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Home My WebLink AboutDiaz, Paul Qualifying Packet 2024 08 28NAME: CITY OF WINTER SPRINGS, FLORIDA 2024 GENERAL MUNICIPAL ELECTION AFFI DAVIT OFACCEPTANCE CITY COMMISSION: DISTRICT THREE/ DISTRICT FIVE Circle which applies to candidacy JA) (� ) ( Tk,161� Date &Time Review Started f 'z/2o z y 2: )9 OM FORM A THIS COMPLETED FORM MUST BE PROVIDED TO THE CITY CLERK DURING QUALIFYING Page 1 of 2 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 READ AND UNDERSTAND THE ELECTION CODE AND 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 ClerkWDesignee no later than 12:00 p.m. on the last day of Qualifying which is Friday, August 30, 2024. "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-DE 302P] "Notice to Federal Government Employees (If applicable) Wptk "Form 1" - Statement of Financial Interest 2023 Accepted: 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 and Disclaimers, etc. ®Candidate and Campaign Treasurer Handbook" (2024) (Which includes "Chapter 12: Political Advertising" and "Chapter 13: Other Disclaimers" "Electioneering Communications Organization Handbook" ,CIA State of Florida. ction Inibrmatian Contacts Accepted: AUG 2 8 2024 Advertising Revised 06/10/2024 CiTV OF `,MNTER SPRINGS r�.=�iCE OF THE CITY CLERIC NNTtR d` CITY OF WINTER SPRINGS, FLORIDA A o a 2020 GENERAL MUNICIPAL ELECTION FORM n U m m t959 wa ,` Vr"` AFFIDAVIT OFACCEPTANCE THIS COMPLETED CITY COMMISSION' STRICT ONE DISTRICT THREE/DISTRICT FIVE FORM MUST BE pFORMMUSTBE TO THE irc ew is applies to candidacy CITY CLERK DURING QUALIFYING NAME: ?A uL Page 2 of 2 CAMPAIGN FINANCE/ELECTRONIC FILING INFORMATION "Contributions Returned" [DS-DE-2] Accepted: aA 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: NOTE: The Candidate SHOULD NOT close out their Campaign Bank Account before they are invoiced and payment is made to the Seminole County Supervisor of Elections for verification of Petition signatures The following signature area is to be signed upon receiving the 2024 Election Qualifying Packet, including the above referenced documents ?N � I l A� have on this date received the forms and information Name of Candidate (Print or Type) noted on these two (2) pages and agree that I will read all the Election Qualifying packet materials that have been provided to me; nd un rst nd thatresponsibility to comply with all Laws as they apply to the 2024 Election. ignature ate State of Florida Countyof �EM/It/o%l� Sworn to (or affirmed) and subscribed before me by means ofVV physical presence or( ) online notarization) his by � day of %"I t%G ) �kG� �V Personally known: OR Provided identification: ---JJJ (Print name ofperson making statement) ignature of Notary Public - State ofFlorida v�rl L�"tense ofldentification produced Type Notary Public State of Florida Christian D Gowan l My Commission HH 43331fl Revised O6/10/2024 Expires 9/15/2V 12024 AUG 2 8 2U24 CITY OF WINTER SPRINGS OFFICE OF THE CITY CLERK CITY OF WINTER SPRINGS, FLORIDA 2024GENEPAL MU NICI PAL ELECTION AFFI DAVI T OF Q UAL I FI ED VOTER STATUS AND CITYAND DISTRICT RESIDENCY CITYCOMMISSION: D/ DISTRICTTHREE/ DISTRICT FIVE Circle which applies to candidacy I, �QU L D tda0c; do hereby state that I seek election to the City Name of Candidate (Print or Type) of Winter Springs' City Commission: District One District Three/ District Five Circle which applies to candidacy FORM I THIS COMPLETED FORM MUST BE PROVIDEDTOTHE CITY CLERK DURING QUALIFYING for a four (4) year term in the election to be held in the City of Winter Springs, Florida on Tuesday, November 5, 2024. I further swear or affirm: (l.) I am a qualified voter in the City of Winter Springs (2.) My legal place of residence is: (3.) Length of time of residency in the City of Winter Springs is: (4.) Length of time of residency in Winter Springs District: (5.) State 5 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: Signature DdIte FL 32fivY StreetAddress City State Zip Code State of Florida Countyof SEn�,nroLr Sworn to (or affirmed) and subscribed before me by means oAf�(I�j physical presence or l' ) online notarization This 2 Q (Au. 0 tt /�uTi 2024 by`� 1 0.'Z •cJ V Personally known: OR Produced Identification �(Pd nrintnameofpersonmakingsta[emen Type of Identification produced SgnatureofNotaryPublic-StateofFlorida Notary Public State of Florida Chrlatlan D Gowan 11111My Commi1810f1 HH 433379 Expires 9/16/2027 FOR OFFICE USE ONLY '�7"�r Copy of Florida Driver's License provided for I[em (5) ,�! jOther documentation provided for Item (S) ' �.- AUG 2 8 2024 Revised 06/10/2024 CITY OF WINTER SPRINGS OFFICE OF THE CITY CLERK PAUL DAVID DIAZ 639 SILVER CREEK DR WINTER SPRINGS The Church at 434 817 E State Rd 434 Winter Springs FL_32708 Ftolnaa 0USA ade DIq� �PAUL DAVID a639 SILVER CREEK OR WINTER SPRINGS, FI.327084119 s U�;G 10128/1974 +p;nx M IbEXP 1012812028 th++v' 6'-00" z, , eRESTA oeFVL NONE SAFE DRIVER Ulu 0911IN2020 ' y 500 X6320f 935Tt'. aEPtACE7 11/0lIZ�p \� - C ZOMSFAt ula SotarN r _ :a'seM to mry 5oC!rety Chris An^ _ SUF 1500 tas'< mil Nv. Sanford, 407.585.V®T�(8683) VoteSeminole.gov REP , 47 WS ® 38 I I 10 2 _ _- 7 CITY OF WINTER SPRINGS, FLORIDA 2024 GENERAL MUNICIPAL ELECTION APPLICATION FOR OFFICE AND ELECTION ASSESSMENT CITY COMMISSION: DISTRICT ONE/ DISTRICT THREE/ DISTRICT FIVE Circle which applies to candidacy Name of Candidate (P rint or Type) FORM 2 THISCOMPLETED FORM MUST BE PROVIDEDTOTHE CITY CLERK DURING QUALIFYING do hereby state that I am a registered and qualified Elector of the City of Winter Springs; and I am applying for the Office of City Commission: istrict One District Three/ District Five for a four (4) year term, in the Election to be held or which applies to candidacy in the City of Winter Springs, Florida on Tuesday, November 5, 2024. 1 further agree to paythe following Qualifying Fee AND applicable Election Assessment QUALIFYING FEE: $150.00 ND THE BELOW ELECTION ASSESSMENT ELECTION ASSESSMENT - COMMISSIONEPfTT20.00 Each Commissioner receives: $1,000.00 per month $1000.00 x12 months = $12,000.00 annually The l% Assessment amounts to: $120.00 NOTE: "Any person seeking to qualifyfor nomination orelection to a municipal officewho is unableto pay the election assessmentwithout imposing an undue burden on personal resources or on resources Otherwise available to him or her shall, upon written certification of such inability given under oath to the qualifying officer, be exempt from paying the election assessment." [99.093 (2) Florida Statutes] Pursuant to F.S.99.093(2), candidateswho are unableto paythe election assessment without imposing an undue burden on their personal resources or resourcesotherwise available tothem shall upon written certification ofsuch inabilitygiven under oath to the city clerk be exempted from paying the election assessment. Any candidate exempt from the election assessmentshgJ1 also be exem•ptfrom the city's qualifying fee. Signature FOR OFFICE USE ONLY PLICATION FEE: Campaign Account Check in the amount of $150.00 attached (Check should be made payable to the City of Winter Springs) 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) OR, IFAPPLICABLE Completed "Notice of Undue Burden" Attached AUG 2 8 2024 D to Check# � O O Check # / tl U Z. Revised 06/10/2024 CITY OF VJINTEP. �Pr?�'��'��'S OFGICE OF BOX 195418 INTER SPRINGS, Fl. 32719 Pay to the /► i n/ �(, Order ofyl•�'( A�%AAAA^_ YNAY,faitw,inLds.s.o'rg Ph: 800,443,6887 For to the Order of_ www.fairwinds.org Ph: :aa ,443,6887 • HeAand Claika 1001 63-8136/2631 01046 �DaateV CHECK ARMOR � }� 1002 2631 snh u� I S m 3-8136/1046 CG/ /+�� 01046 Date JbCHECK ARMOR PAYMENT DATE 08/28/2024 COLLECTION STATION UB Mid Ofc 2 (FI-CH-UB-5-W7j RECEIVED FROM ELECT PAUL DIAZ DESCRIPTION QUALIFYING FEE ityr of Winter springs 1126 E. State Road 434 inter Springs, FL 32708 QUALIFYI�JG FEE Payments: I Type detail 14mounk Check Total Cash Total Check Total Charge Total Wire Total Other Total Remitted Change Total Received Customer Copy 50.00 $150.00 WOO50.00 '. WOOWOO BATCH NO. 2024-00005027 RECEIPT NO. 2024-00122135 CASHIER Vanetta Rucker ENTRY DATE 08/28/2024 02:45:48 PM Printed by_ Vonetta Rucker Page 1 of 1 08J28j2024 02.45.48 PM PAYMENT DATE 08/28/2024 COLLECTION STATION UB Mid Ofc 2 (FI-CH-UB-5-VW) RECEIVED FROM ELECT PAUL DIAZ DESCRIPTION ELECTION ASSESSMENT I ity of Winter Springs 1126 E. State Road 434 4' inter Springs: FL 32708 Generic Payment Cade ELECTION ASSESSMENT Payments: Type Detail Amount iec . Total Cash Total Check Total Charge Total Wire Total Other Total Remitted Change Total Received Customer Copy #0.00 $120.00 $0.00 $0.00 $0.00 $0.00 $6 Total Amount: BATCH NO. zoz4-00005028 RECEIPT NO. 2024-00122138 CASHIER onetto Rucker ENTRY DATE 08t28/2024 02:53:14 PM Printed hy_ Vonetta Rucker Page 1 of 1 08j28f2024 02:53.15 PM CITY OF WINTER SPRINGS, FLORIDA 2024GENEPALMUN ICI PAL ELECTION NOTI CE OF TESTING OF TABULATING EQUIPMENT CITYCOMMISSIO :DISTRICT ONE/ ISTRICTTHREE/ DISTRICT FIVE nc e w h applies to candidacy NOTICE FORM 7J 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 Winter Springs, 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: THE OFFICE OFTHE SUPERVISOR OF ELECTIONS FOR SEMINOLE COUNTY 1500 East Airport Boulevard, Sanford, Florida, 32773 (407) 585-VOTE [86831 City of Winter Springs Municipal Elections Official/Designee AUG 2 8 2n24 CITY OF WINTER SPRINGS OFFICE OF THE CITY CLERK Revised 06/10/2024 CITYOr_ WINTER SPRINGS, FLORIDA o s p 2024GENEPALMUNICIPAL ELECTION � O " lncuM es9 h APPLICATIONFOROFFICE AND ELECTIONASSESSMENT • 'ryC�b WE'tRJ�,C CITYCOMMISSION: QL RICT ON 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 POliticalcampaignAdvertisement/Signsattached: (1) Copy of Florida Statutes 106,1435: Information/References relatedto Political Campaign Advertisements/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 "Chapter13:Other Disclaimers") [Included in Qualifying Packet] ACKNOWLEDGMENT do hereby acknowledge on this date of Name of Candidate (Print or Type) L(� , 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 I�" FOR OFFICE USE ONLY �L=, ttachment:CopyofFloridaStatutes106.1435 AUG 2 8 2024 CITY OF WINTER SPRINGS OFFICE OF THE CITY CLERK D to Revised O6/10/2024 CITY OF WINTER SPRINGS, FLORIDA 2024 GENERAL MUNICIPAL ELECTION APPLICATION FOROFFICE AND ELECTIONASSESSMENT CITYCOMMISSION: TRICT ONE 'STRICT THREE/ DISTRICT FIVE Circle which applies to candidacy SCHEDULE DURING/AFTER QUALIFYING, THE FOLLOWING CAMPAIGN FINANCE REPORTS ARE DUE: FORM b THISCOMPLETED FORM MUST BE PROVIDED TO THE CITY CLERK DURING QUALIFYING Report Due Date: October 10, 2024 .shall contain information regarding all previously unreported contributions and expenditures from July 1, 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�emberl, 2024 - shall contain information regarding all previously unreported contributions and expenditures from October 19, 2024 - October 31, 2024. A Final Report shall be filed 90 days after the General Election - on or before February3, 2025 - shall contain information regarding all previously unreported contributions and expenditures from November 1, 2024 - February 3, 2025 ACKNOWLEDGMENT I, �� - do hereby acknowledge that on this date of Name o Candidate (Print or Type) "Schedu 2024 with my signature below that I received a written mpajgn Fj�'nance Reporting Periods/Due Dates" (as noted above on this form). Signature Do AUG 2 81074 ._ •gn.!TEP. SPRINGS Revised O6/l0/2024 CI IYOFWINTERSPRINGS, FLORIDA 2 )24GENERAL MU NICI PAL ELECTION NOTICE OF/ACCESS TO CAMPAIGN FINANCE FORMS CITYCOMMISSION: 01STRICT E/ DISTRICT THREE/ DISTRICT FIVE hich 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 do hereby acknowledge that on this date of � 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 8 2024 CITY OF WINTEP. SPRINGS OFFICE OF THE CITY CLERK Revised O6/10/2024 oCAN D I DATE P ETITI O N CITY OF WINTERS RINGS FORM / OFFICE OF THE CIT CLERK 'All Information on this form becomes a public record upon receipt by the Supervisor of Elections Olt is a crime to knowinglysign more than one petition for a candidate. (Section 704.7a5 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 I, CW a r" the undersigned, a registered PROVIDED TO THE (Please prinYname as it appears on your voter information card) A CITY CLERK DURING voter in said state and county, petition to have the name of �/v�%t �' A� QUALIFYING placed on the General Election Ballot as a [check/complete box, as applicablel L ^ J Nonpartisan No party affiliation LN/A Not Applicable Party Candidate for the Office of City of Winter Springs - City Commission District One >ate of Birth OR Voter Regisl v1M/DD/YYYY) ity W in2r nature of oter ccoe*t IS -204S, FAG County - State �Jetm nv�7L M°i', CANDIDATE PETITION Date Signed (MM/DD/YYYY (To be completed by Voter] v�jaa�ao�y 'AIIlnformotion on this form becomes a public record upon receipt by the Supervisor ofElectlons '!t Is o crime to knowinglysign more than one petition for o candidate. (Section 704.785Florida SrotutesJ ' If all requested in form/rtion on tl form is not/cbmpleted, the form will not be valid as a Candidate Petition Form. the undersigned, a registered (Please pr(r� name as it appears on yc�r 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 C� Nonpartisan N/A No party affiliation N/A Not Applicable party Cand)date for the Office of City of Winter Springs - City Commission District One to of Birth OR Voter Registration Number M/DD/YYY1� County Voter Rule 15-2.045, FAC. State Date Signed (MM/DD/YVW rro he completed by Voter] Revised06/10/2024 CANDIDATE PETITION CITYOF WNTER sPR hoc;.`.=. OFFICE OF THE CITY I.E, FORM/ "All information on this form becomes a public record on receipt by the Supervisor of Elections "'It is a crime to knowinglysign more than one petition fora candidate. (Section 704.785 Florida Statutes) •If oil requested information on this form is not completed, the form will not be valid as Candidate Petition il.d 2 r woo (Please print name as it appears on your voter information carol voter in said state and county, petition to have the name of placed on the General Election Ballot as a [check/complete box, as of Birth the undersigned, a registered UL V I Ao�to THIS COMPLETED FORM MUST BE PROVIDED TO THE CITY CLERK DURING QUALIFYING Nonpartisan N/A No party affiliation N/Ammmnm Not Applicable Party Candidate for the Office of City of Winter Springs - City Commission District One 3 I73�t Galli7wa7 r unty State I Zip Code Scomiho I FL 32�og Date Signed (MM/DD/YYYYJ (To be completed by Voter] 15-204s, F.A.C, �J��'` CANDIDATE PETITION "All Information on this form becomes a public record upon receipt by the Supervisor ofElections 'It Is a crime to know7nglysign more than one petition fora 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, iI v re a o ry U n.d C? rw DO d the undersigned, a registered (Please prin name as it appears on your voter information card) voter in said state and county, petition to have the name of T'��u 3> (N el— �laced on the General Election Ballot as a [check/complete box, as applicable] FORM TMIS 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 Number Address (MM/DD/YYYY) '� 3� Gci,� IOWCL`J lu2 IV6i City MY) � S�tate � W t��e,r 5p rl n i nv l nature of VotefDate Signed (MM/DD/YWY [To be completed by Voter] 15-2045, FAX* Revised 06/10/2024 TY OF CM- CAN D i DATE PETITION of ICE OF THE CITY irLcs FORM '"I `All Information on this form becomes a public record upon receipt by the Supervisor of Elections ° it is a crime to knowingiysign more than one petition for a candidate. [Section 704.785 Florida Statutes] *Ifol/ requested Information on this form isr at completed, the form will not be valid as a Candidate Petition THIS COMPLETED �(�� I/ FORM MUST BE T11"r �l✓1 N K 1'-Q, the undersigned, a registered PROVIDED TO THE (Please print naA as it appears on your voter information card) //�� CITY CLERK DURING voter in said state and county, petition to have the name of R/v�iL A� 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 C-t County Inter S�ri� 5 SemiA0I of Voter be completed by Voter] 1S•2045, F.A.C. �J�"� CAN D I DATE P ETITI O N •Alllnformation on this form becomes a public record upon receipt by the Supervisor ofEfections '!t Is a crime to knowingiysign more than one petition for o candidate. (Section 104.185Florida 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 dame 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 3a7o$ 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 Date of B(rth OR Voter Registration Number Address (MM/DD/YYY1� (J'�/o3/ I�I�1 �b5 `Aberdeen C+ City County State Zip Code I,vrrl�� S11rc�s t tyyiNnaFL f;Iz of Voter Date Signed (MM/DD/YYW) L � (To be completed by Voter] Revised• 06/10/2024 CANDIDATE PETITION OFFICOE OF SHE CITY `LtY FORM 'Alllnformation on thlsform becomes a public record upon receipt by the Supervisor of Elections Olt Is a crime to knowinglysign more than one petition for a candidate. [Section 704.785 Florida Statutes] If all requested information on this form 7snot completed, the form will not be valid as a Candidate Petition I\1 (Please print name as It on your v¢ter 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 Date of Birth OR (MM/DD/Y" , 1S•2.045, FAC. the undersigned, a registered aVU 'V IAA THIS COMPLETED FORM MUST BE PROVIDED TO THE CITY CLERK DURING QUALIFYING I_ Nonpart(san N/A No party amiiation N/A Not Applicable party Candidate for the Office of City of Winter Springs - City Commission District One �I'�b > I IB County b` ,\VI^/v ��" CAN D I DATE P ETITI O N State J J— m by 'All information on this form becomes a public record upon receipt by the Supervisor ofElect7ons *It is a crime to knowingiysign more than one petition for a candidate. (Section 704.185 Florida Statutes] 'Ifallre uestedinformationonthisform notcbmpieted,,the form will notbevalid Candidate Petition Form. I. undersigned, a registered (Please print name as it ppears on your voter information card) voter in said state and county, petition to have the name of (J�, 3> placed on on the General Election Ballot as a [check/complete box, as applicablel FORM THIS COMPLETED FORM MUST BE PROVIDED TO THE CITY CLERK DURING QUALIFYING V� Nonpartisan N/A No party affiliation N/A Not Applicable pi arty Candidate for the Office of City of Winter Springs - City Commission District One Stat IZ3z�►� Date Signed (MM/DD/YYYY; [To be completed by Voter) Revised• 06/1.0/2024 �`.' CANDIDATE PETITION CITY OF WINTER SP INGS FORM 1 --a OFFICE OF THE CITY LFRK r *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 104,785 Florida Statutes] If all requested Information on this form is Aot completed, the form will not be valid as a Candidate Petition THIS COMPLETED FORM MUST BE 7 C the undersigned, a registered PROVIDED TO THE (Please print name as it appears on your voter Informatlon card) ^ ^ CITY CLERK DURING voter in said state and county, petition to have the name of - V f !T'1� 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 County State Zip Code Date Signed (MM/Dp/Yvrv, [To be completed by Voter) 0 15-2045, FA.C. ,:`�. CANDIDATE PETITION 'All information on this form becomes a public record upon receipt by the Supervisor of Elections `/t is a crime to knowinglysign more than one petition for a candidate. [Section 704.18S Florida Statutes] If all 4q�ested 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 card) voter in said state and county, petition to have the name of placed on the General Election ot as a [, BallchecWcomplete boxas 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 ^1 Candidate for the Office of City of Winter Springs - City Commission District One Date of Btrth OR Voter Registration Number Aaaress Co ty N�i State of Voter T I (Date Signed by 75-2.045, F.A.C. Zip Code Revised 06/10/2024 CANDIDATEPETITION CITY OF W NTER S RINGSFORM / OFFICE OF THE CIT 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 704,185 Florida Statutes] 'If all requested information on this form is not completed, the form will not be valid as a Candidate Petition THIS COMPLETED n FORM MUST BE I, f /� % 0� 1/� ca the undersigned, a registered PROVIDED TO THE (Please print +me as it appears on your voter information card) CITY CLERK DURING voter in said state and county, petition to have the name of pa" I 1 �'� QUALIFYING placed on the General Election Ballot as a [check/complete box, as applicable] A Nonpartisan N/A No party affiliation N/A Not Applicable Party Candidate for the Office of �N City of Winter Springs - City Commission District f4yAw of )ate of Birth OR Voter Regi � M/DDA" M if v signature of Voter Rule 1S-2.045, F.A.C. if G r ouhtyc)�-^^ State Zip JL Date Signed (MM/DD/YYYY', [To be completed by Voter] �/ 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 104.785 Florida Statutes] If all requested information op this form Is not completed, the form will not be valid as a Candidate Petition Form. ( V ( C/o Z e 4! 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 �ri+vu 1 fl Z placed on the General Election Ballot as a [check/complete box, as applicable] Code ju y 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 i ,Qj& City of Winter Springs - City Commission District tire Date of Birth OR Voter Registration Number (MM/DD/YWY) �z118�1�`�3 County of Voter le 15-2.045, F.A.C. ult, Group, Seat Number, It ap ;s n Ill CA, 1 State Zip Code Date Signed (MM/DD/YVYY) [To be completed by Voter] Revised 06/10/2024 TY OF CANDIDATE PETITION of ICE OF THE CITY LIERK FORM 7 '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 704.785 Florida Statutes] If all requested Information on this form is not completed, the form Vvill not be valid as a Candidate Petition THIS COMPLETED FORM MUST BE j, Q Y \ 1 1 LClo Sty 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 Pave-- ' Not QUALIFYING placed on the General Election Ballot as a [check/complete box, as applicable] 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 Date of Birth OR Voter Registration N�umber Aaaress (MM/DD/YYYY) (` � f) J 1 1 qJ`l r � z Y /' ( CK Cj ed r 1) 1 �JI/<r V I I County State Zlp Code 3ture of Voter Date Signed (MM/DD/YYYY) [To be completed b Voter] 1S-2045, FA,C. z�� CAN D I DATE P ETITI O N Fla 'All information on this form becomes a public record upon receipt by the Supervisor of Elections 'ltisacrime toknowingly signmore than one petition for acandidate.(Section704.185 ridaStotutes] '!fall requested information on this form is not completed, the form will not be valid as a Candidate Petition Form. I, (rrA ff,,,✓on,Ffcn `7;'//j`S the undersigned, a registered FORM THIS COMPLETED FORM MUST BE PROVIDED TO THE (Please �irint name as it appeals on your voter informatton card) �1i CITY CLERK DURING QUALIFYING voter in said state and county, petition to have the name of � �� 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 of Birth OR Voter � YV1^�01 5911"kSl of Voter County state Date signed (MM/DD/YYYY (To ba completed by Voterj >Code Rcvised•06/10/2024 CANDIDATE PETITION oFF; of OFnTHE CITYC *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) °!f all requested information on this form is not completed, the form will not be valid as a Candidate Petition I� I Va FI C the undersigned, a registered (Please print n e as it appears on you voter information card) ' r� ' voter in said state and county, petition to have the name of Q .IY\ placed on the General Election Ballot as a [check/complete box, as applicable] s, FORM 7 THIS COMPLETED FORM MUST BE PROVIDED TO THE CITY CLERK DURING QUALIFYING E� Nonpartisan N/A No party affil(ation N/A Not Applicable Party Candidate for the Office of City of Winter Springs - City Commission District One Date of Birth OR Voter Regist (MM/DD/YYYI) !Y�)'1 y'.14�� r yt�'etr 1S2.a45, FAC. IN ,j c eVtA%INA01e :��CANDIDATE PETITION *All Flo p✓L, Date Signed (MMi (To ba cginpleted CJ,J�I 1/2 '3 information on this form becomes a public record upon receipt by the Supervisor of Elections Olt lsacrime toknowinglysignmore than one petition for acandidate. [Section 104.785 rida5tatutesj if all requested information on this form is not completed, the form will not be valid os a Candidate petition Form. ( le"r\ UAT( M ( P_A( C. ly f 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 3> 1 hdq:— placed on the General Election Ballot as a [check/complete box, as applicable] :ip Code 3�ro8 FORM THIS COMPLETED FORM MUST BE PROVIDED TO THE CITY CLERK DURING QUALIFYING 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 Date of Birth OR Voter Registration Number F Address ��'-• �j, //c�� p Ueer q � 1—f City County state Ztp Code � J (" f F a: i��(r�lC� Se t-,rl f/V O L Date Sighed (MM/DDM'W) (To be completed by Voter] Rule 7 � Revised• 06/7 0/2024 A(iG 2 8 CANDIDATE PETITION CITY OF WINTER OFFICE OF THE 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 fora candidate. (Section 704,185Florida Statutes] `If all requested information on this form is not completed, the form will not be valid as a Candidate Petition J (Please printname 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 IN�sFORM 7 THIS COMPLETED FORM MUST BE PROVIDED TO THE CITY CLERK DURING QUALIFYING ANonpartisan N/A 110 partyaffiliation 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/DDA" 1 305 f�7 % /'► nature of Voter A W, Rule 15-2.045, FA.C, County �tate Date Slgnec [To be coml ?'�i '��'� CANDIDATE PETITION 'Ail 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 104.18S Florida Statutes] if all requested information on this form is not completed, the form will not be valid as a Candidate petition Form, i, �G�ty . &vt(oc the undersigned, a registered (Please 6rint name as It appears on your voter information card) /]�� r1 voter in said state and county, petition to have the name of `rAuL. �fd - placed on the General Election Ballot as a [check/complete box, as applicable] Date of Birth OR Voter (MM/DD/YWY) 017 "q City Signature of Voter Rule 1S-2.04S, F.A.0 000dv Revised, 06/10/2024 Code f U 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 IF P, Address County State Zip Code Date Signed (MM/DD/WW) [To be completed by Voter] SP ' CANDIDATE PETITION OFFICEOFTHEGITY '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 voter in said state and county, petition to have the name of placed on the General Election Ballot as a [check/complete box, as the undersigned, a registered , wL `D I Ate. FORM 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 Incnrt the title of Office and include District, circuit, Group, Seat Number, if applicable) Date Of Birth OR Voter Registration Number (MM/DD" 1S•2045, F.A.C. Address County C� � i/�� State - 2(p Code /2pr ' " Date Signed (MMJDD/YYY1� [To be completed by (V'o)ter) J��r02, ,�••\` CAN ®I ®ATE I�" �TITI ®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 704.185 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 BE I, TX1O,vr,y s �� ,�'4 ee� 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 of lJ�, 3> d,®�- QUALIFYING placed on the General Election Ballot as a [check/complete box, as applicable] X � Nonpartisan N/A No party affiliation N/A Not Applicable Party L�.�1 Candidate for the Office of City of Winter Springs - City Commission District One Please Insert the title of office and include District, Circult, Group, Seat Number, if applicable) (MM� D I R Voter Registration Number Address CauntY �/Li /tiD C/c of Voter 7s-z.o45, r-.A.c. State Zip Code Date Signed (MM/DD/YYYY) [To be completed by Voter) 4?rz3-2 Revised• 06/10l2024 CITY OF WINTER INGS rFl CANDIDATE PETITION o,, CI K G. YCLERFORM 7 '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 fora candidate. (Section 704.785Florida Statutes) 'Ifailrequested information on this form ish at completed, the form will not be valid as a Candidate Petition THIS COMPLETED /Vo/&J L1 � VV FORM MUST BE ) I � � � � the undersigned, a registered PROVIDED TO THE (Please print name as It appears on your voter information card) ^ may, CITY CLERK DURING voter in said state and county, petition to have the name of T A UU ) A "L� QUALIFYING placed on the General Election Ballot as a [check/complete box, as applicable] _ L_A Nonpartisan N/A No party affiliation N/A Not Applicable Party LJ 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 ,:p7 / / f Address (MM/DD/YYYI� _ County State Zip Code (To be completed by Vater] 7S•2a45, FAC. �� F CANDIDATE PETITION Flo •All information on this farm becomes a public record upon receipt by the Supervisor ofElections •Itisocrimetoknowing(ysignmore than one petition for ocandidate. [Section 704.185 ridaStatutes] 'If all requested information onthis form isnot ompleted, the form will not be valid as a Candidate Petition Form, I, �� Z �j��' 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 jl1L, 3> r� 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—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 Date of Birth OR /Voter Registration Number Haaress dL V, R Count y 75-2.045, F.A.C. Stat e i^ Date Signed (MM/DD/YYY1'J [To be completed by Voter] CdSC o� Revised•06/10/2024 CANDIDATE PETITION OCITY FFICOEOF�THER C; We, '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 I, G )29�r=rt7IZ`> tw 17 0 the undersigned, a registered (Please print name as it appears on your voter Information card) �Z 11 '' voter in said state and county, petition to have the name of VL placed on the General Election Ballot as a [check/complete box, as applicable] CLE, zIh ' ,ORM rI �.- THIS COMPLETED FORM MUST BE PROVIDED TO THE CIlY CLERK DURING QUALIFYING A 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 (MM/DD" of Voter Rule 15.2045, FA.C. Address �� 6 G� �� V lc I zlz� (Aj I" T-ye 2 P K.I nJ 63 County Sl,! vllN6l.<;,7 State be completed by Voter) FS� z3 (a, �` A�� 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 'I t !so crime to knowinglysign more than one petition fora 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 Form. THIS COMPLETED FORM MUST BE I � > it! l 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 /c�U� �fd"" QUALIFYING placed on the General Election Ballot as a [check/complete box, as applicable] Nonpartisan N/A No party affiliation N/A Not Appllcable 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) Data of Birth OR Voter Registration Number Address (MM/DD/YYYY) f9L✓i' /� � en County StLate� Zip Code of Voter Date Signed (MM/DD/YWY) [To be completed by Voter] (Rule 15-2.045, F.AC. Revised06/10/2024 AUG 2 8 2024 CAN ®I ®ATE PETITION CITY OF WINTER SPF OFFICE OF THE CITY 'All information on this form becomes a public record upon receipt by the Supervisor ofElectlons 'It Is a crime to knowinglysign more t e p ora candidate. [Section 704,785 Florida Statutes] if all requested informotion p� rs is not completed, t e form will not be valid as a Candidate Petition 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 the undersigned, a registered ��VL rV IAA FORM THIS COMPLETED FORM MUST BE PROVIDED TO THE CITY CLERK DURING QUALIFYING L A _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) f�' County Stat� Z-(p7Code ta nature of Voter Date s gne � �� [To be completed 15-2045, CAN ®I DATE P ETITI O N °All informotion on this form becomes a public record upon receipt by the Supervisor of Elections `/tisacrimetoknowinglysignmore than one petition for acandidate. [Section 104.785Florida5to[utesj ° 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 card) nn voter in said state and county, petition to have the name of � 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_` _._.I Nonpartisan N A No party affiliation N/A Not Applicable Patty Candidate I the Office of City of Winter Springs - City Commission District One Date of Birth OR Voter Registration Number (MM/DDIYYY�')1 11 Iill' l l Icity IRule County_ State Zip Code e Signed (MM/DD/YYYY) be completed by Voter] Revised• 06/10l2024 CITY OF NTE IT M56D CAN D I DATE P ETITI O N OFFICE OFVTHE PITY CIL RI( FORM 'All information on this form becomes a public record upon receipt bythe Supervisor of Elections ' It Is a crime to knowinglyslgn more than one petition for a candidate. [Section 704.185 Florida Statutes] If all requested Information on this form is hot completed, the form will not be valid as a Candidate Petition THIS COMPLETED FORM MUST BE I'Mill?,L018 the undersigned, a registered 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 �,dL)L. A,'� 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) of Birth OR Voter Registration Number Address DD/Y" IOU Ige 1 /(.)3/ County - State be completed by voter) `�� CAN D I DATE P ETITI O N 'Alllnformation on this form becomes a public record upon receiptby theSupervisorofElections 'Itlsacrime toknowinglysignmore than onepetItionforocandidate.(Section704,785Floridastatutes) ' Ifoll req{iestef Inforlotfon on this form Is not pleted, the form will not be valid as a Candidate Petition Form. the undersigned, a registered (Please print Name as it appears on yaurvoter 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 affiliation N/A Not Applicable party Candidate for the Office of City of Winter Springs - City Commission District One OR Voter Registration Number � Coun Si �Vc✓Creei� Sri state Date Signed (MM/DD/YWY [To be completed by Voter) Revised• 06/)0/2024 PRINGFORM 7 CITY OF.VNTERCANDI®ATE PETITION OFFICE OF THE Cl Y ERi< '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 704.785 Florida Statutes) 'Ifallreques lnformationonthis for is not completed, the form will not be valid as a Candidate Petition TFOHISRM COMPLETED FORM MUST BE ( f J L' �% � 1CP ne undersigned, a registered PROVIDED TO THE (Please print name as it appearson your voter Information card) ' r (� CITY CLERK DURING voter in said state and county, petition to have the name of v� �' N QUALIFYING placed on the General Election Ballot as a [check/complete box, as applicable] L A _J Nonpartisan N/A No party affiliation N/A Not Applicable Candidate -- 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 j r�,. �%� 1 �� (MM/DD/YWI� . �" 0 � � ; t 6( 3 w I � v \ , County Rule 15-2045, FA.C. ��CAN ®I ®ATE PETITION stale pate Signed (MM/DDM (To be caZ'e qd by Vo /7,031. `AI! information on this farm becomes a public record upon receipt by the Supervisor of Elections '/t is a crime to knowinglysign more than one petition for a candidate. (Section 704.785Florida Stotu[esj °if all requested information on this form is not completed, the form will notbe valid as a Candidate Petition Form, 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 er/,iuL,. 3> i4q:� 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 OR (MM/DD/YYV1� of Voter (Rule 15.2.045, FA.C. Registration Number County State Dale Signed (MM/DD/YYYYJ [To be completed by Voter) Code Revised 06/10/2024 AUG 2 8 2024 CAN DI DATE PETITION FORM 7 CITY OF WINTER SP INGS OFFICE OF THE CITY `All information on thisform becomes apublic record upon receipt by the Supervisor of Elections 'It Is a crime to knowinglysign more than one petition fora candidate. (Section 704.785 Florida Statutes) "If all requested Information on this form is hot completed, the form will not be valid as a Candidate Petition THIS COMPLETED FORM MUST 8E Marcus k4 ya + +� the undersigned, a registered PROVIDED TO THE (Please print name as it appears otlyour voter information card) , r ^ CITY CLERK DURING voter in said state and county, petition to have the name of t/� H QUALIFYING placed on the General Election Ballot as a [check/complete box, as applicable] l� Nonpartisan N/A No party affiliation N/A Not Applicable Party Candidate for the Office of City of Winter Springs - City Commission District One Voter Registration M/DD/YWI� t192 ra,III F16 P1 rile C�N County State Se►� fL LMMUMMMMMMOMOwmi Date Signed (MM/DD/YYYY, (To be completed by Voter) 15-2045, FA.C. J. CAN D I DATE P ETITI O N *All information on this form becomes apublFcrecord upon receipt bythe SupervlsorofElections 'It isacrime toknowinglysignmore than onepetitlonfor ocandidate. [Section 104.785FloridaStatutes] • If all requested information on this form is not completed, the form will not be valid as a Candidate Petition Form. I, 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 dFZUL . placed on the General Election Ballot as a [check/complete box, as applicable] E• FORM THIS COMPLETED FORM MUST BE PROVIDED TO THE CITY CLERK DURING QUALIFYING �X � Nonpart(san N/A No party affiliation N/A Not *A licable Party J Candidate for the Office of City of Winter Springs City Commission District One to oP B1rth OR Voter Registration M/DD/YW1� County ^� 15-2.045, FA.C. State Date Signed (MM/DD/YYW' (To be completed 6y Voterj Revised 06/I0/2024 SIT WE: TR� August 28, 2024 CITY OF WINTER SPRINGS, FLORIDA 1126 EAST STATE ROAD 434 WINTER SPRINGS, FLORIDA32708-2799 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: 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: • Paul Diaz "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: Ch! %span (J� wa►-, Given to Seminole County Supervisor of Elections Office Representative on this date: ---UP / 28 � iti---and time:---------�M-------- -- — Petitions provided: __� ___ CANDIDATE OATH NONPARTISAN OFFICE (Do not use this form if a Judicial or School Board Candidate) �, ' Check box only if you are seeking to qualify as a write-in _ candidate: A.IIG 2 8 2024 Write-in candidate CITY OF WINTER SPP,' OFFICE OF TI-IE� CIT" - OFFICE USE ONLY Candidate Oath Name fAu L. to appear on ballot: 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 w� r�1�L UPU) CWAMk%�.�l (Office) (District #) I am a qualified elector of �t Ny �-� 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 If you do, you must also specify the amount owed and each entity that levied the same on the reverse side. X c �191 boo - o yo eAUL PAOLA)Ik27 -Ana iAA Signature of Candidate Telephone Number Email Address S ' IUVE(L U& IL NOA06 W ► J NIVS S2'O'rO Address of Legal Residence City State ZIP Code STATE OF FLORIDA COUNTY OF ,EM //U 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 91 MINE this Lam' h day of �,.S�i- 2Q 2 44 Public State of FloridaChristian 9 D GowanPersonal) FNotary Known Commission HH 1333�9 y ❑ OR Produced Identification p Expires 9/15/2027 Type of Identification Produced:.L Arl rrrs 4zpenSe DS-DE 302NP (Eff. 10/2023) Rule 1S-2.0001, F.A.C. Phonetic Spellingo ame 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 as may be used by persons with disabilities (see instructions on page 3 of this form): PAW L - T)EE - A 14 OF� 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 . I am over the age of eighteen (18) and the contents of this affidavit are true and correct. My nickname is 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: STATE OF FLORIDA COUNTY OF 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 day of 1 20�6 ► Personally Known ❑ OR Produced Identification ❑ e06 ? 8 2024 Type of Identification Produced: CITY OF WINTER SPRINGS OFFICE OF THE CITY CLERK DS-DE 302NP (Eff. 10/2023) Rule 1S-2.0001, F.A.C. 2023 Form 1- Statement of Financial Interests General Information Name: Address: County: Organization N/A Mr Paul D Diaz PO BOX 195418I WINTER SPGS, FL 32719 Seminole CANDIDATE FOR Position City, Town or Village (Commission or Council), Governing Board - Form 1 (Effective 6/10/2024) Disclosure Period Suborganization Agency Name City of Winter Springs Commission Title Position sought or held Commissioner District 1 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") Name of Source of Income Source's Address of the Source's DescriptionPrincipal Business Activity 1170 TREE SWALLOW DR 343 WINTER TAX RESOLUTION, TAX PLANNING, TAX THE TAX CUTTERY SPRINGS FL 32708 PREPARATION A116 2 8 2024 CITY OF \MNTF� r=ice Printed from the Florida EFDMS System Page 1 of 3 2023 Form 1- Statement of Financial Interests Secondary Sources of Income SECONDARY SOURCES OF INCOME (Major customers, clients, and other sources of income to businesses owned by the reporting person) (If you have nothing to report, write "none" or "n/a") Name of Business Entity Name of Major Sources of Address of Source Principal Business Business' Income Activity of Source TAX THE TAX CUTTERY IRS REPRESENTATION 1170 TREE SWALLOW DR 343 RESOLUTION/PLANNING/PR WINTER SPRINGS FL 32708 EP Real Property REAL PROPERTY (Land, buildings owned by the reporting person) (If you have nothing to report, write "none" or "n/a") Location/Description N/A Intangible Personal Property INTANGIBLE PERSONAL PROPERTY (Stocks, bonds, certificates of deposit, etc. over $10,000) (If you have nothing to report, write "none" or "n/a") Type of Intangible Business Entity to Which the Property Relates N/A pllG 2 8 2024 CITY OF WINTER SPRING. . OFFICE OF "nyF C. r :- �: Printed from the Florida EFDMS System Page 2 of 3 2023 Form 1- Statement of Financial Interests 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 N/A 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 Signature of Filer Digitally signed: 08/28/2024 glli; ? 8 7.024 CITY OF WINTER SPRINGS Printed from the Florida EFDMS System Page 3 of 3