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Home My WebLink AboutBenton, Matt Qualifying packet 2024 08 29NAME: CITY OF WINTER SPRINGS, FLORIDA 2024 GENERAL MUNICIPAL ELECTION AFFI DAVIT OFACCEPTANCE CITY COMMISSION. DISTRICT ONE DISTRICT THREE/ DISTRICT FIVE Circle which applies to candidacy Date&Time I p$�Zq �2 Review Started FORM A THIS COMPLETED FORM MUST BE PROVIDED TO THE CITY CLERK DURING QUALIFYING Pagel oft The following information is provided to you 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 RESPONSIBILITYTO READAND UNDERSTANDTHE ELECTION CODEAND COMPLY WITH ALL APPLICABLE REQUIREMENTS The applicant accepting this document and the attachments should initial after each section as it is reviewed QUALIFYING DOCUMENTS The documents in this section are due to the City Clerk/Designee no later than 12:00 p.m. on the last day of Qualifying which is Friday, August 30, 2024. 4 5 6 7 G�! Accepted: "Appointment of Campaign Treasurer and Designation of Campaign Depository for Candidates" [DS-DE 9] "Statement of Candidate" [DS-DE 84] * "Affidavit of Qualified Voter Status and City Residency" "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") "Notice of Testing Tabulating Equipment" "Notice of Political Campaign Advertisements/Signs" "Schedule of Campaign Finance Reporting Periods/Due Dates" "Notice of Access to Campaign Finance Forms" "Candidate Petition" * Candidate Oath [DS-DE302P] "Notice to Federal Government Employees (If applicable) "Form 1" - Statement of Financial Interest 2023 QUALIFYING DOCUMENTS WITH AN *ASTERISK MUST BE COMPLETED IN FRONT OF THE CITY CLERK/DESIGNEE DURING QUALIFYING 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" (2024) (Which includes "Chapter 12: Political Advertising" and "Chapter 13:Other Disclaimers" "Electioneering Communications Organization Handbook" State of Florida Election Information Contacts Accepted: t AO IJG 2 9 !M14 Revised O6/10/2024 CITY OF WINTER SPRINGS nF�ICG OF � HE CITY CI.L-RY. CITYOF WINTER SPRINGS, FLORIDA 2020 GENERAL MUNICIPAL ELECTION AFF V CCEPTANCE CITYCOMMISSIO DISTRICT ONE DISTRICTTHREE/DISTRICT FIVE Circle which applies to candidacy NAME THIS COMPLETED FORM MUST BE PROVIDED TO THE CITY CLERK DURING QUALIFYING Page 2 of 2 CAMPAIGN FINANCE/ELECTRONIC FILING INFORMATION "Contributions Returned" [DS-DE-2] Accepted: CITY OF WINTER SPRINGS INFORMATION City of Winter Springs 2022 District Map Accepted: MISCELLANEOUS INFORMATION "Foreign nationals" - from the Federal Election Commission Legal References for Qualifying Documents Accepted: CL 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 2024 Election Qualifying Packet, including the above referenced documents I, � 'AJ� n 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 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 2024 Election. Date c� �.• S� �t'� rr'L. 3 7�:7 6k State of Florida Sworn to (or affirmed) and subscribed before me by means of ( ) physical presence or ( ) online notarization) this by 29th day of Aw ca f— ,2024 /Y I a41KV,W � hin Personally known: All name ofperson making statement) �— Dri ver Revised 06/10/2024 Notary Public State of Florida Christian D Gowan 1111 My Commission HH a33379 Expires 9115/2027 OR Provided identification: Signature of Notary Public -State of Florida AIlG 2 9 2IM CITY OF \MNTER SPRINGS r,-,-. •.-: !�;- -I Ht- CITY CLERK CITY OF WINTER SPRINGS, .FLORIDA 2024 GENERAL MUN ICI PAL ELECTION AFFIDAVIT OFQUALIFIED VOTER STATUSAND CITYAND DISTRICT RESIDENCY CITYCOMMISSION: It= NE ISTRICT THREE/ DISTRICT FIVE Circle which applies to candidacy I, n/\G� �- \ �.AL. do hereby state that I seek election tO the City Name of Candidate (Print or Type) of Winter Springs' City Commission: District On District Three/ District Five Circle which applies to candidacy FORM 1 THIS COMPLETED FORM MUST BE PROVIDEDTOTHE CITY CLERK DURING QUALIFYING for a four (4) year term in the election to beheld in the City of Winter Springs, Florida on Tuesday, November 5, 2024. I further swear or afFrm: (1.) I am a qualified voter in the City of Winter Springs (2.) My legal place of residence is: I �� C r uabG.�� % \�j � ,5�� L 3 t 7 0e StreetAddress City State -Zip Code (3.) Length of time of residency in the City of Winter Springs is: p� (4.) Length of time of residency in Winter Springs District: ' is � k. V.0 'S (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: 41 jr �\ a M, 3 Signature b Izs / "-2-'A2�Sr Date StreetAddress City State Zip Code State of Florida Countyof =f JA11D I. E Sworn to (or affirmed) and subscribed before me by means of physical presence or( ) online notarization This by L AA&A*` so j Aen soot's Personally known: (Print nameofperson making statement) L �'c ens It.. Notary Public State of Florida � Christian D Gowan 1I11 My Commission HH 433379 Expires 9/15/2027 FOR OFFICE USE ONLY Copy of Florida Driver's License provided for I[em (5) ther documentation provided for Item (5) (U" i /' ,2024 OR Produced Identification AUG 2 9 2014 c •,�r,nTF(? SPRINGS Revised 06/10/2024 , T.� c _ 1=Rtc CITY OF WINTER SPRINGS UTILITY BILLING MON-FRI 8-5 1126 E STATE ROAD 434 PHONE: 407-327-5996 FAX: 407-327-4753 UTILITYBILLS@WINTERSPRINGSFL.ORG W W W.WINTERSPRINGSFL.ORG/UB Charges Breakdown (Current Month) WATER BASE $788 WATER USAGE $4.21 WATER TAX $1021 SEWER BASE $16.13 SEWER USAGE $1449 STORMWATER BASE $5.50 SOLID WASTE BASE $22.81 Scan this code to make a payment with your smartphone or tablet todayl "News You Can Use" Visit the Alert Winter Springs Everbridge Portal to sign up for emergency notifications or update your account to ensure you stay informed when critical situations arise. Sign up at httpso//www.winterspringsfl .org/community/page/alert- winter-springs to receive eAlerts. Summary of Payments and Charges DUE ACCOUNT NUMBER 10106-001 SERVICE ADDRESS 414 CEDARWOOD CT PAST DUE CHARGES $0.00 IMMEDIATELY PENALTIES $0.00 ADJUSTMENTS $0.00 PAYMENTS ($169.05) CURRENT CHARGES $7223 9/3/2024 MONTHLY WATER USAGE (in gallons) 4000 69659014 January 2024 April 2024 July 2024 Meter Reading Information From To Days Meter # Previous Current Usage 6/25/2024 7/24/2024 29 69659014 403,810 406,110 21300 Payment Options (Use Account Number 10106-001) See back for more! Self -Pay by C+,R Code Scan the code above Self -Pay by Website eservices.winterspringsfl.org Online Bank Pay See your bank's website Call Center 407-327-5996 Please detach and return the bottom portion with your payment (Make Checks Payable to City of Winter Springs) CITY UTILITY BILLING OF WINTER SPRINGS 434PHONE: 407=327w5996 .• Summary of Payments and Charges DUE ACCOUNT NUMBER: 10106-001 SERVICE ADDRESS 414 CEDARWOOD CT PAST DUE CHARGES$0.00 IMMEDIATELY CURRENT CHARGES $72.23 9/3/2024 MATTHEW O BENTON CITY OF WINTER SPRINGS UTILITY BILLING 414 CEDARWOOD CT 1126 E STATE ROAD 434 WINTER SPRINGS, FL 32708 WINTER SPRINGS, FL 32708-2715 CITY OF WINTER SPRINGS, FLORIDA 2024 GENERAL MUNICIPAL ELECTION APPLICATION FOR OFFICE AND ELECTION ASSESSMENT CITY COMMISSION. ISTRICT ONE DISTRICT THREE/ DISTRICT FIVE Circle which applies to candidacy FORM 2 THISCOMPLETED FORM MUST BE PROVIDEDTOTHE CITYCLERKDURING QUALIFYING I, �� .�- `��,�-o�� do hereby state that I am aregistered and qualified Elector ofthe Name of Candidate (Print or Type) City of Winter Springs; and I am applying for the Office of City Commission: District On District Three/ District Five for a four (4) year term, in the Election to be held rc e which applies to candidacy in the City of Winter Springs, Florida on Tuesday, November 5, 2024. I further agree to paythe 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 NOTE: "Any person seeking to qualifyfor nomination or election to a municipal office who is unable to pay the election assessmentwithout imposing an undue burden on personal resources or on resources otherwise available t0 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), candidateswho are unableto pay the election assessmentwithoutimposing anundue burden on their personal resources or resources otherwise available to them shall upon written certification ofsuch inability given under oath to the city clerk be exempted from paying the election assessment. Any candidate exempt from the election assessment shall also be exempt from the city's qualifying fee. Signature FOR OFFICE USE ONLY L-L�� PPLICATION FEE: Campaign Account Check in the amount of $150.00 attached (Check should be made payable to the City of Winter Springs) AW 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 Winter Springs) Check # OR, IFAPPLICABLE Completed "Notice of Undue Burden" Attached F� WED AUG 2 9 2024 Date Revised 06/10/2024 CITY OF WINTER SPRINGS OFFICE OF THE CITY CLERK 'r( %/,�' ��/i/iir.,, r. %%ir, /r�ar%�.,,\� ft \�\� \�� %/i,�,;// o/ ? Matt Benton Campaign \ \ \�` 89 414 CEDARWOOD CT L �V �� \.:Gate CY Winter Springs FL 32708-3441 / CC1 )/ r e j r/ P order of >i Cf T iY1,�-ems Sir �=s �� FAIRWINDS .y\lkit \ MEMO l ; /j IJG, i ,h V� �\ "�9 %r ; Matt Benton Campaign 'A'% 414 CEDARWOOD CT �ll/lWinter Springs FL 32708-3441 °ter — e All/ /FAIRWINDS .\\ p / e��' _ r MEMO C �! R� it— m \\� 1 g Dollars PAYMENT DATE 08/29/2024 COLLECTION STATION UB Mid Ofc 2 (R-CH-UB-5-W7) RECEIVED FROM MAT1" BENTON DESCRIPTION ELECTION ASSESSMENT pity of Winter Springs I 126 E. State Road 434 W inter Springs, FL 32708 Payments: I Type Detail Amount Check Total Cash Total Check Total Charge Total Wire Total Other Total Remitted Change Total Received ��E1/� rrT'Z1T_lil`� BATCH NO_ 2024-00005047 RECEIPT NO. 2024-00122433 CASHIER �lor7etta Rucker ENTRY DATE 08/29/202412:20:29 AM Customer Copy Printed by_ Vonetta Rucker Page 1 of 1 U8J29/2024 12.20.29 AM PAYMENT DATE 08/29/2024 COLLECTION STATION UB Mid Ofc 2 (FI-CH-UB-5-1W7j RECEIVED FROM MATT BENTON DESCRIPTION QUALIFYING pity of Winter springs I 126 E. State Road 434 inter Springs, FL 32708 uer�enc Paymenks_ I Type Detail Amounk Check Total Cash Total Check Total Charge Total 'Wire Total Other Total Remitted Change Total Received $0.00 $150.00 $0.00 $0.00 !. $0.00 $0.00Ti w _ Total Amount= BATCH NO. 2a2�-00005047 RECEIPT NO. 2a2�1-00122434 CASHIER Vorietta Rucker ENTRY DATE a8 29/202412:21 28 AM Customer Copy Printed by_ �onetta Rucker Page 1 0f 1 08}29j2024 12:21=28 AM CITY OF WINTER SPRINGS, FLORIDA 2024GEN ERAL MUNICIPAL ELECTION NOTI CE OF TESTING OF TABULATING EQUIPMENT cITYCoMMISSIo .DISTRICT ONE DISTRICT THREE/ Circle which applies to candidacy NOTICE DISTRICT FIVE FORM 3 THIS COMPLETED FORM MUST BE PROVIDED TO THE CITY CLERK DURING QUALIFYING Please acceptthis notice that the tabulating equipment to be utilized in the City of WinterSprings, Florida's 2024 General Municipal Electionwill betestedon: DATE: Friday, October 11, 2024 TI M E:10:00 a.m. The aforementioned test will be held at: TH E 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 AUG 2 91024 CITY OF WINTER SPRINGS OFFICE OF THE CITY CLERK Revised O6/10/2024 CI IYOFWINTERSPRINGS, FLORIDA 2024GENERAL MUNICIPAL ELECTION APPLICATION FOR OFFICE AND ELECTIONASSESSMENT CITYCOMMISSION. ISTRICTONE DISTRICT THREE/DISTRICT FIVE Circle which applies to candidacy FORM 4 THIS COMPLETED FORM MUST BE PROVIDED TO THE CITY CLERK DURING QUALIFYING Please find the following 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:Information/ReferencesreIatedtoPoliticaICampaignAdvertisements/Signs: (2) "The Florida Election Code, Chapters 97 -106, Florida Statutes" (included in Qualifying Packet) (3) "Candidate and Campaign Treasurer Handbook"-(Whichincludesinformationfrom "Chapter12: Political Advertising" and "Chapter 13:Other Disclaimers") [Included in Qualifying Packet] ACKNOWLEDGMENT /fXGmw sV_ r��cr� do hereby acknowledge on this date of Name of Candidate (Print or Type) rot ,2024with my signature belowthat 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 Code Chapters 97-106, Florida Statutes" and the "Candidate and Campaign Treasurer Handbook." Signature FOR OFFICE USE ONLY attachment: Copy of Florida Statutes 106.1435 Date AUG 2 9 7024 CITY OF WINTEP. OFFi�=E OF THE C:' Revised 06/]0/2024 CITYOF WINTER SPRINGS, FLORIDA 2024 GENERAL MUNICIPAL ELECTION APPLICATION FOR OFFICE AND ELECTIONASSESSMENT CITY COMMISSION: ISTRICT ON ., DISTRICT THREE/ DISTRICT FIVE Circle which applies to candidacy SCHEDULE DURING/AFTER QUALIFYING, THE FOLLOWING CAMPAIGN FINANCE REPORTS ARE DUE: FORM S THISCOMPLETED FORM MUST BE PROVIDEDTOTHE CITY CLERK DURING QUALIFYING Report Due Date: October 10, 2024 .shall contain information regarding all previously unreported contributions and expenditures from Julyl, 2024- September 30, 2024 Report Due Date: October 11, 2024 - shall contain information regarding all previously unreported contributions and expenditures from October 1, 2024 - October 4, 2024 Report Due Date: October25, 2024 - shall contain information regarding all previously unreported contributions and expenditures from October 5, 2024 - October 18, 2024 Report Due Date: No�mberl, 2024 .Shall contain information regarding all previously unreported contributions and expenditures from October 19, 2024 - October 31, 2024. A Final Reportshall be filed 90 days after the General Election - on orbefore February3, 2025 - shall contain information regarding all previously unreported contributions and expenditures from November 1, 2024 - February 3, 2025 ACKNOWLEDGMENT �p4 Elm do hereby acknowledge that on this date of 2024 with my signature below that I received a written "Schedule of Campaign Finance Reporting Periods/Due Dates" (as noted above on this form)61, Signature Date AUG 2 9 2024 CITY OF WINTER SPRINGS OFFICE OF THE CITY CLFF'K Revised 06/l0/2024 ��NTER CITY OF W I NTER SPRI NGS, FLORI DA o2024GENERALMUNICIPAL ELECTION z NOTICE OFACCESS TO ti��5^ CAMPAIGNFINANCEFORMS \Oq ,,�, E S R CITYCOMMISSION: LRICTN /DISTRICTTHREE/DISTRICTFIVE applies to candidacy NOTICE FORM 6 THIS COMPLETED FORM MUST BE PROVIDED TO THE CITY CLERK DURING QUALIFYING Please note that Campaign Finance forms are available at the following State of Florida Website address: https://dos.myflorida.com/elections/forms-publications/forms/ through the Seminole County Supervisor of Elections Office when using their "Online Treasure Reporting System." ACKNOWLEDGMENT me do hereby acknowledge that on this date of ,�- Z4 , 2024 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." Signature Date AUG 2 9 2024 CITY OF 1MNTER �RRINGS OF�ic;F O� "'-tE CITY CLERK Revised OG/]0/2024 CA N D I DAT E P ET I T I O N OFFICOE OFnTHE cn �� 'r'i -` FORM 7 'All information on this form becomes a public record upon receipt by the Supervisor of Elections ' It is a crime to knowingly sign more than one petition for a candidate. (Section 104.185 Florida Statutes] 'If all requested information on this form is not completed, the form wil! not be volfd as a Candidate Petition THIS COM PLE7ED 'FORM MUST BE I, lidlnla� �h'O`y13� W I I �S 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 I��-'tl �� QUALIFYING placed on the General Election Ballot as a [check complete box, as applicable] �` _J Nonpartisan N/A No party affiliation N/A Not Applicable Party Candidate for the Office of City of Winter Springs - City Commission District One (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/WYY) p$/ 0SL /96y 6 9 9 s,«e cfee It City County State Zip Code Gill fey 5'%';/i&Vs S�°M1i1ale �L a'708 of Voter f 15-2.045, F.AC. �= CANDIDATE PETITION Date Signed (MM/DD/YYYY [To be completed by Voter] a si aoay CITY OF WINTER SPRL !['S OFFICE OF THE CITY C t-.� FORM 'All information on this form becomes a public record upon receipt by the Supervisor of Elections 'It Is a crime to knowinglysign more than one petition fora candidate. (Section 104.185 Florida Statutes] ' If all requested information on this form is not ,completed, the form will not be valid os a Candidate Petition (Please print name as It appears on your voter information card) voter in said state and county, petition to have the name of placed on the General Election Ballot as a [check/complete box, as a THIS COMPLETED FORM MUST BE PROVIDED TO THE CITY CLERK DURING QUALIFYING C� Nonpartisan N/A No party affiliation N/A Not Applicable Party Candidate for the Office of City of Winter Springs -City Commission District One Date of Birth OR Voter (MM/DD/YYYI') Co�unfty Signature of Voter Stale Zip Code Date Signed (MM/DD/YYYY [To he completed by Voter] Rule 15-2.045, F.A.C. CANDIDATE PETITION CITY OF VNNTEP. .- OFFICE OF THE CIT � C.. `All information on this form becomes a public record upon receipt by the Supervisor of Elections `It Is a crime to knowinglysign more than one petition for a candidate. (section 704.785F1orldo Statutes) `If all requested information on this form is not completed, the form will not be valid as Candidate Petition ►V UGtA V the undersigned, a registered (Please print name as It appears on your voter information card) voter in said state and county, petition to have the name of..i flit,f placed on the General Election Ballot as a [check/complete box, as applicable] FORM rI THIS COMPLETEQ FORM MUST BE PROVIDED TO THE CITY CLERK DURING QUALIFYING I A� Nonpartisan N/A No party affiliation N/A Not Applicable Party Candidate for the Office of City of Winter Springs - City Commission District One and Date of Birth OR Voter Registration Number (MM/DD/YYY`n cv�ti2?2Z ?) ta city V� to i'4c- s �rt-t nr GVY nature of Voter Rule 15-2045, F.A.C. Group, seat Ivumoer, It a Address County State Zip Code 5 �7s✓� t n, s L ; V7 01a Date Slg ned (MM/DD/WYY) (To be completed by Voter] Oct, `2z) je2�D2 Y CANDIDATE PETITION 'All information on this form becomes a public record upon receipt by the Supervisor of Elections `It is o crime to knowinglysign more than one petition for a candidate. [Section 704.785 Florida Statutes] `If all requested information on this form Is not completed, the form will not be valid as a Candidate Petition Form, I, 4 wLa�%.ea /mac �r e / the undersigned, a registered (Please print name as it appears on your voter Information card) voter in said state and county, petition to have the name of �� y�`I/V''% Ci/� placed on the General Election Ballot as a [check/complete box, as applicable] FORM / THIS COMPLETED FORM MUST BE PROVIDED TO THE CITY CLERK DURING QUALIFYING L— V� Nonpartisan N/A No party affiliation N/A Not Applicable Party Candidate for the Office of City of Winter Springs - City Commission District One and incwoe uistnct, Circuit, Group, Seat Date of Birth OR Voter Registration Number Address City County State Zip Code nature of Voter 15-2.045, F.A.C. Dale Signed (MM/DD/YYYY) (To be completed by Voter] rT f C 1. fir;= L _:_ L S A[ 16 2.9 2024 Revised 06/10/2024 CITY OF WINTER SPRINC3 OFFICE 0F THE C'I'1 (GLEa�� -y. AUG 2 9 2024 CAN DI DATE PETITION CITY OF WINTER SP! OFFICE OF THE CITY 'All information on this form becomes a public record upon receipt by the Supervisor of Elections It is a crime to knowinglysign more than one petition fora candidate. [Section 104.185FlorfdaStatutes] 'if all requested information on this form is not completed, the form will not be valid as o Candidate Petition I, V>fi b �1 (Please print name as it appears on yq(Jr voter Information card) voter in said state and county, petition to have the name of placed on the General Election Ballot as a [check/complete box, as a the undersigned, a registered FORM '7 THIS COMPLETED FORM MUST BE PROVIDED TO THE CITY CLERK DURING QUALIFYING �`A Nonpartisan N/A No party affiliation N/A Not Applicable Party Candidate for the Office of City of Winter Springs - City Commission District One (Please insert the title of Office and include District, Circuit, Group, Seat Number, I Date of Birth OR Voter Registration Number Address (M M/DD/YYW) 9q i[y County Sta Zip Code ��-e, sv�! inTrr s r,,nas s l j27G1 Signature of Voter Date Signed (MMlDDlYYYY) [To be completed by Voter] Z/j Rule 1S-2.045, F.A.C. ��-�'`� CANDIDATE PETITION 'All information on this form becomes a public record upon receipt by the Supervisor of Elections 'It is a crime to knowinglysign more than one petition for a candidate. [Section 104.185FIorida Statutes] *If all requested information on this form Is not completed, the form will not be valid as a Candidate Petition Form. I sp\cs the undersigned, a registered (Please print name as it appears on your voter information card) voter in said state and county, petition to have the name of / �/�� + L2.j �"J", placed on the General Election Ballot as a [check/complete box, as applicable] FORM 7 THIS COMPLETED FORM MUST BE PROVIDED TO THE CITY CLERK DURING QUALI FYI NG X� Nonpartisan N/A No party affiliation N/A Not Applicable Party Candidate I the Office of City of Winter Springs - City Commission District One oiease insert the title of Office and include District, Circuit, Group, Seat Number, If applicable) Date of Birth OR Voter (M M/DD/YW1� City \ o17A `b of Voter Rule 15-2.045, F.A.C. County State Zip Code Dale Signed (MMJDD/WYY, [To he completed by Voter[ AilG 2 9 2024 Revised 06/10/2024 CITY OF WINTER SPRINGS OFFICE OF 1'Hc CITY CLCr?i: :��, CANDIDATE PETITION \:.v 'All information on this form becomes o public record upon receipt by [he Supervisor of Elections `It fs a crime to knowinglysign more than one petition for a candidate. ]Section 704.185 Ffarida Statutes) `Ifall requested information on this form fs not completed, the form will not be valid as a Candidate Petition Form. the undersigned, a registered j (Please print name as tt appears on your voter information card) f voter in said state and county, petition to have the name of �qv� �,,, placed on the General Election Ballot as a [check/complete box, as applicable] FORM 7 THIS COMPLETED FORM MUST BE PROVIDED TO THE CITY CLERK DURING QUALIFYING Nonpartisan N/A No party affiliation N/A Not Applicable ,Party Candidate for the Office of City of Winter Springs -City Commission District one Date of Birth OjR�V(onter jRe�jgistration Number Address Gity W�1r� S 1 Y�f G�e! •r;►� S�� Z3 v� /U� Sign ' ure of Voter Dale Signed (MM/DD/WW) [io be cOmple� by Voter] Rule 15-2.045, F,A.C. '�'�� ,� ��, �,;;� Revised 06/10/2024 AUG 2 9 1024 CITY OF WINTER SPRINGS OFF=10E C7F THE CITY CLEftK �� CANDIDATE PETITION 'All information on this form becomes a public record upon receipt by the Supervisor ofElections 'It is a crime to knowinglysign more tpphan one petition for a candidate. (Section 104.185Florida Statutes] 'Ifallregr� stedinformgt�nonthisforrrtistiotcompleted,theformwillnotbevalidasaCandlda[ePetitionForm. v �1 I, (Please print name voter in said state and county, the undersigned, a registered appears on your voter Information card) _ Rion to have the name of /��'/% g,��` placed on the General Election Ballot as a [check/complete box, as FORM rI THIS COMPLETED FORM MUST BE PROVIDED TO THE CITY CLERK DURING QUALIFYING . Nonpartisan N/A No party affiliation N/A Not Applicable 'Party Candidate for the Office of City of Winter Springs -City Commission District One Date of Birth OR Voter Registration Nu ber (MM/DDNYYY) i� �O �,��/ r of (• and Include District, Circul[, Group, Seat Number, if applicable) Address r � j ,r�� / ,v, li ! County /.`�i �� Sta� Zip Code � �l/ Date Signed (MM/DD/YY1'Y) ITo be completed by Voter] � F.A.C. Revised 06/10/2024 A[IG 2 9 1014 .= CANDIDATE PETITION OCITY FFICE OF THE CITY INGSr FORM 'All information on this form becomes a public record upon receipt by the Supervisor of Elections ' It Is a crime to knowinglysign more than one petition for a candidate. (Section 704.785 Florida Statutes] '/fall requested information on this form is hot completed, the form will not be valid as a Candidate Petitlon THIS COMPLETED FORM MUST BE I, VfM (A) c % s the undersigned, a registered PROVIDED TO THE (161ease print name as it appears on your voter Information card) voter in said state and county, petition to have the name of placed on the General Election Ballot as a [check/complete box, as CITY CLERK DURING QUALIFYING ANonpartisan N/A No party affiliation N/A Not Applicable party Candidate for the Office of City of Winter Springs - City Commission District One Date of Birth OR Voter Registration Number (MM/DD/Y" �NJki of Voter F.A.c. title of Office and include District, Circuit, Group, M / G County State 5 19 ii a t..:l I I FL :��1 CANDIDATE PETITION *All Z(p Code Date Signed (MM/DD/YYYYj (To be completed by Voter] information on this form becomes a public record upon receipt by the Supervisor ofEfections `!t is o crime to knowinglyslgn more than one petition for o candidate. (Section 104.185 Florida StotutesJ ' If all requested Information on this form is not completed, the form will not be valid os a Candidate Petition Form. the undersigned, a registered FORM THIS COMPLETEb FORM MUST BE 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 r�-+t—�1L.f� ! �� QUALIFYING placed on the General Election Ballot as a [check/complete box, as applicable] I� Nonpartisan N/A No party affiliation N/A Not Applicable Party Candidate for the Office of City of Winter Springs - City Commission District One Please Insert the title of Office and include District, Circuit, Group, Seat Number, if applicable) Date of Birth OR Voter (MM/DD" County 15-2.045, F.A.C. Stale Date Signed (MM/DD/YWY [To be completed by Voter] Code Revised 06/10/2024 �� r r. `f` �( CAN DI DATE PETITION OCITY FFICOE OF THE CITY 'All information on this form becomes a public record upon receipt by the Supervisor of Elections It Is a crime to knowinglysign more than one petition for a candidate. (Section 704,185 Florida Statutes] 'If all requested information on this form is not completed, the form will not be valid as a Candidate Petition the undersigned, a registered (Please print name as it appears on your voter information card) GS Efz� FORM 7 THIS COMPLETED FORM MUST BE PROVIDED TO THE CITY CLERK DURING voter in said state and county, petition to have the name of Gam' -lam k QUALIFYING placed on the General Election Ballot as a [check/complete box, as applicable] C� Nonpartisan N/A No party affiliation N/A Not Applicable Party Candidate for the Office of City of Winter Springs -City Commission District One (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/YYYY) 3 ` l C) b 66 UU City � County •� State Zlp Code � Signature Date Signed (MM/ D/YYW) [To be co plete by Voter] rA FA.C. «l CANDIDATE PETITION 'All information on this form becomes a public record upon receipt by the Supervisor of Elections `It is crime to knowingly sign more than one petition for o candidate. (Section 704.785 Florida Statutes] if all requested information on this form is not completed, the form will not be valid as a Candidate Petition Form. the undersigned, a registered jpPease print name as it appears on your voter Information card) voter in said state and county, petition to have the name of placed on the General Election Ballot as a [check/complete box, as FORM 7 THIS COMPLETEb FORM MUST BE PROVIDED TO THE CITY CLERK DURING QUALI FYI NG Nonpartisan N/A No party affiliation N/A Not Applicable Party Candidate for the Office of City of Winter Springs - City Commission District One 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) County of Voter le 15-2.045, F.A.C. State Z(p Code Date Signed (MM/DD/WW) [ro be completed by Voter] U Revised O6/10/2024 Fl °l F'-.r�St ti. F`: �NNj ✓.w Li -. j .� a Iu ei lr 2 9 2024 CANDIDATEPETITION CITY OF WINTER SPRIN OFFICE OF THE CITY CL 'All information on this form becomes a public record upon receipt by the Supervisor of Elections It Is a crime to knowingly sign more than one petition for a candidate. [Section 704.785 Florida Statutes] If all requested information on this form is not completed, the form will not be valid as a Candidate Petition the undersigned, a registered (Please print name as It appears on your voter Information card) voter in said state and county, petition to have the name of (placed on the General Election Ballot as a [check/complete box, as FORM / THIS COMPLETED FORM MUST BE PROVIDED TO THE CITY CLERK DURING QUALIFYING Nonpartisan N/A No party affliation N/A Not Applicable Party Candidate for the Office of City of Winter Springs - City Commission District One umoer, it a Date of Birth OR Voter Registration Number AddressL�/ / r ^ ' / J (MM/DD/YYYY) t Y C r/l,./ie i16 �� y a0 City County State Zip Code nature of Rule 15-2.045, FAC. Date Signed (MM/DD/YWY) [To be completed by Voter] �� CAN D I DATE P ETITI O N FORM 'All information on this form becomes a public record upon receipt by the Supervisor of Elections *it is o crime to knowinglysign more than one petition for a candidate. [Section 704.185 Florida Statutes] *If ailrequested information on this form is not completed, the form will not be valid as a Candidate Petition Form. THIS COMPLETED [�' FORM MUST BE �G I, l ! r''12 y �hG %� the undersigned, a registered PROVIDED TO THE (Please print name aslit appears on your voter Information card) CITY CLERK DURING voter in said state and county, petition to have the name of �/IQ: f �%2� �e 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 One 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/YYYI) ) `� City County State Zip Code Dale Signed (MM/DD/YYYV) [To be completed Voter] % F.A.C. Revised 06/10/2024 AUG 2 9 ro CANDIDATE PETITION CITYOFWINTER: OFFICE OF THE Cll 'All information on this form becomes a public record upon receipt by the Supervisor of Elections It is a crime to knowinglysign more than one petition for a candidate. [Section 704,785 Florida Statutes] If all requested Information on this form is not completed, the form will not be valid as a Candidate Petition the undersigned, a registered name as It appears on your voter Information card) NG�ORM / THIS COMPLETED FORM MUST BE PROVIDED TO THE 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 One OR Voter %lCA 7�i�?��J�Y County State Zip Code 5(f 9706Y of Voter Date Signed (MM/DD/YY1'Y /,(l�oi)be co//mJplet�e/d b/lVnote/r] 15-2.045, F.A.C. `` CAN D I DATE P ETITI O N FORM 'All information on this form becomes a public record upon receipt by the Supervisor of Elections `It is a crime to knowingly sign more than one petition for a candidate. [Section 704,165 Florida Statutes] `If all requested information on this form Is not completed, the form will not be valid as a Candidate Petition Form, THIS COMPLETED ) � FORM MUST 8E I, blu5 J r / Q �� 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 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 One 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 County State Zip Code s/) Olen-1 13Z� �S Date Signed (MM/DD/YYYY) (To be omelet d by Voter ��--- Rule 15-2.045, F.A.C. Revised OG/10/2024 CEaV CANDIDATE PETITION CITY OF WINTER SP[21NGS �7 OFFICE OF THE CITY CLERKFORM / All information on this form becomes a public record upon receipt by the Supervisor of Elections ' It is a crime to knowinglysign more than one petition fora candidate. (Section 704,185 Florida Statutes] ' if all requested information on this form is not completed, the form will not be valid as a Candidate Petition the undersigned, a registered (Please print name as it appears on your voter information card) voter in said state and county, petition to have the name of placed on the General Election Ballot as a [check/complete box, as THIS COMPLETED FORM MUST BE PROVIDED TO THE CITY CLERK DURING QUALIFYING Nonpartisan N/A No party affiliation N/A Not Applicable Party Candidate for the Office of City of Winter Springs - City Commission District One (Please insert the title of Office and include District, Circuit, Group, Seat Number, if applicable) Date of Birth OR Voter Registration Number Address Ci[ y Signature of Voter ,Rule 1S-2.045, FA.C. County /y1 iwa r� `� CAN D I DATE P ETITI O N State Date Signed (MM/DD/YWY [To be completed by Voter] 'S T /2Zs� Lo � 'All information on this form becomes a public record upon receipt by the Supervisor ofElections ' It is o crime to knowingly sign more than one petition for acandidate. [Section 104.185 Florida Statutes) if all requested information on this form is not completed, the form will not be valid as or Candidate Petition Form. I , (Please print name as it appears on your voter information card) voter in said state and county, petition to have the name of placed on the General Election Ballot as a [check/complete box, as a the undersigned, a registered FORM THIS COMPLETED FORM MUST BE PROVIDED TO THE CITY CLERK DURING QUALIFYING L—.J Nonpartisan N/A No party affiliation N/A Not Applicable Party Candidate for the Office of City of Winter Springs - City Commission District One Please insert the title of Office and include District, Circuit, Group, Seat Number, if applicable) Date of Birth OR Voter (M n Number Address Cou S[a� Zip M' Dale Signed (MM/DDYY) [To be completed by Voter] I l CAN D I DATE P ET IT I O N OCITY FF COE OF THE CITYR LNGS EM FORM 'All Information on this form becomes a public record upon receipt by the Supervisor of Elections ' It is a crime to knowinglysign more than one petition for a candidate. (Section 704.785 Florida Statutes] If all requested information on this form is not completed, the form will not be valid as a Candidate Petition THIS COMPLETED FORM MUST BE Aril 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 /�� j � e,� 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 One (Please Insert the title of Office and include District, Circuit, Group, Seat Number, If applicable) Date of Birth OR Voter RNumber registrationess 10 (C j d/ , wz� I U County , S[ e Zip Code c�>�-M�r�� pro K� �1 Lsz nature of Voter Date Signed (MM/DD/YWY) [To be completed by Voter le 15-2.045, F.A.C. CANDIDATE PETITION FORM 'All information on this form becomes o public record upon receipt by the Supervisor of Elections 'It is a crime to knowingly sign more than one petition for a candidate. [Section 104.785 Florida Statutes] *Ifallrequested information on this form isnotcompleted, theform willnotbe valiclas cy Candidate Petition Form. THIS COMPLETED FORM MUST BE I, Dpt%4�t l4 t%wk V-A5Pf�jQssthip the undersigned, a registered PROVIDED TO THE (Please print name as It appears on your voter information card) I CITY CLERK DURING voter in said state and county, petition to have the name of ^ 41�%•/ z?df7jvX QUALIFYING placed on the General Election Ballot as a [check/complete box, as applicable] �_J Nonpartisan N/A No party affiliation N/A Not Applicable Party Candidate for the Office of City of Winter Springs - City Commission District One 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) 59 9 ALTO r�J I2 9� �2 �yl + l`��1D 51?Rt#�l6S L 31'?0 c3 ;ity County State Zip Code wt�T"tR SI��ZiNUS S�►�-L�No�C �� Z"��3 nature of Voter Date Signed (MM/D D/YYW) [To be completed by Voter] (Rule 15-2.045, F.A.C. Revised O6/]0/2024 )G �970 CITY OF VN NTER SP CAN D I DATE P ETITI O N OFFICE OF THE CITY 'All information on this form becomes a public record upon receipt by the Supervisor of Elections ' It is a crime to knowinglysign more than one petition for a candidate. (Section 704,785 Florida Statutes) *if all requested information on this form is not completed, the form will not be valid as a Candidate Petition Z p�`fii4A AE)� 1 � ` the undersigned, a registered (Please print name as It appears on your voter information card) voter in said state and county, petition to have the name of placed on the General Election Ballot as a [check/complete box, as Efts FORM THIS COMPLETED FORM MUST BE PROVIDED TO THE CITY CLERK DURING QUALIFYING u Nonpartisan N/A No party affiliation N/A Not Applicable Party Candidate for the Office of City of Winter Springs - City Commission District One Date of Birth DR Voter (MWDD/Y" / C5l6j�1l City nature 15-2.045, F.A.C. Number of Office and Include Seat Num County State Zip Code sat%kko ly R, 1 W�30% CANDIDATE PETITION Dale Signed (MM/DD/YYYY) ITo be completed by Voter] ZD2 'All information on this form becomes a public record upon receipt by the Supervisor of Elections 'It is a crime to knowingly sign more than one petition for o candidate. )Section 104.185 Florida Statutes) •If all requested information on this form is not completed, the form will not be valid as a Candidate Petition Form. the undersigned, a registered (Please print name as it appears on your voter information in said state and county, petition to have the name of I QQQ\`�0A voter placed on the General Election Ballot as a [check/complete box, as applicable] FORM THIS COMPLETED FORM MUST BE PROVIDED TO THE CITY CLERK DURING QUALIFYING I ".J Nonpartisan N/A No party affiliation N/A Not Applicable Party Candidate for the Office of City of Winter Springs - City Commission District One Please Insert the title of office and include District, Circuit, Group, Seat Number, if applicable) Address Date of Birth OR Voter Registration Number (MM/DD/YYl'Y) Signl-atu/r/ f V er 6 ` Ru2.045, F.A.C. County State Zip Code S �l ►�� LL �L. 3 Z-7 Date Signed [To be comp by Voter] Revised 06/10/2024 r CANDIDATE PETITION OFFCOEOFTHECI 'All information on this form becomes a public record upon receipt by the Supervisor of Elections ' It is a crime to knowinglysign more than one petition for a candidate. [Section 104,785 Florida Statutes] If all requested information on this form is not completed, the form will not be valid as a Candidate Petition the undersigned, a registered (Please prt name as it appears on your voter information card) voter in said state and county, petition to have the name of placed on the General Election Ballot as a [check/complete box, as 21NGS CLERKFORM / THIS COMPLETED FORM MUST BE PROVIDED TO THE CITY CLERK DURING QUALIFYING A Nonpartisan N/A No party affliation N/A Not Applicable Party Candidate for the Office of City of Winter Springs - City Commission District One and include District, Circuit, Group, Seat Number, Date of Birth OR Voter Registration Numb (MM/DD/1'YYY) / County W i WOW Spring s S i nol� Signature of Voter le 15-2.045, F.A.C. I rcvy v C 1 rCl >✓ `4 CANDIDATE PETITION State �� Zip Code og Date Signed (MM/DD/YWY) ITo be completed by Voter] vslta/zozq 'All information on this form becomes o public record upon receipt bythe Supervisor of Elections 'It is a crime to knowinglysign more than one petition for a candidate. (Section 104.185 Florida Statutes) ' if all requested information on this form is not completed, the form will not be valid as a Candidate Petition Form. I, �=101�� (Please print name as it appears on your voter Information card) voter in said state and county, petition to have the name of ,placed on the General Election Ballot as a [check/complete box, as a the undersigned, a registered FORM 7 THIS COMPLETED FORM MUST BE PROVIDED TO THE CITY CLERK DURING QUALIFYING Nonpartisan N/A No party affiliatioh N/A Not Applicable Party -- Candidate for the Office of City of Winter Springs - City Commission District One Please insert the title of Office and include District, Circuit, Group, Seat Number, if applicable) Date of Birth OR Voter Registration Number Address (MM/DDM'1'Y), (� r 9 Vl al /q�loa�/ �r2. 1f11NTsR. S�/�INca FL y County GvJ,vr�2 S��»� 9��r�i✓az.� nature of (Rule 15-2.045, a St Date Signed (MM/DD/YWY) [To be completed by Voter] Revised 06/10/2024 CANDIDATE PETITION CITY OF WINTER STRINGS ORM OFFICE Or THE CIT CLERiE `All information on this form becomes a public record upon receipt by the Supervisor of Elections ' It Is a crime to knowingly sign more than one petition for a candidate. [Section 704.785 Florida Statutes] ' if all requested Information on this form is riot completed, the form will not be valid as a Candidate Petition the undersigned, a registered (Please print name as it appears on your voter information card) voter in said state and county, petition to have the name of placed on the General Election Ballot as a [check/complete box, as a THIS COMPLETED FORM MUST BE PROVIDED TO THE CITY CLERK DURING QUALIFYING l A Nonpartisan N/A No party affiliation N/A Not Applicable Party Candidate for the Office of City of Winter Springs - City Commission District One (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/DD11("M) ;y Count j State Zip Code ,rv(d� I b." ►9 ! ^r vLf.' -... �L- �o'Z 7 CJ�` nature of Voter Date Signed (MM/DD/WW) [To be completed by Voter] 15-2.045, F.A.C. CANDIDATE PETITION 'All information on this form becomes a public record upon receipt by the Supervisor of Elections `It isa crime to knowinglysign more than one petition for a candidate. (Section 704,185F1orida Statutes) ' If all requested information on this form Is not completed, the form will not be valid as a Candidate Petition Form, I A��a�t� � ,bjes l the undersigned, a registered (Please print name as it appears on your voter Information card) voter in said state and county, petition to have the name of placed on the General Election Ballot as a [check/complete'box, as an FORM THIS COMPLETED FORM MUST BE PROVIDED TO THE CITY CLERK DURING QUALIFYING Nonpartisan N/A No party affiliation N/A _ — Not Applicable Party Candidate for the Office of City of Winter Springs - City Commission District One Please Insert the title of office and Include District, Circuit, Group, Seat Number, if applicable) Date of Birth OR Voter Registration (MM/DD/YYYY) 0Rl*V/171.5 County SignatureofVoter Iv Rule 1S-2.04S, F.A.C. Revised 06/10/2024 Address l& �,ZpDif State Zip Code Date Signed (MM/DD/YYW) [To be completed by Voter] ,qlt� 2 9 2024 --� CITY OF VVINTER SPR OFFICE OF THE CITY LERK CANDIDATE PETITION �-7 FORM 'All Information on this form becomes a public record upon receipt by the Supervisor of Elections It Is a crime to knowinglysign more than one petition for a candidate. [Section 104,185 Florida Statutes] 'Ifoll requested information on this form is not completed, the form will not be valid as a Candidate Petition THIS COMPLETED 114 )� FORM MUST BE ,rL/ 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 QUALIFYING placed on the General Election Ballot as a [check/complete box, as applicable] ANonpartisan N/A No party aff liation N/A Not Applicable Party Candidate for the Office of City of Winter Springs - City Commission District One (Please insert the title of Office and include District. Circuit, Group. Seat Number, if applicable) OR Voter Registration N a 11 CJJ Sri Sfl o4w�� i County l q SRAW4Gies 1 1 -�:'(54ill00 L� Signature 15-2045, State Dale Signed (M [To be comple(� CANDIDATE PETITION 'All information on this form becomes a public record upon receipt by the Supervisor of Elections •It Is o crime to knowinglyslgn more than one petition for a candidate. [Section 704,785 Florida Statutes] *if all requested information onthis form �Isnot complete theform will not be valid as a Candidate Petition Form. I, vey� i�ta Vy �� e the undersigned, a registered y (Please print name as It appears on your voter informs ion card) voter in said state and county, petition to have the name of /I/� A4 K4-j Q� placed on the General Election Ballot as a [check/complete box, as applicable] Date of Birth OR Voter Reg (MM/DD/YWY) G I � Ci[ yr, Signature of Voter 15-2.045, F.A.C. FORM 7 THIS COMPLETED FORM MUST BE PROVIDED TO THE CITY CLERK DURING QUALIFYING Nonpartisan N/A No party affiliation N/A Not Applicable Party Candidate for the Office of City of Winter Springs - City Commission District One 5 Number Address�n �J if State_,r Zlp Code Date Signed (MM/DD/YYYV) (To he completed by Vpter] Revised 06/10/2024 ~a` CANDIDATE PETITION _»:-jf CITY OF WINTERS RINGS FORM OFFICE OF THE CI'r CLERK 'All information on this form becomes a public record upon receipt by the Supervisor of Elections It is a crime to knowinglysign more than one petition for a candidate. (Section 104.185 Florida Statutes] If all re?*sd4inth rmation on this form is not completed, the form will not be valid as Candidate Petition THIS COMPLETED <. A66FORM MUST BE '/ rejn�lersigned, 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 A e^ w QUALIFYING placed on the General Election Ballot as a [check/complete box, as applicable] I�A Nonpartisan N/A No payaffliation N/A Not Applicable Party Candidate for the Office of City of Winter Springs - City Commission District One (Please Insert the title of office and include District, Circuit, Group, Seat Number, if applicable) Date of Birth OR Voter Registration Number Address, (MM/DD/YWY) �`��(l�!�c—l:r�c �/L�'\ City County State Zip Code Date Signed (MM/DC ITo be comp) ed by 157909/ Rule 1S-2045, F.A.C. �� CAN D I DATE P ETITI O N FORM � *Ailinformation on this farm becomes a public record upon receipt by the Supervisor of Elections 'It is a crime to knowinglysign more than one petition for o candidate. [Section 704,785 Florida Statutes] `If all requested Information on thisform isnotcomplated, theform willnotbe voildosa Candidate Petition Form, THIS COMPLETED y� FORM MUST BE I, %9L-jec9 &7e,8 �� /� I �L (_'fe< 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 QUALIFYING placed on the General Election Ballot as a [check/complete box, as applicab e] XNonpartisan N/A No party affiliation N/A Not Applicable Party Candidate for the Office of City of Winter Springs - City Commission District One Please insert the title of office and include District, Circuit, Group, Seat Number, if applicable) Date of Birth OR Voter (M M/DD/YYW) S(gnature of V ter Revised 06/10/2024 Number County ooress , Statg/� Date Signed (MM/DD/YYl' [To be completed by Vote 640� 2- . ��v A(►6 2 9 2024 CITY aj OF WINTER SPRI � CANDIDATE PETITION OFFICE OF THr C"'v C _E FORM 'All information on this form becomes a public record upon receipt by the Supervisor of Elections It is a crime to knowinglysign more than one petition fora candidate. (Section 104.785Florida Statutes) 'lfollrequest r ationonthis is not completed,t�mwill not bevalid asaCandidate Petition THIS COMPLETED FORM MUST BE I the undersigned, a registered PROVIDED TO THE (Please print name as it appears on your voter Information card) 1 CITY CLERK DURING voter in said state and county, petition to have the name of/VVILJ�, �g� _ QUALIFYING placed on the General Election Ballot as a [check/complete box, as applicable] I A Nonpartisan N/A No party a,Imation N/A Not Applicable Party Candidate for the Office of City of Winter Springs - City Commission District One (Please Insert the title of office and include District, Circuit, Group, Seat Number, If applicable) Date of Birth OR Voter Registration Number Address Q Co y State Zip Code I of Voter Date Signed (MM/DD/YWY. (To be completed b Voter] Rule 15-2045, �� CANDIDATE PETITION 'All information on this farm becomes a public record upon receipt by the Supervisor of Elections `It is crime to knowinglysign more than one petition fora candidate. (Section 704.78SFiofldo Statutes] •Ifall reqTt d Information on this form is not completed, the form will not be valid as a Candidate Petition Form. I, A it/ F Y the undersigned, a registered (Please print name s it appears on your voter Information card) voter in said state and county, petition to have the name of � V\ L'TC��?'�'~— placed on the General Election Ballot as a [check/complete box, as applicable] FORM THIS COMPLETED FORM MUST BE PROVIDED TO THE CITY CLERK DURING QUALIFYING Nonpartisan N/q No party affiliation N/A Not Applicable 'Party Candidate for the Office of City of Winter Springs - City Commission District One 1. Date of Birth OR Voter Registration Number Address City unty r Sta Zip dp—, nature of Rule 15-2.045, F.A.C. Date Signed (MM/DD, [To be completed b�` Revised 06/10l2024 re kro \00 WE*V? August 29, 2024 CITY OF WINTER SPRINGS, FLORIDA 1126 EAST STATE ROAD 434 WINTER SPRINGS, FLORIDA 32708-2799 TELEPHONE: (407) 327-6560 FACSIMILE: (407) 327-4753 WEBSITE: www.winterspringsfl.org The Honorable Chris Anderson Supervisor of Elections for Seminole County 1500 East Airport Boulevard Sanford, Florida 32773 Dear Mr. Anderson: AG 29 r Please find attached original Petition forms for the following individual who is interested in Qualifying for the City of Winter Springs, Florida 2024 General Municipal Election: • Matt Benton "Fifteen (15) registered voters of the city" on the Petition are required for the City of Winter Springs, Florida 2024 General Municipal Election. Please contact me as soon as possible with the results from verifying the signatures on this Petition. Sincerely, Christian Gowan, MPA City Clerk Hand carried by City of Winter Springs, Florida Representative: _—__�� — �°�"'o-"_ Given to Seminole County Supervisor of Elections Office Representative on this date: a n d ti m e:----- Petitions provided: CANDIDATE OATH NONPARTISAN OFFICE (Do not use this form if a Judicial or School Board Candidate) qqyys_ tr7 `5 qQ{fin Check box only if you are seeking to qualify as a write-in candidate: AUG 2 9 2024 Write-in candidate CITY OF WINTER SPRINGS OFFICE OF THE CITY CLFRK OFFICE USE ONLY Candidate Oath Name to appear on ballot: /V\C� r'.zA�r� Check box if two last names without hyphen. ❑ (Name cannot be changed after qualifying.) Check box if name includes nickname. (For use of a nickname, you must complete the Nickname Affidavit on reverse side.) swear or affirm that I am a candidate for the nonpartisan office of 1 S C ' S �:�nrn i ssf,-� (Office) (District #) c- I am a qualified elector of , io'. •� County, Florida (Circuit #) (Group or Seat #) I am a qualified elector 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. Statement of Outstanding Fines, Fees, or Penalties I owe outstanding fines, fees, or penalties, that cumulatively exceed $250, for ethics or campaign finance violations (s. 99.021(1)(d), F.S.). YES, I Do NO, I Do Not _jZ If you do, you must also specify the amount owed and each entity that levied the same on the reverse side. Signature of Candidate Telephone Number Email Address alp rux�xJN `[jai 4 &N-jv^ Address of Legal Residence City State ZIP Code STATE OF FLORIDA COUNTY OF f14//1/0 LE Signature of Notary Public 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 this Z17y' day of ALAA 1 20 2 Notary Public State of Florida Christian D Gowan Personally Known ❑ OR Produced Identification'® AM tut My Commission HH 433379 T Expires 9/1512027 Type of Identification Produced:/ l )rl% pra lo`cens� DS-DE 302NP (Eff. 10/2023) Rule 1S-2.0001, F.A.C. t� Phonetic Spelling of Name Phonetic spelling for the audio ballot (not required for qualifying purposes): Print the name phonetically on the line below as you wish it to be pronounced on the audio ballot asmaybe used by persons with disabilities (see instructions on page 3 of this form): Statement of Outstanding Fines, Fees or Penalties Pursuant to Section 99.021(1)(d), F.S., each candidate, whether a party candidate, a candidate with no party affiliation, or a write-in candidate, shall, at the time of subscribing to the oath or affirmation, state in writing whether he or she owes any outstanding fines, fees, or penalties that cumulatively exceed $250 for any violations of s. 8, Art. II of the State Constitution, the Code of Ethics for Public Officers and Employees under part III of chapter 112, any local ethics ordinance governing standards of conduct and disclosure requirements, or chapter 106. Amount Entity Affidavit of Nickname (Only required if using nickname for the ballot.) My legal name is ` Ar �1Q� e ��+.-� I am over the age of eighteen (18) and the contents of this affidavit are true and correct. My nickname is _�AJ�rlc� j e ✓�� I am generally known by this nickname or have used it as part of my legal name. I have not created the nickname to mislead voters. My nickname does not imply I am some other person, constitute a political slogan or otherwise associate me with a cause or issue, or that is obscene or profane. Signature of Candidate: 4yr-f4��— STATE OF FLORIDA COUNTYOF .5EA4//V6C�E Signature of Notary Public 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,9] -^ ®' h Notary Public State of Florida this �� day of 20 Zy . ® Christian D Gowan My Commission HH 433379 llll Personally Known ❑ O Produced Identification Expires 9/t5/2o27 Type of Identification Produced: FL %�oii vrcr LI rcni e 0 AUG 2 9 2024 DS-DE 302NP (Eff. 10/2023) s Rule 1S4.0001, F.A.C. CITY CLERIC 1 2023 Form 1 - Statement of Financial Interests General Information Name: Mr Matthew Oliver Benton Address: 414 Cedarwood Ct, Winter Spgs, FL 32708 County: Seminole AGENCY INFORMATION Organization Winter Springs Disclosure Period Suborganization Mayor And City Commission Filed with COE& 07/07/2024 PID 287291 Title Commissioner THIS STATEMENT REFLECTS YOUR FINANCIAL INTERESTS FOR CALENDAR YEAR ENDING DECEMBER 31, 2023 . Primary Sources of Income PRIMARY SOURCE OF INCOME (Over $2,500) (Major sources of income to the reporting person) (If you have nothing to report, write "none" or "n/a") Description of the Source's Name of Source of Income Source's Address Principal Business Activity Graphic Services LLC 945 Longdale Ave, Longwood FL 32750 Printing AUG 2 9 1024 otT�v �� aon�rtrta� �?�ir'k�: �fRl13:IE QAF _� � Crl`i��` C L F h k Printed from the Florida EFDMS System Page 1 of 4 2023 Form 1 = Statement of Financial Interests Filed with COE: 07/07/2024 Liabilities LIABILITIES (Major debts valued over $10,000): (If you have nothing to report, write "none" or "n/a") Name of Creditor Address of Creditor Midland Mortgage P.O. Box 26648 Oklahoma City, OK 73126 Interests in Specified Businesses INTERESTS IN SPECIFIED BUSINESSES (Ownership or positions in certain types of businesses) (If you have nothing to report, write "none" or "n/a") Business Entity # 1 N/A Training This section applies only to an appointed school superintendent, or a commissioner of a community redevelopment agency created under Part III, Chapter 163, each of whom are required to complete annual ethics training pursuant to Section 112.31421 F.S. Q I certify that I have completed the required training under Section 112.3142, F.S. ❑ Required training under Section 112.3142, F.S., not applicable to filer for this form year. AUG 2 9 1.024 CITY OF WINTER SPRINGS OrFICE OF THE CITY CLERK Printed from the Florida EFDMS System Page 3 of 4