The URL can be used to link to this page

Home My WebLink AboutCandidate Packet_Laurie Brandon_12/15/2017 Date: 5 2017 Lori McWilliams, MMC RECEIVED Village Clerk Village of Tequesta DEC 15 2017 345 Tequesta Drive Tequesta, Florida 33469 VILLAGE CLERKS OFFICE RE: NOTICE OF CANDIDACY I < «c a✓i P— L✓ 480 n a resident of the Village of Tequesta, residing at t 7 s , 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 13, 2018. 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$103.44 payable to the Village of Tequesta for the required $30.00 filing fee and the Florida Department of State's $73.44 assessment fee (one percent (1%) of the annual salary of the office being sought), and a completed Statement of Financial Interests (Form 1 —2016). Respectful) ubmitte andidate's Signature Office use Only: Date filed: I 414lq Received by: Date Candidate Qualified: Received by the Village Clerk: Loyalty Oath /Oath of Candidate Candidate Name Pronunciation (on Oath of Candidate Statement of Financial Interests From 1-2016 Nominating Petitions Notice of Candidacy L&A Testing Driver's License to prove residency—SOE will certify voter status) Qualifying Check — I Iol--tkk RECEIVED CANDIDATE OATH - DEC 15 2017 (�ukvtjj NONPARTISAN OFFICE VILLAGE CLERKS OFFICE (Not for use by Judicial or School Board Candidates) OFFICE USE ONLY OATH OF CANDIDATE (Section 99.021,Florida Statutes) i, Eau-f-olci- bray) c�cN) (PLEASE PRINT NAME AS YOU WISH IT TO APPEAR ON THE BALLOT*— NAME MAY NOT BE CHANGED AFTER THE END OF QUALIFYING) am a candidate for the nonpartisan office of (office) (district#) I am a qualified elector of �al,/� �ecxdl\,— 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, rida Statutes; and I will upport the Constitution of the United States and the Constitution of the State of Florida. X (5c 1) 1 �- L E" �d Signature of Candidate Telephone Number Email Acl re is �7 1 Ie —Ie ue5tzk Address City L State ZIP Code Candidate's Florida Voter Registration Number(located on your voter information card): I I Cqn 9 q 7,30 * Please print name phonetically on the line below as you wish it to be pronounced on the audio ballot for persons with disabilities (see instructions on page 2 of this form): \ L dd � �� l nn� C�yld61/1 STATE OF FLORIDA COUNTY OF PPJ-W 864ttt J Sworn to(or affirmed)and subscribed before me this IS day of t)&1-0MLeV , 20 ffi ON" Personally Known: orl.Ll. / / Signature of Notary Public Produced Identification: ✓ Print Type,or Stamp Commissioned Name of Notary Public '' •• ZS� �`I�gVS� D =:a;'"Y +LORIMCWILLIAMS Type of Identification Produced:FL O(� �Y�� J *Aay.�,-" :Commission#GG 004067 s Expires October 18,2020 Bonded Thiu Troy Fain Insumna 800.385.7019 DS-DE 25(Rev.5/11) Rule 1S-2.0001,F.A.C. FORM 1 STATEMENT OF 2016 Please print or type your name,mailing FINANCIAL INTERESTS FOR OFFICE USE ONLY: tddress,agency name,and position below: LAST NAME—FIRST NAME—MIDDLE NAME: brcocLn MAILING ADDRESS _ t RECEIVED DEC 15 2017 Ap CITY: ZIP: COUNTY: VILLAGE CLERKS OFFICE 0A Tequp LI69cl, Tot NAME OF AGENCY: NAME OF OFFICE OR POSITION HELD OR SOUGHT: 3 You are not limited to the s ace on the lines on this form.Attach additional sheets,if necessary. CHECK ONLY IF to OR NEW EMPLOYEE OR APPOINTEE **** BOTH PARTS OF THIS SECTION MUST BE COMPLETED **** DISCLOSURE PERIOD: THIS STATEMENT REFLECTS YOUR FINANCIAL INTERESTS FOR THE PRECEDING TAX YEAR,WHETHER BASED ON A CALENDAR YEAR OR ON A FISCAL YEAR. PLEASE STATE BELOW WHETHER THIS STATEMENT IS FOR THE PRECEDING TAX YEAR ENDING EITHER(must check one): gym/ DECEMBER 31, 2016 OR ❑ SPECIFY TAX YEAR IF OTHER THAN THE CALENDAR YEAR MANNER OF CALCULATING REPORTABLE INTERESTS: FILERS HAVE THE OPTION OF USING REPORTING THRESHOLDS THATARE ABSOLUTE DOLLAR VALUES,WHICH REQUIRES FEWER CALCULATIONS,OR USING COMPARATIVE THRESHOLDS,WHICH ARE USUALLY BASED ON PERCENTAGE VALUES(see instructions `or further d s). CHECK THE ONE YOU ARE USING(must check one): COMPARATIVE(PERCENTAGE)THRESHOLDS OR Lr 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 UOVIC Div 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 PART C—REAL PROPERTY [Land,buildings owned by the reporting person-See instructions] (If you have nothing to report,write"none"or"nia") FILING INSTRUCTIONS for when and where to file this form are located at the bottom of page 2. 1 INSTRUCTIONS on who must file this form and how to fill it out begin on page 3. CE FORM 1-EHecuve:January 1,2077 (Continued on reverse side) PAGE t Incorporated by reference in Rule 34-8.202(l),F.AC. 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 AlQhJEI PART E—LIABILITIES [Major debts-See instructions] (If you have nothing to report,write"none"or"nla") NAME OF CREDITOR ADDRESS OF CREDITOR 1a 4CC 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 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. ❑ 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 attomey 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 Date Signed: disclosure herein is true and correct. CPA/Attorney Signature: l 1� Date Signed: FILING INSTRUCTIONS: WHAT TO FILE: WHERE TO FILE: WHEN TO FILE: After completing all parts of this form, including If you were mailed the form by the Commission Initially,each local officer/employee,state officer, signing and dating it, send back only the first on Ethics or a County Supervisor of Elections for and specified state employee must file within sheet(pages 1 and 2)for filing. your annual disclosure filing, return the form to 30 days of the date of his or her appointment that location. or of the beginning of employment. Appointees If you have nothing to report in a particular Local officers/employees file with the who must be confirmed by the Senate must file section,write"none"or"n/a"in that section(s). Supervisor of Elections of the county in which they prior to confirmation, even if that is less than permanently reside. (If you do not permanently 30 days from the date of their appointment. NOTE: reside in Florida, file with the Supervisor of the Candidates must file at the same time they file MULTIPLE FILING UNNECESSARY: county where your agency has its headquarters.) their qualifying papers. A candidate who files a Form 1 with a qualifying State officers or specified state employees Thereafter,file by July 1 following each calendar officer is not required to file with the Commission file with the Commission on Ethics, P.O. Drawer year in which they hold their positions. or Supervisor of Elections. 15709, Tallahassee, FL 32317-5709; physical Finally, file a final disclosure form (Form 1F) address:325 John Knox Road, Building E, Suite within 60 days of leaving office or employment. Facsimiles will not be accepted. 200,Tallahassee,FL 32303. Fling a CE Form 1F(Final Statement of Financial Interests)does D_ol relieve the filer of filing a CE Candidates file this form together with their qualifying papers. Form 1 if the filer was in his or her position on December 31,2016. To determine what category your position falls under,see page 3 of instructions. CE FORM 1-Effective:January 1,2017. PAGE 2 Incorporated by reference in Rule 34-8.202(1),FA.C. Village of Tequesta 345 Tequesta Drive 561-768-0700 Tequesta, FL 33469 www.tequesta.org RECEIVED DEC 15 2017 � , VILLAGE CLERKS OFFICE NOTICE OF LOGIC AND ACCURACY (L&A) TEST I, Lcxulne ,GVI rl 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 13, 2018 Municipal Election,will be on iN a vC 20 � �, (if blank date is TBA). I plan to attend the Logistics and Accuracy Test I do not plan to attend the Logistics and Accuracy Test L d Y r Candidate Name (Print) Candidate Signature i r;L/15/-14)(2 1:?-- Date Vice-Mayor Frank D'Ambra Mayor Abby Brennan Council Member Tom Paterno Council Member Steve Okun Council Member Vince.arena Village Manager Michael R.Couzzo,Jr. VILLAGE 01 _QUESTA RECEIVED March 13, 201s3 Nominating Signatures DEC 15 2017 J� %hi We, the undersigned duly qualified voters of the Village of Tequesta, do hereby nominate: CANDIDATE NAME: I L -iZ-,vm,,jczoAGE: -, to be a Candidate for the Tequesta Village Council, SEAT NO. �' , Village of Tequesta, Palm Beach County, Florida for a two (2) year term pursuant to the Charter and Ordinances of said Village. (The above must be completed on all pages ofpetition) PRINT NAME STREET ADDRESS DATE OF BIRTH SIGNATURE ve Or Tequesta, FL 33469 -:-) / (I (0 5 -2!>( � (A ' Te uesta, FL 33469 /' �� y� fC_ q� I:- Te uesta, FL 33469 0 -'a ''//�- `� 2— � Te uesta, FL 33469 I Z - 2/ -65 ,7� Te uesta, FL 33469 �3 Te uesta, FL 33469 - 1 r. ►�Y G>y��u Del�e Te uesta, FL o3 a 7/33469 5 Ian kok r6 Te uesta, FL 33469 (o - I (p --) 1 eq--� Te uesta, FL 33469 J II',-I 140 Wu I(-V-Te uesta, FL 33469 RECEIVED VILLAGE 01� -.;QUESTA March 13, 20`18 Nominating Signatures DEC 15 2017 ;`�' We, the undersigned duly qualified voters of the Village of Tequesta, do hereby nominate: CANDIDATE NAME: i e 'AGE:. to be a Candidate for the Tequesta Village Council, SEAT NO. , Village of Tequesta, Palm Beach County, Florida for a two (2) year term pursuant to the Charter and Ordinances of said Village. (The above must be completed on all pages of petition) PRINT NAME STREET ADDRESS DATE OF BIRTH .MATURE A1910 Te uesta FL 33469 ( L ci.G � � - Te uesta, FL 33469 071 Te uesta, FL 33469 /0 C��iAnj 6,L s/1-717� t� Te uesta, FL 33469 f1cv- OaUt�.* �L,,Z jo 6�8 Te uesta, FL 33469 rr �� "ZU I �'�n C'b T>r C k `Ca1 Te uesta, FL 33469 (( 44 Te uesta, FL 33469 Te uesta, FL 33469 U l ��\ 'F '`�,)#\) E I q <� Te uesta FL 33469 I Te uesta, FL 33469 VILLAGE Ok' _QUESI•A REGEIVED ,h March 13, 2018 Nominating Signatures DEC 15 2017- VILLAGE MERKS OFFICE: undersigned duly qualified voters of the Village of Tequesta, do hereby nominate: CANDIDATE NAME: AGE: to be a Candidate for the Tequesta Village Council, SEAT NO. , Village of Tequesta, Palm Beach County, Florida for a two (2) year term pursuant to the Charter and Ordinances of said Village. (The above must be completed on all pages of petition) PRINT NAME STREET ADDRESS DATE OF BIRTH SIGNATURE Te uesta FL 33469 ° r� �O 0 J f 5 n1 Te uesta, FL 33469 7 �f/ I�(o (30�-( /1 q 5 8XeAllb-- , I C� �1-0- 1Pv ;9- Te uesta, FL 33469 ba-- 17(a CrnW 4w Or 7 4"�/(7 d,6 "; a Te uesta, FL 33469 Te uesta FL 33469 1 � � Te uesta, FL 33469 H —O I Coea� S�'ic�P/ ��r, 6D �r I- ✓ cw (Y r'� � �� s Te uesta, FL 33469 Te uesta, FL 33469 I36 &d v;vwOr _ I kkck- At(- Wato oeL - Te uesta, FL 33469 31 I ►o79 n 1� Te uesta, FL 33469 RECEI'IEED VILLAGE 01 —QUESTA March 13, 20.18 Nominating Signatures DEC 1 5 2017 We, the undersigned duly qualified voters of the Village of Tequesta, do hereby nominate: VILI S OFFICE CANDIDATE NAME: �e to be a Candidate for the Tequesta Village Council, SEAT NO. . . 4)_, Village of Tequesta, Palm Beach County, Florida for a two (2) year term pursuant to the Charter and Ordinances of said Village. (The above must be completed on all pages of petition) PRINT NAME STREET ADDRESS DATE OF BIRTH SIGNATURE Tequesta, FL 33469 IS(V' Te uesta FL 33469 Te uesta FL 33469 1 � Te uesta FL 33469 Te uesta, FL 33469 Wl, / 6,111/Cer P�- Te u'en{sta, FL 33469 e uesta, FL 33469 k'0 I)IR Te uesta, FL 3 69 L"'v ro z/ Ca� Te uesta, FL 33469 / /� Te uesta, FL 33469 i VILLAGE Oki _QUESTA (RECEIVED (March 13, 20'13 Nominating Signatures DEC 1 5 2017 ' We, the undersigned duly qualified voters of the Village of Tequesta, do hereby nominate: VILLAGE CLERKS OFFICE CANDIDATE NAME: to be a Candidate for the Tequesta Village Council, SEAT NO. �, Village of Tequesta, Palm Beach County, Florida for a two (2) year term pursuant to the Charter and Ordinances of said Village. (The above must be completed on all pages of petition PRINT NAME STREET ADDRESS DATE OF BIRTH SIGNATURE q �� CIo,j sV1 �Y Te uesta, FL 33469 tu ew Te uesta, FL 33469 Psf� �5-& (76 T w 4w I Te uesta, FL 33469 <�-& &z)I f-U k zw -DC Tequesta, FL 33469 Ci n („s1'v v Lz i !� L` �'' Te uesta, FL 33469 (� U l LI i Te uesta, FL 33469 t _ 17 .5 L 6�nke.r Teguesta, FL 33469 L G, 1-1 o C� Te uesta, FL 33469 I Te uesta, FL 33469 9� Te uesta, FL 33469 \j�, VILLAGE O► _QUESTA RECEIVED A March 13, 2018 Nominating Signatures DEC IA 5 2017 ,V We, the undersigned duly qualified voters of the Village of Tequesta, do hereby nominate: CLEM CANDIDATE NAME: tit,A AGE: to be a Candidate for the Tequesta Village Council, SEAT NO. Village of Tequesta, Palm Beach County, Florida for a two (2) year term pursuant to the Charter and Ordinances of said Village. (The above must be completed on all pages of petition PRINT NAME STREET ADDRESS DATE OF BIRTH SIGNATURE ��L-i Te uesta, FL 33469 — Te uesta, FL 33469 — I`� (Z v Dr / P r)!Q nboR DV Teguesta, FL 33469 Te uesta, FL 33469 zc 6 c Te uesta, FL 33469 1to �Go »� J Te uesta, FL 33469 Mtf �f Te uesta, FL 33469t - � r 5 PAIm'clto t�Uay �lv / Te uesta, FL 33469 Tequesta, FL 33469 Te uesta, FL 33469 VILLAGE O�' _QUESTA RECEIVED ,fib � March 13, 20,18 Nominating Signatures �b " DEC 1.� �5 2017 �1�` We, the undersigned duly qualified voters of the Village of Tequesta, do hereby nominate: JILLAGE CLERKS OFFICE CANDIDATE NAME: e AGE:. , 1 - vZ to be a Candidate for the Tequesta Village Council, SEAT NO. , Village of Tequesta, Palm Beach County, Florida for a two (2) year term pursuant to the Charter and Ordinances of said Village. (The above must be completed on all pages of petition PRINT NAME STREET ADDRESS DATE OF BIRTH SIGN TURE Tequesta, FL 33469 / CJL T- I 1 �1 Te uesta, FL 33469 " dtl V(4(//A4 NOD Te uesta, FL 33469 \ \ Te uesta, FL 33469 Te uesta, FL 33469 Te uesta, FL 33469 Te uesta, FL 33469 Te uesta, FL 33469 Te uesta, FL 33469 Te uesta, FL 33469 VILLAGE O� WESTA RECEIVED ,� March 13, 2018 Nominating SignatureIDEC 18 2017 11' 3 Qr We, the undersigned duly qualified voters of the Village of Tequesta, do hereby nomi CANDIDATE NAME: au✓i e d /1 AGE: .- a to be a Candidate for the Tequesta Village Council, SEAT NO. , Village of Tequesta, Palm Beach County, Florida for a two (2) year term pursuant to the Charter and Ordinances of said Village. (The above must be completed on all pages ofpetition) PRINT NAME STREET ADDRESS DATE OF BIRTH SIGNATURE -70 C `�A Te uesta, FL 33469 Te uesta, FL 332 Tequesta, FL 33469 Te uesta, FL 33469 M A K fle r Te uesta, FL 33469 1 -7 1S 7 t v e v- h Te uesta, FL 33469 CDl I I V G Tequesta, FL 33469 0-/L Y C In Y 1511 av G r ro Te uesta, FL 33469 D 3 ' LA -&zAo�>C)�j �75- 0 5-/at;�'X q 7q Te uesta, FL 33469 Te uesta, FL 33469