Candidate Packet_Jayson French_11/7/2023 jr
Lori McWilliams, MPA, MMC Date: W 'T — l 2023
Village Clerk RECEIVED
Village of Tequesta
345 Tequesta Drive NOV - 7 2023
Tequesta, Florida 33469
VILLAGE CLERKS OFFICE
RE: NOTICE OF CANDIDACY
I 5' '��1 }� a resident of the Village of Tequesta, residing
at `, ov for a minimum of one continuous year prior to qualif ing, do
hereby file as a Candidate for the two (2) year term for the Office of the Council Member, Seat No. I on
the Tequesta Village Council to be elected by the Village electors at the Municipal Election to be held on
March 19, 2024.
In accordance with the provisions of the Village Charter and Code of Ordinances, I certify that I meet the
qualifications for candidacy:
• I am a registered voter of the incorporated Village of Tequesta
• I reside at the above stated address within the incorporated Village of Tequesta
• I have resided in the Village of Tequesta for a minimum of one continuous year prior to qualifying
• I 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 the following:
• Candidate Oath
• Statement of Financial Interests (Form 1 —2022).
• Petitions containing the signatures of at least fifty (50) registered voters of the incorporated Village of
Tequesta in support of my candidacy
• Notice of Candidacy
• L&A Testing
• Residency Affidavit
• Check for $112.71 payable to the Village of Tequesta
• Copy of Driver's License or State ID Card
Respectfully submitted,
�Z 5- .
Candid ignature
Office use only:
Date filed: 1 �-3 Received by: Date Candidate Qualified: 11140
Received by the Village Clerk:
Oath of Candidate
Statement of Financial Interests From 1-2022
Nominating Petitions L)
Notice of Candidacy
L&A Testing
Residency Affidavit
✓' Driver's License to prove residency — SOE will certify voter status
Qualifying Check
CANDIDATE OATH
NONPARTISAN OFFICE RECEIVE®
(Do not use this form if a Judicial or School Board Candidate) ^
Check box only if you are seeking to qualify as a write-in NOV — 7 2023`,k
candidate: "
VILLAGE CLERKS OFFICE
Write-in candidate
OFFICE USE ONLY
Candidate Oath
Name to appear on ballot: _�]—' �' S Q A �_— /V c 14
Check box if two last names without hyphen. ❑ (Name cannot be changed after qualifying.)
Check box if name includes nickname. ❑ (For use of a nickname,you must complete the Nickname Affidavit on reverse side.)
I swear or affirm that I am a candidate for the nonpartisan office of VI
Office) (District#)
-S ` r� II
C�G ; 1 am a qualified elector of (ll/� CSC U�.1'� County, Florida
(Circuit#) (Group or Seat#)
I am a qualified elector 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.
Statement of Outstanding Fines, Fees, or Penalties
I owe outstanding fines, fees, or penalties,that cumulatively exceed$250,for ethics or campaign finance violations(s. 99.021(1)(d), F.S.).
YES,I Do NO,I Do Not ✓
If you do,you must also specify the amount owed and each entity that levied the same on the reverse side.
X (sc;,0 �2 8
SigrLorAo6f Candidate Telephone Number Email Address
Address of Legal Residence City State ZIP Code
STATE OF FLORIDA t `
COUNTY OF Palm QrC&C.k tk M
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 LORI MCWILUAMS
�041;...Vb.:
OR physical presence '_' �* Commission#HH 011916
this day of 20 ' ; P ' Expires October 18,2024
•''•°f.F;;. Banded Thru Troy Fain Insurance 800.3E5�7019
Personally Known ❑ OR Produced Identification � C �1
Type of Identification Produced: 1 'Aa,I o
DS-DE 302NP(Eff. 10/2023) Rule 1S-2.0001, F.A.C.
Phonetic Spelling of Name
Phonetic spelling for the audio ballot(not required for qualifying purposes): Print the 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 3 of this form):
Ci SL) H-t1C'k
Statement of Outstanding Fines, Fees or Penalties
Pursuant to Section 99.021(1)(d), F.S., each candidate, whether a party candidate, a candidate with no party affiliation, or a write-in
candidate, shall,at the time of subscribing to the oath or affirmation,state in writing whether he or she owes any outstanding fines, fees,
or penalties that cumulatively exceed$250 for any violations of s.8,Art. II of the State Constitution,the Code of Ethics for Public Officers
and Employees under part III of chapter 112, any local ethics ordinance governing standards of conduct and disclosure requirements,or
chapter 106.
Amount Entity
Affidavit of Nickname (Only required if using nickname for the ballot.)
My legal name is . I am over the age of eighteen(18)and the contents of this
affidavit are true and correct.
My nickname is I am generally known by this nickname or have used it as part
of my legal name. I have not created the nickname to mislead voters. My nickname does not imply I am some other person, constitute
a political slogan or otherwise associate me with a cause or issue, or that is obscene or profane.
Signature of Candidate:
STATE OF FLORIDA
COUNTY OF
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 ❑
this day of ,20
Personally Known ❑ OR Produced Identification ❑
Type of Identification Produced:
DS-DE 302NP(Eff. 10/2023) Rule 1S-2.0001, F.A.C.
FORM 1 STATEMENT OF 2021
Please print or type your name,mailing FINANCIAL INTERESTS FOR OFFICE USE ONLY:
address,agency name,and position below:
LAST NAME--FIRST NAME--MIDDLE NAME
French Jayson Edward
MAILING ADDRESS
39 Willow Rd RECEIVE®
N 0 V -- 7 2023+-
CITY : ZIP: COUNTY: VILLAGE CLERKS OFFICE
equesta 33469 Palm Beach County
NAME OF AGENCY: RECEIVED
Village of Tequesta \ s
NAME OF OFFICE OR POSITION HELD OR SOUGHT. NOV 2 1 2023 ���
Council Seat 1 VILLAGE CLERKSOFFlCE ���
CHECK ONLY IF ❑✓ 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 CAR 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"nia")
NAME OF SOURCE SOURCE'S DESCRIPTION OF THE SOURCE'S
OF INCOME ADDRESS PRINCIPAL BUSINESS ACTIVITY
City of West Palm Beach 401 Clematis St.West Palm Beach,FL 33401 Firefighter/Paramedic
International Assoc.of Firefighters 1750 New York Ave.Washington DC 20006 Consultant
Enviro Management Inc. 2370 W.state Route 89 sedona,Arizona 86336 Consultant
Pal eGC, Lou.. cow -?3-�Y s Cai S., 14ve FL
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"nia")
NAME OF NAME OF MAJOR SOURCES ADDRESS PRINCIPAL BUSINESS
BUSINESS ENTITY OF BUSINESS'INCOME OF SOURCE ACTIVITY OF SOURCE
n/a
PART C—REAL PROPERTY [Land, buildings owned by the reporting person-See instructions] You are not limited to the space on the
(If you have nothing to report,write"none"or'Wa") lines on this form.Attach additional
sheets, if necessary.
n/a 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 (Continued on reverse side) PAGE 1
Incorporated by reference in Rule 34-8.202(1),F.A.C.
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 BUSINESS ENTITY TO WHICH THE PROPERTY RELATES
a L o L-'C 1 .S 3� v c /--174 1 d C1we 4d1 V f-1`7 e-1
�G Ms M. 4I �.� S v64e— �C,
PART E—LIABILITIES [Major debts-See instructions]
(If you have nothing to report,write"none"or"n/a")
NAME OF CREDITOR ADDRESS OF CREDITOR
n/a
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 BUSINESS ENTITY#2
NAME OF BUSINESS ENTITY n/a
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,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: CPA or ATTORNEY SIGNATURE ONLY
If a certified public accountant licensed under Chapter 473,or attorney
Signature: 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.
Date Signed:
CPA/Attorney Signature:
11 17/2023
Date Signed:
FILING INSTRUCTIONS:
If you were mailed the form by the Commission on Ethics or a County Candidates file this form together with their filing papers.
Supervisor of Elections for your annual disclosure filing, return the MULTIPLE FILING UNNECESSARY:A candidate who files a Form
form to that location. To determine what category your position falls 1 with a qualifying officer is not required to file with the Commission
under, see page 3 of instructions. or Supervisor of Elections.
Local officers/employees file with the Supervisor of Elections WHEN TO FILE: Initially, each local officer/employee, state officer,
of the county in which they permanently reside. (If you do not and specified state employee must file within 30 days of the
permanently reside in Florida, file with the Supervisor of the county date of his or her appointment or of the beginning of employment.
where your agency has its headquarters.) Form 1 filers who file with Appointees who must be confirmed by the Senate must file prior to
the Supervisor of Elections may file by mail or email. Contact your confirmation, even if that is less than 30 days from the date of their
Supervisor of Elections for the mailing address or email address to appointment.
use. Do not email your form to the Commission on Ethics. it will be
returned. Candidates must file at the same time they file their qualifying
State officers or specified state employees who file with the papers.
Commission on Ethics may file by mail or email. To file by mail, Thereafter,file by July 1 following each calendar year in which they
send the completed form to P.O. Drawer 15709, Tallahassee, FL hold their positions.
32317-5709; physical address: 325 John Knox Rd, Bldg E, Ste 200, Finally, file a final disclosure form (Form 1 F) within 60 days of
Tallahassee, FL 32303. To file with the Commission by email, scan leaving office or employment. Filing a CE Form 1 F(Final Statement
your completed form and any attachments as a pdf(do not use any of Financial Interests)does not relieve the filer of filing a CE Form 1
other format), send it to CEForml@ieg.state.fl.us and retain a copy if the filer was in his or her position on December 31,2021,
for your records. Do not file by both mail and email. Choose only one
filing method. Form 6s will not be accepted via email.
CE FORM 1-Effective:January 1.2022, PAGE 2
Incorporated by reference in Rule 34-8.202(1).F.A.C.
VOTE
9 O
cous04 �
CERTIFICATION
I, WENDY SARTORY LINK, SUPERVISOR OF ELECTIONS, for Palm Beach County,
Florida, do hereby certify that 59 signatures on the Nominating Petitions of JAYSON E.
FRENCH for VILLAGE COUNCIL, SEAT 1, 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 JAYSON EDWARD FRENCH is a registered voter in Precinct
6803, in the Village of Tequesta, Florida.
I am only certifying that the signatures match the signatures we have on file and that the
electors reside within the municipal limits. I am not certifying the validity or legal sufficiency
of the petitions.
Signed, this the 9t"day of November, 2023.
WENDY SAP ORY LINK
SUPERVISOR' OF ELECTIONS
PALM BEACH COUNTY
(SEAL)
Wendy SartOry Link Palm Beach County Supervisor of Elections
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Village of Tequesta
345 Tequesta Drive 561-769-0700
Tequesta, FL 33469 www.tequesta.org
-D
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RECEIVED
NOV - 7 2023
VILLAGE CLERKS OFFICE
NOTICE OF LOGIC AND ACCURACY(L&A)TEST
I, --j C4Cy-sc,-\ E. H e') (J\ , 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 19,2024
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) q§kdfidate Signature
7/2 �
Date
RECEIVED
RESIDENCY AFFIDAVIT NOV - 7 2023' V
Village of Tequesta VILLAGE CLERKS OFFICE
Charter- Section 2.02. -Qualifications and Disqualifications.
No person shall be eligible to hold any elective office of the Village unless said person shall be a
qualified elector and resident of the Village for a minimum of one continuous year
prior to qualifying.
I swear (or affirm) under oath that I have been a resident of the Village of Tequesta continuously
for the one (1) year immediately preceding qualification, and that I have read and meet all of the
requirements of Section 2.02. Qualifications and Disqualifications of the Village Charter.
Under penalties of perjury, I declare that I have read the foregoing affidavit and that the facts
stated in it are true.
�CiJ�sGr1 'Z'
Print Name of Candidate Sign of Candidate
—?I Oi 110 'J c1
Residence Address (do not use post office box)
1 e
City State Zip Code
i ) 1 1 12 G; 3 �l
Cell Phone
Email Address
SWORN TO (OR AFFIRMED) and SUBSCRIBED before me this day of N
1 Commissbn#HH 011916
il�'
xm�'
Expires October 18,2024
Braided TWv Uoy Fein In um"$003*7010 Lori McWilliams, M M C
Village Clerk
Village of Tequesta
Please attach one of the following items as proof of residency for the one(1)year immediately
preceding qualification: Village of Tequesta Utility bill in your name or rental/lease agreement
showing rental date range.
Village of Tequesta '
345 Tequesta Drive
To receive a paperless water bill Tequesta FL 33469
instead of a paper copy, please
check the box and provide your 561-768-0421
email below.
WWW.tequesta.org
Regular Hours of Operation:
Monday-Friday 8:30am-5:00pm
After-Hours Emergencies Call 561-768-0421
FRENCH,JAYSON &JESSICA
39 WILLOW RD
Account Number 2142220157 TEQUESTA, FL 33469
Please Pay $110.98
By Due Date Of 11/14/2023
Return the upper portion with payment
Service Information Messages
Account Number: 2142220157
Location ID: WLWR-000039-0000-05
Service Address: 39 WILLOW RD
PIN Number: 3e65414
Water Used From: 09/01/23 to 10/01/23
Monthly Billing Detail Consumption History per Billing
Previous Balance: $0.00 30
25 N N
N N
20 W
FIRE PROTECTION $1.39
,s Q
MONTHLY SERVICE CHARGE $22.25 C r
WATER $69.12 0
CAPITAL IMPROVEMENT CHG $10.00 °°
UTILITY TAX TEQ $8.22 5
0
Oct-1 Dec-1 Feb-1 Apr-1 Jun-1 Aug-1 Oct-1
Current Bill Due By: 11/14/23
Current Charges For This Billing $110.98 Water Usage Detail in 1000's of Gallons
$110.98 Meter From To Read Gallons
1 09/01/23 10/01/23 936 17
If unpaid, a 1% late fee will be assessed or a $5
minimum charge as of 11/14/23
Amount Due If Late: 11/15/2023 $125.98
Please Retain This Portion For Your Records