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HomeMy WebLinkAboutcsanders_candidate_qualifying_paperwork_20220817APPOINTMENT OF CAMPAIGN TREASURER AND DESIGNATION OF CAMPAIGN 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. RECEIVED AUG 17 2022 MG OFFICE USE ONLY 1. CHECK APPROPRIATE BOX(ES): X Initial Filing of Form Re -filing to Change: ❑ Treasurer/Deputy Depository Office Party 2. Name of Candidate (in this order: First, Middle, Last) Carroll G. Sanders 3. Address (include post office box or street, city, state, zip code) 221 Canaveral Beach Blvd Cape Canaveral, FL 32920 4. Telephone (CELL) (404) 4I0-6203 5. E-mail address Carroll@CGSLAW.org 6. Office sought (include district, circuit, group number) City Council 7. If a candidate for a nonpartisan office, check if applicable: My intent is to run as a Write -In candidate. 8. If a candidate for a .artisan office, check block and fill in name of party as applicable: My intent is to run as a Write -In No Party Affiliation ❑ Party candidate. 9. I have appointed the following person to act as my X Campaign Treasurer ❑ Deputy Treasurer 10. Name of Treasurer or Deputy Treasurer Carroll G. Sanders 11. Mailing Address 221 Canaveral Beach Blvd 12. Telephone (404) 410-6203 13. City Cape Canaveral 14. County Brevard 15. State FL 16. Zip Code 32920 17. E-mail address Carroll@CGSLAW.org 18. I have designated the following bank as my X Primary Depository Secondary Depository 19. Name of Bank Sunrise Bank 20. Address 5604 N. Atlantic Ave 21.City Cocoa Beach 22. County Brevard 23. State Florida 24. Zip Code 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 F TS STATED IN IT ARE TRUE. 25. Date 8-16-2022 26. Signature of Candidate X- (Signature) 27. Treasurer's Acceptance of Appointment (fill in the blanks and check the appropriate block) I, Carroll G. Sanders , do hereby accept the appointment (Please Print or Type Name) designated above as: X Campaign Treasurer Deputy Treasurer. 8-17-2022 Date X (Signature) Signature of Campaign Treasurer or Deputy Treasurer DS-DE 9 (Rev. 10/10) Rule 1S-2.0001, F.A.C. 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 candidate: Write-in candidate RECEIVED AUG 1 7 2022 MG OFFICE USE ONLY Candidate Oath (Section 99.021(1)(a), Florida Statutes) I, Carroll G. Sanders , (Print name above as you wish it to appear on the ballot. If your last name consists of two or more names but has no hyphen, check box (see page 2- Compound Last Names). No change can be made after the end of qualify. Although a write-in candidate's name is not printed on the ballot, the name must be printed above for oath purposes.) am a candidate for the nonpartisan of City Council (Office), (District #) , ; I am a qualified elector of Brevard County, Florida; (Circuit #) (Group or Seat #) I am qualified 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. Candidate's Florida Voter Registration Number (located on your voter information card): 103627316 Phonetic spelling for audio ballot: Print 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 2 of this form): (Not applicable to write-in candidates.] K-ER-UH-L SAND-ER-S X (Signature) (404) 410-6302 Carroll@CGSLAW.org Signature of Candidate Telephone Number Email Address 221 Canaveal Beach Blvd Cape. Canaveral FL 32920 Address City State ZIP Code STATE OF FLORIDA (Signature) Signature of Notary Public COUNTY OF Brevard Print. Type, or Stamp Comissioned Name of Notary Public below: Sworn to (or affirmed) and subscribed before me by means of online notarization OR physical presence X this 17th day of August 20 Personally known OR Produced Identification X Type of Identification Produced FL Driver License Mia Goforth Notary Public State of Florida Comm# HH108700 Expires 5/16/2025 DS-DE 302NP (Rev. 08/2021) Rule 1S-2.0001, F.A.C. Compound Last Names If your last name consists of two or more names and has no hyphen, check the box in the Candidate Oath section. If you fail to check the box, your name will be listed with the name appearing last on the line. Example: John Jones Smith — If the last name has no hyphen and you do not check the box, the last name on the ballot would be "Smith." If you check the box, your last name would be listed on the ballot as "Jones Smith." If you have a hyphen within your last name, the last name would be listed as "Jones -Smith." Guide for Designating Phonetic Spelling of Candidate's Name for Audio Ballot 1. Use tables below. 2. Use upper case for "stressed" syllables. Use lower case for "unstressed" syllables. 3. Use dashes (-) to separate syllables. 4. Add any notes such as rhyming examples, silent letters, etc. Vowels Stressed Vowel Sounds Unstressed Vowel Sounds EE (FEET) feet uh (SO-fuh) sofa (FING-guhr) finger 1 (FIT) fit E (BED) bed A (KAT) cat (KAD) cad AH (FAH-thur) father (PAHR) par AH (HAHT) hot (TAH-dee) toddy UH (FUHJ) fudge (FLUHD) flood UH (CHUHRCH) church AW (FAWN) fawn Certain Vowel Sounds with R U (FUL) full AHR (PAHR) par 00 (FOOD) food ER (PER) pair OU (FOUND) found IR (PIR) peer 0 (FO) foe - OR (POR) pour El (FEIT) fight OOR (POOR) poor Al (FAIT) fate UHR (PUHR) purr 01 (FOIL) foil YOO (FYOOR-ee-uhs) furious Consonants B (BED) bed R (RED) red D (DET) debt S (SET) set F (FED) fed T (TEN) ten G (GET) get V (VET) vet H (HED) head Y (YET) yet HW (HWICH) which W (WICH) witch J (JUHG) jug CH (CHUCRCH) church K (KAD) cad SH (SHEEP) sheep L (LAIM) lame TS (ITS) its (PITS-feeld) Pittsfield M (MAT) mat TH (THEI) Thigh N (NET) net TH (THEI) Thy NG (SING-uhr) singer ZH (A-zhuhr) azure (VI-zhuhn) vision P (PET) pet Z (GOODZ) goods (HUH-buhz-tuhn) Hubbardston Examples of Phonetically Spelled Names NAME ON BALLOT PRONOUNCED AS Mishaud mee-SHO ('d' is silent) Jahn HAHN (rhyme: fawn) Beauprez boo-PRAI (rhyme: hooray) Maniscalco man-uh-SKAL-ko Tangipahoa TAN-ji-pah-HO-uh Monte Mahn-TAI Tanya TAWN-yuh (not TAN) Do not submit this page to the filing officer. DS-DE 302NP (Rev. 08/2021) Rule 1S-2.0001, F.A.C. OATH OF CANDIDATE I, Carroll Sanders , do solemnly swear or affirm that I am qualified under the City of Cape Canaveral Charter and Ordinances to hold the Office of Council Member, to which I desire to be elected and I will support the City of Cape Canaveral Charter and Ordinances. (Signature) Signature of Candidate (intitial) State of Florida County of Brevard City of Cape Canaveral Sworn to (or affirmed) and subscribed before me by physical presence this 17th day of August, 2022 by CARROLL Sanders , who is personally known or produced Florida Driver Lic Identification. (Signature) Signature of Notary Public Print, type or stamp Commissioned Name of Notary Public Mia Goforth Notary Public State of Florida Comm# HH108700 Expires 5/16/2025 FORM 1 STATEMENT OF 2021 Please print or type your name, mailing address, agency name, and position below: FINANCIAL INTERESTS RECEIVED AUG 17 2022 MG FOR OFFICE USE ONLY: LAST NAME -- FIRST NAME -- MIDDLE NAME : Sanders, Carroll G. MA!LING ADDRESS : 221 Canaveral Beach Blvd. Cpe. Canaveral, FL 32920 City of Cpe Canaveral CITY : ZIP :. COUNTY : NAME OF AGENCY : City Council NAME OF OFFICE OR POSITION HELD OR SOUGHT : CHECK ONLY IF X CANDIDATE OR NEW EMPLOYEE OR APPOINTEE **** THIS SECTION MUST BE COMPLETED **** DISCLOSURE PERIOD: THIS STATEMENT REFLECTS YOUR FINANCIAL INTERESTS FOR CALENDAR YEAR ENDING DECEMBER 31, 2021. MANNER OF CALCULATING REPORTABLE INTERESTS: FILERS HAVE THE OPTION OF USING REPORTING THRESHOLDS THAT ARE ABSOLUTE DOLLAR VALUES, WHICH REQUIRES FEWER CALCULATIONS, OR USING COMPARATIVE THRESHOLDS, WHICH ARE USUALLY BASED ON PERCENTAGE VALUES (see instructions for further details). CHECK THE ONE YOU ARE USING (must check one): COMPARATIVE (PERCENTAGE) THRESHOLDS OR DOLLAR VALUE THRESHOLDS PART A -- PRIMARY SOURCES OF INCOME [Major sources of income to the reporting person - See instructions] ( if you have nothing to report, write "none" or "n/a") NAME OF SOURCE OF INCOME CGS LAW SOURCE'S ADDRESS 7001 N. Atlantic Ave, Ste. 110 Cpe. Canaveral, FL 32920 DESCRIPTION OF THE SOURCE'S PRINCIPAL BUSINESS ACTIVITY Law Practice PART B — SECONDARY SOURCES [Major customers, clients, and other sources of income to businesses owned by the report person-See instructions] (If you have nothing to report, write "none" or "n/a") NAME OF BUSINESS ENTITY OF INCOME N/A NAME OF MAJOR SOURCES OF BUSINESS' INCOME ADDRESS OF SOURCE PRINCIPAL BUSINESS ACTIVITY OF SOURCE PART C — REAL PROPERTY [Land, buildings owned by the reporting person - See instructions] (If you have nothing to report, write "none" or "nla") Primary Residence You are not limited to the space on the lines on this form. Attach additional sheets, if necessary. FILING INSTRUCTIONS for when and where to file this form are located at the bottom of page 2. INSTRUCTIONS on who must file this form and how to fill it out begin on page 3. CE FORM 1 - Effective: January 1, 2022 Incorporated by reference in Rule 34-8.202(1). F.A.C. (Continued on reverse side) PAGE 1 PART D — INTANGIBLE PERSONAL PROPERTY [Stocks, bonds, certificates of deposit, etc. - See instructions] (If you have nothing to report, write "none" or "n/a") TYPE OF INTANGIBLE N/A CS BUSINESS ENTITY TO HIGH THE PROPERTY RELATES N/A CS PART E — LIABILITIES [Major debts - See instructions] (If you have nothing to report, write "none" or "n/a") NAME OF CREDITOR Associated Credit Union ADDRESS OF CREDITOR 6251 Crooked Creek Rd, P'tree Corners, GA 30092 NAME OF CREDITOR MOHELA ADDRESS OF CREDITOR 633 Spirit Dr., Chesterfield, MO 63005 PART F — INTERESTS IN SPECIFIED BUSINESSES Ownership or positions in certain types of businesses - See instructions] (If you have nothing to report, write "none' or "n/a") NAME OF BUSINESS ENTITY BUSINESS ENTITY #1 CGS LAW. P.A. A/KA ADDRESS OF BUSINESS ENTITY 7001 N. Atlantic Ave., Ste. 110, 32920 PRINCIPAL BUSINESS ACTIVITY Legal Services BUSINESS ENTITY # 2 Smarter Legal Solutions POSITION HELD WITH ENTITY Owner/ Operator I OWN MORE THAN A 5% INTEREST IN THE BUSINESS YES- 100% NATURE OF MY OWNERSHIP INTEREST Owner/ Operator PART G — TRAINING For elected municipal officers appointed school superintendents, and commissioners of a community redevelopment agency created under Part III. Chapter 163 required to complete annual ethics training pursuant to section 112.3142, F.S. ❑ I CERTIFY THAT I HAVE COMPLETED THE REQUIRED TRAINING. IF ANY OF PARTS A THROUGH G ARE CONTINUED ON A SEPARATE SHEET, PLEASE CHECK HERE ❑ SIGNATURE OF FILER: Signature: Date Signed 8/17/22 CPA or ATTORNEY SIGNATURE ONLY If a certified public accountant licensed under Chapter 473, or attorney in good standing with the Florida Bar prepared this form for you, he or she must complete the following statement: I, , prepared the CE Form 1 in accordance with Section 112.3145, Florida Statutes, and the instructions to the form. Upon my reasonable knowledge and belief, the disclosure herein is true and correct. CPA/Attorney Signature: Date Signed: FILING INSTRUCTIONS: If you were mailed the form by the Commission on Ethics or a County Supervisor of Elections for your annual disclosure filing, return the form to that location. To determine what category your position falls under, see page 3 of instructions. Local officers/employees file with the Supervisor of Elections of the county in which they permanently reside. (If you do not permanently reside in Florida, file with the Supervisor of the county where your agency has its headquarters.) Form 1 filers who file with the Supervisor of Elections may file by mail or email. Contact your Supervisor of Elections for the mailing address or email address to use. Do not email your form to the Commission on Ethics, it will be returned. State officers or specified state employees who file with the Commission on Ethics may file by mail or email. To file by mail, send the completed form to P.O. Drawer 15709, Tallahassee, FL 32317-5709; physical address: 325 John Knox Rd, Bldg E, Ste 200, Tallahassee, FL 32303. To file with the Commission by email, scan your completed form and any attachments as a pdf (do not use any other format), send it to CEForm1@leg.state.fl.us and retain a copy for your records. Do not file by both mail and email. Choose only one filing method. Form 6s will not be accepted via email. Candidates file this form together with their filing papers. MULTIPLE FILING UNNECESSARY: A candidate who files a Form 1 with a qualifying officer is not required to file with the Commission or Supervisor of Elections. WHEN TO FILE: Initially, each local officer/employee, state officer, and specified state employee must file within 30 days of the date of his or her appointment or of the beginning of employment. Appointees who must be confirmed by the Senate must file prior to confirmation, even if that is less than 30 days from the date of their appointment. Candidates must file at the same time they file their qualifying papers. Thereafter, file by July 1 following each calendar year in which they hold their positions. Finally, file a final disclosure form (Form 1F) within 60 days of leaving office or employment. Filing a CE Form 1 F (Final Statement of Financial Interests) does not relieve the filer of filing a CE Form 1 if the filer was in his or her position on December 31, 2021. CE FORM 1 - Effective. January 1. 2022. Incorporated by reference in Rule 34-8.202(1), F.A.C. PAGE 2 STATEMENT OF CANDIDATE (Section 106.023, F.S.) (Please print or type) OFFICE USE ONLY RECEUVED AUG 17 2022 MG I, Carroll Sanders candidate for the office of City Council have been provided access to read and understand the requirements of Chapter 106, Florida Statutes. X (Signature) Signature of Candidate 8-17-2022 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) CITY OF CAPE CANAVERAL 100 POLK AVE. CAPE CANAVERAL, FL 32920 (321) 868-1220 Received Of: CARROLL G SANDERS The sum of: $39.00 RECEIPT 08/ 17/ 202215:40 Number: Cashier: 78726 C.Puleo ELE TAX ELECTION TAX PAYABLE MISC MISC Total $ 24.00 $15.00 $39.00 TENDERED: Remaining Balance: $0.00 CHECK 91 $39.00 CANDIDATE OATH NONPARTISAN OFFICE . (Do not use this form if a Judicial or School Board Candidate) Check box only if you are seekingto qualify as a write-in candidate: ❑ Write-in candidate RECEIVED AUG 19 2022 CCO DL 11:40A OFFICE USE ONLY Candidate Oath (Section 99.021(1)(a), Florida Statutes) I, Carroll Sanders , (Print name above as you wish it to appear on the ballot. If your last name consists of two or more names but has no hyphen, check box ❑ (see page 2 - Compound Last Names). No change can be made after the end of qualifying. Although a write-in candidate's name is not printed on the ballot, the name must be printed above for oath purposes.) am a candidate for the nonpartisan office of City Council , , (Office) (District #) , ; I am a qualified elector of Brevard County, Florida; (Circuit #) (Group or Seat #) I am qualified 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. Candidate's Florida Voter Registration Number (located on your voter information card): 103627316 Phonetic spelling for audio ballot: Print 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 2 of this form): (Not applicable to write-in candidates.] K-ER-uh-I SAND-er-s X (321) 234-5244 Info@carrollsanders.com Signature of Candidate Telephone Number Email Address 221 Canaveral Beach Blvd. Cape Canaveral Florida 32920 Address City State ZIP Code STATE OF FLORIDA COUNTY OF BREVARD (Intitial) 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 X this 19th day of August, 2022 Personally Known ❑ OR Produced Identification X Type of Identification Produced: FL DL Daniel LaFever Notary Public State of Florida Comm# HH014221 Expires 6/24/2024 DS-DE 302NP (Rev. 08/2021) Rule 1S-2.0001, F.A.C. APPOINTMENT OF CAMPAIGN TREASURER AND DESIGNATION OF CAMPAIGN DEPOSITORY FOR CANDIDATES (Section 106.021(1), F.S.) RECEIVED SEP 12 2022 By: 12:56 PM KS (PLEASE PRINT OR TYPE) NOTE: This form must be on file with the qualifying officer before opening the campaign account. 1. CHECK APPROPRIATE BOX(ES): ❑ Initial Filing of Form Re -filing to Change: X Treasurer/Deputy ❑ Depository Office ❑ Party 2. Name of Candidate (in this order: First, Middle, Last) Carroll Sanders 3. Address (include post office box or street, city, state, zip code) 221 Canaveral Beach, Blvd. Cape Canaveral, FL 32920 4. Telephone ( 404 ) 410-6203 5. E-mail address Carroll@carrollsander 6. Office sought (include district, circuit, group number) City Council 7. If a candidate for a nonpartisan office, check if applicable: ❑ My intent is to run as a Write -In candidate. 8. If a candidate for a . artisan office, check block and fill in name of party as applicable: My intent is to run as a Write -In X No Party Affiliation ❑ Party candidate. 9. I have appointed the following person to act as my ❑ Campaign Treasurer X Deputy Treasurer 10. Name of Treasurer or Deputy Treasurer Stephen J. Cribb 11. Mailing Address 10524 Demillo Place #305 12. Telephone (252) 423-0046 13. City Orlando 14. County Orange 15. State FL 16. Zip Code 32836 17. E-mail address Stephen@cgslaw.org 18. I have designated the following bank as my X Primary Depository ❑ Secondary Depository 19. Name of Bank Sunrise Bank 20. Address 5604 N. Atlantic Ave. 21. City Cocoa Beach 22. County Brevard 23. State FL 24. Zip Code 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 September 10, 2022 26. Signature of Candidate X (Signature) 27. Treasurer's Acceptance of Appointment (fill in the blanks and check the appropriate block) I, Stephen J. Cribb , do hereby accept the appointment (Please Print or Type Name) designated above as: ❑ Campaign Treasurer. X Deputy Treasurer. September 10, 2022 X (Signature) Date Signature of Campaign Treasurer or Deputy Treasurer. DS-DE 9 (Rev. 10/10) Rule 1S-2.0001, F.A.C.