Smith- Petitions verified / ' , 0
NOMINATION PETITION
We, the undersigned electors of the City of Atlantic Beach, hereby nominate
'1-184-C--(.-SHJ 1't4M./I ' , whose residence is
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for the office of City Commissioner, Seat No. 3 , to be voted for at the
election to be held on the 25th day of August, 2015, A.D., and we individually
certify that our names appear on the rolls of registered voters, and that we are
qualified to vote for a candidate for election to the Atlantic Beach City
Commission.
PRINTED NAME ADDRESS DATE OF BIRTH SIGNATURE , HATE
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STATEMENT OF CIRCULATOR
The undersigned is the olive ator of the fo egoing paper containing I ti signatures. Each signature appended
hereto was made in my preset e and is th *e uine signature of the person whose name it purports to be.
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SIGNATURE OF CIRCU i OR A
ADDRESS ( '73 OceNocole fin , A-Tc- 66.1,, t6... 72-2-33
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ACCEPTANCE OF NOMINATION
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I hereby accep the nomination for Seat No. ',) on the City Commission. I have been a full time resident of the
City of Atlantic ach fo .:t least ■pe year prior to qualifying and am qualified to be a candidapWAtmlffice.
SIGN RE , 11----------'
HOME PHONE 614 - .0 og-- i i 0 0 JUN 4 2015
BUSINESS-PI-101E,g() -/- V-16. 5-6'07)
Office of City Clerk
NOMINATION PETITION
We, the undersigned electors of the City of Atlantic Beach, hereby nominate
IA 2 LS H..) i 01 J . P1,/-1- , whose residence is
3 oc ivS( 6-6. 2(z-- A lC.4(V-riC /364a-/, icL.-3 223 ,
for the office of City Commissioner, Seat No. .3 , to be voted for at the
election to be held on the 25th day of August, 2015 A.D., and we individually
certify that our names appear on the rolls of registered voters, and that we are
qualified to vote for a candidate for election to the Atlantic Beach City
Commission.
PRINTED NAME ADDRESS DATE OF BIRTH SIGNATURE DATE
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**** Signatures must be verified *
STATEMENT OF CIRCULATOR
The undersigned is the circulator of the foregoing paper containing I 6 signatures. Each s!gnature appended
hereto was made in my presk - and is the genuine signature of the person whose name it purports to be.
i SIGNATURE OF CIRCULATOR- AAA- -
ADDRESS .-7 0 e614,4=i4,2:- p>it it... r it(e, to k, i u_53
ACCEPTANCE OF NOMINATION
I hereby accept the nomination for Seat No. .M on the City Commission, I have been a full time resident of the
City of Atlantic e ch for "Mast one year prior to qualifying and am qualified to be a candidate for this office.
Received
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SIGNATURE
HOME PHONE Orl ' O`.1- f(DO
�. / ,11Jy �� 2015
BUSINESS-PHONE (�q- Z L(6- 56 00
Office of City Clerk