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HomeMy WebLinkAboutMeyer, Karen Qualifying Packet 2024 08 27STATEMENT OF CANDIDATE (Section 106.023, F.S.) (Please print or type) candidate for the office of i have been provided access to read and understand the requirements of Chapter 106, Florida Statutes. i %L ignatuFe of CaryQidate ate Each candidate must file a statement with the qualifying officer within 10 days after the Appointment of Campaign Treasurer and Designation of Campaign Depository is filed. Willful failure to file this form is a first degree misdemeanor and a civil violation of the Campaign Financing Act which may result in a fine of up to $1,000, (ss. 106.19(1)(c), 106.265(1), Florida Statutes). DS-DE 84 (OS/11) NAME: CITY OF WINTER SPRINGS, FLORIDA 2024 GENERAL MUNICIPAL ELECTION AFFI DAVI T O FACCEPTANCE CITY COMMISSION: DISTRICT ONE DISTRICTTHRE DISTRICT FIVE Circle which applies to candidacy Date &Time Review Started 3 60 nrn 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 RESPONSIBILITY TO READ AND 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 1200 p.m. on the last day of Qualifying which is Friday, August 30, 2024. 1* 2 S 6 Accepted: "Appointment of Campaign Treasurer and Designation of Campaign Depository for Candidates" [DS-DE 9] "Statement of Candidate" [DS-DE 84] * "Affidavit of Qualified Voter Status and City Residency" "Application for Office and Election Assessment" (WITH a check drawn from campaign account for the Application Fee AND the applicable 1%Assessment OR "Notice of Undue Burden") "Notice of Testing Tabulating Equipment" "Notice of Political Campaign Advertisements/Signs" "Schedule of Campaign Finance Reporting Periods/Due Dates" "Notice of Access to Campaign Finance Forms" "Candidate Petition" * Candidate Oath [DS-DE 302P] "Notice to Federal Government Employees (If applicable) "Form 1" - Statement of Financial Interest 2023 QUALIFYING DOCUMENTS WITH AN *ASTERISK MUST BE COMPLETED IN FRONT OF THE CITY CLERK/DESIGNEE DURING QUALIFYING STATE OF FLORIDAINFORMATION 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" 1 State of Florida Election Information Contacts Accepted: AUG 2 '1 2024 Advertising Revised 06/10/2024 CITY OF \MNTER SPRINGS THE CITY CLERK % %t-ATE'gs CITY OF WINTER SPRINGS, FLORIDA A o� pa 2020GENERAL MUNICIPAL ELECTION FORM U 0 ^I959 wn'w` AFFIDAVIT OFACCEPTANCE THIS COMPLETED "Jy CITY COMMISSION: DISTRICT ONE DISTRICTTHREE DISTRICT FIVE MUSTBE FORM MUST PROVIDED THE Circle which applies to candidacy CITY CLERK DURING QUALIFYING NAM E: /7R r,1V / k' Page 2 2 of CAMPAIGN FINANCE/ELECTRONIC FILING INFORMATION "Contributions Returned" [DS-DE-2] Accepted: er CITY OF WINTER SPRINGS INFORMATION City of Winter Springs 2022 District Map Accepted: W MISCELLANEOUS INFORMATION "Foreign nationals" - from the Federal Election Commission Legal References for Qualifying Documents Accepted: 1 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 /I/ kyfC(/;;;o have on this date received the forms and information Name a, Candidate(Piin r or Type, noted on these two (2) pages and agree that I will read all the Election Qualifying packet materials that have been provided to me; and understand that it is my responsibility to comply with all Laws as they apply to the 2024 Election, sr S[ree[Address 6s-/�i/�iayvote State ofFlorida Countyof SFj✓I fin/-UL� Sworn to (or oim medj onnd subscribed before me by means or 1XI physical presence or[ ) online notarization) this Z l day of A"& (Print n am e ofperson by Kaoer1 Mev er Personally known: ma gsta[emen[) �L 71)riv�cll LI'tentse. Type ofldentifica[ion produced Notary Public State �(Flori�. Christian D Gowen 1111 MY Commission HH ♦33919 Expires 911512021 Revised 06/10/2024 _ ,2024 OR Provided identification: � AUG 2 'r 2014 ^� \MNTER SPRINGS �E CITY CLERK CITY OF WINTER SPRINGS, FLORIDA 2024GENEPAL MUNICIPAL ELECTION AFFI DAVIT OF Q UALI FI ED VOTER STATUS AND CITYAND DISTRICT RESIDENCY CITYCOMMISSION: DISTRICT ONE/ ISTRICTTHREE DISTRICT FIVE Circle which applies to candidacy FORM 1 THIS COMPLETED FORM MUST BE PROVIDEDTOTHE CITY CLERK DURING QUALIFYING it j�in/(L /✓ !f � do hereby state that I seek election to the City Name of Candid e (Print or Type) of Winter Springs' City Commission: District One/ istrict Thre District Five for a four (4) year term Circlele whio candidacy in the election to be held in the City of Winter Springs, Florida on Tuesday, November 5, 2024. I further swear or affirm: (1.) I am a qualified voter in the City of Winter Springs y���f/r�"� s ��i�Cy� (2.) My legal place of residence is: 7*411 AVWk C/kz:4 j 74d StreetAddress city State Zip Code (3.) Length of time of residency in the City of Winter Springs is: (4) Length of time of residency in Winter Springs District: is (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: jL'�`l�lTl� 13�L L Siqnatufe Date 7� StreetAddress SP�iu� S City State State of Florida Countyof 5 are) NO L f_ Sworn to (or affirmed) and subscribed before me by means of {K) physical presence or[ ) online notarization This by �^ 27t" dc-r d� � ug "� /� tV e r Personally known: (Print name ofpersonm ingstatement) ve ('I t � %ceI1C2 Type ofldentification produced ,2024 OR Produced Identification Notary Public State of Florl�a Christian D Gowan I111MIAWMy Commission HH �3337e Expires 9/15/2027 FOR OFFICE USE ONLY Copy of Florida Driver's License provided for Item (S) 'Other documentation provided for Item (5) V 7 1 Zip Code AUG 2 'i 1014 Revised 06/10/2024 CITY OF WINTER SPRINGS OFFICE OF THE CITY CLERK CITY OF WINTER SPRINGS UTILITY BILLING MON-FRI &S 1126 E STATE ROAD 434 PHONE: 407-327-5996 FAX:407-327-4753 UTILITYBILLS@WINTERSPRINGSFL.ORG W W W.WINTERSPRINGSFL.ORG/UB Charges Breakdown (Current Month) WATER BASE $788 WATER USAGE $17.60 WATER TAX $255 SEWER BASE $16.13'' SEWER USAGE $60961, STORMWATER BASE $4.13 SOLID WASTE BASE $2281 Scan this code to make a payment with your smartphone or tablet today) rr� Summary of Payments and Charges ACCOUNT NUMBER 17192-002 DUE SERVICE ADDRESS 741 ANDOVER CIR PAST DUE CHARGES $0.00 IMMEDIATELY PENALTIES $0.00 ADJUSTMENTS $0.00 PAYMENTS ($138.79) CURRENT CHARGES $131.71 8/13/2024 MONTHLY WATER USAGE (in gallons) .533658 Meter Reading Information From To Days Meter # Previous Current Usage 6/3/2024 7/1/2024 28 533658 4,000,740 41010,360 91620 "News You Can Use" ,,_ Payment Options (Use Account Number 17192-002) See back for more! K Water Conservation Is Self -Pay by QR Code Scan the code above N Important! Please help save Self -Pay by Website eservices.winterspringsfl.org water by referring to the Online Bank Pay See your bank's website N reverse side of this bill for Irrigation Restrictions. Call Center 407-327-5996 Please detach and return the bottom portion with your payment (Make Checks Payable to City of Winter Springs) tarp � .. WQ� ,34 FAX: 407�3274753 • C KAREN A MEYER 741 ANDOVER CIR WINTER SPRINGS, FL 32708 Summary of Payments and Charges DUE ACCOUNT NUMBER' 17192-002 SERVICE ADDRESS 741 ANDOVER CIR PAST DUE CHARGES $0.00 IMMEDIATELY CURRENT CHARGES $131.71 CITY OF WINTER SPRINGS UTILITY BILLING 1126 E STATE ROAD 434 WINTER SPRINGS, FL 32708-2715 8/13/2024 0000017192DD2DDDDD137,77, CITY OF WINTER SPRINGS, FLORIDA 2 D24 GENERAL MUNICIPAL ELECTION APPLICATION FOR OFFICE AND ELECTION ASSESSMENT CITYCOMMISSION: DISTRICT ONE DIST ICTTHRE DISTRICT FIVE Circle which applies to candidacy 'V ame of Ca or FORM 2 THISCOMPLETED 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 istrict Three District Five for a four (4) year term, in the Election to be held Circle 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 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: $120000 NOTE: "Any person seeking to qualifyfor nomination or election to a municipal office who is unable to paythe election assessmentwithout imposing an undue burden on personal resources oron resources otherwise availableto him or her shall, upon written certification of such inability given under oath to the qualifying officer, be exempt from paying the election assessment." [99.093(2) Florida Statutes] Pursuant to F.S. 99.093(2), candidateswho are unableto paythe election assessmentwithoutimposing anundue burden on their personal resources or resources otherwise available to them shall upon written certification ofsuch inability given under oath to the city clerk be exempted from paying the election assessment. Any candidate exempt from the election assessment shall also be exempt from the city's qualifying fee. Signature FOR OFFICE USE ONLY Date ( / %/rj�- (APPLICATION FEE: Campaign Account Check in the amount of $150.00 attached LLV_L'b��/ J (Check should be made payable to the City of Winter Springs) 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 # 3 OR, IF APPLICABLE Completed "Notice of Undue Burden" Attached q _ AUG 2 72024 Revised O6/10/2024 CITY OF WINTER SPRINGS OFFICE OF THE CITY CLE��K PAYMENT DATE 08/2912024 COLLECTION STATION UB Mid Qfc 2 (FI-CH-UB-5-W7j RECEIVED FROM KAREN MEYER DESCRIPTION CAMPAIGN ACCOUNT I�ity of Winter springs 1126 E. State Road 434 Winter Springs, FL 32708 Payments: ( Type Detail i�mount Check Total Cash #0.00 Total Check $150.00 Total Charge #0.00 Total Wire t0.00 Total Other $0.00 Total Remitted Change $15M t0.00 Total Received $ ��TE1[c iiT'TLTtiI'� BATCH NO. 2024-00005040 RECEIPT NO. 2024-0012227E CASHIER Vonetta Rucker ENTRY DATE 08j29/2024 08:22:59 AM Customer Copy Printed by_ Vonetta Rucker Page 1 of 1 08}29}2024 08.23:00 AM PAYMENT DATE 08/29/2024 COLLECTION STATION UB Mirk Of 2 (FI-CH-UB-5-%0) REutzlVLD FROM KAREN MEYER DESCRIPTION CAMPAIGN ACCOUNT Payments= pity of Winter Springs 1126 E. State Road 434 Winter Springs, FL 32708 Type Detail Amount heck Total Cash Total Check Total Charge Total Mire Total Other Total Remitted Change Total Received 50.00 i $120.00 WOO S0.00 WOO$120M! woo $120.00 Total Amount: BATCH N O. 2024-00005041 RECEIPT NO. 202�-00122277 CASHIER Vonetta Rucker ENTRY DATE 08f29/2024 08:29:17 AM Customer Copy Printed by: Vonetta Rucker Page 1 of 1 08}29}2024 08:29:18 AM CITY OF WINTER SPRINGS, FLORIDA 2024GENERAL MUNICIPAL ELECTION NOTI CE OF TESTING OF TABULATING EQUIPMENT CITYCOMMISSION: DISTRICT ONE/ISTRICTTHRE DISTRICT FIVE Circle which applies to candidacy NOTICE FORM 3 THIS COMPLETED FORM MUST BE PROVIDED TO THE CITY CLERK DURING QUALIFYING Please accept this 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) S85-VOTE [86831 AUG 917 2024 CITY OF WINTER SPRINGS OFFICE OF THE CITY CLERK Ci[y of Winter Springs Municipal Elections Official/Designee Revised 06/10/2024 moo wEtR� CITY OF WINTER SPRINGS, FLORIDA 2024GENERAL MUNICIPAL ELECTION APPLICATION FOR OFFICE AND ELECTIONASSESSMENT CI IYCOMMISSIOIN: DISTRICT ONE DIS E 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 related to 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 "Chapter 13: Other Disclaimers") [Included in Qualifying Packet] ACKNOWLEDGMENT do hereby acknowledge on this date of Name of Can idate (Print or Type) S7' Z7 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 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." FOR OFFICE USE ONLY achment: Copy of Florida Statutes 106.1435 AUG 2 7 2014 CITY OF WINTER SPRINGS OFFICE OF THE CITY CLERK Date Revised O6/]0/2024 CITY OF WINTER SPRINGS, FLORIDA 2024 GENERAL MUNICIPAL ELECTION APPLICATION FOR OFFICE AND ELECTIONASSESSMENT CITYCOMMISSION: DISTRICT ONE tDISTRICTTHRE DISTRICT FIVE Circle which applies to candidacy SCHEDULE DURING/AFTER QUALIFYING, THE FOLLOWING CAMPAIGN FINANCE REPORTS ARE DUE: FORM S 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 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 ReportDue Date: October25, 2024 - shall contain information regarding all previously unreported contributions and expenditures from October 5, 2024 - October 18, 2024 Report Due Date: No�mberl, 2024 .Shall contain information regarding all previously unreported contributions and expenditures from October 19, 2024 - October 31, 2024. A Final Reportshall be filed 90 days after the General Election - on or before February3, 2025 -shall contain information regarding all previously unreported contributions and expenditures from November 1, 2024 - February 3, 2025 ACKNOWLEDGMENT do hereby acknowledge that on this date of name or [,apaiaa[e �Nnn[ or iype� f�lC--ilS'% cat 7 , 2024 with my signature below that I received a written "Schedule of Campaign Finance Reporting Periods/Due Dates" (as noted above on this form). s n :7� AUG 2 71014 CITY OF W!TdTER SPRINGS n,FcirF OFT+-�c C7T"! CL ERfG 08/a'7�n?Gd�f to Revised 06/10/2024 CITYOFvvINTERSPRINGS, FLORIDA 2024GENERAL MUNICIPAL ELECTION "/ NOTICE OFACCESS TO j CAMPAIGN FINANCE FORMS CIIYCOMMISSION:DISTRICTONE ISTRICTTHRE DISTRICT FIVE 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, ���� ��� � do hereby acknowledge that on this date of ame o `Tn31 ate rent or Type A, asr- c/ 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." AUG 2 7 2014 CITY OF wNTER SPRINGS nFFiCE OF THE CITY CLERK Revised O6/10/2024 AIJG 2 '7 2024 � ;: TY OF WINTER SPRINGS �7 -���` CAN D I DATE P ETITI O N ` .. -- ' � 'l`"� FORM ��` `All information on this form becomes a public record upon receipt by the Supervisor ofElections 'It isa crime to knowinglysign more than one petition fora candidate. j5ection 104.1BSFlorlda Statutes) 'Ifall requested info/rmotion on this form is notcompleted, the form will not be valid asa Candidate Petition THIS COMPLETED I, � L?,/�l�/ I���L � FORM MUST SE �" /2 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 K�� j�-1�C �� QUAUFYING placed on the General Election Ballot asa [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 Three Date of Birth OR Voter Registration Number . (M M/DD/YYW) �� 121 Its ti�,.�Tri�.. sQfZ� +�65 Rule of Office and include District, Circuit, Group, Seat Number, if applicable) Address � t.oy Pc� �s� T c,�2.c�� County Stat� ��� � �� � Code ��a� Date Signed (MM/DD/YYYV) [To be completed 6y Voter] ©g�z3��zy '��"r � CAN D I,DATE P ETITI O N CIT CO ^�NHE CITY ILIERK 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 104.185 Florida Statutes) `Ifoll requested information on this form isnot completed, the form will not be valid asa Candidate Peti[!on THIS COMPLETED p � t FORM MUST BE I, S ��. '� (� (� � ,�}�� f� the undersigned, a registered PROVIDED TO THE (Please print name as (t appears on your voter information card) t) � CITY CLERK DURING voter in said state and county, petition to have the name of �� �' �� QUALIFYING placed on the General Election Ballot asa [checWcomplete box, as applicable] �X� 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 inset[ the title of Office and Include District. Circuit. Grouo. Seat Number. if aoolicablel Date of Birth OR Voter Registration Number (MM/DDM'W) oal�.�119�1 �,`��� s^ S� � nature of Voter s tau u i eas County Slate Date Signed (MM/DD/` [To be completed by V o � /a3 0 p Code � � 7�� le 15-2.045, F.A.0 1 CANDIDATE PETITION CITY OF W NTER SPINGS FORM 7 OFFICE OF THE CITY LER'• •All information on this form becomes a public record upon receipt by the Supervisor ofFlectlons 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 Candidate Petition I,p� r�,� �a/�yLf the undersigned, a registered (Please print name as it appears o4 your voter information card) voter in said state and county, petition to have the name of a rL11 �YGi2 pAced on the General Election Ballot as a [check/complete box, as appl' able] THIS COMPLETED FORM MUST BE PROVIDED TO THE CITY CLERK DURING QUALI FYI NG I �J Nonpartisan N/A No pa, tyaffliation N/A Not Applicable Party Candidate for the Office of City of Winter Springs -City Commission District Three (Please Date of Birth OR Voter Registration Number (M M/DD/YYW) City kopfw S rV W #Wj� f7i i le 15-2.045, F.A.C. Group, Seat Number, IT a address County Slate ZIp Code '.. CMJ," /C 7�7 �:��� CAN D I DATE P ETITI O N Date Signed (MM/DD/YVYY� [To 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 704.785 Florida 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 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 asa (check/complete box, as ap Date of Birth OR (M M/DD/YYW) ,J 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 Applicable 'Party Candidate for the Office of City of Winter Springs - City Commission District Three fPlease insert the title of office and Include District. Circuit. Groum. Seat Number, if aomlicable) Number City County Signature of Voter Rule Address S[a[e Dale Signed (MM/DD/YYYY) [To be completed by Voter] Aug z .r zo2a Revised 06/10/2024 CITY OF WINTER SPRINGS OFFICE OF THE CITY CLERK yr�� CAN D I,DATE P ETITI O N �'� �� o�^T E CITY CLERKFORM / 'All information on thlsform becomes a public record upon receipt by the Supervisor ofElectians ' It is a crime to knowingly sign more than one petition for a candidate. [Section 104.785 Florida Statutes] 'Ifall requested information on this form is not completed, the form will not be valid asa Candidate Petition THIS COMPLETED ��n � 1 j[ r g g FORM MUST BE I, G� �J the undersi ned, a re istered 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 ��-��/� �1�1 " ^� QUALIFYING placed on the General Election Ballot as a [check/complete box, as applicable) oNonpartisan 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) of Birth OR Voter Registration Number D� nature of Voter Rule 15-2.045, FA.C. Coun[ State ZI Cade Date Signed (MM/DD/YYYY) �- �C�^L ITo be completed by Voter] CA N D I DAT E P ET I T I O N CITY OF WINTER SP�tINOS FORM OFFICE OF THE CITY 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 704.785 Florida Statutes) 'If all requested information on t is f4 m is not cam feted, the form will not be valid as a Candidate Petition t the undersigned, a registered (Please print name as It appears nformation card) your voter i voter in said state and county, petition to have the name of placed on the General Electron Ballot as a [check/complete box, as Date of Birth OR Vot (M M/DD/YWY) of Voter 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 applicable) Num Count State Zlp Code Dale Signed (MM/DD/YYYY) [To be completed by Voter) 7 15-2.045, FA.C. AUG 2 7 2024 CA N D l DAT E PETITION CITY OF W NTER SP FORM 7 -�,•\;� OFFICE OF THE CITY CLERK omv `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) `1 all requested information on this form is not completed, the form will not be valid as Candidate Petition THIS COMPLETED ;41� (`� "� 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 In 6s QUALIFYING pAced on the General Election Ballot as a [check/complete box, as applica le] u Nonpartisan N/A No party affiliation N/A Not Applicable Party Candidate for the Office of City of Winter Springs - City Commission District Three Office and Include District, Circuit, Group, Seat Date of Birth OR Voter Registration Number (MM/DD/WYY) V1 11 Q Sig f Voter Rule 15-2.045, F.A.C. (��`r, CANDIDATE PETITION Staff.. Zip Code Date Signed (MM/DD/YYl'Y) 4�e Go�te� by�]Vo(te�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 o 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. I, NQfi-#ci G Ah+% Fr1ies (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 asa [check/complete box, as a the undersigned, a registered 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 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/YYW) 3d G�'L01/ Le r Ctrs C) z/ bl/ 14Ltaw .t County State Zip Code h-�-er S� �,►tt Signature of Voter Rule 15-2.045, FA.C. e Signed (MM/DD/YYW) be completed by Vote r a3 108� a �y AUG 2 '7 2024 Revised 06/10/2024 CITY OF WINTER SPRINGS OFFICE OF THE CITY CLERK 'EE� li4vs! CITY OF WINTER J CANDIDATE PETITION 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 for a candidate. (Section 704,785 Florida Statutes] If oil requested information on this form is not completed, the form will not be valid as a Candidate Petition I, �/V Oce (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 g the undersined, reg a istered CLERi FORM THIS COMPLETED FORM MUST BE PROVIDED TO THE CITY CLERK DURING QUALI FYI NG Nonpartisan N/A No party affiliation N/A Not Applicable Party Candidate for the Office of City of Winter Springs - City Commission District Three (Please Insert the title of Office and include District, Circuit, Group, Seat Number, if applicable) h�OR Voter Registration Number Address _� ^ / 1, 0 i 1 County State Zfp Code i A)TO ' S D l" 3=1 �7d of Voter Date Signed (MM/DD/YYYY) [To be comple d by Voter] Zoe 15-2.045, FA.C. ��� CANDLDATE 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 7044185 Florida Statutes] 'If all requested information on this form is not completed the form will not be valid as a Candidate Petition I, �Vz GakA L— K `2/I i C4 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] ERYC FORM 7 THIS COMPLETED FORM MUST BE PROVIDED TO THE CITY CLERK DURING QUALIFYING Nonpartisan N/A No party affiliation N/A Not Applicable pa ty Candidate for the Office of City of Winter Springs - City Commission District Three Iriease insert the title or Office and include District, Circuit, Group, Seat Number, if a Date of Birth OR Voter Registration Number Address City County Signature of Voter State Date Signed (MM/DD/YYYY; [TO be completed by Voter] Code F.A.C. y-.�c. . {��`� CAN D I DATE P ETITI O N �-7 �,4;, FORM / •AlllnformationonthisformbecomesapublicrecorduponreceiptbytheSupervisorofElections 'It is a crime to knowinglysign more than one petition for a candidote. (Section 104.185 Florida Statutes] 'Ifollrequestedfnformatlononthlsfarmisnotcompleted,theformwillnotbevolidasaCandidatePetitionForm. THIS COMPLETED o FORM MUST BE I, ��/L'/ yYf Q //, C7 �/^✓!J ��j the undersigned, a registered pROVIDED TO THE (Please print name as it appears on your voter informatton card) CITY CLERK DURING voter in said state and county, petition to have the name of �- , � � QUALIFYING placed on the General Election Ballot as a [check/complete box, as applicable] , Nonpartisan N/A No party affiliation N/A Not Applicable 'Party Candidate for the Office of " City of Winter Springs -City Commission District 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) Cityj ,� County � / Staate Zip Code Gam' e � . �l� �� ��J'�I � :-� �j L.. 2 �""'� � r� � �% n � �✓s� � Signature of Voter � Date Signed (MM/DD/YWY) /yy/CF' �� (To be completed by Voter] r� Rule 15-2.0 5, F.A.C. � � f"" � � '''i �r� L`' u Y�--� pIIG 2 rl 10Y4 Revised 06/10/2024 CITY OF WNTER SPRINGS OFFICE OF THE CITY CLERY. ���; CANDIDATE PETITION FORM '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 104.185Florida Statutes] • Ifal! requested Information on this form is not completed, the form will not be valid as a Candidate Petition Form. THIS COMPLETED I, �� YyC �Q }j�l� �� the undersi ned, a re Istered FORM MUST BE g g PROVIDED TO THE (Please print name as it appears on your voter informatton card) CITY CLERK DURING voter in said state and county, petition to have the name of �- ,� � � QUALIFYING placed on the General Election Ballot as a [check/complete box, as applicable] Nonpartisan N/A No party affiliation N/A Not Applicable Party Candidate for the OfFce of " City of Winter Springs -City Commission District Three (Please insert the title of Office and Include District, c(rcuit, Group, Seat Number, If applicable] Date of Birth OR Voter Registration Number Address (MM/DD/YYW) City � County Slate Zip Code Signature of Voter Date Signed (MM/DD/YWY) (To be completed by Voter] .� Rule 15-2.045, F.A.C. ������ ��� h L� �-y r AIIG 2 7 2024 Revised 06/10/2024 CITY OF WINTER SPRINGS nFFi�F nF THE CITY CLERK I, CANDIDATE PETITION CITY OF WINTER SPRI GS OFFICE OF THE CITY C ERK FORM 7 `All information on this form becomes a public record upon receipt by the Supervisor at Bections ' It is a crime to knowingfysign more than one petition fora candidate. [Section 704.785 Florida Statutes] If all requested information this form�is not completed, the form will not be valid os a Candidate Petition A✓%.7 the undersigned, a registered (Please print name as it appears on your voter information card) voter in said state and county, petition to have the name of placed on the General Election Ballot as a [check/complete box, as a THIS COMPLETED FORM MUST BE PROVIDED TO THE CITY CLERK DURING QUALIFYING ANonpartisan 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 and include District, Circuit, Group, ite of Birth OR Voter Registration Number - M/DD/YYW) a%/oa 711 G� l ire of Voter 15-2.0451 F.A.C. County �// 17" /M A ko�o�� CAN D I DATE P ETITI O N State /J Ztp Code Date Signed (MM/DD/YYYY) [To be completed by Voter] l�I `All information on this form becomes a public record upon receipt by the Supervisor of Elections ' It is a crime to knowingfysign more than one petition for a candidate. (Section 104.185 Florido Statutes] If all requested information on this form is not completed, the form will not be valid as a Candidate Petition Form. I, �Prrnni (Please print name as I[ appears on your voter Information card) the undersigned, a registered FORM THIS 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 applicable] l-- I Nonpartisan N/A No party affiliation N/A Not Applicable Party Candidate for the Office of QUALIFYING City of Winter Springs -City Commission District Three serf the title of Office and Include District, Circuit, Group, Seat Number, If a to of Birth OR Voter Registration Number M/DD/YWY) 1�� n Signature of Voter LcJe Ru 1S-2.0451 F.A.C. a 63 County l— State Zip Code Dale Signed (MM/DD/VWV [To be completed by Voter] Revised 06/10/2024 AiJG � '� 2024 `CITY OF WINTER SPRINGS OFFICE OF THE CITY CLERK `\�+' `,dy,�'d [_' `;s i.3.se ,-.�,,; ,�i t,:: Cam, ���f�� 2 '12024 CITY OF WINTER SPRINGS �` �y� CA N D I DAT E P ET I T I O N OFFICE OF THE CITY C RK �7 FORM 'All information on this form becomes a public record upon receipt bythe Supervisor of Elections ' It is a crime to knowing/ys(gn more than one petition for a candidate. (Section 104.185 Florida Statutes) •Ifallrequestedfnformationonthisformisnotcompleted,theformwillnotbevalidasaCandidatePetition THIS COMPLETED (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 a [check/complete box, as app FORM MUST BE the undersigned, a registered PROVIDED 70 THE CITY CLERK DURING ���� /�1��� 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 the [I[le of Office and Date of Birth OR Voter Registration Number (M M/D D/YYW) ���/��e r Signature of Voter�,�A Rule 15-2.045, F.A.C. (Address � ��i ������ �'��e�e� County State Z(p Code Date Signed (MM/D D/WVY; (To be completed by Voter] ,h•,., -:`� CANDIDATE PETITION •All information on this form becomes a public record upon receipt bythe Supervisor of Elections 'It Isa crime to knowinglysign more than one petition fora candidate. (Section 104.185Florida Statutes) `(fall requested information on this form is notcompleted, [he form will not be valid as a Candidate Petition Form. I' � t�..� O' the undersigned, a registered (Please print name as It appears on your voter infor a[ion 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 QUALIFYING C� Nonpartisan N/A No party affiliation N/A Not Applicable pl arty 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) �/ ) q o� %� J�� Q / �S I l �� � l �J 4 G� l� ' � 'V _Ity Cou ty State Zip Code �Ign r of V ter Date Signed (MM/DD/YWY] ITo be complete by Voter] 2ule 15-2. 5, F.A.C. c L- Revised 06/10/2024 AUG 2 '7 �2024 CITY OF WINTER SPRINGS OFFICE OF THE CITY CLERK AUG 2 '7 2024 CANDIDATE PETITION CITY OF WINTER SP OFFICE OF THE CITY 'I `All information on this form becomes a public record upon receipt by the Supervisor of Elections ' It is a crime to knowinglysign more than one petition for a candidate. [Section 704.785 Florida Statutes] ' If all requested information on this form is not completed, the form will not be valid as a Candidate Petition the undersigned, a registered (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 ERK 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 Three (Please insert the title of Office and Include District, Circuit, Group, Seat Number, if applicable) Date of Birth OR Voter Registration Num (MM/DD/Y" ity County 1kj , V) e-r S P T�%' V\ SP Se „v\. le 15-2.045, FA.C. A ..ram �VN'r!L rAGe ��:�` CANDIDATE PETITION Slate Zip Code �L 32�o�s Date Signed (MM/DD/YWY) (To be completed by Voter] 0 81 as l �o ��-- 'Ail 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 104185 Florida Statutes) If all requested information on this form isnot7pWed. the Form will not bevalid asaCandidate Petition Form, I, /n ler d/-o 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 asa [check/complete box, as a FORM THIS COMPLETED FORM MUST BE PROVIDED TO THE CITY CLERK DURING QUALIFYING V t 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 title of Office and Include District, Circuit, Group, Seat Number. If appl(cablel of Birth OR j(oter Re�iorltll.lnzber i4'0�l t �c 45PAIA)6 s of Voter le 15-2.045, F.A.C. County oL � State �G. Date Signed [To be comp) Zlp Code by Voter] a� AUG 2 7 2024 Revised 06/10/2024 CITY OF WINTER SPRINGS OFFICE OF THE CITY CLERK CANDIDATE PETITION CITY OF WINTER SP LER OFFICE OF THE CITY LEFt1C �7 C�� FORM / `All information on this form becomes a public record upon receipt by the Supervisor of Elections `It Iso 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 FORM MUST BE Itejrley "1� Q� the undersigned, a registered PROVIDED TO THE (Please print narde 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 applic I ] Nonpartisan F77N/A No party affiliation F771 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 ( M M/DD/YYYY) /- (0 - Sio nature of Voter 15-2.045, F.A.C. ddress A y arm 1010 Stat � 2Ip Code 3T-? ve Dale Signed (MM/DD/YYYV) [To be completed by Voter] ro� °� CAN D LDATE P ETITI O N oFFICOE OF THE CITY '� �� 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] if all requested information on this arm is not completed, the form will not be valid as a Candidate Petition THIS COMPLETED f / 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 efh o M4 y'15p 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 Three Date of Birth OR Voter Registration Number /�sg.�s� Gity WtN'% Signature of Voter e District, Circuit, Group, Seat N State County Z(p Code S�✓UI<NDGL� �L. � ��D (M be completed by Voter] 15-2.045, FA.C. MU0411 -' CITY OF VVINTER SP �=� CAN D I DATE P ET I T I O N OFFICE OF THE CITY `All information on this form becomes o public record upon receipt by the Supervisor of Elections `It is a crime to knowingly sign more than one petition for a candidate. [Section 104.785 Florida Statutes] If all requested information on this form is not completed, the form will not be valid as a Candidate Petition 0 Ve (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 a [check/complete box, as the undersigned, a registered LERK 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 Three (Please insert the title of Office and Include District, Circuit, Group, Seat Number, If applicable) Date of Birth OR Voter Registration N (M M/DD/YYYY) / rvr �'I �j✓ �'� nature of Voter 15-2045, FAC. county % e"ihd le I State Zip Code Z7d Date Signed (MM/OD/YYYY) [ro 6e completed by Voter] AUG r,.' 8 2024 CITY(`., VNNTER S�RIN3S OFFICE OF THE CITY CLER CANDIDATE PETITION FORM / r7 '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 Petitlon THIS COMPLETED %, FORM MUST BE I, ()wol /'o% hhpow7a'S wl i/S the undersigned, a registered PROVIDED TO THE (Please print name as it appears on your voter Information card) CITY CLERK DURING voter in said state and county, petition to have the name ofpt% ✓�� 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 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 (MM/DD/" County State Z(p Code i fe e /�ri s s"efr?10~1 e to nature of Voter Rule 15-2.045, FAC. Date Signed (MM/DD/YYYY, [To be completed by Voter] NIiJ CITY OF WINTER SPRIN^^ %'�'`` OFFICE OF THE CITY CL Rf< �I 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 f r is not completed, the form will not be valid as a Candidate Petition THIS COMPLETED ,I 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 Kq fyn C 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 Three (Please insert the title of Office and Include District, Circuit, Group, Seat Number, If applicable) of Birth OR Voter Registration Number Address DDAYiAd U�� l �� ���C4e �(] (Signature of County State Zip Cade Signed Ito be c Tnpleted by Voter) CANDIDATE PETITION *Ali 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 704.185FIorida Statutes) *if oil requested information on this �form is npt completed, the form will not be valid as a Candidate Petition Form. I c 1/0 �\ 1 the undersigned, a registered (Please print name as it voter in said state and county, rs on your voter Information card) to have the name of placed on the General Election Ballot as a Lcheck/complete box, as a FORM 7 THIS COMPLETED FORM MUST BE PROVIDED TO THE CITY CLERK DURING QUALIFYING u Nonpartisan N/A No party affiliation N/A Not Applicable Party Candidate for the Office of City of Winter Springs - City Commission District Three the Date of Birth OR Voter Registration Number (MM/DD/YYYY) (^ ^ F III r nature of Voter 15-2.045, Revised 06/IV/2024 GroupSeat Num , (�V0004 County Sta Zip u VW CITY OF VVINTEP, SPRINGS OFFICE OF THE CITY CLERK e Signed (MM/DD/YYYYJ be completed by Vo[er] i IM U • Incorporated 1959 .,Coo WE'(FCJyC CITY OF WINTER SPRINGS, FLORID►=' f_ to 1126 EAST STATE ROAD 434 • WINTER SPRINGS, FLORIDA 32708-279R m t ¢ jr > TELEPHONE: (407) 327-6560 v FACSIMILE: (407) 327-4753 WEBSITE: www.winterspringsfl.org August 29, 2024 The Honorable Chris Anderson Supervisor of Elections for Seminole County 1S00 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: • Karen Meyer "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: _—_��t��5'�� — lean Given to Seminole County Supervisor of Elections Office Representative on this date: a�1Z 4 ! 2t1 %•c�� ------------ and time: ----��'^_— -- 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: AUG 2 7 2024 ❑Write-in candidate CITY NTER OFF COE OF THE CITY CIL RK OFFICE USE ONLY Candidate Oath Name to appear on ballot: kj#r A 2216KNZ Check box if two last names w hout 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 (Office) (District #) I am a qualified elector of S%�'il No4E 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, 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. Signaflirie of Candidate Telephone Number IEmail Address eZ�'!/? P o YA Address of Legal Residence City State ZIP Code STATE OF FLORIDA 21 COUNTY OF 5CM/NGLF_ 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 2.77"' day of A U ir #A t 20.Zq. Notary Public State of Florida Christian p Gowan Personally Known ❑ OR Produced ® Iltl My Commission 433378 Identification 20 Expires 8/15/2027 —� Type of Identification Produced: FL /✓l, Vers L,ICeri!' e 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): 7v�� 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 '= ff' � �V L D Personally Known ❑ OR Produced Identification ❑ AUG 2 7 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. Qua ti s 2624 2023 Form 1- Statement of Financial Interests CITY OF WRITER 5 PRINrq OF THE CITY CLERK General Information Name Address: County Organization N/A Karen Meyer 741 ANDOVER CIR, WINTER SPRINGS, 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 City of Winter Springs Title Position sought or held City Commissioner, Seat 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 Descriptionof the Source's rincipal Business Activity Social Security 1100 West High Rise, 6401 Security Retirement Boulevard, Baltimore Maryland 21235 Stifel, Nicolaus & Co 501 North Broadway, St. Louis, Missouri Investments Brokerage Firm Printed from the Florida EFDMS System Page 1 of 3 l 'r faU�7 �,; c) lUL4 2023 Form 1- Statement of Financial Interests CITY OF VNANTER SPRINGS 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 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 Roth IRA, IRA, Brokerage Accounts Stifel Bank Printed from the Florida EFDMS System Page 2 of 3 pl ir, n 8 21124 2023 Form 1- Statement of Financial Interests CITY OF WINTER SPRINGS OFF' QF Tuc rrry r1i r-p?v 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 Karen Meyer Digitally signed: 08/28/2024 Printed from the Florida EFDMS System Page 3 of 3