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HomeMy WebLinkAboutBaker, Sara Qualifying Packet 2024 08 28NAME: CITY OF WINTER SPRINGS, FLORIDA 2D24 GENERAL MUNICIPAL ELECTION AFFI DAVIT OFACCEPTANCE CITY COMMISSION: DISTRICT ONE ISTRICTTHR / DISTRICT FIVE d air,, h (3a k e r Circle which applies to candidacy Date &Time Review Started �d/?8/Zo2Y WO , 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 ISYOUR 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. "Appointment of Campaign Treasurer and Designation of Campaign Depository for Candidates" [DS-DE 9] "Statement of Candidate" [DS-DE 84] 1* * "Affidavit of Qualified Voter Status and City Residency" 2 "Application for Office and Election Assessment" (WITH a check drawn from campaign account for the Application Fee AND the applicable 1%Assessment OR "Notice of Undue Burden") 3 "Notice of Testing Tabulating Equipment" 4 "Notice of Political Campaign Advertisements/Signs" 5 "Schedule of Campaign Finance Reporting Periods/Due Dates" 6 "Notice of Access to Campaign Finance Forms" 7 "Candidate Petition" * Candidate Oath [DS-DE 302P] "Notice to Federal Government Employees (If applicable) "Form V - Statement of Financial Interest 2023 Accepted: Wt j 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" L I State of Florida Election Information Contacts Accepted: I ��I &�4 �( AUG 2 $ 2024 Advertising 7F WINTER SPRINGS Revised 06/10/2024 - Tr` cl' Y cLLnK tyN7kgs CITY OF WINTER SPRINGS, FLORIDA A 2020 GENERAL MUNICIPAL ELECTION FORM � I959 • w , AFFIDAVITOFACCE2L4MY. THIS COMPLETED v CITY COMMISSION: DISTRICT ONE/ STRICT THREE ISTRICT FIVE FORM MUST BE PROVIDED TO THE Circle which applies to candidacy CITY CLERK DURING QUALIFYING NAME: �raa h Page 2of2 CAMPAIGN FINANCE/ELECTRONIC FILING INFORMATION "Contributions Returned" [DS-DE-2] Accepted: CITY OF WINTER SPRINGS INFORMATION City of Winter Springs 2022 District Map Accepted: � A.,( MISCELLANEOUS INFORMATION "Foreign nationals" -from the Federal Election Commission Legal References for Qualifying Documents Accepted: 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 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; jprTM"Xnderstand that it is my responsibility to comply with all Laws as they apply to the 2024 Election. lojcoel zoew/ F/ Z,?/"l Sign ure to ,for',' �Q/1'/l A � 'L S[reetAddress } QI � Zip -Code State of Florida Countyof ��EM//l!0 Lf Sworn to (or affirmed) and subscribed before me by means off X,) physical presence or ( ) online notarization) this 24604h day of Aa'utt v by eQh 40.1"� Personally known: (Print name ofperson making statement) SG• FL l�riy�erj Li"c�nJ'e Type oflden[itrcation produced Revised O6/10/2024 Notary Public State of Florid• Christian D Gowan l My COII1r11iSSlOr1 HH 433379 Expires ef1s12os7 2024 , OR Provided identificatioynn1: /` y Signature of Notary Public -State of Florida AUG 2 $ 2014 CITY OF VNNTER SPRINGS OFFICE OF THE CITY CLERK CITY OF WINTER SPRINGS, FLORIDA 2024GENERALMUNICIPAL ELECTION AFFI DAVIT OFQUALI RED VOTER STATUS AND CITYAND DISTRICT RESIDENCY CITY COMMISSION: DISTRICT ONE 1STRICTTHPEE/ ISTRICT FIVE Circle which applies to candidacy h 136L kf do hereby state that I seek election to the City FORM 1 THIS COMPLETED FORM MUST BE PPOVIDEDTOTHE CITY CLERK DURING QUALIFYING Name of Candidate (Print or Type) of Winter Springs' City commission: District one istrict Three District Five for a four (4) year term Circle which applies to candidacy in the election to be held in the City of Winter Springs, Florida on Tuesday, November 5, 2024. 1 further swear or affirm: (1.) 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: is if!,a f S (5.) 1 am attaching two (2) documents, one to be a Florida Driver's License, as verification of my residency in the City of Winter Springs. The second document is: Pr A o.rmw M 7110 An *-el %Y�. Street�AfAi: .--. City L State of Florida Countyof ) Flo //UOLE Sworn to (or affirmed) and subscribed before me by means of (K) physical presence or[ ) online notarization This z �01 �y C F /�a.k by �C.✓A �L ! Aker Personally known: (Print name of person makingstatement) f�- Dri�rS Z,Cen$' Type of Identification produced , 2024 i M1111111111110.91 State OR Produced Identification Notary Public State of Florida Christian D Gowan ( My Commission HH 433379 Expires 9/15/2027 FOR OFFICE USE ONLY py of Flor(da Driver's L(cense provided for Items(5) Other documentation provided for Item (5) AUG 2 81024 C17Y OF WINTER SPRINGS OF'fHE CITY CLERK Zip Code Revised 06/10/2024 T ` =� ��- �: � �" �+ :; �:�: T LOT 91 TUSCAWILLA UNIT 12 PB 28 PGS 98 TO 102 COUNTY GENERAL FUND $908,697 $50,000 $858,697 Schools $908497 $25,000 $883,697 CITY WINTER SPRINGS $908497 $50,000 $858,697 FIRE FUND $9082697 $50,000 $858,697 SJWM(Saint Johns Water Management) $908,697 $50,000 $858,697 WARRANTY DEED CERTIFICATE OF TITLE WARRANTY DEED WARRANTY DEED 5/27/2021 12/1/2017 4/1/1993 11/1/1992 3/1/1990 4/1/1988 $870,000 $100 $245,000 $100 $50,000 $301500,000 09953/1594 09041/1813 02571/0359 0250011645 02160/0115 01952/0270 Improved Improved Improved Improved Vacant Vacant 1 Lot $160,000/Lot $160,000 $160,000 1 SINGLE FAMILY 1990 4 460 15 2573 5496 CUSTOM WOOD/STUCCO/BRICK $884,295 $753,861 Building 1 * Year Built =Actual /Effective Wednesday, August28, 2024 2/4 BASE 610 GARAGE FINISHED 693 OPEN PORCH FINISHED 293 OPEN PORCH FINISHED 136 UPPER STORY FINISHED 1191 2023- 1551 WINTER SPRINGS BLVD: DOOR / 00003519 WINDOW DOOR / WINDOW $171,698 11/15/2023 2023- 1551 WINTER SPRINGS BLVD: SCREEN 00002142 ENCLOSURE 2023-06-28 $30,120 6/28/2023 2023- 1551 WINTER SPRINGS BLVD: ROOF 2023 00001673 05-16 $33,725 5/16/2023 02842 REROOF W/30 YR ARCH SHINGLES $20,800 12/13/2010 02278 HVAC CHANGEOUT $2,400 10/19/2009 03093 INSTALL 10 X 12 HARDI-BOARD SHED $22515 6/21/2005 00605 ROOM ADDITION; 927 SQ FT $59,615 4/1/1998 FIREPLACE 2 1990 2 $12,000 $4,800 POOL 2 1990 1 $45,000 $27,000 GAS HEATER 1990 1 $19653 $661 SOLAR HEATER 1998 1 $0 $0 ACCESSORY BLDG 1 2005 1 $1,250 $500 SCREEN ENCL 3 2023 1 $16,000 $162000 Indian Trails Winter Springs Wednesday, Auqust28, 2024 3/4 Copyright 2024 ©Seminole County Property Appraises CI IYOF WINTER SPRINGS, FLORIDA 2024 GENERAL MUNICIPAL ELECTION APPLICATION FOR OFFICE AND ELECTION ASSESSMENT CITY COMMISSION: DISTRICT ONE/ ISTRICT THR / DISTRICT FIVE Circle which applies to candi acy FORM 2 THIS COMPLETED FORM MUST BE PROVIDEDTOTHE CITYCLERKDURING 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: District One District Three/ District Five for a four (4) year term, in the Election to be held Circle which app tes to candidacy in the City of Winter Springs, Florida on Tuesday, November 5, 2024. 1 further agree to pay the following Qualifying Fee AND applicable Election Assessment QUALIFYING FEE: $150.00 AND THE BELOW ELECTION ASSESSMENT ELECTION ASSESSMENT - COMMISSIONER: $120.00 Each Commissioner receives: $1,000.00 per month $1000.00 x12 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 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 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 assessme sha also be exempt from the city's qualifying fee. IL Signature FOR OFFICE USE ONLY Date I /�//7i`/•IAPPLICATION FEE: Campaign Account Check in the amount of $150.00 attached (/T`T (Check should be made payable to the City of Winter Springs) Check # p G G 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 # O Q D 2 OR, IFAPPLICABLE Completed "Notice of Undue Burden" Attached Revised O6/10/2024 TTfFANINS INCLUDE NICAMINT BORDEN. NEAT SENSITIVE ICON ANDEPIC HOLOGRAU Sarah Baker for Winter Springs 1551 Winter Springs Blvd Winter Springs, FL 32708 (513) 910-4891 sarahforwintersprings,com TOTi- Flffh Yhird 11 Bi E State Rd 434, Winter Springs, FL 63.993/631 DATE f� //dCDOLLARS � ISr/�' / "I -- /:L Sarah Baker for Winter Springs 1551 Winter Springs Blvd. g Winter Springs, FL 32708 (513)910-4891 sarahforwintersprings.com H M; x Fifth Yh,._ 1181 ES Rd 434, Winter Springs, FL � �vOn"o DOLLARS AfAGl :j PAYMENT DATE 08/28/2024 COLLECTION STATION UB Mid Ofc 2 (FI-CH-UB-5-m) RECEIVED FROM SARAH BAKER DESCRIPTION QUALIFYING FEE I;ity of Winter springs 1126 E. State Road 434 Winter Springs, FL 32708 � QUALIFYING FEE Payments. I Type Detailom Amount � it>aItl Total Cash $0.OQ Total Total Check Charge $150.00 #0.00 Total Wire W00 Total Other ;0.00 Total Remitted Change t0.00 Total Received Customer Copy Total Amount: BATCH NO. 2a2�-00005022 RECEIPT NO. 2024-00122127 CASHIER 1onetta Rucker ENTRY DATE 08j28/2024 02:00:06 Phi Printed by_'�onetta Rucker Page 1 of 1 08f28J2024 02:00:07 PM PAYMENT DATE 08}28}2024 COLLECTION STATION UB Mid Ofc 2 (FI-CH-UB-5-\A/7j RECEIVED FROM SARAH BAKER DESCRIPTION ELECTION ASSESSMENT Pity of Winter Springs 1126 E. State Road 434 Winter Springs. FL 32708 ;UUt Generic Payment Code ELECTION ASSESSMENT Payments: I Type Detail �4mount Check Total Cash Total Check Total Charge Total Wire Total Other Total Remitted so.ao $120.00 WOO $0.00 WOO Change _ WOO Total Received Total Amount: Customer Copy BATCH NO_ 202a-00005023 RECEIPT NO. 2024-00122129 CASHIER 1onetta Rucker ENTRY DATE 08}28}2024 02:02:57 PM Printed 6y_ Vonetta Rucker Page 1 of 1 08}28f2024 02:02.57 PM CITY OF WINTER SPRINGS, FLORIDA 2024GENERALMUN ICI PAL ELECTION NOTICEOF TESTING OF TABULATING EQUIPMENT CITY COMMISSION: DISTRICT ONE DISTRICT THREE/ ISTRICT FIVE Circle which applies to candidacy NOTICE FORM 7J THIS COMPLETED FORM MUST BE PROVIDED TO THE CITY CLERK DURING QUALIFYING Please acceptthis notice thatthetabulating 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 [8683] City of Winter Springs Municipal Elections Official/Deslg nee AUG 2 8 2024 CITY OF WINTER SPRINGS OFFICE OF THE CITY CLERK Revised 06/10/2024 TE�Rs CI IYOFWINTERSPRINGS,FLORIDA \fie 2024GENERALMUNICIPAL ELECTION bAPPLICATION FOR OFFICE AND ELECTIONASSESSMENT • /ry%O WEIt CJ • CITYCOMMISSION: DISTRICT ONE 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: (])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" - (Which includes information from "Chapter12: Political Advertising" and "Chapter 13:Other Disclaimers") [Included in Qualifying Packet] ACKNOWLEDGMENT do hereby acknowledge on this date of Name of Candidate (Print or Type) U. Lt&S r 01 2024with my signature below that I received a copy of Florida Statutes 106.1435 and with my signature affixed below, I understand that it is MY responsibility as a Candidate for Elected Office to comply with all laws, especially as related to Political Campaign Advertisements/Signs. Also with my signature affixed below, I acknowledge that I will comply withal] laws related to Disclaimers as explained/noted in 'The Florida Elec;iQp 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 AUG 2 8 2024 CITY OF WINTER SPRINGS OFFICE OF THE CITY CLERK Revised O6/10/2024 CITY OF WINTER SPRINGS, FLORIDA 2024GENERAL MUNICIPAL ELECTION APPLICATION FOROFFICE AND ELECTIONASSESSMENT CITY COMMISSION: DISTRICT ON DISTRICTTt DISTRICT FIVE Circle which applies to candidacy SCHEDULE DURING/AFTER QUALIFYING, THE FOLLOWING CAMPAIGN FINANCE REPORTS ARE DUE: FORM 5 THISCOMPLETED FORM MUST BE PROVIDEDTOTHE CITY CLERK DURING QUALIFYING Report DueDate: 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�emberl, 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 or before February3, 2025 -shall contain information regarding all previously unreported contributions and expenditures from November 1, 2024 - February 3, 2025 "Schedule ACKNOWLEDGMENT o� do hereby acknowledge that on this date of Q ,2 �f , 2024 with my signature below that I received a written Finance Reporting Periods/Due Dates" (as noted above on this form). Signature AUG 2 8 2024 CITY OF VNNTER SPRINGS OFFICE OF "I"FiE CITY CLERK Revised 06/10/2024 U WE CITYOF WINTER SPRINGS, FLORIDA 2024GENERAL MUNICIPAL ELECTION NOTICE OFACCESS TO CAMPAIGN FINANCEFORMS CITYCOMMISSION: DISTRICT ONE ISTRICTTHRE DISTRICTFIVE Circle which 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 I. (� ��� ���r do hereby acknowledge that on this date of �a/me o C.a 3i ate not or Type U G all 6? 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 2 Date AUG 2 81024 CITY OF WINTER SPRINGS (7r r'ICE OF THE CITY CLERK Revised 06/10/2024 �`'. �? �G 1'� lam• 2 8 202�, CAN D I DATE P ETITI O N CITY OF WINTER SPtc �r�s ^�� OFFICE OF THE CITY LERK '�`,''��,;,- 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 for a candidate. (Section 704.785 Florida Statutes) `Ifallrequestedinformationonthisformisnotcompleted,theformwillnotbevalidasaCandidotePe[itJon THIS COMPLETED /� 1 FORM MUST BE I, � � � � � � Ll�gntx�� Miri�+ae� Mp((';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 �'� 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 Three (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) ty County State Zip Code p �nl�n+�( SP��n,�5 SUn�nol� F 32� � nature of Voter Date Signed (MM/DD/YVW) (Ta be completed by Voterj pg/1°I/ Zoe Rule 15-2.045, F.A.C. t•;s � c n m r,<� _ ���3� l'Er> � i� �� Lim' th,1; ;� �� CAN D I DATE P ETITI O N CITY OF VNNTER SP "'�Y,:;. OFFICE OF THE CITY ��'' , 'All information on this form becomes a public record upon receipt by the Supervisor ofElections ' It is a crime to knowinglysign more than one petition for a candidate. (Section 104.785 Florida Statutes] `Ifall requested information on this form is notcompleted, the form will not be valid as a Candidate Petition I, 1�c�� ^� r ,5G#,,� J— II (, �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 placed on the General Election Ballot as a [check/complete box, as Date of Birth OR Voter Re (MM/DD/YYW) l0/o4/2Go� GS 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 Three 15'S1 �Ilr,zi'Er City Co my 1,t1�n�-er Sp�In�S �c���rcole ��,,.,',��s (�l vd Slate r-� p Code 32708' Date Signed (MM/DD/YWY) (To be completed by Voter] ng/�g�zG2Y Rule 15-2.045, F.A.C. CANDIDATE PETITION CITYOFWNTERSPFRIINGS 7OFFICE OF THE CITY C ERK FORM •All information on this form becomes a public record upon receipt by the Supervisor of Elections It is crime to knowinglysign more than one petition fora candidate. (Section 104,785Florida Statutes) • if all requested information on this form Is not completed, the form will not be valid as a Candidate Petition I, V 1 11 VW0('(F'(S&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 placed on the General Election Ballot as a [check/complete box, as app THIS COMPLETEQ 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 Three Insert the title of Office and Include District, Circuit, Group, Seat Number, if a Date of Birth OR/Voter Registration Number (MC � / 1 signature of Voter 15-2.045, Count LOP00% �� CAN D I DATE P ETITI O N ( Z(p�ode Date signed (MM/DD/WYY) [To� m�ed py Vaot�r] I �� 'All Information on this form becomes a public record upon receipt by the Supervisor of Elections 'I[ is o crime to knowinglysign 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. (Please print name as it appears on your voter Information card) the undersigned, a registered FORM 7 THI5 COMPLETED FORM MUST BE PROVIDED TO THE CITY CLERK DURING voter in said state and county, petition to have the name of ��- placed on the General Election Ballot as a [check/complete box, as applica le] Nonpartisan N/A No party affiliation FF71 Not Applicable Party Candidate for the Office of QUALIFYING City of Winter Springs -City Commission District Three ;ert the title of Office and Include District, Circuit, Group, Seat Number, If a Date of Birth OR Voter Registration Number (M M/DD/YWY)1/07/1 Address oSsl Iry � h+-tr S p�'� Sys ity county I�ih-i-fr Sp r►t�s �c�,� hU�e nature of Voter 5-2.045, F.A.C. �L Slate Date Signed (MM/DD/YYYY] ITo be completed by Voter] Revised 06/10/2024 A�JG 2 8 1024 CITY OF WINTER SPRINGS OFFICE OF THE CITY CLERK s`���`� CANDIDATE PETITION �,�� FORM 7 'All Information on this form becomes a public record upon receipt by [he Supervisor of Elections 'It is a crime to knowinglysign more than one petition for o candidate. (Section 704.185Florida Statutes] "Ifall r@quested Information on this form is not completed, the farm will not be valid as a Candidate Petition Form. I, �.rn � I /^( �„ ��-�� .((�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 � iA.{'1. /SQL. �It'' placed on the General Election Ballot as a [check/complete box, as applicable] THIS COMPLETED FORM MUST BE PROVIDED TO THE CITY CLERK DURING QUALIFYING �' ` _I Nonpartisan N/A No party affiliation N/A Not Applicable � Party Candidate for the Office of City of Winter Springs -City Commission District Three (Please Insert the title of Office and include District, Circuit, Group, Seat Number, If applfcable] Date of Birth OR Voter Registration Number (MM/DD/YYYY) co my nature of Rule 15-2.045, Revised 06/10/2024 Wk.�'Fe ��,1 e 1%2 . AUG 2 8 1024 CITY OF WINTER SPRINGS OFFICE OF THE CITY CLERK :�` CAN DI,DATE PETITION stag, C Date Signed (MM/DD/YWY [To be completed by Voter] �/� / � 9 ".i Sim � �mv � �u'7 ,.r c CITY OF WINTER SPRINGS OFFICE OF THE CITY CL RK 'All information on this form becomes a public record upon receipt by the Supervisor ofElections "It !sa crime to knowinglyslgn more than one petition fora candidate. (Section 104.185 Florida Statutes] 'Ifall requested information on this form is not cpmpleted, the form will not be valid as a Candidate Petition the undersigned, a registered (Please print r�me as it appears on your voter information card) voter in said state and county, petition to have the name of placed on the General Electron Ballot as a [check/complete box, as �O� �� FORM 7 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 Three (Please Insert the t([le of Office and Include DlstriM, Circuit, Group, Seat Number, if applfcable) of Birth OR Voter 1 - ��- � �if�iG�t. ress Count jJ iN ��M 7 big' v Code �a.7e 15-2.045, F.A.C. Date Signed (MM/DD/VYVY', [To be completed by Voter] � - z-.� (• CANDIDATE PETITION 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 704.185 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 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 oNonpartisan N/A No party affiliation N/A Not Applicable ' Party Candidate for the Office of City of Winter Springs - City Commission District Three Date of Birth OR Voter Registration Number (MM/DD/YYYY) nature o f Voter ile 1S-2.04S, F.A.C. Revised 06/10/2024 Group, Seat Address AUG 2 81024 CITY OF WINTER SPRINGS OFFICE OF THE CITY CLERK State e Signed (MM/DD/WYY; be completed by Voter] o Code 3 play CITY OF WINTER SP INGS n�J CAN D I•DATE P ETITI O N OFFICE OF THE C�T`� LFRY 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 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 Candidate Petition THIS COMPLETED FORM MUST BE the undersigned, a registered PROVIDED TO THE (Please print name as it appears on your voter information card) CITY CLERK DURING voter in said state and county, petition to have the name of QUALIFYING placed on the General Election Ballot as a [check/complete box, as applicable] CX� Nonpartisan N/q No party affiliation N/A Not Applicable Party Candidate for the Office of City of Winter Springs - City Commission District Three (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� f � ✓ ,J�"" � S7,�,1 (�C.. tglt 1�G� rIty , count / State Z Code L� s i Signat of r Date Signed (MM/DDty VM) [To be completed by Voter] Rule 1S-2.045, FA.C. CANDIDATE PETITION FORM •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 704.185Florida Statutes) • If all requested information on this form is not completed, the form will not be valid as a Candidate Petition Form, 1 the undersigned, a registered (Please print name as It appears on yoyrvoter 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 ap TH15 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 Three (Please Insert the title of Office and Include District, Circuit, Group, Seat Number, if applicable) Date of Birth OR Voter Registration Number Address City w County State Zip Code Signature of Voter Date Signed (MM/DC zZZ4d, � - [To be completed%bGy� �G I Rule 1S-2.045, FA.C, r� rm R7:� ru ['�, Ivir, E A�JG 2 8 2014 Revised 06/10/2024 CITY OF WINTER SPRINGS OFFICE OF THE CITY CLERK CANDIDATE PETITION *Ali information on this form becomes a public record upon receipt by the Supervisor ofElections 'It is a crime to knowinglyslgn more than one petition fare 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. 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 7 THIS COMPLETED FORM MUST BE PROVIDED TO THE CITY CLERK DURING QUALI FYI NG Nonpartisan N/A No party affiliation N/A Not Applicable rParty Candidate for the Office of City of Winter Springs - City Commission District Three (Please Insert the title of office and Include District, Circuit, Group, Seat Number, if applicable) Date of Birth OR Voter Registration Number (M M/DD/YYYY) Cou , I✓l�� ��i�r�S �em Ino�e� Signature of Voter Rule 1S-2. 4 , FA.C. Revised 06/10/2024 AN 2 8 ZUA TY NTER SPRR� Cam❑ r� OF THE r Stale Zip Code Dale Signed (MM/DD/1'VYY, [To be completed by Voter] i CANDIDATE PETITION CuTY • �r : 'All information on this form becomes a public record upon receipt by the Supervisor of Elections ' It Is crime to knowinglysign more than one petition fora candidate. [Section 704.785FIorlda Statutes] 'If all requested information on this form is not completed, the form will not be valid as Candidate Petition I, ��.�,a//7f�D /�u,25vtr1 •� 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 applicable] 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 Three Date of Birth OR Voter Registration Number (MM/DDA^NY) nature of Voter Rule 15-2.045, FA.C. of Office and Include Address County /1: rl rho �r� CANDIDATE PETITION v� State Zfp Code 5Z�ov e Signed (MM/DD/YYYY; be completed by Voter] '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 704.785Florida Statutes] ' If all requested Information on this form 1s not completed, the form will not be valid as a Candidate Petition Form. I, the undersigned, a registered FORM THIS COMPLETED 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 Q.. �/ QUALIFYING old pAced on the General Election Ballot as a [check/complete box, as applicable] Nonpartisan N/A No party affiliation N/A7 Not Applicable Party Candidate for the Office of City of Winter Springs -City Commission District Three ;ert the title of Office and Include District, Circuit, Orouo, Seat Number, if a to of Birth OR Voter Registration Number M/DD/YYYY) Signature of Voter F.A.C. County State /j ZI Codd'ee � v f Date Signed (MM/DD/YYY [To be completed by Vote Revised 06/10l2024 AUG 2 8 2024 r OF WINTER SPRINGS :p OF THE CITY CLERK AIJG 2 8 7074 CITY OF WINTER SP ;- CAN D I DATE P ETITI O N OFFICE OF THE CITY CLERK 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 will not be valid as a Candidate Petition THIS COMPLETED + O// ` FORM MUST BE the undersigned, a registered PROVIDED TO THE (Please print name as it appears on your voter information card) CITY CLERK DURING voter in said state and county, petition to have the name of ell ell 13 Crep 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 Five (Please insert the title of Office and include District. Circuitrimim. saat Niimhcr if annlir,h1w Date of Birth OR Voter Registration N (M M/D D" .rt. Signature of Voter Rule 15-2.04s, FAC. County Address ({\� CANDIDATE PETITION \J 'All G- State Zip Code 3 z e7ae Date Signed (MM/DD/WW [fo be completed by Voter] information on this form becomes a public record upon receipt by the Supervisor afElections 'It isa crime to knowinglysign more than one peii[ion fora candidate. (Section 104.785Florida Statutes) If all re"ted information his form is not completed, the form will not be valid as a Candidate Petition Form, (Please print name a�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 Date of Birth OR Voter of Voter Rule 15-2.045, FA.C. the undersigned, a registered FORM THIS COMPLETED FORM MUST BE PROVIDED TO THE CITY CLERK DURING QUALIFYING Nonpartisan N/A No party affiliation N/A Not A Ilcabl L— PP e Party Candidate for the Office of City of Winter Springs -City Commission District Five ration Number Address 4� Date Signed (MM/DDNYYY (To be completed by Voter] Revised 06/10/2024 AIJG 2 8 2024 CITY OF WINTER SPRINGS OFFICE OF THE CITY CLERK Erg I t� f•:� t':✓ AUG 2 8 2024 CITY OF WINTER OFFICE OF THE 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 704,185 Florida Statutes] `Ifgliikquested information on this form is not completed, the form will not be valid as 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 CLERK 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 Three of Office a Date of Birth OR Voter Registratic (MM/DD x1 /47 Signature of Voter ArzeweW4 F.A.C. County ress State ZIp Code 127p Date Signed (MM/DD ) [To be completed by er] CITY OF WINTERS RINGS �7 `��`�' CAN D I•DATE P ETITI O N OFFICE OF THE CIT 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 704,785 Florida Statutes] 'If all requested information on this form is not completed, the form will not be valid asor candidate Petition THIS COMPLETED �`_ � FORM MUST BE r, it �b I\NA 0j`e r 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 f e /� d/ �� QUALIFYING placed on the General Election Ballot as [check/complete box, as appli le] Nonpartisan N/A No party affiliation N/A Not Applicable Party Candidate for the Office of City of Winter Springs - City Commission District Three (Please Insert the title of Office and Include District, Circuit, Group, Seat Number, if applicable) Date Birth OR Voter Registration Number Address d $ .Tw QA v O q� � r (M M/D D/YYYY) , nature of Voter i(/l Rct Q County Sera` a State Zip Code Date Signed (MM/DD/YYYY) [To be completed by Voter] zc3z 15-2.0451 F.A.C. CANDIDATE PETITION FORM •All information on this form becomes a public record upon receipt bythe Supervisor of Electlons ' I t is a crime [o knowingly sign more than one petition for o candidate. (Section 704.785 Florida Statutes) 'Ifall requestedlnformation on thlsform is notcompleted, the form will not be valid as a Candidate Petition Form. G 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 [checWcomplete box, as the undersigned, a registered 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 Three Insert Date of Birth OR Voter Registration (MM/DD/YYYY) . Signature of Voter Rule 15-2.045, F.A.C. Revised 06/10/2024 Seat Address � '. Zlp Code 3 � �M'Yv] Voter] 7 l // -'l ..� /1 O FORM 7 THIS COMPLETED FORM MUST BE PROVIDED TO THE CITY CLERK DURING QUALI FYI N G Nonpartisan N/A No party affiliation NSA Not Applicable 'Party Candidate for the Office of City of Winter Springs -City Commission District Three to of Birth OR Voter Registration Nu((mb�e'r% M/DD/YWY) O LI � 'SO � l � / L( Group, Seat Number, If a caress jJ City p � p,,� � County- / of Voter Rule 15-2.045, F.A.C. State Zip Code Dale Signed (MM/DD/WW) [To be completed by Voter] / Revised 06/10/2024 AUG 2 8 2024 CITY OF WINTER SPRINGS I�ll6 28 CANDIDATE PETITION CITY OFVVINTERSP 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 1, '"aV tcc � i� S --u (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 QUALI FYI NG ANonpartisan N/A No party affiliation N/A Not Applicable ' Party Candidate for the Office of City of Winter Springs - City Commission District Three Date of Birth OR Voter Registration Number (M M/DD/YYYY) City t,4) nature of Voter Rule 15-2.045, FA.C. and Include District, Circuit, Group, Seat County f ��vvt.c v�v 1=e ( ��/� Date Signed (MM/DD/1'WY) (To be completed by Voter] CAN D I.DATE P ETITI O N oFF �� o�^THE '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 Candidate Petition M104" the undersigned, a registered (Please print name as i[ 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 [check/complete box, as elnlc�<. �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 Three (Please insert the title of Office and Include District, Circuit, Group, Seat Number, if app Date of Birth OR Voter Registration Number Address lo]o rpx County 5 Sep -tom; n r� le nature of Voter State c�L Zlp Code Date Signed (MM/DD/YWY) [To be completed by Voter] 15-2A45, FAC. I __ CANDIDATE PETITIONCIL l'� i'`�'L-. Notes: All information on this form becomes a public record upon receipt by the Supervisor of Elections. AUG 2 $ 1024 - 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 will not be valid as a Candidate PetigiornYoFrn�2 NreR SPR Nc s I, d the undersigned, a registered voter (print name as it appears on your voter information card) III said state and county, petition to have the name of Sarah Baker placed on the Primary/Generai Election Ballot as a: [check/complete box, as applicable] QNonpartisan ❑ No party affiliation ❑ Party candidate for the office of City of Winter Springs, Florida Commissioner, District 3 (insert title of office and include district, circuit, group, seat number, if applicable) Date of Birth or Voter Registration Number (MMIDDrT I /3 s_Z Address /,95 /� �y/d �VICi IIXF City County State Zip Code 2A Signature of Voter Date Signed (MM/DD/YY) [to be com feted by Voter] D�.r/ Ir .7. Rule lFr F.A.C. DS-DE 104 (Eff. 09111 CANDIDATE PETITION Notes: -All information on this form becomes a public record upon receipt by the Supervisor of Elections. AUG 2 8 2024 - 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 will not be valid as a Candidate Petitmnrf@rMMNTER SPRING `i r. - QF OTHIF CITYCLEf I, D00eO the undersigned, a registered voter (print name as •it appears on your voter information card) in said state and county, petition to have the name of Sarah Baker placed on the Primary/General Election Ballot as a: [check/complete box, as applicable] ❑✓ Nonpartisan ❑No party affiliation ❑ Party candidate for the office of City of Winter Springs, Florida Commissioner, District 3 (insert title of office and include district, circuit, group, seat number, if applicable) Date of Birth or Voter Registration /Number Address G/a. �e0W V elc ifPit v City County State Zip Code /4d Signature of Date Signed (MM/DD/YY) [to be completed by Voter] V X/ol Rule 09/11 CANDIDATE PETITION Notes: -All information on this form becomes a public record upon receipt by the Supervisor of Elections. f �(JG i 8 ZOZk - 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 will not be valid as a Candidate Peti�p�,,�,ri�„ NT ER S PR I N G I, �.�.� (print name as it ppears on your voter information card) in said state and county, petition to have the name of Sarah Baker placed on the Primary/General Election Ballot as a: [checWcompiete box, as applicable] ✓ONonpartisan ❑No party affiliation City of Winter Springs, Florida Commissioner, District 3 Date of Birth City Rule >r the undersigned, a registered voter Party candidate for the office of (insert title of office and include district, circuit, group, seat number, if applicable) or Voter Registration Number � � � Address of Voter ���7 � ,�Gi� ��',0�� /c 4 ,� j vim. County State Zip Code- Date Signed (MM/DD/YY) [fo be com leted by oter] off' a 7 � DS-DE 104 (Eff. 09/7 ANT • Incorporated 1959 i,�coD WEKR� 2I 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 August 28, 2024 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: • Sarah Baker "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: ____(� /�r�`15�i4•-1— "°`vO"� Given to Seminole County Supervisor of Elections Office Representative on this date: Z1f�28� 20 zY___ and time: ...To No Ap o -- ---------- Petitions provided: __ 23 CANDIDATE OATH NONPARTISAN OFFICE (Do not use this form if a Judicial or School Board Candidate) R E C E 0 V EFE D Check box only if you are seeking to qualify as a write-in candidate: AUG 2 8 2024 ®Write-in candidate CITY OF WINTER SPRINGS OFFICE OF THE CITY CLERK OFFICE USE ONLY Candidate Oath Name to appear on ballot: CJ a ra YL Z a %`-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.) W k('�Of'►el'_ 3 swear or affirm that I am a candidate for the nonpartisan office of i) ri nj f U mrY7i S SI , (Office) 4ol (District #) I am a qualified elector of 111 �P/ County, Florida (Circuit N (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, 1 Do NO, 1 Do Not If you do, you must also specify the amount owed and each entity that levied the same on the reverse side. Vo �e Sara k ba.krr NiSrna 11. (r13) L o - y )fCandidate Sig Telephone Number Email Address Address of Legal Residence City j State ZIP Code STATE OF FLORIDA COUNTY OF FM//VO 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 RX this 26 ' day of /'t1kTpsS20 2q Notary Public State of Florida Personal) Known V Christian D Gowan ❑ OR ® y Produced Identification M Commission HH 433379 My C Itll 9115/2027 L )"Vef-t LIteru'e Type of Identification Produced:_ / DS-DE 302NP (Eff. 10/2023) Rule 1S-2.0001, F.A.C. 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 as may be used by persons with disabilities (see instructions on page 3 of this form): �Pv r U1n T3 ck1- K e Ir 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 20 r I ' Personally Known ❑ OR Produced Identification ❑ AUG 2 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 Mrs Sarah Baler 1551 WINTER SPRINGS BLVD, WINTER SPGS, FL 32708 Seminole (CANDIDATE FOR Position City, Town or Village (Commission or Council), Governing Board - Form 1 (Effective 6/10/2024) Disclosure Period Suborganization Agency Name Winter Springs, Florida Commission Title Position sought or held Commissioner, District 3 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 Description of the Source's Principal Business MCLIVILY Penn Station, Inc. 1226 US Highway 50 Milford, OH 45150 Marketing Coordinator Aft 2 8 2024 CITY OF WINTER SPRINGS OFFICE OF THE CITY CLERK 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 EntityName of Major Sources of Address of Source Principal Business Business' Income Activity of Source N/A Real Property REAL PROPERTY (Land, buildings owned by the reporting person) (If you have nothing to report, write "none" or "n/a") Location/Description 2834 Euston Rd. Winter Parlc, FL 32789 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 AUG 2 8 2024 CITY OF \MNTER SPRINGS OFFICE OF THE CITY CLERK 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 N/A Interests in Specified Businesses Address of Creditor 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 AUG 2 81014 CITY OF WINTER SPRINGS OFFICE OF THE CITY CLERK Printed from the Florida EFDMS System Page 3 of 3