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Home My WebLink AboutMorrissey, Brandon Qualifying Packet 2024 08 28NAME: CITY OF WINTER SPRINGS, FLORIDA FORM A 2024 GENERAL MUNICIPAL ELECTION THIS COMPLETED AFFIDAVITOFACCEPTANCE FORM MUST BE PROVIDED TO THE CITY CLERK DURING CITY COMMISSION: DISTRICT ONE/ DISTRICTTHREE DISTRICT FIVE QUALIFYING Circle which applies [o candidacy Date &Time I Review Started _ 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 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 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" LDS -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 Accepted: QUALIFYING DOCUMENTS WITH AN *ASTERISK MUST BE COMPLETED IN FRONT OF THE CITY CLERK/DESIGNEE DURING QUALIFYING STATE OF FLORIDA INFORMATION ' �,� "The Florida Election Code, Chapter 97 -106, Florida Statutes (includes Chapter 106 which addresses Political and Disclaimers, etc. Candidate and Campaign Treasurer Handbook" (2024) (Which includes "Chapter 12: Political Advertising" and "Chapter 13: Other Disclaimers" 1��"Electioneering Communications Organization Handbook" State of Florida Election Information Contacts Accepted: A(JG 2 8 2014 Advertising Revised O6/l0/2024 CITY OF WINTER SPRINGS THE CITY CLERK rJ\NTkgs CITY OF WINTER SPRINGS, FLOP IDA A 2020 GENERAL MUNICIPAL ELECTION FORM y T w AFFIDAVIT OFACCEPTANCE o' THIS COMPLETED Vr1Vtl CITY COMMISSION: DISTRICT ONE/ DISTRICTTHRE DISTRICT FIVE FORM MUST BE PROVIDED MUST THE Circle which applies to candidacy CITY CLERK DUPING QUALIFYING NAME: , ?^ oLn Page2of2 CAMPAIGN FINANCE/ELECTRONIC FILING INFORMATION 0/ "Contributions Returned" [DS-DE-2] Accepted: CIVY OF WINTER SPRINGS INFORMATION MM City of Winter Springs 2022 District Map Accepted: /71� MISCELLANEOUS INFORMATION bi✓} "Foreign nationals" - from the Federal Election Commission Legal References for Qualifying Documents Accepted: NOTE: The Candidate SHOULD NOT close out their Campaign Bank Account before they are invoiced and payment is made to the Seminole County Supervisor of Elections for verification of Petition signatures The following signature area is to be signed upon receiving the 2024 Election Qualifying Packet, including the above referenced documents I, � � Ift ��(� M � r � s have on this date received the forms and information Name ofCandida[e (Print or Type/� noted on these two (2) pages and agree that I will read all the Election Qualifying packet materials that have been provided to me; and understand that it is my responsibil' y to comply with all Laws as they apply to the 2024 Election. sig Date Address City Zip Code State of Florida Countyof SE'M ► N aLE Sworn to (or affirmed) an�d's�u'lbscribed before me byJJJJr eons of physical presence or( ) online notarization) this �� " day of �t .� ,2024 by ��t /Q/h �n A" Personally known: OR Provided identification: (Print name of person making statement) 2 v'eors Ll'tvrl..t e Type of Identification produced Notary Pubilc State of Florida Christian D Gowan llll My Commission HH 43337fi Revised O6/10/2024 EXPIfa3 Vl15/2V27 Signature of Notary Public-s[a eofFlorida AUG 2 8 21J24 CITY OF WINTER SPRINGS r�F F1C'.F OF THE CITY CLERK CITY OF WINTER SPRINGS, FLORIDA 2024GENERALMUNICI PAL ELECTION AFFI DAVI T OF Q UAL I FI ED VOTER STATUS AND CITYAND DISTRICT RESIDENCY CITY COMMISSION: DISTRICT ONE/ DISTRICT THRE I DISTRICT FIVE Circle which applies to candidacy I,raft Wdpn inareova 92N do hereby state that I seek election to the City Name of Candidate (Print or Type) FORM 1 THIS COMPLETED FORM MUST BE PROVIDEDTOTHE CITY CLERK DURING QUALIFYING of Winter Springs' City Commission: District One/ District Three istrict 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: q� S�`4c LIV is p/J I am attaching two (2) documents, one to be a Florida Driver's License, as verification of my residency in the Street of Florida Countyof .501Vj//UVjg"4C Sworn to (or affirmed) and subscribed before me by means off' x) physical presence or ( )online notarization This by 2& d�y of ,� .� a AM 1&401011 /V %j Personally known: (Print name of person making statementr /�L 1�nve�fr �r�('eY�t Revised 06/10/2024 Type of Identification produced Notary Public State of Florida Christian D Gowan My Commission HH 433379 Expires 9/15/2027 FOR OFFICE USE ONLY py of Florida Driver's License provided for Item (S) / /ppj. %• J' O[her documentation provided for Item (5) �¢ r 2024 OR Produced Identification X AUG 2 8 2U24 -� Y pp WINTER SPRINGS act Up THE CITY CLERK rids DRIVER 9CLA8S E V620- ` zWiLL1AM BRANDom Gl1615l1998 A 0111512030 � *NONE _�e NONE 0712812020 I :�_� "��` A -,. "an of a iriotar �' eenSeln Dasry 59Wiply by lan CITY OF WINTER SPRINGS UTILITY BILLING MON4111 M 1126 E STATE ROAD 434 PHONE: 407-327-5996 FAX: 40M274753 UTILITYBILLS@WINTERSPRINGSFL.ORG W W W. W INTERSPRINGSFL.ORG/UB Charges Breakdown (Current Month) WATER BASE $7.88 WATER USAGE $4.47 WATER TAX $1.24 SEWER BASE $16.13 SEWER USAGE $15.37 STORMWATER BASE $5.50 SOLID WASTE BASE $22.81 TOTAL CURRENT CHARGES $7340 Scan this code to make a payment with your smartphone or tablet today! "News You Can Use" Ensure you stay informed - Sign up via the Winter Springs Everbridge Portal at httpso//www.winterspringsfl .org/alertwintersprings to receive emergency notification alerts. Summary of Payments and Charges DUE ACCOUNT NUMBER 17835-001 SERVICE ADDRESS PAST DUE CHARGES $76.32 IMMEDIATELY PENALTIES $5.00 ADJUSTMENTS $0.00 PAYMENTS ($83.47) CURRENT CHARGES $73.40 9/17/2024 TOTAL DUE $14932 MONTHLY WATER USAGE (in gallons) 3500 3000. 2500 2000 1500• 1000 500� 0- o o £ o E o N N Ul fl .0 Q N N 2 Z O U O 71473650 0 f0 Meter Reading Information From To Days Meter # Previous Current Usage 7/11/2024 8/9/2024 29 71473650 900,150 9021590 21440 Payment Options (Use Account Number 17835-001) See back for more! If -Pay by QR Code If -Pay by Website Online Bank Pay Call Center Scan the code above eservices.winterspringsfl.org See your bank's website 407-327-5996 Please detach and return the bottom portion with your payment (Make Checks Payable to City of Winter Springs) ---------------------------------------------------- CITY OF WINTER SPRINGS UTILITY BILLING MON4111 S-5 sysv 1126 E STATE ROAD 434 PHONE: 407-32M996 FAX: 407-327-4753 UTILITYBILLS@WINTERSPRINGSFL.ORG W W W. W INTERSPRINGSFL.ORG/UB BRANDON MORRISEY & WILLIAM MORRISEY Summary of Payments and Charges ACCOUNT NUMBER 17835-001 SERVICE ADDRESS PAST DUE CHARGES $76.32 IMMEDIATELY CURRENT CHARGES $73.40 9/17/2024 TOTAL DUE $149.72 CITY OF WINTER SPRINGS UTILITY BILLING 1126 E STATE ROAD 434 WINTER SPRINGS, FL 32708-2715 CITYOF WINTER SPRINGS, FLORIDA 2024GENEPAL MUNICIPAL ELECTION APPLICATION FOR OFFICE AND ELECTION ASSESSMENT CITY COMMISSION: DISTRICT ONE/ DISTRICT THRE ISTRICT FIVE Circle which applies to candidacy I,WM• �SfM� Morr; ame of Candidate (Print or FORM 2 THISCOMPLETED FORM MUST BE PROVIDEDTOTHE CITY CLERK DURING QUALIFYING do hereby state that I am a registered and qualified Elector of the City of Winter Springs; and I am applying for the Office of City Commission: District One/ District Three/ istrict 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 pay the following Qualifying Fee AN D 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 qualify for 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), candidates who are unableto pay the election assessmentwithoutimposing anundue burden on their personal resources or resources otherwise available to them shall upon written certification ofsuch inability given under oath to the city clerk be exempted from paying the election assessment. Any candidate exempt from the election assessment shall also be exempt the city's qualifying fee. 212�2/" Signature FOR OFFICE USE ONLY FEE: Campaign Account Check in the amount of $150.00 attached (Check should be made payable to the City of Winter Springs) A D °� 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) OR, IFAPPLICABLE Completed "Notice of Undue Burden" Attached Check # Check # A AUG 2 8 1024 Date Revised O6/10/2024 CITY OF V�gN?F� `;PRIhGS OFFICE OF -I".r: 1..-'. N' Cl.ii.itV< GI,GGc�v�- 50-9245/531 PAY TO ! k1 G� 1 1 ii { b THE ORDER OF tgo •/0o T�RUSTCO j.� NK �y Yor�rHorne Town Bank MEMO CXU�•ZV to '' 0 nL TO B ��RUSTCO j.� ANK Yorrr Horne Town Bank MEMO v — PAYMENT DATE 08/29/2024 COLLECTION STATION UB Mid Ofc 2 (FI-CH-UB-5-W7) RECEIVED FROM BRANDON MORRISEY DESCRIPTION QUALIFYING Payments: pity of Winter Springs 1126 E. State Road 434 1Ninter Springs, FL 32708 Type Detail Amount heck Total Cash Total Check Total Charge Total Wire Total Other Total Remitted Change Total Received sa.ao $150.00 WOO#0.00 WOOWOO slmm Total Amount= BATCH NO. 2024-00005048 RECEIPT NO. 2024-00122435 CASHIER �Ianetta Rucker ENTRY DATE 08j29/202412:24:40 AM Customer Copy Printed by: Vonetta Rucker Page 1 of 1 08{29f2024 12:24.40 AM PAYMENT DATE 08/29/2024 COLLECTION STATION UB Mid Ofc 2 (FI-OH-UB-5-VV7) RECEI;,fED FROM BRANDON MORRISEY DESCRIPTION ELECTION ASSESSMENT pity of Winter springs 1 126 E. State Road 434 1�+.+inter Springs. FL 32708 Payments: I Type Detail Amount Check Total Cash Total Check Total Charge Total Write Total Other Total Remitted Change Total Received �0.00 $12000 $0.00 #0.00 WOO a WOO $12ffW Total Amount: BATCH NO. 2024-00005048 RECEIPT NO. 2024-00122436 CASHIER 1'onetta Rucker ENTRY DATE 08j29/202412:26:07 Alva Customer Copy Printed by_ Vonetta Rucker Page 1 of 1 08{29{2024 12.26:08 AM CITY OF WINTER SPRINGS, FLORIDA 2024GENEPAL MUNICIPAL ELECTION NOTICE OF TESTING OF TABULATING EQUIPMENT CITYCOMMISSION: DISTRICT ONE/ DISTRICT THRE ISTRICT FIVE Circle which applies [o 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 W inter Springs, Florida's 2024 General Municipal Election will betestedon: DATE: Friday, October 11, 2024 TIME:10:00 a.m. The aforementioned test will be held at: THE OFFICE OFTHE SUPERVISOR OF ELECTIONS FOR SEMINOLE COUNTY 1500 East Airport Boulevard, Sanford, Florida, 32773 (407) 585-VOTE [86831 City of Winter Springs Municipal Elections Official/Designee AUG 2 8 1024 CITY OF WINTER SPRINGS OFFICE OF THE CITY CLERK Revised O6/10/2024 CITY OF WINTER SPRINGS, I- LOP[ DA 2024GENERAL MUNICIPAL ELECTION APPLICATION FOR OFFICE AND ELECTIONASSESSMENT CITY COMMISSION: DISTRICT ONE/ DISTRICT THREE/ t=50 Circle which applies to candidacy FORM 4 THIS COMPLETED FORM MUST BE PROVIDED TO THE CITY CLERK DURING QUALIFYING Pleasefind 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/Referencesrelatedto 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 I�iM� �CA/1�DIn Mo rc ►� do hereby acknowledge on this date of Name of Candidate (Print or Type) ;rr► 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 de Chapters 97-106, Florida Statutes" and the "Candidate and Campaign Treasurer Handbook." Signatwe FOR OFFICE USE ONLY Attachment: Copy of Florida Statutes 106.1435 g/Z,g/2b Date AUG 2 81024 CITY OF WINTER SPRINGS OFFICE OF THE CITY CLERK Revised O6/]0/2024 CITY OF WINTER SPRINGS, FLORIDA 2024GENEPAL MUNICIPAL ELECTION APPLICATION FOR OFFICE AND ELECTIONASSESSMENT CITYCOMMISSI0N: DISTRICT0NE/ DISTRICTTHREEDIS TRICT 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 Due Date: October 70, 2024 - shall contain information regarding all previously unreported contributions and expenditures from July1, 2024- September 30, 2024 Report Due Date: October 71, 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�mk�r7, 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 I' �' � C/'I/Yh/� O �i do hereby acknowledge that on this date of 4 '11 , 2024 with my signature below that I received a written "Schedule of Campaign Finance Reporting Dates" (as noted above on this form). AUG 2 8 2024 - •r OF WINTER SPRINGS THE CITY CLERK Revised O6/]0/2024 ADD WE CITY OF WINTER SPRINGS, FLORIDA 2024GENERAL MUNICIPAL ELECTION NOTICE OFACCESS TO CAMPAIGN FI NANCE FORMS CITYCOMMISSION: DISTRICT ONE/ DISTRICT THRE IQLELyioo, 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' (,JM� ��, /1 MO��;SrL.f do hereby acknowledge that on this date of 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 ele.ctronicallyflle their campaign treasurer's reports required by state law utilizing the Seminole County Supervisor of Elections Office's electronic filing system. The electronic filing deadline for a completed campaign report shall be the same as the deadline established by law for filing an original paper copy of the report with the City's filing officer." Signature Date auc z s 2024 uire� Tn+e Ciry Revised O6/10/2024 � rat aeJG 2 8 2024 CANDIDATE PETITION CITY OF WINTER OFFICE OF THE CITY LERI< 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 thisform is not completed, thed form will not be valias a Candidate Petition I, C7 Gott) C nyrrxw 'wo� /wl�L/the undersigned, a registered (Please priMname as It appears on your voter Information card) voter in said state and county, petition to have the name of pAced on the General Election Ballot as a [check/complete box, as THIS COMPLETED FORM MUST BE PROVIDED TO THE CITY CLERK DURING QUALIFYING I A Nonpartisan N/A No party afiiliat[on 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, Circuit, Group, Seat Number, if applicable) Date of Birth OR Voter Registration Number Address / (MM/DD/YYYYj _ ) G O cIr 0 county ewe nature of Voter Rule 15-�.045, F.AC. �� CANDIDATE PETITION State w� Date Signed (MM/DC [To be completed by is '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 ford candidate. (Section 704.785Florfda Statutes] , ' If all requested information on this form Is not/ -completed, the form will not be valid as a Candidate Petition Form. h I, Lt h 0(46� C ILtf , 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 MUSTiBE PROVIDED TO THE CITY CLERK DURING QUALIFYING —� Nonpartisan N/A No party affiliation N/A Not Applicable r Party Candidate for the Office of City of Winter Springs - City Commission District Five Insert the title of Office Date of Birth OR Voter /Registration Number nature of` VV/ootter�% le 15-2.045, F.AC. Group, Seat Number, If a County�� i StatgR, Date Signed (MM/DD/YYW) [To be completed by oter) Revised 06/10/2024 CITY OF WINTER SP CAN D I DATE P ETITI O N OF=,GE ^F rHE 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 104.185 Florida Statutes) •iLg I 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 a FORM 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 Five of Birth oR Voter Registration Number I (Address City county : A ! 61 IL "pf Voter c Rule 15-2.045, F.A.C. Seat Num CANDIDATE PETITION State �L Date Slgned (MM/DD/YYW [To be completed by Voter] 'Ali information on this form becomes a public record upon receipt bythe Supervisor ofElections •!t is crime to knowingly sign more than one petition fora candidate. [Section 104.185Florida StotutesJ • 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 Code .�� i o 2r FORM 7 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 C , C ! S 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 Five Date of Birth OR Voter Registration Number (MM/DD/YYYY) lty 1n Ier ()9nnV of Voter 15-2.045, F.A.C. of Office and Include District, Circuit, Group, Seat Number, if a loaf SC�,pl�n��r State . Dale Signed (MM/DD/YWY, [To be completed by Voter] Revised 06/10/2024 oil 'AUG 2 8 20241 CAN D I DATE P ETITI O N CITY OF WINTER sP OFFICE OF THE CITY 'All information on this form becomes a public record upon receipt by the Supervisor of Elections ' It Is a crime to knowinglysign more than one petition for a candidate. [Section 104.185 Florida Statutes] ' If all requested information on this form is not completed, the form will not be valid as a Candidate Petition 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 Xx rxorNdo n Me Ir r i QUALIFYING placed on the General Election Ballot as a [check/complete box, as applicable] Nonpartisan N/q No party affiliation N/A Not Applicable Party Candidate for the Office of City of Winter Springs - City Commission District Five Date of Birth OR Voter Registration N (MM/DD/YYYY) City signature of er Rulel - ., C. county Number, ress 155 % vi (n et' pc q) �; CAN D I DATE P ETITI O N State FL Zip Code 31410 � Date Signed (MM/DD/YYY1'; [To be completed by Votet] �k I °I ) 2 0 '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 104.185 Florida Statutes] If all requested information on this form is not completed, the form will not be'validas a Candidate Petition Form. I, yaj� aAh Qa14 (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 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 Five (Please Insert the title of office and Include District, Circuit, Group, Seat Number, If applicable) Date of Birth OR Voter Registration (MM/DD/YYYY) or a� �4J'b iy (,/rt h +Cr S p 3nature of Voter Rule 15-2.045, F.A.C. ress County If^iyt j Se�iNd�� State Zip Code Date Signed (MM/DD/YYYY) [To be completed by Voter] de'/6 4 Revised 06/10/2024 RINGS CITY OF CANDIDATE PETITION °FF"� 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 704.185Florida Statutes] *If oil requested Information on this form is not completed, the form will not be valid as a Candidate Petition THIS COMPLETED FORM MUST BE I, Oa, n n& �IoS the undersigned, a registered PROVIDED TO THE Please print name as It appears on your voter Information card) ft CITY CLERK DURING voter in said state and county, petition to have the name of (D r( QUALIFYING placed on the General Election Ballot as a [check/complete box, as applicable] Nonpartisan N/A No party affliation N/A Not Applicable Party Candidate for the Office of City of Winter Springs - City Commission District Five )ate of Birth OR Voter Registration Number MM/DD/YYYY) �R� to-[�5 U� k�eI Signatu 15-2.045, Group, Seat Number, if a L) rvo�i' r County State � be completedby Voter] _aG ` a �� CAN D I DATE P ETITI O N *All information on this form becomes a public record upon receipt by the Supervisor of Elections • It is a crime to knowingly sign more than one petition for a candidate. [Section 104.185 Florida Statutes] "If all requested information on this form is not completed, the form will not be valid as a Candidate Petition Form. it the undersigned, a registered (Please print name as it appears on your voter information card) FORM 7 THIS COMPLETED FORM MUST BE PROVIDED TO THE CITY CLERK DURING voter in said state and county, petition to have the name of �1/�Aill�Oclj�/ �`'�� `c �/ QUALIFYING placed on the General Election Ballot as a [check/complete box, as applicable] L �J Nonpartisan N/A No party affiliation N/A Not Applicable Party Candidate for the Office of City of Winter Springs -City Commission District Five urt the title of Office and include District, Circuit, Group, Seat Number, if Date of Birth OR Voter Registration Number Address (M M/D D/YYYY) o.D/ia 11Y51 Boa County nature of Voter Rule 15-2.045, F.A.C. State Zlp Code Date Signed (MM/DD/YYYY) [To be cc pleted by Voter] eC 4144 Revised 06/10/2024 �F r CANDIDATE PETITION CITY OF WINTER SPRINy. 7 OFFICE OF THE CITY Ct R:< FORM `All information on this form becomes o public record upon receipt by the Supervisor of Elections *it !so crime to knowinglysign more than one petition for a candidate. [Section 104.18S Florida Statutes] `If all requested information on this form is not completed, the form will not be valid as a Candidate Petitlon I, Isaac �1j1GN 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 I A Nonpartisan N/A No party affiliation N/A Not Applicable Party Candidate for the office of City of Winter Springs - City Commission District Five Date of Birth OR Voter Registr�a%tion Number (MWDDf !fN"l0/0q ooI W i n +� ( pri%G�jS Signature of Voter 15-2.045, F.A.C. and include District, circuit, Group, Seat Number, 155 I l,J�n�6( Jpri �t�S County State Sens i nol e, FL CANDIDATE PETITION Zip Code 32 IUD � be completed by Voter] �17/ ZG2y 'All information on this form becomes a public record upon receipt by the Supervisor of Elections `I t !s a crime to knowingly sign more than one petition for a candidate. (Section 704785 Florida Statutes) 'If all requested information on this form !s not completed, the form will not be valid as a Candidate Petition Form. 1uI cothe undersigned, a registered (Please print name as it appears on your voter Information card) voter in said state and county, petition to have the name of placed on the General Election Ballot as a [check/complete box, as FORM THIS COMPLETED FORM MUST BE PROVIDED TO THE CITY CLERK DURING QUALIFYING Nonpartisan N/A No party 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, Circuit, Group, Seat Number, if applicable) Date of Birth OR Voter Registration Number (MM/DD o IUD l r�L 4K? Signature of Voter Rule 1S-2,cas, F.A.C. Revised 06/10/2024 County State Date Signed (M [To be co pleb Voter] A�JG 2 8 2024 CITY OF VJINTEP. `.•" CANDIDATE PETITION OFFICE OF 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 704,785 Florida Statutes] ' If all requested information on this form is not completed, the form will not be valid as a Candidate Petition 5 the undersigned, a registered (Please print name as it appears on your voter information card) voter in said state and county, petition to have the name of placed on the General Election Ballot as a [check/complete box, as FORM THIS COMPLETED FORM MUST BE PROVIDED TO THE CITY CLERK DURING QUALIFYING �`� Nonpartisan N/A No party affiliation N/A Not Applicable Party Candidate for the Office of City of Winter Springs - City Commission District Five Date of Birth OR Voter Registration Number (MM/DD" Group, Seat 1 lPJ � �e C( U o \J County Istate Zip Code c �7 Date Signed (MM/DD/WYY) ITo be completed by Voter] a ) I P'D(DDq :;:fir 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 704.785 Florida Statutes] `If all requested Information on this form is not completed, the form will not be valid as a Candidate Petition Form. the undersigned, a registered (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 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 Five (Please insert the'title of Office and Include District, Circuit, Group, Seat Number, if applicable) Date of Birth OR Voter Registration Number jAddress County Voter le 15-2.045, F.A.C. State Date Signed (M M/DD/YYYY; (To be completed by Voter] Code �a Revised 06/10/2024 5 � ram.�- M�i \4 EE-; CANDIDATE PETITION OCITY F FFCOEO\FTHECITSP Y I', FORM 'All information on this form becomes a public record upon receipt by the Supervisor of Elections ' It is a crime to knowinglysign more than one petition for a candidate. (Section 704.785 Florida Statutes) If ail requested information on this form is not cgp Meted, the form will not be valid as a Candidate Petition the undersigned, a registered (Please print na as it appears on your voter Information 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 L A Nonpartisan N/A No party affiliation N/A Not Applicable Party Candidate for the Office of City of Winter Springs - City Commission District Five (Please Insert the title of Office and Include District, Circuit, Group, Seat Number, if applicable) Date of Birth OR Voter Regi: (MM/DD/YYY`/) City w) n1 �rGCZ Signature of Voter Ad Rule 1S-2,045, F.A.C. Number Address -- County i.N s7com I 6 E =:t� CANDIDATE PETITION St� , .Zip Code Date Signed (MM/DD/YY1'Y, [To be completed by Vo[erj "All Information on this form becomes a public record upon receipt bythe Supervisor ofElections '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. 000 {, �, (C it el ei 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 je .%7 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 Five (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/Y,m County Siat� Zip odeJoe Signature of Voter Date Signed (MM/DD/YYYY [To be completed by Voter] Rule 15-2.045, F.A.C. Revised 06/10/2024 i�,. CAN DIDATE PETITION FIFICOEOtFTFiEC '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 (Please print name as it appeavS�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 gne the undersid, a registered rtq,.lporct FORM 7 THIS COMPLETED FORM MUST BE PROVIDED TO THE CITY CLERK DURING QUALIFYING L A J Nonpartisan N/A No party affiliation N/A Not Applicable Party Candidate for the Office of City of Winter Springs - City Commission District Five nclude District, Circuit, Group, Seat Date of Birth OR Voter (MM/DD/YYYY) -r CoUhty P!'Krt� SPAT 9�MwVLC Signature of Voter 15-2.045, F.AC. �� CANDIDATE PETITION 772c�� State Date Signed (MM/DD/YWY [To be completed by Voter] '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 o candidate. (Section 704185 Florida Statutes] ' If all requested information on this form Is notcompleted, the form willnot be valid as a Candidate Petition Form. Ll (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 Date of Birth OR Voter Regis (MM/DDM'YY) Signature of Vot)_r a vl&( -2 Rule .o4S, F.AC. %•��o the undersigned, a registered 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 Five Num E Group, Seat County State Date Signed (MM/DD/YYYY) [To be completed,by Voter]. o1��ay o� ) Code 337v�, Revised 06/10/2024 CITY OF WINTER SPRIG ".ID OFFICE OF THE CITY C' FORM 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 704.785 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 I, Q)ej 2; [X 5EL\C) ,(,j A the undersigned, a registered PROVIDED TO THE (Please print aame as It appears on your voter Information card) CITY CLERK DURING voter in said state and county, petition to have the name of Bcawl�S QUALIFYING placed on the General Election Ballot as a [check/complete box, as applica e Nonpartisan N/A No partyaffliation N/A Not Applicable Party Candidate for the Office of City of Winter Springs - City Commission District Five of Birth OR Voter Registration Number of Voter le 15-2.045, F.A.C. county SCM1 NO_C CANDIDATE PETITION State Date Signed (MM/DD/YYYY [To be completed by Voter] 0 •Al►information on this form becomes o public record upon receipt bythe Supervisor ofElections • It is a crime to knowinglysign more than one petition for a candidate. (Section 704.785FIorida StotutesJ If all requested information on this form Is not completed, the form will not be valid as a Candidate Petition Form. undersigned, a registered (Please print name as l[ appears on your voter FORM 7 THIS COMPLETED FORM MUST BE PROVIDED TO THE CITY CLERK DURING voter in said state and county, petition to have the name of ] Q .� QUALIFYING placed on the General Election Ballot asa [chec]//complete box, as applicab e] Nonpartisan N/A No party affiliation N/A Not Applicable Patty Candidate for the Office of a City of Winter Springs - City Commission District Five of Birth OR l� of Voter nature Rule 15-2.045, F.A.C. (Please insert the title of Office and Include District, Circuit, Group, Seat Number, It applicable) Registration Number Address q Date Signed (MM/DD/YYYY) [To be-�ompJRted by�joter] �� o Revised 06/10/2024 ' rs rqE r iE, D Oto CANDIDATE PETITION CITY OF WINTER SPR NGS 7OFFICE OF THE CITY LERK FORM 'All information on this form becomes a public record upon receipt by the Supervisor of Elections ' It is a crime to knowingly sign more than one petition for a candidate. (Section 704.785 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 5OW44Q (`�S 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 Nonpartisan N/A No party affiliation N/A Not Applicable Party Candidate for the Office of City of Winter Springs - City Commission District Five Date of Birth OR Voter Registration Number (M WDD/Y" Signature of Voter 0Ah Rule 1S-Z045, C. title of Office and Include District, Circuit, Group, rcounty CANDIDATE PETITION State �L Date Signed (MM/DD/YWY [To be completed by Voter] I , 2t 12 'All information on this form becomes o public record upon receipt by the Supervisor ofElections `!t is a crime to knowinglysign more than one petition for o candidate. (Section 104.785 Florida Statutes] , If all requested information on this form is not completed, the form will not be valid as a Candidate Petition Form. A) � eiQ 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 Code C12r FORM 7 THIS COMPLETED FORM MUST BE PROVIDED TO THE CI1Y CLERK DURING QUALIFYING �� Nonpartisan N/A No party afrliation 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, Circuit, Group, Seat Number, if applicable) Date of Birth OR Voter Registration Number Address (MM/DD") 4'2 City County Stat W �� w� s SPwt� �d C f ��✓1 completed of VoterIDate o be / V�i 15-2.045, F.A.C. Revised O6/10/2024 CANDIDATE PETITION OF=ICP OF THE CITY 'All information on this form becomes a public record upon receipt by the Supervisor of Elections ' It is a crime to knowingiysign more than one petition for a candidate. [Section 704.785 Florida Statutes] If (III requested information on this form is not completed, the form will not be valid as a Candidate Petition the undersigned, a registered (Please printlname as it appears �n your voter Information card) voter in said state and county, petition to have the name of �n ] placed on the General Election Ballot as a [check/complete box, as applicable K FORM 7 THIS COMPLETED FORM MUST BE PROVIDED TO THE CITY CLERK DURING QUALIFYING X� Nonpartisan N/A No party affl]ation N/A Not Applicable Party Candidate for the Office of City of Winter Springs - City Commission District Five the to of Birth OR Voter Registration Number M/DD/YYYY) City Signature of Voter Rule 1S-2.045, F.AC. Seat Q. r County State Zip Code SLoM; note. 308 Date Signed (MM/DD/YYYI') [To be completed by Voter] ` �` CAN D I DATE P ETITI O N '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 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 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 E lection Ballot heck/complete boxas to of Birth OR Voter M/DD/YYW) nature of Voter 15-2.045, F.A.C. the undersigned, a registered FORM THIS COMPLETED FORM MUST BE PROVIDED TO 7HE 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 Five Number I (Address County State Z(p Date Signed (MM{DD/WW [To be completed by Voter] Revised O6/] 0/2024 A!�G 2 8 20 CITY OF WINTER4,1 QNCFS CANDIDATEPETITION OFFICE OF THE CITY1 LERK FORM *All information on this form becomes a public record upon receipt by the Supervisor of Elections • It Is a crime to knowinglysign more than one petition for a candidate. (Section 704,785 Florida Statutes) If oil requested Information on this form is not completed, the form will not be volldos a candidate Petition THIS COMPLETED ft ^� FORM MUST BE A an �,/�}, the undersigned, a registered PROVIDED TO THE (Please print name as It app�ealrs on your voter Information card) n CITY CLERK DURING voter in said state and county, petition to have the name of r and on i CCOL QUALIFYING placed on the General Election Ballot as a [check/complete box, as applicable] C] Nonpartisan N/A No party affliation 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, Circuit, Group, Seat Number, if applicable) Date of Birth OR Voter Registration Number Address (MM/DD/YYY l) tuc\ G1nvV�eGh�rlr� ON r I�, County State .Zip Code Voter , /\ I I Date Signed (MM/DD/YWY', �� /V I ITo be completed by Voter] Zz�ZU Rule 15-2.046, F.A.C. �� CANDIDATE PETITION 'All information on this form becomes a public record upon receipt by the Supervisor of 'It lsa crime to knowinglysign more than one petition fora candidate. )Section 104185Florida 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 [checWcomplete box, as FORM 7 THIS COMPLETED FORM MUST BE PROVIDED TO THE CITY CLERK DURING QUALIFYING V Nonpartisan N/A No party affiliation N/A Not Applicable Party Cai, ate for the Office of City of Winter Springs - City Commission District Five Date of Birth OR Voter Registration (MM/DD/YY1'y) nature of Voter Rule 15-2.045, F.A.C. Group, Seat County State Zip Cade Date Signed (MM/DD/WYY. [To be completed by Voter] Revised 06/10/2024 \�D WE�R� August 29, 2024 CITY OF WINTER SPRINGS, FLORIDA 1126 EAST STATE ROAD 434 WINTER SPRINGS, FLORIDA 32708-2799 TELEPHONE: (407) 327-6560 FACSIMILE: (407) 327-4753 WEBSITE: www.winterspringsfl.org The Honorable Chris Anderson Supervisor of Elections for Seminole County 1500 East Airport Boulevard Sanford, Florida 32773 Dear Mr. Anderson: 1� sty 3 Fri PU 23 P 4: 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: • Brandon Morrisey "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: ____��Jr,4ah _ GOw�.�-, Given to Seminole County Supervisor of Elections Office Representative on this date: ---- U and time: Petitions provided: _ Z Z. ___ CANDIDATE OATH NONPARTISAN OFFICE (Do not use this form if a Judicial or School Board Candidate) 7 P W Check box only if you are seeking to qualify as a write-in candidate: AUG 2 8 2024 Write-in candidate CITY OF W NTER SPRINGS OFFICE O� THE CITY CLERK OFFICE USE ONLY Candidate Oath Name to appear on ballot: !6A Check box if two last names without hyphen. 11 (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 -M 1,5 104 L) (District #) �+ ^(Of#-ce) I am a qualified elector of , JCS 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, I Do Not r If you do, you must also specify the amount owed and each entity that levied the same on the reverse side. X Signature of Candidate Telephone Number Email Address . City State ZIP Code STATE OF FLORIDA Z "y COUNTY OF ` EM/iyoL4 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 7., day of �/fttw�l eSi 20,ZA. Notary Public State of Florida ® Christian D Gowan Personally Known ❑ OR Produced Identification �M Commission HH 433379 My 1®III W612027 Type of Identification Produced: FL .!ort`vrrf GiYence DS-DE 302NP (Eff. 10/2023) Rule 1S-2.0001, F.A.C. Phonetic Spellingo ame Phonetic spelling for the audio ballot (not required for qualifying purposes): Print the name phonetically on the line below as you wish it to be pronounced on the audio ballot as may be used by persons with disabilities (see instructions on page 3 of this form): Can '- Doer Mori , sCC( 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 �J' )! , Am Qcovt4on N' LklgA M� 1 am over the age of eighteen (18) and the contents of this affidavit are true and correct. My nickname is ( - (, t j n� M 9 rrF 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 SLEMiNoZ.F 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 Notary Public State of Florida this Z9 day of 4"►a, 20 2Zq . Christian D Gowen My Commission HH 433379 Personally Known ❑ OR Produced Identification ® IIIt Expires 9/75/2027 Type of Identification Produced: fL Vr4r vrrs 0�ee Ogee F - ,s? DS-DE 302NP (Eff. 10/2023) AUG 2 8 2024 Rule 1S-2.0001, F.A.C. , 0 y OF \MN `' CLERK 2023 Form 1 - Statement of Financial Interests General Information Name: Address: County: Organization N/A Mr William Brandon Michael Morrisey 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 City Commission Title Position sought or held District 5 Commissioner THIS STATEMENT REFLECTS YOUR FINANCIAL INTERESTS FOR CALENDAR YEAR ENDING DECEMBER 31, 2023. Primary Sources of Income PRIMARY SOURCE OF INCOME (Over $2,500) (Major sources of income to the reporting person) (If you have nothing to report, write "none" or "n/a") Description of the Source's Name of Source of Income Source's Address Principal Business Activity 4601 N John Young Parkway, Orlando, FI American Ambulance Emergency Medical Services 32804 Air BNB 888 Brannan St. San Francisco, Ca, 94103 Property Rental Printed from the Florida EFDMS System Page 1 of 3 CITY OF WINTER 6PRINGS OFFICF OF 7"H,- CITY C;IFRK 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 204 Yarmouth Rd. Fern park FI 548 Orange Dr. unit 24, Altamonte Springs FI 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 9 2024 CITY OF WINTER SPRINGS OFFICE OF 71.IE CI'i �' CL. [-:':,. Printed from the Florida EFDMS System Page 2 of 3 2023 Form 1 = Statement of Financial Interests Liabilities LIABILITIES (Major debts valued over $10,000): (If you have nothing to report, write "none" or "n/a") Name of Creditor Address of Creditor Flagstar bank 1801 E colonial dr st111 Orlando FI PNC Bank P.O. Box 1820 Dayton ohio One main Financial 5803 S US 1792 casselberry FI 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 Printed from the Florida EFDMS System Page 3 of 3