winter Springs recently vacated by former Mayor Lacey. APRIL 1,2021 Date of Birth OR Voter Registration Number Address (MM/DD/Y" DOB not provided ��' S Cfry tatre Zip Code[ounty i�0 I V I -7Z76- Signature of Voter t` Date Signed IMM DDA-M) [To be completed by Voter] 0)fb-T 2t Rule 1S-2.045,FA.C. NO KA M I NATION PETITION 6 /,�Lz 'All information on this form becomes a public record upon receipt by the Supervisor of Flections THIS COMPLETED 'It is a crime to knowinglysign more than one petition for a candidate.[Section 704.785 Florida Statutes) '"!fall requested information on this form is nat co pleted,the form wilinot be vaild as a Candidate Petition Form. FORM MUST BE OVIDED THE I, ID&rr e-n h 0 CUr� e the undersigned, a registered PC 17Y CLEERKONO E (Please print name as it appears on your voter Information cardl LATER THAN NOON voter of the City of Winter Springs,nominatep� ,}� .0 ON THURSDAY, 1-4111:449b 02. 1 A040,9Q APRIL 1,2021 to complete the unexpired term of Office of Mayor of Winter Springs recently vacated by former Mayor Lacey. Date of Birth OR Voter Registration Number Address A {MM/DD ? i.rY YL /Z P1 l rf fes{(�. `t-+ �I'1, W v ded Da Ciiitt-y�Jq [ounty� tate ( Zip Code f nature of er Date Signed(MM/DD/YYYY) rro be complet e d Voter) Pule 15-2.045,F.A.G. RIECEIVED MAR 3 12021 CITY OF WINTER SPRINGS OFFICE OF THE CITY CLERK NOM I NATION PETITION 'All information on this form becomes a public record upon receipt by the Supervisor of Elections THIS COMPLETED .It is a crime to knowingtysign more than one petition for a candidate.[Section 704.785Fiorida Statutes] FORM MUST BE 'ifa quested infor ation on this form is not completed,the form will not be vaild as a Candidate Petition Form. � PROVIDED TO THE ( 1 " ,, 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,nominate4wA02D � J ON THURSDAY, to complete the unexpired term of Office of Mayor of WinterSpringsrecently vacated y former Mayor Lacey. APRIL 1,2021 Date of Birth OR Voter Registration Number Address (MM/DD" 1-2 CityICounty Istate Zip Code signature of Voter Date Signed(MM/DD ) [To be completed by Voter) 3 , Rule 1S-2.045,F.A.C. :.� 1 NOMINATION PETITION 'Allinformationonthisformbecomesapublic record upon recelptbytheSupervisor ofElection THIS COMPLETED 'It is a crime to knowinglysign more than one petition for a candidate.[Section 704.785Florida Statutes] '/fall requested information on this form is not completed,the form will not be vaild as a Candidate Petition Form. FORM MUST BE PROVIDED THE the undersigned, a registered CITY CLERK NO .T, (Please print name as it appears on your voter information card) LATER THAN NOON voter of the City of Winter Springs,nominate }� ON THURSDAY, "`+/A� J e APRIL 1,2021 to complete the u expired term of Office of Mayor of Winter Springs recently va a e by former Mayor Lacey. 1 Date of BirtR of r Registration Number Address (MMJDD Tc)� 1 -0 cap ')Dli�-- $1,1 O�X) cz( P I V Cit � [ountyrttj� Zip Cade Sire of Voter Date Signed(MM DD ) (To be completed by Voter) AIA'D C� Rule 7S-2.045,F.A.-. MAR 312021 CITY OF WINTER SPRINGS OFFICE OF THE CITY CLERK NOMINATION PETITION 'All information on this form becomes a public record upon receipt byrhe Supervisor ofElectiOns THIS COMPLETED it is a crime tPknOw1?79tV$49nmore than one petition for a candidate,[Section 704.165 Florida Statutes] FORM MUST BE 'Ifallre tedi fo mation on this form is not completed,bhe form willnot be 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) LATER THAN NOON voter of the City of Winter Springs,nominate II L ON THURSDAY, Tplld"wab 14 o complete the unexpired term of Office of Mayor of Winter Springs recently &;byftornmaeA —r"Mayelr=ey. APRIL 1,2021 Date of Birth OR Voter Registration Number Address (MM/DDN" 130/)�170 S01-f 5hCtdOW GZe-V Cnty �tate P code it S- cm I Mote IVLL IOU Signature of Voter Date signed(MM/DD)9YM) (To be completed by Voter] 13 12f Rule 1S-2jD45,FAC, NOMINATION PETITION 64r� `Afi Information on this form becomes a public record upon receipt bythe Supervisor oreyecrfat75 THIS COMPLETED it is a crime to knowingly sign more than one petition fora candidate.[Section 104 785 Florida Statutes] FORM MUST BE *ffaltr uested information m is not completed,the form will not be vaildas 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) LATER THAN NOON voter of the City of Winter Springs,nominate ON THURSDAY, ll* YIT APRIL 1,2021 to complete the unexpired term of Office of Mayor of Winter Sp Rngs AIA vacate former mayor Lacey. Date of Birth OR Voter Registration Number Address (MMIDE)Hff 30� city Date Signed(MMIDD" Si nature of ter [To be completby Voter] Rule I -D45,F.A.C. F.ECEIVED MAR 312021 CITY OF WNTER SPRINGS OFFICE OF THE CITY CLERK A T� NOMINATION PETITION ' .Allinfo,mation on this form becomes aPub11cr--dbP0n receiptbYtheSupervisor ofElections THIS COMPLETED il-is a crime to kno wing�Y sign more than one petition for a candA�Wte.[Section 704.785 Florida Statutes] FORM MUST BE *1fallrequested information this farm isn :,mp/e reo,the form i4j#not be valid as a Candidate Petition Form. PROVIDED TO THE n A Ili,A the undersigned, a registered CITY CLERK NO vill %�Q - --1 -1 inlormation card) (Please print P7.it oil You, t1T. LATER THAN NOON voter of the City of Winter Springs,I nominate ON THURSDAY, a — APRIL 1,2021 to complete the unexpired term of Office of Mayor of Winter4prings�recentfy vacatedby former Mayor Lacey. Date of Birth OR Voter Number Registration Address .n Number (MM/OD" ytZI�94nt :�ew V Date Signed(mm/DDAYM Signature of ter ff [To be C pi by voter] Put JS.2. -;7Z7r,( PUIAS-2*�,F.A.C.F NOMINATION PETITION 'All information on this form becomesa Public record Won we'Prby the Supervisor ofElecrions THIS COMPLETED 'ft lsa crime toknoMnglysign more than one petition fora candidate[Section 704785Florlda Statutes] FORM MUST BE ffailrequested information.on this form Is not completed,the form Kit/not be valid as a Candide re Petition Form. PROVIDED TO THE I, PA- 6-61--A-- AAC-k,j S 9; C-- 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 ON THURSDAY, APRIL 1,2021 ngs, to complete the unexpired term of Office of Mayo Pri 3 vacatedbyformer Mayor Lacey. Date of Birth OR Voter Regi7 ton Number Address (MM/DO" 1y city u —S C 0or tate Zr Date signed(MM Signatureof V ter [To be completed by voter] C Pule 7S•2.0 S,F.A.C. C;9,ryrciF VINTER SPR'NC' T= 1 NOMINATION PETITION :1 *All information on this form becomes a public record upon receipt by the Supervisor of Elections THIS COMPLETED *It is a crime to knowinglysign more than one petition fora candidate.[Section 704.185 Florida Statutes] FORM MUST BE *ifal/requested information on this form is of compled,the form wilinot be vaild as a Candidate Petition Form. 'l PROVIDED TO THE R! 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 / ON THURSDAY, o complete the unexpired term of Office of Mayor of Wint Springs redly v ated Aor M1y r acey. APRIL 1,2021 Date of Birth OR Voter Registration Number Address (MM/DD[YYYY)city c [ountytate Zip Code Signature of Voter Date Signed(MM/DD f� [To be completed by Voter] 3 / Rule 1S-2.04,FAC. NOMINATION PETITION wl 'Ailinformationonthisformbecomesapublicrecord upon receiptbytheSupervisorofElections THIS COMPLETED *It is a crime toknowingiysignmore than one petition for acandidate.[Section 704.185F1oridaStatutes] FORM MUST BE *If all requested Information on this form is not completed,the form wilinot be vaild as a Candidate Petition Form, PROVIDED TO THE fl the undersigned, a registered CITY CLERK NO (please pr+ t name as it appears on your voter Information card) LATER THAN NOON voter of the City of Winter Springs,nominate r) b JAS +J�F ON THURSDAY, to complete the unexpired term of Office of Mayor of ll ei Springs recently vvacated by former Mayor APRIL 1,2021 Lacey. Date of Birth OR Voter Registration Number I Address N � (, (MM/DD" f..(r Z b �LU � 1^� (�0, t `� City tZip codeWC 7Q�(t � [ounty �`� Y ��t(�c��.�. � Lam- � IZ,? Signature ter Date Signed(MM/DD ) _ [To be completed by Voter] Rule 1S-2.04S,FAC. MAR 312021 CITY OF VVINTER SPRINGS OFFICE OF THE CITY CLERK NOMINATION PETITION 'Allinformation on this form becomes a public record upon receipt by the Supervisor ofElecrions THIS COMPLETED *It is a crime to knowinglysign more than one petition for a candidate.[Section 704,785 Florida Statutes] *Ifallrequestedinformat'wo onthisformisnotcomplet d,th,eformwillnotbevalidasaCandidatePetitionForm. FORM MUST BE � t PROVIDED TO THE 1, L) the undersigned, a registered CITY CLERK NO (Please print name as it appears on your voter inform tion card) LATER THAN NOON voter of the City of Winter Springs,nominate 1y� ?fft4rN".yorTa—cey.} ON THURSDAY, a complete the unexpired term of Office of Mayor of Winterringss reecce�vacated bAPRIL 1,2021 Date of Birth OR Voter Registration Number Address /) 9 ch City [ounty tate Zip Code signature of voter Date Signed(MM/DDNYW) [To be completed by Voter[ Rule 1S-2.045,FAC. NOM I NATION PETITION 'All information on this form becomes a public record upon receipt by the Supervisor of Elections THIS COMPLETED *It is a crime to knowingiysign more than one petition fora candidate.[Section 704.785 Florida Statutes/ *If all requested information on this form is not completed,the form will not be vadd as a Candidate Petition Form. FORM MUST BE e ICA 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 Zt teON THURSDAY, to complete the unexpired term of Office of Mayor o41NAr pangs rceritfyGeac�byformer Mayor APRIL 1,2021 Lacey. Date of Birth OR Voter Registration Number Address (MM/DD/YYYI) fir. -� _ �� �t� City tt [ountyrte Zip Code FL- 65A Signature of Voter '�. Date Signed(MM/DD/VYYV) / [ro be completed by Voter) 3w J ` 3C� a Rule 1S-2.045,FAC. APR 012021 NGS ,Ty OF VviNTER I THF CITY CLERK NOMINATION PETITION 'All information On this form becomes a public record upon receipt by the SupervisorofElections THIS COMPLETED 'It is a crime toknowingtVsign more than One perition for a candidafe.[Section 704.785Florida Statutes) FORM MUST BE *1fatirequested information on this form is not co plated theform will notbe valid as a Candidate Petition Form PROVIDED TO THE ('c4 A- CITY CLERK NO I, the undersigned, a registered (Please print name as It appears on your voter information card) LATER THAN NOON voter of the City of Winter Springs,non-linateaON THURSDAY,�j APRIL 1,2021 to complete the unexpired term of Office of Mayor of Wirrt4Springsrecently vacated by former Mayos, Date of Birth OR voter Registration Number Address (MMA:)DN" , i ,4Y dr Wo- City aunty [tate Zip code A Y7ru ?09 signature of voter ♦ Date Signed(M ITO be completed by Voter] Rule 1S-2,045,FAC. NOMINATION PETITION *Alliniormation on this form becomes a public record upon rw7eipt by the SuperkFor OfElecrlon5 THIS COMPLETED .Itlsa crime taknowinglYsign more than onepelitiOn fora candidate.[Section 104785F)d6da'statutes] FORM MUST BE 'If all requested information on this form is not c:.,,-mpWed,the form W11not be vaildasa Candidate Petition Form. PROVIDED TO THE the undersigned, a registered CM CLERK NO (Please print name as it appears on your voter information card) LATER THAN NOON voter of the City of Winter Springs,nominate p ON THURSDAY ,�' bt ?t4t9APRIL 1,2021 to complete the unexpired tern of Office of Mayor Ajtprngs recent� aPy5Crmer Mayor Lacey. I Date of Birth OR Voter Registration Number Address (MMAD0" city [Ounry [tat. zip Code rn UDW�� Signature of Voter Date Signed(MWDDA-�" [To be completed by Voter] Pule IS-2.045.FV- RECEIVED MAR 312021 CITY OF WINTER SPRINGS OFFICE OF THE CITY CLERK