DS-DE 9 STATE OF FLORIDA
:, : -;-A'PIS~IJ~TMENT OF CAMPAIGN TREASURER
AND DES!CsN~ .ATION OF CAMPAIGN DEPOSITORY
'~ , '.... FOR CANDIDATES
(PLEASE TYPE)
Name of Candidate
CHECK APPROPRIATE BOX
[] Original Appointment
[] Deputy Treasurer
[] Reappointment of Treasurer
[] Secondary Depository
1, Address (include post office box or street, city, state, zip code)
Telephone (optional) I 2. Party (Partisan candidates only) I 3. Qffice (add district, circuit or gro~up number)
I have appointed the following person to act as my [] Campaign Treasurer ~ Deputy Treasurer
4, Name of Treasurer or Deputy Treasurer
5. Mailing ~(dd'[ess ill post office box or drawer add street address)
7. City I 8. County
I have designated the following named bank as my
11. Name of Bank
9. State
J'~J Primary Depository
6. Telephone
I
10. Zip Code
r-~ secondary Depository
12. Street Address
14. County I 15. State I 16. Zip Code
I WILL NOTIFY YOU OF ANY ADDITIONS OR CHANGES TO THESE APPOINTMENTS.
17. Signature of Candidate I Date
/ ! . -
~/ ~d~mpalgn Treasurer's Acceptance of Appointment
(Ptease Print ~ Type)
F"'~ Campaign Treasurer F~ Deputy Treasurer for the campaign of
who is seeking nomination or election as a
(party)
~,.o-~),,~..~(~,~. . As a duly registered voter in
County, Florida, I am qualified to accept this appointment.
, do hereby accept the appointment as
candidate to the office of
x
Date
DS-DE 9 (Rev. 11/95)
~'gnat,~ of Campaign '~asurer or Deputy Treasurer