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HomeMy WebLinkAboutColangelo, Victoria Qualifying Packet - 2022 08 30 NTER CITY OF WINTER SPRINGS, FLORIDA FORM A F U 2022 GENERAL MUNICIPAL ELECTION W THIS COMPLETED ' h 1959y� • AFFIDAVITOFACCEPTANCE FORM MUST BE Cbb WETP'J PROVIDED TO THE CITY CLERK DURING CITY COMMISSION: MAYOR 2ppo DD__ISTRICT TWO/ D STRICT FOUR QUALIFYING Circle which /re�t ,,C,' acy NAME: V, Date&Time L f I � �,� Review Started g J7j� y I`;Y h't Page 1 of 2 The following information is provided toyou to assist in your campaign for Public Office;however,please note the documents in this packet of materials are not intended to be a complete digest of Florida's Election Laws. IT IS YOUR RESPONSIBILITY TO READ AND UNDERSTAND THE ELECTION CODE AND COMPLY WITH ALLAPPLICABLE REQUIREMENTS The applicant accepting this document and the attachmentsshould initial after each section as itis reviewed QUALIFYING DOCUMENTS The documents in thissection are due to the CityClerk/Designee no later than 12.•00 p.m,on the lastdayofQualifying which is Friday,September2,2022. "Appointment of Campaign Treasurer and Designation of Campaign Depository for Candidates" [DS-DE 9] "Statement of Candidate" [DS-DE 84] 1* *"Affidavit of Qualified Voter Status and City Residency" 2 "Application for Office and Election Assessment"(WITH a check drawn from campaign account for the Application Fee AND the applicable 1%Assessment OR"Notice of Undue Burden") 3 "Notice of Testing Tabulating Equipment" 4 "Notice of Political Campaign Advertisements/Signs" QUALIFYING DOCUMENTS 5 "Schedule of Campaign Finance Reporting Periods/Due Dates" WITH AN *ASTERISK MUST 6 "Notice of Access to Campaign Finance Forms" BE COMPLETED IN FRONT 7 "Candidate Petition" OF THE CITY *Candidate Oath CLERK/DESIGNEE DURING_ "Notice to Federal Government Employees (If applicable) QUALIFYING "Form 1"-"Statement of Financial Interests 2021" Accepted: STATE OF FLORIDA INFORMATION "The Florida Election Code,Chapter 97-106, Florida Statutes(includes Chapter 106 which addresses Political Advertising and Disclaimers,etc. Candidate and Campaign Treasurer'Handbook" (04/27/22) (Which includes"Chapter 12:Political Advertising"and "Chapter 13:Other Disclaimers" "Electioneering Communications Organization Handbook" State of Florida Election Information Contacts Accepted: Revised 08/29/2022 RECEIVF—® AUG 3 0 2022 CITY OF WNTcER'SRINGS Y CLERK OFFICE OF T - CITY OF WINTER SPRINGS,FLORIDA o 2020 GEN ERALMUNICIPAL ELECTION FORM A "^r959• N AFFIDAVITOFA CCEPTANCE THIS COMPLETED FORM MUST BE PROVIDED TO THE CITY COMMISSION:MAYOR/ :,Tfl!:�T STRICTFOUR CITY CLERK DURING QUALIFYING Circle which NAME: �t ���� 6D / l U Page 2of2 CAMPAIGN FINANC /ELECTRONIC FILING INFORMATION "Contributions Returned" [DS-DE-2] Envelope of Checks/Receipts Accepted: Vd, CIN OF WINTER SPRINGS INFORMATION City of Winter Springs 2022 District Map Accepted: V V MISCELLANEOUS INFORMATION "Statement of Ethical Campaign Practices" (From the Seminole County Supervisor of Elections "Foreign nationals" -from the Federal Election Commission Legal References for Qualifying Documents Accepted: w I NOTE: The Candidate SHOULD NOT closeout 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 2022 Election Qualifying Packet,including the above referenced documents I, V ' (?/aI L-C 6/G{I,S 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/2022 Election. Signature Date 2 `1 61f erLr C C�r (fZ ��, ' JC6 street/lddress City e State ofFlorida Countyof Sworn to(or affirmed)andsubscribed before me by means off )physica/presence or f )online notarization) this 3ctk day off— ' c 7z by V J�C`f•ti`j 1 C� (� l L\n 9 Q Personally known: OR Provided identification: (Print name ofperson making statement Type ofidentihcation produced Notary Public State Wffj�ur OfNoly Public-State of Florida RECEIVED rlstlan D Gowan NptiN My Commission GG 913234 AUG 3 01022 7erF Expires 09/15/2023 CITY OF WINTER SPRINGS OFFICE OF THF CITY CLERK Revised 08/29/2022 �y�NTergs CITY OF WINTER SPRINGS, FLORIDA 0 _� 2022 GENERAL M U N ICI PAL ELECTION FORM F z e � rn...v.1959 " AFFIDAVITOFQUALIFIED VOTERSTATUSAND 5� . CITYANDDISTRICTRESIDENCY THISCOMPLETED cab`vEsao FORM MUST BE PROVIDEDTOTHE CITY COM MISSION:MAYOR/ ISTRICTTWO/D TRICT FOUR CITYCLERKDURING Circle which applies tocandidacy QUALIFYING I, / .�/U� W I tt r)4Gy do hereby state that I seek election to the City Name of Candidate(Print or Type of Winter Springs' City Commission: Mayor ( Fichapplie, strict Four for a four(4)year term to candidacy in the election to be held in the City of Winter Springs,Florida on Tuesday,November 8,2022.1 further swear or affirm: (l.) 1 am a qualified voter in the City of Winter Springs (2.) My legal place of residence is: 1 �/`9 (�lC c%/t e(`c(e StreetAddress City Stale Zip code (3.) Length of time of residency in the City of Winter Springs is: / (4.) Length of time of residency in Winter Springs District: is eS (S.) 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: L z Si ture Date 2 7 StreetAddress City State Zip Code State ofFlorlda r Countyof SLr 1'1`f M I Sworn to(or affirmed)and subscribed before me bymeans of( )physical presence or( )onlllne notarization) this 30#- dayof 2022 by V f t4-0 rt Lo )q pj ftp Ll Personally known: OR Produced Identification / (Printnameofpersonmakingstate o ^ Type ofldentificationproduced SignatureofNotaryPublic-StateofFlorida CJs' Notary Public Stale of Florida Christian D Gowan AUG 3 0 2022 a^ My Commission GG 913234 �i Expires 09/15/2023 CITY OF WINTER SPRINGS OFFICE OF THE CITY CLERK FOR OFFICE USE ONLY opy of Florida Driver's License provided for Item(5) ther documentation r / provided for Item(5) V6�C/ �P gt�c�lt-/'nom} �Q✓ Revised 08/29PO22 �%NTeq CITY OF WINTER SPRINGS, FLORIDA FORM 2 A2022 GENERAL MUNICIPAL ELECTION ~ * THISCOMPLETED V 1959 APPLICATIONFOROFFICE FORM MUST BE •ry�oQ`YeY��S` AND ELECTIONASSESSMENT PROVIDED TO THE CITYCLERK DURING CITY COMMISSION: MAYOR/ ;ISTRICTO ISTRICT FOUR QUALIFYING rr Circle which applies to candidacy 42 J-0 do hereby state that I am a registered and qualified Elector of the Name of Candidate(Print r ype) Cit gf inter Springs;and I am applying for the Office of City Commission: Mayor/ istrict T /District Four for a four(4)year term,in the Election to be held Circle whic es fo candidacy in the City of Winter Springs,Florida on Tuesday, November 8,2022. 1 further agree to pay the following Qualifying Fee AND applicable Election Assessment QUALIFYING FEE: $150.00 AND THE BELOW ELECTION ASSESSMENT ELECTION ASSESSMENT - COMMISSIONER: $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 ELECTION ASSESSMENT-MAYOR:$144.00 The Mayor receives:$1,200.00 per month $1200.00 x 12 months=$14,400.00 annually The 1%Assessment amounts to:$144.00 NOTE: "Any person seeking to qualify for nomination or election to a municipal office who is unable to pay the election assessment without imposing an undue burden on personal resources or on resources otherwise availableto 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 xempt from the city's qualifying fee. Signature Date 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# AND 1%ASSESSMENT-Commissioner:Campaign Account Check in the amount of$120.00 attached OR Mayor:Campaign Account Check in the amount of$144.00 attached (Check should be made payable to the City of Wintb C 1`,fF V Check# l0 Z OR,IFAPPLICABLE 1� Completed"Notice of Undue Burden"Attached AUG 3 0 2022 CITY OF Revised 08/29/2022 rCITY � 1 �NTeRs CITY OF WINTER SPRINGS,FLORIDA 2022 GEN ERALMUNICIPAL ELECTION FORM 3 � z '= * 0 U m.orPai959 NOTICEOF •ti 4� TESTING OF TABULATING Ef2UIPMENT THIS COMPLETED C00 WE'l - -- FORM MUST BE PROVIDED TO THE CITY COMMISSION:MAYOR DISTRICT TWO/D PICT FOUR CITY CLERK DURING Circle which applrestocan r acy QUALIFYING NOTICE Please accept this notice that the tabulating equipment to be utilized in the City of Winter Springs,Florida's 2022 General Municipal Election will be tested on: DATE:Friday,October 14,2022 TIME:10:00 a.m. The aforementioned test will be held at: THE OFFICE OFTHE SUPERVISOR OF ELECTIONS FOR SEMINOLE COUNTY 1500 East Airport Boulevard,Sanford,Florida,32773 (407)585-VOTE[8683] City of Winter Springs Municipal Elections Official/Designee Revised 08/09/2022 AUG 3 0 1011 CITY OF WINTER SPRINGS OFFICE OF THE CITY CLERK �N%t4TER CITY OF WINTER SPRINGS,FLORIDA FORM 4 o_ _ so 2022GENERAL MUNICIPAL ELECTION * ` ) u 1--pi��APPL ICA TION FOR OFFICE THIS COMPLETED s . AND ELECTIONASSESSMENT FORM MUST BE j F`�Jy PROVIDED TO THE CITY CLERK DURING CITYCOMMISSION: MAYOR ISTRICTTWO/ ISTRICT FOUR QUALIFYING Circle which ddcy Pleasefind thefollowi ng documents/information/references related to Political Campaign Advertisements/Signs in this Notice: Copies related to Political campaign Advertisement/Signs attached: (1) Copy of Florida Statutes 106.1435 I nformation/References related to Political Cam pa ig.n Advertisements/Sig ns: (2) "The Florida Election Code,Chapters 97-106,Florida Statutes"(included in Qualifying Packet) (3) "Candidate and Campaign Treasurer Handbook"-(Whichincludedinformationfrom "Chapter-12: Political Advertising"and"Chapterl3:Other Disclaimers") [Included in Qualifying Packet] ACKNOWLEDGMENT I / ����/.L </G `p do hereby acknowledge on this date of Name of Candidate(Print or pe) �1�fi Jf 3l� 2022 with my signature below that I received a copy of Florida Statutes 106.1435 and with my signature affixed below, I understand that it is MY responsibility as a Candidate for Elected Office to comply with all laws, especially as related to Political Campaign Advertisements/Signs.Also with my signature affixed below, I acknowledge that I will comply with all laws related to Disclaimers as explained/noted in"The Florida Election Co e Chapters 97-106, Florida Statutes"and the"Candidate and Campaign Treasurer Handbook." ,Y/5" /z > 61 Signature .Date FOR OFFICE USE ONLY Attachment:Copy of Florida Statutes 106.1435 Revised 08/29/2022 RECEIVED AUG 3 0 7021 CITY OF WINTER SPRINGS OFFICE OF THE CITY CLERK i `�i�NTERS CITY OF WINTER SPRINGS,FLORIDA 2022 GENERAL MUNICIPAL ELECTION FORM S tn.o,o195.... �' APPLICATIONFOROFFICE • ANDELECTIONASS MENT THISCOMPLETED ~o0o WEIRVy FORM MUST BE PROVIDEDTOTHE CITY COMMISSION: MAYOR DI TWO/ TRICT FOUR CITYCLERKDURING Circle which applies to candidacy QUALI FYI NG SCHEDULE DURING/AFTER QUALIFYING*,THE FOLLOWING CAMPAIGN FINANCE REPORTS ARE DUE: Report Due Date:October 77,2022 -shall contain information regarding all previously unreported contributions and expenditures from September 1,2022- September 30,2022 Report Due Date:October 74,2022 -shall contain information regarding all previously unreported contributions and expenditures from October 1,2022- October 7,2022 ReportDue Date:October28,2022 -shall contain information regarding all previously unreported contributions and expenditures from October 8,2022- October 21,2022 _ Report Due Date.-Nowmber4,2022 -shall contain information regarding all previously unreported contributions and expenditures from October 22,2022- November 3,2022. A Final Reportshall be filed 90 days afterthe General Election-on orbefore February6,2022 shall contain information regarding all previously unreported contributions and expenditures from November 4,2022 - February 6,2022 *For Unopposed Candidates Report Due Date:December 7,2022 -shall contain information regarding all previously unreported contributions and expenditures from September 1, 2022- December 1,2022 �m ACKNOWLEDGMENT I, �����(A- ( Z?6 n �R D do hereby acknowledge that on this date of r Name o candidate(print or Qt/� ;3i 2022 with my signature below that I received a written "Schedule of Campai9p Finance Reporting Periods/Due Dates" (as noted above on this form). f!�Z/_M4 aLE2 Z Z Signature Date Revised 08/09/2022 ?' ^CEIVE AUG 3 0 1022 TY OF WINTER SPRINGS =iCE OF THE CITY CLERK ��NTeRs CITY OF WINTER SPRINGS,FLORIDA o- 7 2022GENERALMUNICIPAL ELECTION FORM 6 NOTICE OFACCESS TO 1959 THIS COMPLETED 010 WE CAMPAIGNFINA FOR S 1 FORM MUST BE / PROVIDED TO THE CITYCOMMISSION:MAYOR ISTRICTTW /DISTRICT FOUR CITY CLERK DURING Circ% lhichappli ocandidacy QUALIFYING NOTICE Please note that Campaign Finance forms are available at the following State of Florida Website address: https://dos.mvflorida.com/elections/forms-publications/forms/ 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 I, 01 *)a &( � 6- �Ldo hereby acknowledge that on this date of Name ot canaiciate Trint or Tye 2022 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 Office'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." Sign re Date Revised 08/09/2022 JR!EC:E, !/ F—® AUG 3 0 2022 CITY OF WINTER SPRINGS OFFICE.OF THE CITY CLERK :. CANDIDATE PETITION FORM 'All information'on this form becomes a public record upon recelpt by the Supervisor of Elections •!t Is crime to knowinglys7gn more than one petition fora candidate.(Section 704.785Florlda statutes] 'lfallrequestedInformationonthisformIsnotcompleted,theformwillnotbevalidasaCandidatePetit/onForm. THIS COMPLETED 'A 'K`A,7 A FORM MUST BE ] 4126 I, ft'KAI the undersigned, aregistered 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 �-��j� , G QUALIFYING placed on the General Election Ballot as a [check/complete 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 Two (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/YYYYj Af jtw /) ,Aot city County Stat Zip Code Signature of Voter Date Signed(MM/DD/YVYY) [ro be leted y Voter] E;7com,r}�a Rule 15-2.045,F.A.C. H CANDIDATE PETITION FORM *All information on this form becomes a public record upon recelpt bythe SupervisorofElections *It is crime to knowinglysign more than one petition fora candidate.[Section 104.785Flor/da Statutes) *ffallrequestedlnformarion on this form Is notcompleted,the form will not be valldas a Cand1date Petition Form. THIS COMPLETED FORM V I, \�x��c,\% C�AN� )oVms the undersigned, a registered pROV DEDUTOgHE (Please print name as It appears on your oter Information card) CIN CLERK DURING voter in said state and county,petition to have the name of V , ( QUALIFYING placed on the General Election Ballot as a [check/complete 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 Two (Please Insert the title of Office and Include District,Circuit,Group,Seat Number,If applicable) Date of Birth OR Voter Registration Number Address City County State Zip Code \ G 1 \ Signature of Voter Date Signed(MM/DD") [To be completed by Voter] Rule 1S-2.045,FAC. AUG 3 0 722 CITY OF WINTER SPRINGS OFFICE OF THE CITY CLF_RK CANDIDATE PETITION FORM 7 'All information on this form becomes a public record upon rece/pt by the Supervisor ofElectlons "t/sa crime to knowingysign more than one petition fora candidate./Section 104185Florida Statutes] •lfallre a information nthFms�notc /eted,theform.willnotbevalldasaCandlda[ePetitionForm. THIS COMPLETED l \ FORM MUST BE I, V t � J iz rY'r1�^^� 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 .L , QUALIFYING placed on the General Election Ballot as a[check/complete box,as applicable] Nonpartisan N/q No party affiliation N/A71 Not Appiicabie Party Candidate for the Office of City of Winter Springs-City Commission District Two (Please insert the title of Office and Include District,Circuit,Group,Seat Number,if applicable) Date of Birth OR Vot Regis ation Number Address (MM/DD/WW) I TY9i�ff , CityCounty State Zip Code Signature of Vote Date Signed(MM/DDM'YY) [To be compl ed by V er) 8 Rule 1S-2.045,FAC. CANDIDATE PETITION FORM *AH Information on this form becomes a public record upon recelpt bythe Supervisor ofElections *It isa crime to knowinglyslgn more than one petition fora candidate.[Section 704.785Florida Statutes] 3 •IfailrequestedInformationonthisfor0mIsnotcomleted,theformwillnotbevalidasaCandidatePetitionForm. THIS COMPLETED FORM MUST BE I, Q the undersigned, a registered PROVIDED TO THE (Please print name as It appears on your voter information c ) CITY CLERK DURING voter in said state and county,petition to have the name of L4VIAS OC)149" QUALIFYING placed on the General Election Ballot as a [check/complete box,as applicable] Nonpartisan N/q No party affiliationN/A Not Applicable Party Candidate for the Office of City of Winter Springs-City Commission District Two (Please insert the title of Office and Include District,Circuit,Group,Seat Number,if applicable) Date of Birth OR Voter Re tration Number Lre�(MM/DD/YYYY) Ci Coin , State` Zip Code v Signature of Voter Date Signed(MM/DD" [To be completed by Voter) Rule 1S-2.045,FAC. AUG 3 0 [012 CITY Or VIt,,T:n rF!CE"F THE CITY(:t f?• CANDIDATE PETITION FORM 7 •Alllnformation on this form becomes a public record upon receipt by the Supervisor of Elections •It Is a crime to knowinglysign more than one petition fora candidate./Section 101085 Statutes) •/fall requested information on this form Is not completed,the form will notbe valid as a Candidate 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 •L b'c-� `t�/ QUALIFYING placed on the General Election Ballot as a [check/complete box,as app(cable] Nonpartisan N/A No party affiliation N/A Not Applicable Party Candidate for the Office of City of Winter Springs-City Commission District Two 1 (Please Insert the title of Office and Include District,Circuit,Group,Seat Number,If applicable) Date of Birth OR Voter Registration Number Address p �C SCJ city County state Zip Code Signature o e ate Signed(MM/DD/YYYY) [To be completed by Voter) Rule 1S-2.0 .AC. CANDIDATE PETITION FORM 7 'All information on thlsform becomes public record upon receipt bythe5upervlsorofElections •Itlsa crime to knowinglysign more than one petition fora candidate.(Section 704.185Florida Statutes) 11fallrequestedinformation on thisform Isnotcomplated,the form willnotbe validasa Candidate Petition Form. THIS COMPLETED I, the undersigned, a registered FORM MUST BE - 4 r S f'O Ct' g g PROVIDED TO THE (Please print name as it appears o our voter information card) 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] Nonpartisan N/A No party affiliation N/A Not Applicable Party Candidate for the Office of City of Winter Springs-City Commission District Two (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) ^ / the gs" C/ City County State Zip Code 141 T-a- a,' se,� ' �. �L fir✓ Signature of Voter Date Slgned(MM/DD" [To be completed by Voter) RuleS- .0457,".C- AUG F.A.0 AUG 3 0 2021 CITY OF WINTER SFRINGS OFFICE OF THE CITY CLERK t" FORM CANDIDATE PETITION 'Aff information'on this form becomes a public record upon receipt by the Supervisor of Elections 'it 1s a crime to knowinglysign more than one petition fora candidate.[Sect/on 104.185Fiorida Statutes] If allrequestedlnformatlon on this form Is not completed,the form W11 not be valid as a Candidate Petition Form. THIS COMPLETED ` FORM MUST BE I, 1` C'n 5Gry ) the undersigned, a registered PROVIDED TO THE (Plea a tint name as it appears on your voter Information card) CITY CLERK DURING voter in said state and county,petition to have the name of Aq QUALIFYING placed on the General Election Ballot as a(check/complete 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 Two (Please insert the title of Office and Include District,Circuit,Group,Seat Number,if applicable) Date of Birth OR Voter Registration Number Address �r (MM/DD" LP 0'55 Lt y CityCounty State Zip Code V') cY1 I r�c�1 32'1u� Signature of Voter Date Signed(MM/DD/YYYY) [To be completed by Voter] 8� 12c�2Z Rule 1S-2.045,RAC. CANDIDATE PETITION FORM A111nformatlon on this form becomes a public record upon recelpt bythe SupervisorofElections 'It Isa crime to knowinglyslgn more than one petitlon fora candidate.[Section 704.785FIorlda Statutes] 'lfallrequestedinformationonthlsformisnotcompleted,the form wllinotbevalldasaCandidate Petition Form, THIS COMPLETED FORM MUST BE 1,�irctn C'-t :5L® V 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 oftG (� �� QUALIFYING placed on the General Election Ballot as a [check/complete box,as applicable] Nonpartisan N/A No party affiliation N/A Not Applicable Party Candidate for the Office of City of Winter Springs-City ComnTiission District Two (Please insert the title of Office and Include District,Circuit,Group,Seat Number,If applicable) Date of Birth OR Voter Registration Number Address OLD iq� City Coun[� � Sta[e jZIp Code��('� Signature of Voter Y • Date Signed(MMIDDIYYYY`)J!� (To be completed y oter] 1f�-r Rule 1S-2.045,F.A.C. AUG 3 0 2022 CITY OF WINTER SPRINGS OFFICE OF THE CITY CLERK CANDIDATE PETITION FORM 'Ali informatlon'on this form becomes a public record upon receipt by the Supervisor of Elections It Is crime to knowinglysign more than one petition fora candidate.(Section 704.785 Florida Statutes] •lfall requested information on this form Is not completed,the form will not be valid as a Candidate Petition Form. THIS COMPLETED Q FORM MUST BE I, n Q�'}�lore 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 V I'Ct)r/A �'p Q� QUALIFYING placed on the General Election Ballot as a[check/complete 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 Two (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) l - 2Z✓ -7 92 deje4lddGer city County Siate Zip Code nr Signature of Voter Date Signed(MM/DDA Y" [To be completed by Voter] S'-2 2 Rule 1S-2.045,FAC. <� .� CANDIDATE PETITION FORM A111nformatlon on this form becomesa public record upon rete1ptbytheSupervisor ofElections 'lt isa crime to knowingysign more than one petition fora candidate.(Section 704.785Florida Statutes] 'lfallrequestedInformatlononthisform/snotcomp/eted,theformwillnotbevalldasaCandidatePetitionForm. THIS COMPLETED f- '0 FORM MUST BE I, f�/ll� U,� D the undersigned, a registered PROVIDED TO THE (Please pri4 name as it appears on your voter information card) CITY CLERK DURING voter in said state and county,petition to have the name of ) 0 QUALIFYING placed on the General Election Ballot as a [check/complete 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 Two (Please insert the title of Office and include District,Circuit,Group,Seat Number,if applicable) Date of Birth OR Voter ' r on tuber/ Address �/}ff�Q (MM/D®7 f ^� / ('2--,7 \JV r li'N �� �� ®V CityCo Stat Z' Code (�✓th���� � � X2,76 Signature of Voter Date Signed(MM/DD/YYYY) [To be completed by Voter] g -z' Rule IS-2.045,F. C. 7 M 011 L'+j AUG 3 0 2022 CITY OF WINTER SPRINGS OFFICE OF THE CITY CLERK (K' CAN D I DATE P ETITI O N FORM 'Alfinformation'on this form becomes a public record upon receipt by the Supervisor of Elections �It Is crime to knowingfyslgn more than one petition fora candidate[Section I04.7a5Fforlda Statutes] •lfaffrequestedInformation onthis form Isnorcompleted,the formK411notbevalidasaCandidatePetitlonForm. THIS COMPLETED Al Un S FORM MUST BE I, L.Q,(,,��_ the undersigned, a registered PROVIDED TO THE (Please print name as it appears on your voter Information card) 1 ' f CITY CLERK DURING voter in said state and county,petition to have the name of V� c4Wt� Opla QUALIFYING placed on the General Election Ballot as a [check/complete 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 Two (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 O ! l S�a �a /e Nrs-t cLos C Cou Fst—.t—e---1 Zip Code SIP Signat Vote Date Signed(MM/DD/YYYY) [robe comple ed by Voter] 2Z R 15-2.045, .AC. CANDIDATE PETITION FORM •Alf7nformatlon on this form becomes a public record upon recelpt bythe Supervisor ofElections •!t 1s a crime to knowingQ sign more t an one p Itlon fora candidate.[Section 704.1a5Florlda Statutes] 'Ifallrequ tedlnfo ationonthlsfor notco eyed,theformwlllnorbevalldasaCandidate Petition Form. THIS COMPLETED FORM MUST BE I, rCirl/ the undersigned, a regi tered PROVIDED TO THE lease 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 411calble] D�/ / � QUALIFYING placed on the General Election Ballot as a [check/complete box,as app Nonpartisan N/A No party affiliation N/A Not Applicable Party Candidate for the Office of City of Winter Springs-City Commission District Two (Please Insert the title of Office and Include District,Circuit,Group,Seat Number,if applicable) Date of Birth Ogistraation Number Address l� (MM� -f✓ city lsouZio.Cocip LA. s 3P�i) Signature of Voter Date Signed(MM/DD/Y)W (To be comple d by Vot .0rw ,45,FAC. �;�4- AUG 3 01011 CITY OF WINTER SPRINGS OFFICE OF THE CITY CLERK =, CANDIDATE PETITION FORM 7 .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 704.185 Florida Statutes] (fall requested information on this form i�not completed,the form will not be valid as a Candidate Petition Form. THIS COMPLETED �"��� ®® FORM MUST BE I, <—�SC�e. 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 V,G b�l (%a QUALIFYING placed on the General Election Ballot as a [check/complete box,as applicable] Nonpartisan F N/A No party affiliation N/A Not Applicable Party Candidate for the Office of City of Winter Springs-City Commission District Two (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 City County - State Zip Code Signature of Voter Date Signed by /YWY) [To be completeete .by Voter] b� Z7 Rule 15-2.045,FAC. CANDIDATE PETITION FORM •Alf information on this form becomes a public record upon recelpt by the Supervisor of Elections It is crime to knowingysign more than one petitlon fora candidate.[Section 704.78S Florida Statutes] 'Ifallrequestedinformationonthisformisnotcompleted,theformwillnotbevalidasaCandidatePetitionForm. THIS COMPLETED FORM MUST BE &6 the undersigned, a registered PROVIDED TO THE (Please print name as it appears pn our voter inform.ion card) CITY CLERK DURING voter in said state and county,petition to have the name of i QUALIFYING placed on the General Election Ballot as a [check/complete 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 Two (Please insert the title of Office and include District,Circuit,Group,Seat Number,if applicablel Date of Birth OR Voter Registration Number Address (M M/DD/YYl'Y)/0 /-z 4VKW ke'a'-w Ciry Count State Code ® Zip3 Signature of vote Date Signed(MM/DD/YYYY) [To be completed by V er] NZ Rule 1S-2.045,F.A.C. en 'u,E L'-C' AUG 3 0 2022 CITY OF WINTER SPRINGS OFFICE OF THE CITY CLERK CANDIDATE PETITION FORM 'All information*on this form becomes a public record upon recelpt by the Supervisor of Elections 'It Ise crime to knowingyslgn more than one petition fora candidate.(Section 104.78S Florida statutes] *ffaffrequested information on this form Is not completed the form will notbe validas a Candidate Petition Form, THIS COMPLETED FORM MUST BE I, [ CLM 0lw )m 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 V [CtofI,0. C'0- 2L ' QUALIFYING placed on the General Election Ballot as a [check/complete 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 Two (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/DDA" p3�a► Iq�[g 1582 le N2s� G,�cl� City County - State Zip Code Signature o[er Date Signed(MM/DD/YYYY) fro be completed by Voter) Cv�a 0 e 15-2.045,FAC. CANDIDATE PETITION FORM A/llnformationon thlsform becomesa public record upon rete1ptbytheSupervisor ofElections 'It/se crime to knowingQrsign more than one petition fora candidate.[Section 704.785Florida Statutes] `lfallrequested/nformationon this form Is not completed,the form willnot be valldas a Candidate Petition Form. THIS COMPLETED FORM MUST BE I, Awan u, pid6op the undersigned, a registered PROVIDED TO THE (Please print name as It appears on your voter information card) y CIN CLERK DURING voter in said state and county,petition to have the name of i l ria ()I(](�l e CO QUALIFYING placed on the General Election Ballot as a [check/complete 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 Two (Please Insert the title of Office and Include District,Clrcult,Group,Seat Number,if applicable) Date of Birth OR Voter Registration Number Address (M M/DDN" Ol lI I�nS ©I Casa mar k Cbur-� City County State Zip Code kAeu' e, 32708 signature o/f�rVote /1 Date Signed(MM/DD/YYYY) v(, [To be completed by voter) pd" 262Z �t Rule 15-2.045,RAC. AUG 3 0 2022 CITY OF WINTER SPRINGS OFFICE OF THE CITY CLERK CANDIDATE PETITION FORM •All information'on this form becomes a public record upon recelpt by the Supervisor of Elections *It/sa crime to knowingysign more than one petition for a candidate.(Section 104.785 Florida Statutes] *lfafl requested information on this form Is not completed,the form Wit not be valid as a Cand1date Petition Form. THIS COMPLETED FORM MUST BE I, Gte the undersigned, a registered PROVIDED TO THE lease prirk name as it appears on your voter nformation card) V' CITY CLERK DURING / 1 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] IF VNonpartisan N/A No party affiliation N/A Not Applicable Party Candidate for the Office of City of Winter Springs-City Commission District Two (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/1'YW) ' w. et city County S[a[e Zip Code CJi',vec v; K-�nwle FL 3a7a8 Signature of Voter b n Date Signed(MM/DD/YVW) �''✓!:"�`9`L�—C [To be completed by Voter] '212-3).2b2-2- Rule 1z3)2bL2Rule lS-2.045,FAC. r }; CANDIDATE PETITION FORM 7 'A/llnformadon on this form becomes a public record upon rece/pt bythe Supervisor of Elections *It isa crime to knowinglysign more than one petition fora candidate.[Section 104.185Florlds Statutes] "IfailrequestedInformationonthisformIsnotcompleted,theformwillnotbevalldasaCandldatePet7tionForm. THIS COMPLETED ." FORM MUST BE the undersigned, a registered PROVIDED TO THE (Please print name as it ap s on yo er Information card) CITY CLERK DURING voter in said state and county,petition to have the name of ` C��� CU � QUALIFYING placed on the General Election Ballot as a [check/complete 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 Two (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/DD/YYW) City�1t�(� CouptyA'f'1 ZI Code / V Signature V ter J Date Signed(MM/D /YYYY) (To be completed Voter] Rule 1S-2. 5,F.A.C. AUG 3 0 2022 CITY OF WINTER SPRINGS OFFICE OF THE CITY CLERK CANDIDATE OA 1 .1 RlECF-I#% . ED NONPARTISAN OFFICE AUG 3 0 2012 (Do not use this form if a Judicial or School Board Candidate) CITY OF WINTER SPRINGS Check box only if you are seeking to qualify as a oFF'rF OF THF CITY CLERK 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 but has 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 �X r, J � , ( ice) (District#) ; I am a qualified elector of C ^(�td�'�KJ 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 I 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 voter information card): -0 17—Is 7 yf 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.] 2L Z Z_ -ff,64f 6 XL Signature of Candiday Telephone Number Email Address 11)0 r,If'.f. 1 z r r- Cs� 6�r_f� Zd 5�►r � 3z7aA' J Address City ate ZIP Code -v STATE OF FLORIDA Signature of Notary Public COUNTY OF P_rO t ✓10 f Print,Type,or Stamp Commissioned Name of Notary Public below: Sworn to(or affirmed)and subscribed before me by means of online notarization ❑ OR physical presence 7 �/ RE lic State of Florida this J 0�day of 20 G. _ D Gowan ssion GG 813234 Personally Known ❑ OR Produced Identification 0 /15/2023 Type of Identification Produced: FL \-Pl'r`I'e 41 L''e- DS-DE 302NP(Rev.0812021) Rule 1S-2.0001, F.A.C. FORM 1 STATEMENT OF 2021 Please print or type your name,mailinglow: FINANCIAL INTERESTS FOR OFFICE USE ONLY: address,agency name,and position be ELAST NAME--FIRST NAME--MIDDLE NAME: 01 ) 1t� a lam. K RECENVLD MAILING ADDRESS: a c AUG 3 0 2022 CITY OF WINTER SPRINGS OFFICE OF THE CITY CLERK CITY:/e ZIP: 99 COUNTY: rm NAME OF ENCY: 6+1 rp r AiAE OF OFFICE OR POSI ION LD OR SOUGHT: t c� CHECK ONLY Ir' CA (DATE OR ❑ NEW EMPLOYEE OR APPOINTEE **** THIS SECTION MUST BE COMPLETED **** DISCLOSURE PERIOD: THIS STATEMENT REFLECTS YOUR FINANCIAL INTERESTS FOR CALENDAR YEAR ENDING DECEMBER 31, 2021. 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 UALLY BASED ON PERCENTAGE VALUES (see instructions for further details). CHECK THE ONE YOU ARE USING (must c ck one): O 11 COMPARATIVE (PERCENTAGE)THRESHOLDS R 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"n/a") NAME OF SOURCE SOURCE'S DESCRIPTION OF THE SOURCE'S OF INCOME ADDRESS PRINCIPAL BUSINESS ACTIVITY /tl1 yd C • ( C ��/�, �, 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"nla") .NAME OF NAME OF MAJOR SOURCES ADDRESS PRINCIPAL BUSINESS BUSINESS ENTITY OF BUSINESS'INCOME OF SOURCE ACTIVITY OF SOURCE PART C--REAL PROPERTY [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'n/,a'")1 lines on this form.Attach additional U,� rZ 2 7&f— sheets,if necessary. !v/� Q(1 CS 1 Z FILING INSTRUCTIONS for when LW VIA and where to file this form are located at the bottom of page 2. INSTRUCTIONS on who must file r , this form and how to fill it out •//L 32- 7 begin on page 3. CE FORM 1-Effective:January 1,2022 (Continued on reverse side) 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"n/a") TYPE OF INTANGIBLE BUSINESS ENTITY TO WHICH THE PROPERTY RELATES PART E—LIABILITIES [Major debts-See instructions] (if you have nothing to report,write"none"or"n/a") NAME OF CREDITOR ADDRESS OF CREDITOR 0 t 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'Wa") BUSINESS ENTITY#1 BUSINESS ENTITY#2 NAME OF BUSINESS ENTITY ADDRESS OF BUSINESS ENTITY PRINCIPAL BUSINESS ACTIVITY POSITION HELD WITH ENTITY I OWN MORE THAN A 5%INTEREST IN THE BUSINESS NATURE OF MY OWNERSHIP INTEREST PART G—TRAINING For elected municipal officers,appointed school superintendents,and commissioners of a community redevelopment agency created under Part III,Chapter 163 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 CONTINUED ON A SEPARATE SHEET, PLEASE CHECK HERE ❑ SIGNATURE OF 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, prepared the CE Form 1 in accordance with Section 112.3145, Florida Statutes, and the instructions to the form. Upon my reasonable knowledge and belief,the disclosure herein is true and correct. Date Signed: 8 24"7 CPA/Attorney Signature: Date Signed: FILING INSTRUCTIONS: 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 form to that location. To determine what category your position falls 1 with a qualifying officer is not required to file with the Commission under, see page 3 of instructions. or Supervisor of Elections. Local officers/employees file with the Supervisor of Elections WHEN TO FILE: Initially, each local officer/employee, state officer, of the county in which they permanently reside. (If you do not 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 not email your form to the Commission on 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 1 F(Final Statement your completed form and any attachments as a pdf(do not use any of Financial Interests)does not relieve the filer of filing a CE Form 1 other format), send it to CEForml@leg.state.fl.us and retain a copy if the filer was in his or her position on December 31,2021. 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 1,2022. PAGE 2 Incorporated by reference in Rule 34-8.202(1),F.A.C.