HomeMy WebLinkAboutCandidate Packet_Harrison Vaughn_12/11/2020/o"N
n
Date:
j Ii Z0-2,
Lori McWilliams, MMC
Village Clerk
Village of Tequesta
345 Tequesta Drive
Tequesta, Florida 33469
RE: NOTICE OF CANDIDACY
RECEIVED
VILLAGE CLERKS OFFICE
I I` �' '`� �1c1 �� a resident of the Village of Tequesta, residing at
do hereby file as a Candidate for the two (2) year term for
the Office of the Council Member, Seat No. on the Tequesta Village Council to be
elected by the Village electors at the Municipal Election to be held on March 9, 2021.
In accordance with the provisions of the Village Charter and Code of Ordinances, I certify that I
meet the qualifications for candidacy:
• 1 am a registered voter of the incorporated Village of Tequesta
• 1 reside at the above stated address within the incorporated Village of Tequesta
• 1 do not hold any other public office in the Village (Exceptions: Notary Public,
membership in the National Guard, organized Reserve of the Armed Forces of the
United States, or in any other defense agency recognized by the Village, or in a status of
retirement from any of the foregoing)
• 1 acknowledge that I must subscribe to the Oath of Office as outlined in the Section 2.03
of the Village Charter and as required by 99.021, F.S.
Attached is a petition containing the signatures of at least fifty (50) registered voters of the
incorporated Village of Tequesta in support of my candidacy, a check for $107.93 payable to the
Village of Tequesta for the required $30.00 filing fee and the Florida Department of State's
$77.93 assessment fee (1% of the annual salary of the office being sought), and a completed
Statement of Financial Interests (Form 1 — 2019).
Respectfully submitted,
Candidate's Signature
Office use only:
Date filed: 121h L2R Received by: lYWC, Date Candidate Qualified:
Received by the Village Clerk:
✓
Loyalty Oath / Oath of Candidate
Candidate Name Pronunciation on Oath of Candidate)
v
Statement of Financial Interests From 1-2019
✓
Nominating Petitions
/
Notice of Candidacy
L&A Testing
Driver's License (to prove residency — SOE will certify voter status)
Qualifying Check
0
Village
345 Tequesta Drive
Tequesta, FL 33469
of Tequesta
t'
561-768-0700
www.tequesta.org
RECEIVED
VILLAGE CLERKS OFFICE
NOTICE OF LOGIC AND ACCURACY (L&A) TEST
the undersigned, hereby
acknowledge that "Due Notice" has been given to me that the "Logic and Accuracy Testing of the
Computerized Tabulation Equipment," which will be used to tabulate the votes cast for the March 9,
2021 Municipal Election, will be on TBA at the Palm Beach County Supervisor of Elections Office.
I plan to attend the Logistics and Accuracy Test
I do not plan to attend the Logistics and Accuracy Test
Candidate Name (Print) Candidate ignature
21-
Date
Vice -Mayor Kyle Stone Mayor Abby Brennan
Council Member Laurie Brandon
Council Member Frank D'Ambra
Council Member Bruce Prince
Village Manager Jeremy Allen
CANDIDATE OATH —
NONPARTISAN OFFICE
AECEIVED
blot
use this form if a Judicial or School Board Candidate)
ieck box only if you are seeking to qualify as a
write-in candidate:
, OD
VILLAGE CLERKS OFFICE
❑ Write-in candidate
OFFICE USE ONLY
Candidate Oath
`
ii / (Section 99.021 (1 )(a), Florida Statutes)
(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 C-4-KA 6--
V (Office) (District #)
z__ ; I am a qualified elector of C < 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
r''Vk; and I have resigned from any office from which I am required to resign pursuant to Section 99.012, Florida Statutes;
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): 7 � 3 I- J
Phonetic spelling for audio ballot: Print name phonetically on the line below as you wish it to be pronounced on the audio
ballot as maybe used by persons with disabilities (see instructions on page 2 of this form): [Notapplicab/e to write-in candidates.]
i'
Signature of Candi ate Telephone Number Email Address W�^
i
Address city State ZIP Code
qq
STATE OF FLORIDA
Signature of Notary Public
COUNTY OF Pn I fY) h Print, Type, or Stamp Commissioned Name of Notary Public below:
Sworn to (or affirmed) and subscribed before me by physical or ;;w:: •., pUNACOLETTEMANAII
Commission l HH 064373
,nline presence this. day of , 201C. = Z
Exores November 17, 2024
Personally Known: or Produ ed Identification: °',f`•• B.W Tin Troy Fan kiaur,. Bo Urpolo
ony
. ef5
Type of Identification Produced: `-- ,Sc "_)%e_1 - L
DS-DE 302NP (Rev. 04/20) Rule 1S-2.0001. F.A.C.
FORM 1 STATEMENT OF
2019
Please print or type your name, mailing FINANCIAL INTERESTS FOR OFFICE USE ONLY:
ress, agency name, and position below:
.,TT NAME — FIRST NAME — MIDDLE NAME:
MAILING ADDRESS:
RECEIVES`.
l �
VILLAGE CLERKS OFFICE
CITY: ZIP: COUNTY:
i(
C
NAME OFLLAGENCY:
ll
NAME OF OFFICE ,OR POSITION HELD OR SOUGHT:
CHECK ONLY IF J— CANDIDATE OR EJ NEW EMPLOYEE OR APPOINTEE
**** THIS SECTION MUST BE COMPLETED ***�
DISCLOSURE PERIOD:
THIS STATEMENT REFLECTS YOUR FINANCIAL INTERESTS FOR CALENDAR YEAR ENDING DECEMBER 31, 2019.
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
j000iNe instructions for further details). CHECK THE ONE YOU ARE USING (must check one):
❑ COMPARATIVE (PERCENTAGE) THRESHOLDS OR R1 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 SOURCE'S
DESCRIPTION OF THE SOURCE'S
OF INCOME ADDRESS
PRINCIPAL BUSINESS ACTIVITY
L L,) 4-
ems. .mac. �•tiz—
7. G}
1.+2
Z t..��i S ` I-1 L
r l'Lj �.w •'�C-� _ ISM I ^3C wel
PART B -- SECONDARY SOURCES OF INCOME
[Major customers, clients, and other sources of income to businesses owned by the reporting person - See instructions]
(If you have nothing to report, write "none" or "n/a")
NAME OF NAME OF MAJOR SOURCES ADDRESS
PRINCIPAL BUSINESS
BUSINESS ENTITY OF BUSINESS' INCOME OF SOURCE
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 "n/a")
You are not limited to the space on the
lines on this form. Attach additional
110� f r
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, 2020 (Continued on reverse side) PAGE 1
RECEIVED ,A
r�
PART D — INTANGIBLE PERSONAL PROPERTY [Stocks, bonds, certificates of deposit, etc. - See instructions]
(If you have nothing to report, write "none" or "n/a") ,GGEE CCLLEERR
BUSINESS ENTITY TO WHICH THE PROPERTYARELATESKS OFFICt=
TYPE OF INTANGIBLE
PART E — LIABILITIES [Major debts - See instructions]
(If you have nothing to report, write "none" or'Wa")
NAME OF CREDITOR
ADDRESS OF CREDITOR
I `7L-- (— I CI �/I A,.- S, tc-D
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")
BUSINESS ENTITY # 1
NAME OF BUSINESS ENTITY (�
ADDRESS OF BUSINESS ENTITY
PRINCIPAL BUSINESS ACTIVITY
POSITION HELD WITH ENTITY
I OWN MORE THAN A 5% INTEREST IN THE BUSINESS
NATURE OF MY OWNERSHIP INTEREST
PART G — TRAINING
For elected municipal officers required to complete annual ethics training pursuant to section 112.3142, F.S
BUSINESS ENTITY # 2
0 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:
Signed:
I ( V2,0---,
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
mission on Ethics may file by mail or email. To file by mail,
the completed form to P.O. Drawer 15709, Tallahassee, FL
i 7-5709; 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 CEForml@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.
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:
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 1 F) 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, 2019.
�� r�Rm - ❑octave: January i. note. PAGE 2
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SUPERVISOR OF ELECTIONSga Wendy Sartory link
'?- 2020 DEC I I AM 11= S o
OF PA' ` palm Beach County Supervisor of Elections
PALM BE CH cOuNTY, FL.
PETITION SUBMITTANCE FORM
Name on Petition, Candidate, or Committee:
Office Candidate is seeking: V ! i
Number of Petitions Submitted: (Approx.) T
7
V"
Name of person submitting petitions: LOVi bd C U )[ ! J a-ft S
Address:
City, State, Zip Code:
Phone:
Signature:
Deputy's Initials: _ �il .2
Revised 04/2020
3VS e
s-P, fir.
7zi_ 33
Email: ; I f 1l /J�(� { sSk .
Date: ]�-! i ( ?22D - - -
240 South MilitaryTrail, West Palm Beach, FL 334151 Post Office Box 22309, West Palm Beach, FL 33416
Telephone: 561.656.62001 Fax Number: 561.656.6287
pp1
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Wently Sartory link
OF pA`� Palm Beach County Supervisor of Elections
CERTIFICATION
I, WENDY SARTORY LINK, SUPERVISOR OF ELECTIONS, for Palm Beach County, Florida, do
hereby certify that 73 signatures on the Nominating Petitions of HARRISON VAUGHN for SEAT
2, FOR THE VILLAGE OF TEQUESTA are registered electors within the municipal limits of the
VILLAGE of TEQUESTA, according to the registration records on file in this office.
This is to further certify that HARRISON VAUGHN is a registered voter in Precinct 1078, in the
Village of Tequesta, Florida.
Signed, this the 11t"day of December, 2020.
WENDY SARTORY LINE(
SUPERVISOR OF ELECTIONS
PALM BEACH COUNTY
(SEAL)
240 South Military Trail. West Palm Beach. FL 334151 Post Office Box 22309. West Palm Beach. FL 33416
Telephone: 561.656.62001 Fax Number: 561.656.6287
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