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HomeMy WebLinkAboutAnnouncement of Intention to Run Forms 5-15-15 • r CITY OF CAPE CANAVERAL, FLORIDA gg ANNOUNCED CANDIDATE PACKET ACKNOWLEDGMENT I, .Y✓'-2' �r,5-°1 would like to announce my candidacy for Mayor and do hereby acknowledge receipt of: 1. April 20, 2015 Candidate Information Memo 2. 2015 Election Information 3. Announcement of intention to become a Candidate for Office 4. Form DS-DE 9 (rev. 10/10), Appointment of Campaign Treasurer and designation of campaign depository for Candidates 5. Form DS-DE 84 (rev. 05/11), Statement of Candidate 6. Election Laws of the State of Florida as of September 2014 7. Candidate and Campaign Treasurer Handbook as of November 2013 8. 2015 Campaign Treasurer's Report Due Dates for Announced Candidates and general information about filing reports 9. Do's & Don'ts for Campaign Treasurer's Reports 10. Form DS-DE 12 (rev. 11/13), Campaign Treasurer's Report Summary 11. Form DS-DE 13 (rev. 11/13), Campaign Treasurer's Report— Itemized Contributions 12. Form DS-DE 13A (rev. 11/13), Campaign Treasurer's Report — Fund Transfers 13. Form DS-DE 14 (rev. 11/13), Campaign Treasurer's Report— Itemized Expenditures 14. Form DS-DE 14A (rev. 11/13), Campaign Treasurer's Report — Itemized Distributions 15. Form DS-DE 87 (rev. 11/13), Waiver of Report 16. Public Service Request Form 17. Political Sign Regulations I understand to have my name appear on the November 3, 2015 Municipal Election Ballot, I must complete qualifying paperwork and pay qualifying fees during the qualifying period which begins on August 7, 2015 at noon and ends August 21, 2015 at noon. OFFICE USE ONLY Z ECCElVC- Signature Late: ,SS �A- MAY 01 2015 Enter Date X Time Received IY and Initials of Clerk's Office Staff Member % '/6p,,‘ timityr CITY OF CAPE CANAVERAL, FLORIDA ANNOUNCEMENT OF INTENTION TO BECOME A CANDIDATE FOR OFFICE v ,z hereby declare and announce my intention to become a Candidate for the office of Mayor in the City of Cape Canaveral General Election on November 3, 2015. I understand it is my responsibility to comply with all applicable election laws and that I must be a resident and registered voter of the City of Cape Canaveral. •i• ' z Date: 4545— Signature OFFICE USE ONLY ECCOMC MAY 15 2015 • Enter Date&Time Received and Initials of Clerk's Office Staff Member n IEC E I1 V APPOINTMENT OF CAMPAIGN TREASURER L�, AND DESIGNATION OF CAMPAIGN MAY 15 2015 DEPOSITORY FOR CANDIDATES (Section 106.021(1), F.S.) �- (PLEASE PRINT OR TYPE) NOTE: This form must be on file with the qualifying officer before opening the campaign account. OFFICE USE ONLY 1. CHECK APPROPRIATE BOX(ES): XO Initial Filing of Form Re-filing to Change: ID Treasurer/Deputy Ei Depository El Office ❑ Party 2. Name of Candidate(in this order: First, Middle, Last) 3. Address(include post office box or street, city, state, zip Buzz Petsos code) 618 Madison Avenue 4. Telephone 5. E-mail address Cape Canaveral, FL 32920 (321 ) 799-1876 buzzpetsos@earthlink.net 6. Office sought(include district, circuit, group number) 7. If a candidate for a nonpartisan office,check if Mayor, City of Cape Canaveral applicable: ❑ My intent is to run as a Write-In candidate. 8. If a candidate for a partisan office,check block and fill in name of party as applicable: My intent is to run as a Ej Write-In El No Party Affiliation [] Party candidate. 9. I have appointed the following person to act as my Q Campaign Treasurer El Deputy Treasurer 10. Name of Treasurer or Deputy Treasurer Buzz Petsos 11. Mailing Address 12.Telephone 618 Madison Avenue ( 321 ) 799-1876 13. City 14. County 15. State 16. Zip Code 17. E-mail address Cape Canaveral Brevard FL 32920 buzzpetsos@earthlink.net 18. I have designated the following bank as my Q Primary Depository fl Secondary Depository 19. Name of Bank 20. Address Sunrise Bank 5604 North Atlantic Avenue 21. City 22. County 23. State 24. Zip Code Cocoa Beach Brevard FL 32931 UNDER PENALTIES OF PERJURY,I DECLARE THAT I HAVE READ THE FOREGOING FORM FOR APPOINTMENT OF CAMPAIGN TREASURER AND DESIGNATION OF CAMPAIGN DEPOSITORY AND THAT THE FACTS STATED IN IT ARE TRUE. 25. Date 26. Sign Candi f 05/14/15 Xz 27. Treasurer's Acceptance of Appointment(fill in the blanks and check the appropriate block) Buzz Petsos , do hereby accept the appointment (Please Print or Type Name) designated above as: 0 Campaign Treasurer ED Depu asurer. 05/14/15 Date Signature of Campaign Treasurer or Deputy Treasurer DS-DE 9 (Rev. 10/10) Rule 1S-2.0001, F.A.C. OFFICE USE ONLY STATEMENT OF CANDIDATE © �I (Section 106.023, F.S.) MAY 15 2015 (Please print or type) C---7;2-ea4 t J 1, Buzz Petsos candidate for the office of Mayor, City of Cape Canaveral have been provided access to read and understand the requirements of Chapter 106, Florida Statutes. Xi /CZ 05/14/15 Signature of Candidate Date 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(05/11)