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HomeMy WebLinkAboutAnnouncement of Intention to Run MB 7-01-16 (11 CITY OF CAPE CANAVERAL, FLORIDA ANNOUNCED CANDIDATE PACKET ACKNOWLEDGMENT I, P1(\ CAn,o-eJ, would like to announce my candidacy for City Council and do hereby acknowledge receipt of: 1. June 20, 2016 Candidate Information Memo 2. 2016 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 August 2015 7. Candidate and Campaign Treasurer Handbook as of January 2016 8. 2016 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 8, 2016 Municipal Election Ballot, I must complete qualifying paperwork and pay qualifying fees during the qualifying period which begins on August 12, 2016 at noon and ends August 26, 2016 at noon. �, OFFIC • "---291/462., E © IEOV signature • 111 Date: fl II 1I� 1 �1 di JUL 01 2016 Enter II. - neceivel and Initials : A-2-F--LHI ‘t/' , %air—I CITY OF CAPE CANAVERAL, FLORIDA ANNOUNCEMENT OF INTENTION TO BECOME A CANDIDATE FOR OFFICE I, (b' , Ke, `6 c�W , hereby declare and announce my intention to become a Candidate for the office of City Council in the City of Cape Canaveral General Election on November 8, 2016. 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. II //k,1/4_______ Date: -1 I ( b Signature OFFICE USE ONLY RC CGOMG- JUL012016 b rai:.,./- z, ri, --- -- Enter Date&Time Received and Initials of Clerk's Office Staff Member APPOINTMENT OF CAMPAIGN TREASURER EcrEBVE AND DESIGNATION OF CAMPAIGN DEPOSITORY FOR CANDIDATES JUL 01 2016 (Section 106.021(1), F.S.) I - (PLEASE PRINT OR TYPE) ■►y F mr NOTE: This form must be on file with the qualifying officer before opening the campaign account. OFFICE USE ONLY 1. CHECK APPROPRIATE BOX(ES): Er Initial Filing of Form Re-filing to Change: fl Treasurer/Deputy ® Depository 0 Office 0 Party 2. Name of Candidate(in this order: First, Middle, Last) 3. Address (include post office box or street, city, state, zip I code) (Y\ l tJ\c� ,rct CAO SP,-te\\. "biLt.re 4. Telephone 5. E-mail address C.-+z Qe. CrJN.averL4 i. z -- 1 363 .-- 315,1.0 6. Office sought (include district, circuit, group number) 7. If a candidate for a nonpartisan office, check if applicable: C .V. t ❑ 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 Ei Write-In ❑ No Party Affiliation El Party candidate. 9. I have appointed the following person to act as my 2 Campaign Treasurer ❑ Deputy Treasurer 10. Name ofTreasureror ff Deputy Treasurer 1 L . ru. - .•> 11. Mailing Address 12. Telephone CASioe1 c%.- �2t, = ( 'Sz ) 3o3 13. City 14. County 15. State 16. Zip Code 17. E-mail address 18. I have designated the following bank as my ❑ Primary Depository p Secondary Depository 19. Name of Bank 20. Address%\arJ& 3. '- E.. C 21. City 22. County 23. State 24. Zip Cod 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. Signature of C idat 27. Treasurer's Acceptance of Appointment (fill in the blanks and check the appropriate block) (\1\ cc�� ` . 1�rCw•� , do hereby accept the appointment (Please Print or Type Name) designated above as: Er Campaign Treasurer ❑ Deputy Treasurer. --� (kc, x � � t Date Signature of Campaign Treasurer or Deputy Treasurer DS-DE 9 (Rev. 10/10) Rule 1S-2.0001, F.A.C. CAMPAIGN TREASURER'S REPORT SUMMARY (1) I Y1 k I`C\.„i iti OFFICE USE ONLY Name C IEU V E (2) L•; . C t A .P 1 1 D C.► �� Q (ddress (nu ber and street) JUL 1 2 2016 'J ANA .q.L 3;19)O 0 P � City, State, Zip Code /�f�' 1 n Check here if address has changed (3) ID Number (4) Chec appropriate box(es): L Candidate Office Sought: PL A 4r -n 1 Q . \ Q �(\;t=-. ❑ Political Committee (PC) ❑ Electioneering Communications Org. (ECO) ❑ Check here if PC or ECO has disbanded ❑ Party Executive Committee (PTY) ❑ Check here if PTY has disbanded ❑ Independent Expenditure (IE) (also covers an ❑ Check here if no other IE or EC reports will be filed individual making electioneering communications) (5) Report Identifiers r-' Cover Period: From 0O / ;),S— / L To 07 / LS / ( ( Report Type:4) Or Original ❑ Amendment ❑ Special Election Report (6) Contributions This Report (7) Expenditures This Report oc. Monetary Cash & Checks $ , , '.2 Do. Expenditures $ , , . Loans $ , , • Transfers to Office Account $ . Total Monetary $ , Total Monetary $ , • In-Kind $ , , • (8) Other Distributions $ , , . (9) TOTAL Monetary Contributions To Date (10) TOTAL Monetary Expenditures To Date $ , , ,1-( ). x $ , , . (11) Certification It is a first degree misdemeanor for any person to falsify a public record (ss. 839.13, F.S.) I certify that I have �examined this report and it is true, correct, and complete: V (Type name) 1 `t��- l��C.� .ai (Type name) N t ham, ,�(.24.:,,,j.....ty-3 ❑ Individual(only for I . Wreasurer ❑ Deputy Treasurer Candidate ❑ Chairperson(only for PC and PTY) or electioneer g m / X �� / .._—____.. X 6'1,...--1/4..---• Signature Signature DS-DE 12(Rev. 11/13) SEE REVERSE FOR INSTRUCTIONS CAMPAIGN TREASURER'S REPORT - ITEMIZED CONTRIBUTIONS (1) Name (Y\ J row( 3 (2) I.D. Number (3) Cover Period 06 / oZ 5.--/ I ( through 07 I DB / I b (4) Page \ of (5) (7) (8) (9) (10) (11) (12) Date Full Name (6) (Last, Suffix, First, Middle) Sequence Street Address& Contributor Contribution In-kind n Number City, State,Zip Code Type Occupation Type Description Amendment Amount MKerk 2e4;04 �j( CAsa k-Uri (n� of LV- �� aiN e-pN O r t a-ItYLac-, 02 w. I I I I I I I I I I DS-DE 13(Rev. 11/13) SEE REVERSE FOR INSTRUCTIONS AND CODE VALUES INSTRUCTIONS FOR CAMPAIGN TREASURER'S REPORT — ITEMIZED CONTRIBUTIONS (1) Candidate's full name or name of the political committee (PC), electioneering communications organizations (ECO) or party executive committee (PTY). (2) The identification number assigned by the filing officer. (3) Cover period dates (e.g., 1/1/15 through 1/31/15). (See filing officer's reporting dates calendar for appropriate year and cover periods.) (4) Page numbers (e.g., 1 of 3 ). (5) Date contribution was RECEIVED (Month/Day/Year). (6) Sequence Number— Each detail line shall have a sequence number assigned to it. Sequence numbers are to be assigned within each reporting period and for each type of detail line. Thus the report type, detail line type, and sequence number will combine to uniquely identify a specific contribution, expenditure, distribution or fund transfer. This method of unique identification is required for responding to requests from the filing officer and for reporting amendments. For example, a M1 report having 75 contributions would use sequence numbers 1 through 75. The next report (M2), comprised of 40 contributions would use sequence numbers 1 through 40. Contributions on amended M1 reports would begin with sequence number 76 and on amended M2 reports would begin with sequence number 41. See the Amendment Type instructions below. (7) Type full name and address of contributor (including city, state and zip code). (8) Enter the type of contributor using one of the following codes: Occupation of contributor for contributions over$100 only. (If a business, please indicate nature of business.) I Individual B Business (also includes corporations, organizations, groups, etc.) E Electioneering Communications Organizations F Political Committee (federal or state) P Political Parties (includes federal, state and county executive committees) O Other (e.g., candidate surplus funds to party, etc.) S Candidate to Self (9) Enter Contribution Type using one of the following codes: NOTE: Cash includes cash and cashier's checks. Code Description CAS Cash or Cashier's Check CHE Check COF Carryover Funds from Previous Campaign INK In-Kind INT Interest LOA Loan MO Money Order MUC Multiple Uniform Contributions RCT Other Receipts REF Refund (Negative Amount Only) WAIVER OF REPORT D C C E 0 V E (Section 106.07(7), F.S.) JUL 282016 [J (PLEASE TYPE) 1 % �- --1:-= r0k,..)NJ Q...,0-pe, J .2A1 C.atVAC �e C �ry o , c_. 1 Name { Office Sought S L 2, 0_, e).- 14 --C CIA,CA— rb("Lx,,,_:(_. C 0_ . Address City State Zip Code Candidate ❑ Political Committee ❑ Party Executive Committee NOTE: This form does not apply to an electioneering communications organization (ECO). An ECO must file a report(not a waiver)that no reportable contributions or expenditures were made during the reporting period (s. 106.0703(6), F.S.). Check here if address has changed since last report. I I Check here if PC has DISBANDED and will no longer file reports. TYPE OF REPORT (Check Appropriate Box and Complete Applicable Line beneath Box) ❑ MONTHLY REPORT ®PRIMARY ELECTION ❑ GENERAL ELECTION ❑ OTHER REPORT TYPE Indicate report# Indicate report# Indicate report# Indicate report type and# M P 3 G as applicable: TERMINATION REPORT SPECIAL ELECTION NOTIFICATION OF NO ACTIVITY IN CAMPAIGN ACCOUNT FOR THE REPORTING PERIOD OF Ori 1 Oct \ l 10 THROUGH (3`( L 2 2- I t L. X rAttil1aS I ice, Signature Date X �;4 c i , t,, Signature Date REQUIRED SIGNATURES FOR: Candidates: Candidate and Campaign Treasurer or Deputy Treasurer(s. 106.07(5), F.S.) Political Committees: Chairman and Campaign Treasurer or Deputy Treasurer(s. 106.07(5), F.S.) Party Executive Committees: Treasurer and Chairman (s. 106.29(2), F.S.) Except as noted above for an ECO, in any reporting period when there has been no activity in the account(no funds expended or received)the filing of the required report is waived. However,the filing officer must be notified in writing on the prescribed reporting date that no report is being filed. DS-DE 87(Rev. 06/15) LOM U LC� CF;) WAIVER OF REPORT AUG 0 4 2016 (Section 106.07(7), F.S.) ...J • (PLEASE TYPE) OFFICE USE ONLY f r V"Ne, ewe., 00N-AvCRA r Cj.S Name Office Sought CSA -t \eL- `v , (JQtic, v74- 32ca Address City State Zip Code Candidate ❑ Political Committee 0 Party Executive Committee NOTE: This form does not apply to an electioneering communications organization(ECO). An ECO must file a report(not a waiver)that no reportable contributions or expenditures were made during the reporting period(s. 106.0703(6), F.S.). ❑ Check here if address has changed since last report. ❑ Check here if PC has DISBANDED and will no longer file reports. TYPE OF REPORT (Check Appropriate Box and Complete Applicable Line beneath Box) O MONTHLY REPORT RIMARY ELECTION ❑ GENERAL ELECTION ❑ OTHER REPORT TYPE Indicate report# Indicate report# Indicate report# Indicate report type and# M P G as applicable: ❑ TERMINATION REPORT ❑ SPECIAL ELECTION NOTIFICATION OF NO ACTIVITY IN CAMPAIGN ACCOUNT FOR THE REPORTING PERIOD OF V ),3-3 \\ THROUGH O-1 a_o 1 r Co X ----)1D8( 04 lig ff Signature Date X °$ 1 Signature Date REQUIRED SIGNATURES FOR: Candidates: Candidate and Campaign Treasurer or Deputy Treasurer(s. 106.07(5), F.S.) Political Committees: Chairman and Campaign Treasurer or Deputy Treasurer(s. 106.07(5), F.S.) Party Executive Committees: Treasurer and Chairman(s. 106.29(2), F.S.) Except as noted above for an ECO, in any reporting period when there has been no activity in the account(no funds expended or received)the filing of the required report is waived. However,the filing officer must be notified in writing on the prescribed reporting date that no report is being filed. DS-DE 87(Rev.06/15) WAIVER OF REPORTAUG 10 2016 (Section 106.07(7), F.S.) -l J (PLEASE TYPE) orriCC USC ONLY • (\r\ \._..)1( et. CAA r\r AC.R.0 0-6 tom* Name Office Sought ii • 9 ,5 e_AStc) ba•-t,ot k � o.A ry a v U2.a l j -tom 3��jZv Address City State Zip Code C Candidate ❑ Political Committee ❑ Party Executive Committee NOTE: This form does not apply to an electioneering communications orization(ECO). An ECO must file a report(not a waiver)that no reportable contributions or expenditures were made during the reporting period (s. 106.0703(6), F.S.). Check here if address has changed since last report. n Checkere if PC has DISBANDED and will no longer file reports. TYPE OF REPORT (Check Appropriate Box and Complete Applicable Line beneath Box) ❑ MONTHLY REPORT E PRIMARY ELECTION ❑ GENERAL ELECTION ❑ OTHER REPORT TYPE Indicate report# Indicate report# Indicate report# Indicate report type and# M P G as applicable: TERMINATION REPORT SPECIAL ELECTION NOTIFICATION OF NO ACTIVITY IN CAMPAIGN ACCOUNT FOR THE REPORTING PERIOD OF ©7 3 L 1 ) THROUGH �C%/ oLD X b$ ��; • ure Date X d� pto ( I,, SignatureDate REQUIRED SIGNATURES FOR: Candidates: Candidate and Campaign Treasurer or Deputy Treasurer(s. 106.07(5), F.S.) Political Committees: Chairman and Campaign Treasurer or Deputy Treasurer(s. 106.07(5), F.S.) Party Executive Committees: Treasurer and Chairman(s. 106.29(2), F.S.) Except as noted above for an ECO, in any reporting period when there has been no activity in the account(no funds expended or received)the filing of the required report is waived. However, the filing officer must be notified in writing on the prescribed reporting date that no report is being filed. DS-DE 87(Rev.06/15) WAIVER OF REPORT (Section 106.07(7), F.S.) 1 AUG 1 7 2016 �. . (PLEASE TYPE) L �Y_. __ OFFICE USE ONLY_ " 1 ke.., T 2Q 4.)"/ 0.-41WNA)n v c124 Cce,06•43v. A. Name Office Sought a � CSS' --iee‘`&- -0 a- (pe Cicaot - 3 "2.c1, to Address City State Zip Code Candidate ❑ Political Committee ❑ Party Executive Committee NOTE: This form does not apply to an electioneering communications organization (ECO). An ECO must file a report(not a waiver)that no reportable contributions or expenditures were made during the reporting period (s. 106.0703(6), F.S.). Check here if address has changed since last report. Check here if PC has DISBANDED and will no longer file reports. TYPE OF REPORT (Check Appropriate Box and Complete Applicable Line beneath Box) ❑ MONTHLY REPORT EIRIMARY ELECTION ❑ GENERAL ELECTION ❑ OTHER REPORT TYPE Indicate report# Indicate report# Indicate report# Indicate report type and # M P (0 G as applicable: TERMINATION REPORT SPECIAL ELECTION NOTIFICATION OF NOACTIVITY IN CAMPAIGN ACCOUNT FOR THE REPORTING PERIOD OF( U 0 L 1 ( THROUGH o8 ( 2.i ( L X // gfn II c. ignature Date X F117 it (4:1 Signature Date REQUIRED SIGNATURES FOR: Candidates: Candidate and Campaign Treasurer or Deputy Treasurer(s. 106.07(5), F.S.) Political Committees: Chairman and Campaign Treasurer or Deputy Treasurer(s. 106.07(5), F.S.) Party Executive Committees: Treasurer and Chairman (s. 106.29(2), F.S.) Except as noted above for an ECO, in any reporting period when there has been no activity in the account(no funds expended or received)the filing of the required report is waived. However, the filing officer must be notified in writing on the prescribed reporting date that no report is being filed. DS-DE 87 (Rev. 06/15)