HomeMy WebLinkAboutAnnouncement of Intention to Run Forms 5-19-15 SQA EA
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CITY OF CAPE CANAVERAL, FLORIDA
ANNOUNCED CANDIDATE PACKET ACKNOWLEDGMENT
/ PlOO4 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. 1`
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Signature /
MAY 052015
Late: S S /S' TePT't/i4p"
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Enter Date&Time Received
and Initials of Clerk's Office Staff Member
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CITY OF CAPE CANAVERAL, FLORIDA
ANNOUNCEMENT OF INTENTION
TO BECOME A CANDIDATE FOR OFFICE
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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.
CI 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.
AP •
Date:
Signature
OFFICE USE ONLY
MAY 19 2015
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Enter Date&Time Received
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and Initials of Clerk's Office Staff Member
APPOINTMENT OF CAMPAIGN TREASURER Q L5 C E 0 V I
__ AND DESIGNATION OF CAMPAIGN MAY 19 2015
DEPOSITORY FOR CANDIDATES
(Section 106.021(1), F.S.) --
(PLEASE PRINT OR TYPE) f °.//?..f i,
NOTE: This form must be on file with the qualifying
officer before opening the campaign account. OFFICE USE ONLY
1. 94ECK APPROPRIATE BOX(ES):
ad Initial Filing of Form Re-filing to Change: ❑ Treasurer/Deputy El Depository Office 0 Party
2. Name of Candidate(in this order: First, Middle, Last) 3. Address(include post office box or street, city, state, zip
7oot:er"7- E code) 0,/E-fle-6-RsO,V 4V,
C,4PE CAt/A✓e,eAG, ,e-/,
4. Telephone 5. E-mail address 32./ZO
( 37-I ) 50 3-8`l/6 3.40)0e,6,‘,/-0676 .66,r1
6. Office sought(include district, circuit,t,group number) 7. If a candidate for a nonpartisan office,check if
/ 14ye,� @�7-y f 6 0l.�,w4VV,ea,L applicable:
El 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
❑ Write-In El No Party Affiliation ❑ Party candidate.
9. I have appointed the following person to act as my ® Campaign Treasurer ❑ Deputy Treasurer
*4420' 10. Name of Treasurer or Dep ty Treasurer
-5Oy C t- fi tlICia II
11. Mailing Address //D j'i-FTG-:ft-SON AV. G'/)L'C44-0(2-41-1/47/i(2-1-/}c!/T .' y).v 12. Telephone
ea _Bout/ iCR-pir crnii► V 7 ,/z- 3-11)0 (9l ) 5 yy- /cc 51
13. City 14. County 15. State 16.Zip Code 17. E-mail a dress
C net 614/h vicl»t 0/LLAMA 0/LLAMA0 ft, 3 a 1,x0 A'/taro 1,14'(?.3 60-cGv`-7
18. I have designated the following bank as my Et Primary Depository 0 Secondary Depository
19. Name of Bank 20.Address
3o Je' - 34/Jt-< 5‘.(, /Ake„7-6/ 4rI. W7 Al(
21. City 1;ve,r_w 22. County 23. State 24.Zip Code
R AE)D -1-7-/D2/,D.a 3293 r
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- g'e of Candida e
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27. Treasurer's Acceptance of Appointment(fill in the blanks and chec appropriate block)
I, 3a yCL pith L 7-6A/ , do hereby accept the appointment
(Please Print or Type Name)
designated above as: ® Campaign Treasurer Deputy Treasurer.
��o �i9�,(s X
Dateta. Si n
g re 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 D IEC E D W IE
(Section 106.023, F.S.) MAY 1 9 2015
(Please print or type) W
1,
candidate for the office of /24/.,i-' ( ��Q���'�- f 7-
have been provided access to read and understand the requirements of
Chapter 106, Florida Statutes.
Signature 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)
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