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Candidate Packet_Julie Mitchell_11/15/2023 Lori McWilliams, MPA, MMC Date: �U 13 2023 !Ilage Clerk RECEIVED age of Tequesta ' S 3 Tequesta Drive N O V 2023 equesta, Florida 33469 VILLAGE CLERKS OFFICE RE: NOTICE OF CANDIDACY I �f sI ` " I a resident of the Village of Tequesta, residing at , for a minimum of one continuous year prior to qualifying, do hereby file as a Candidate for the two (2) year term for the Office of the Council Member, Seat No. _L _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 Re ZIly 2L�Z ndidate's Signature Office use only: X I Date filed: It Received by: "4--- Date Candidate Qualified: Received by the Village Clerk: Oath of Candidate Statement of Financial Interests From 1-2022 'Nominating Petitions -11 Notice of Candidacy L&A Testing Residency Affidavit Driver's License to prove residency- SOE will certify voter status CANDIDATE OATH NONPARTISAN OFFICE (Do not use this form if a Judicial or School Board Candidate) RECEIVED "heck box only if you are seeking to qualify as a write-in andidate: NOV 15 2023 Write-in candidate VILLAGE CLERKS OFFICE OFFICE USE ONLY KILLCIVEW Candidate Oath NOV 2 1 20234 Name to appear on ballot: 1 I Ll t `� b I VILLAGE CLERKS OFFICE�h��' ' 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 V1 I F l l D I am a qualified elector of Q(,L�m r 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 "onstitution 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 V If you do,you must also specify the amount owed and each entity that levied the same on the reverse side. LSignajfure � of C didate Telep!2 -Number / EmailAddress ress of Legal Residence City State ZIP Code STATE OF FLORIDA flia" COUNTY OF �(}f ��-[��j Signatlurre.of Notary Public Print,Type,or Stamp Commissioned Name of Notary Public below: Sworn to(or affirmed)and subscribed before me by meanss of online notarization El 11 OR ' physical presence 51 �S day of N� 6tt 200 LORI M sion#HH 0 this '� � Commission#HH011916 a Expires October 18,2024 Personally Known Er— OR Produced Identification ❑ O•:':° eomW TNvTmy F&Insumm 800 385 Iota ype of Identification Produced: DS-DE 302NP(Eff. 10/2023) Rule 1S-2.0001,F.A.C. Phonetic Spellingo ame 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): 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 U-1/ . 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. 1012023) Rule 1S-2.0001, F.A.C. FORM I STATEMENT OF 202 ease print or type your name,mailinglow: FINANCIAL, INTERESTS FOR OFFICE USE ONLY: Jdress,agency name,and position be LAS AME—FIR ST NAME—MIDDLE NAME: tfi c MAILING ADPLRESS ' RECEIVED NOV 15 2023 CITY �3 I C N fac VILLAGE CLERKS OFFICE N ME OF ENCY: --- S . ( �Fl U-e fGi- NAME OFF OFFICE OR P TION HELD OR SOUGHT: CHECK ONLY IF CANDIDATE OR [3 NEW EMPLOYEE OR APPOINTEE **** THIS SECTION MUST BE COMPLETED **** DISCLOSURE PERIOD: THIS STATEMENT REFLECTS YOUR FINANCIAL INTERESTS FOR CALENDAR YEAR ENDING DECEMBER 31, 2022. MANNER OF CALCULATING REPORTABLE INTERESTS: FILERS HAVE THE OPTION OF USING REPORTING THRESHOLDS THATARE ABSOLUTE DOLLAR VALUES,WHICH REQUIRES WER CALCULATIONS, OR USING COMPARATIVE THRESHOLDS, WHICH ARE USUALLY BASED ON PERCENTAGE VALUES e instructions for further details). CHECK THE ONE YOU ARE USING (must check one): ❑ COMPARATIVE (PERCENTAGE)THRESHOLDS OR �r 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 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 I ACTIVITY OF SOURCE 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"n!a") lines on this form.Attach additional sheets,ii necessary. FILING INSTRUCTIONS for when J u 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 1,2023 (Continued on reverse side) PAGE 1 Incomorated by reference in Rule 34-8.202(1).FA.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 PROPE TY RELATES PART E—LIABILITIES [Major debts-See instructions] (If you have nothing to report,write"none"or"n/a") NAME OF CREDITOR ADDRESS OF CREDITOR 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 ADDRESS OF BUSINESS ENTITY IV/ IFT 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 1 HAVE COMPLETED THE REQUIRED TRAINING. IF ANY OF PARTS A THROUGH G ARE CONTINUED ON A SEPARATE SHEET, PLEASE CHECK HERE �J 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: 1' 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: C� � CPA/Attomey Signature: Date Signed: LUNG,: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/emp/oyees 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 specked state employees who file with the papers. mmission on Ethics may file by mall or email. To file by mail, Thereafter,file by July 1 following each calendar year in which they the completed form to P.O. Drawer 15709, Tallahassee, FL hold their positions. ,17-5709; physical address: 325 John Knox Rd, Bldg E, Ste 200, Finally, file a final disclosure form (Form 1 F) within 60 days of Ilahassee, 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 CEFormi @leg.state.fl.us and retain a copy if the filer was in his or her position on December 31,2022. 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 1,2023. PAGE 2 Incorporated by reference in Rule 34.8.202(1),F.A.C. - VOTE �eF4�coutrc ~ CERTIFICATION I, WENDY SARTORY LINK, SUPERVISOR OF ELECTIONS, for Palm Beach County, Florida, do hereby certify that 53 signatures on the Nominating Petitions of JULIE MITCHELL, 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 JULIE MITCHELL is a registered voter in Precinct 6801, 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 17"day of November, 2023. NDY SAR LINK SUPERVISO OF ELECTION PALM BEACH COUNTY (SEAL) Wendy Sartory Link Palm Beach County Supervisor of Elections A � N rr 75 C w o Lr o — o (1) CL ea 13 1� a N s O= c v � w 7 (� � c fn d — cc i i� >, in :E a a `� ' � Luc o o n rA _ p W M _ em0 __~ 0 Q ' � u- E L i+ w ( E W a V wo p T Q M J co M P coo co ? cov (M M 1\ M M t tm w N w ch > M M M M co M = M v o N `: �" coo Q JC M M c cn cn cn cn �" cn cn cn cn cn cn o J a� �o a� a� aD C� (D a� c� a) a� a� _ L `—` O —�—� c !t a ci o LU 1 Q � o Q e� N d 7 h a) F-- w O d � d � ; Z �y � � N Cl� . o ^ r Z ''' F- �7 CL c m o U. 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L m Z > o � � - , � Z 0 N W O I H I O eU m � � Q c O 1 N LU N v 1 -- C Q .a ✓� L 'C O ^ ^I Ax Q Lm c a cn Cl) L it }Oi W M L pea cy O Q LL E L O Z N Q Q. co71 W co Qo a °� m O p rn rn rn `� rn rn S rn rn rn rn rn J N z m p co co efl � co 3 efl co co (D - co ✓ efl p H �� Q CM M M y M M M M M M co M M M cM M C'M M M U E W i O LL LL F LL LL -� LL LL S LL LL LL LL m > C J (tea M �� m m V m (tea `— m (tea 4- (tea m c N en en cn C� N cn V cn rn cn en to m 1�n es 07 o U a) Q) m m a� a) N ea f- H F- I- Cx �- c-6 H H N 0"a eU ea L 0 `- O > / LL eU N w' !F to 0- 0 / C U F- t W cl C, O L m Z �- ,� kn L z a C— W W Ce a ci Z a �. o Village of Tequesta 345 Tequesta Drive AKN 561-768-0700 Tequesta, FL 33469 www.tequesta.org RECEIVE® NUV 15 2023 VILLAGE CLERKS OFFICE NOTICE Or LOGIC AND ACCURACY (L&A)TEST Ait�L(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 a]1�, M J -�JLI I /I& ejj6z Candidate Name (Print) Candidate Signature Date RESIDENCY AFFIDAVIT RECEIVED Village of Tequesta NOV 15 2023 Charter-Section 2.02. - Qualifications and Disqualifications. ylLIAC;ErrL No person shall be eligible to hold any elective office of the Village unless said person sFLft9FFiCE 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 t at the facts stated in it are true. Print Name of Candidate VSiatu&reof Candidate 7� (;6 (f V(&') D f r y Residence Address (do not use post office box) 7'ea ts � City State Zip Code Cell Phone L'd I�' Lim [��d 1 7 d c-A�� Emll Address SWORN TO (OR AFFIRMED) and SUBSCRIBED before me thisA— day of v� o4007Y. * Commission#HH 011916 aa°" oner_Lls'�,2,.oy2_aTroy -- Lori McWilliams, MMC LORI MCWILLIAMS N, "�wr�0�9 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 instead of a paper copy, please Tequesta, FL 33469 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 **CREDIT BALANCE DO NOT PAY** MITCHELL,JULIE 86 GOLFVIEW DR Account Number 1082030142 TEQUESTA, FL 33469-1947 Please Pay $(151.21) By Due Date Of 11/14/2023 Return the upper portion with payment Service Information Messages Account Number: 1082030142 Location ID: GLFD-000086-0000-04 Service Address: 86 GOLFVIEW DR PIN Number: 15355ba Water Used From: 09/01/23 to 10/01/23 Monthly Billing Detail Consumption History per Billing Previous Balance: $(309.58) ;0 60 s0 FIRE PROTECTION $1.39 <o MONTHLY SERVICE CHARGE $22.25 ; o WATER $112.59 30 CAPITAL IMPROVEMENT CHG $10.00 20 UTILITY TAX TEQ $12.14 ,0 0 Oct-1 Dec-1 Feb-1 Apr-1 Jun-1 Aug4 Oct- Current Bill Due By: 11/14/23 Current Charges For This Billing $158.37 Water Usage Detail in 1000's of Gallons $(151.21) Meter From To Read Gallons 1 09/01/23 10/01/23 1173 24 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 $(151.21) Please Retain This Portion For Your Records