DS-DE9
STATE OF FLORIDA
APPOINTMENT OF CAMPAIGN TREASURER.. ' , : :: i:;
AND DESIGNATION OF CAMPAIGN DEP'OSITOF,lY;C" '2' 52
FOR CANDIDATES
(Section 1 06.021 (1), F.S.)
CHECK APPROPRIATE BOX
1Xf Original Appointment
'0 Deputy Treasurer
o Reappointment of Treasurer
~ ,- 0 Secondary Depository
(PLEASE TYPE)
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Telephone (optional)
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2. Party (Partisan candidates only)
1, Address (include post office ~ox or street, city, state, zip code)
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3. Office (add district, circuit or group number)
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Name of Candidate
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1 have appointed the following person to act as my
Campaign Treasurer
o Deputy Treasurer
4. Na~ of Treasurer or Deputy Treasurer /7
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5. Mailing Address (If post office box or drawer add street address) 1>1,0-;. Telephone
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7. City 8. County 9. State 10. Zip Code
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I have designated the following named bank as my Primary Depository 0 Secondary Depository
11. Name of Bank 12. Street Address
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14. County 15. State
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I WILL NOTIFY YOU OF ANY ADDITIONS OR CHANGES TO THESE APPOINTMENTS,
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16. Zip Code
'/
Date
9- 7 - 6/ /
Campaign Treasurer's Acceptance of Appointment
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(Please Print or Type)
, do hereby accept the appointment as
I,
~CampaignTreaSurer 0 Deputy Treasurer for the campaign of ~CAt2- L., ~,..4"Z
who is seeking nomination or election as a ---r;J~J'A<-,-~f)~,,- t- /1.//4 candidate to the office of
(Party) ,
m A '1 D.L- . As a duly registered voter in tnl c...t?11 - ~ D if?
County. Florida, I am qualified to accept this appointment.
C)-7- 0\
Date
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er
OS-DE 9 (Rev. 11/95)
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STATEMENT OF CANDIBATEp;\12: S2
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(Section 106.023, F.S.) .
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candidate for the office of
have received, read and understand the requirements of Chapter 106,
Florida Statutes.
e of Candidate
9- 7-0/
Date
Each candidate must file a statement with the qualifying officer within 10 days after the
Appointment of Campaign Treasurer and Designation of Campaign Depository is filed. Willful
failure to file this form is a first degree misdemeanor and a civil violation of the Campaign
Financing Act which may result in a fine of up to $1,000, (ss. 106.19(1 )(c), 106.265(1), Florida
Statutes).
OS-DE 84 (Rev, 8199)