DS-DE 9-1 J. Libbin 09STATE OF FLORIDA OFFICE USE ONLY
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APPOINTMENT OF CAMPAIGN TREASURER
AND DESIGNATION OF CAMPAIGN 2Qpg .1~N ~ 4 iAM 10= 55
DEPOSITORY FOR CANDIDATES
(Section 106.021(1), F.S.) GIj~ (;Lr ~~i'"o=~ ~(~S_ 1~~
(PLEASE TYPE)
CHECK APPROPRIATE BOX:
Original Appointment ~ eputy Treasurer ~ Reappointment of Treasurer
Name of Candidate 1. Address (include post office box or street, city, state, zip code)
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Telephone (optional) 2. Party (Partisan candidates only) 3. Office (add district, circuit, group number)
I have appointed the following person to act as my ~ Campaign Treasurer Deputy Treasurer
4. Name of Treasurer or eputy Treasure
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5. Mailing Address (If post office box or drawer add street'address) 6. Telephone
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7. City 8. County 9. Stat
e 10. Zip Code
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I have designated the following named bank as my Primary Depository ~ Secondary Depository
11. Name of Bank 12. Street Address
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13. City 14. County 15. State 16. Zip Code
17. Signature of Candidate Date
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Campaign Treasurer's Acceptance of Appointment
I, til f~/i'/~. ~ ~ i~~~jn/ , do hereby accept the appointment as
(Please Print or Type)
Campaign Treasurer Deputy Treasurer for the campaign of ,) e%'/c'rf ~• ~~~~ ~~ ,
who is seeking nomination or election as a ~/ /~ candidate to the office of
(Party)
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UNDER PENALTIES OF PERJURY, I DECLARE THAT 1 H AVE READ THE FOREGOING CAMPAIGN TREASURER'S
ACCEPTANCE OF APPOINTMENT AND THAT THE FACTS STATED ARE TRUE.
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Date S' ature of a paig reasurer eputy Treasur r
DS-DE 9 (Rev. 01/08) v