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DS-DE 9 J. Libbin 09 2305 6?3?254 P.02 JIJL-01-2009 1121 CITY MIAMI BCH CLERK DEPT • _ o~~e use oNLr STATE OF FLORIDA ~ o • APPOINTMENT OF CAMPAIGN TREASURER AND DESIGNATION OF CAMPAIGN ~-- ~, c DEPOSITORY FOR CANDIDATES r- r- -°_' N . (8eotlon 100.021(1) F.B.) ~ ~ • (PLEABE TYPE) fir' ~ G `_' ; ~ CHECK APPROPRIATE ®OX: ~prjgina! Appojrrhrtsnt ^ Deputy Treasurer ^ Reappr>inlment of Treasurer ^ Seowrdar~l~ee Nsna of Candidate 1. Address (inGude post ciflce boot or sheet, city, sta0s, zip cede) _ /~ !/ Z S ti~S.Co2e /Ji~- TBlephone (optional) 2. Party (Partisan candldabs only) 3.Ot~ee (add district. circuit or group number) ~•2 v/~~ Campai n Treasurer ^ Deputy Treasurer I have appointed the folbwing Person to act as my 0 4. Namo of Treasurer or Deputy Treasurer ~ ~~ f 6.Te ~ 5. Meiling Address (tf poet OfAce bWr or drawer add street address) ~DJ ~ p C,_o7~0 S f~ ,@t' ~- 10. Zip trade 7. City / 0. County 9. Sfate Primary Depository Secondary Dsposrtory . I have designated the foNo~wing named bank a3 my 11. Nana of Bank 12~ Sheet Address ~e ~',`p,,~-~` ~~'~c 15. stale t6. zip cede 13. City 14. County /~ Date 17. Signature of Candidate ~ '~~ ~. f~ Campaign Treasurer's Acceptance of Appointment L 6 r/J~' , do hsrebY accept the aPPa-Nment as t' ~V 6 (Please aTypel l mpaign Treasurer ^ Deputy Treasurer for the campaign of J C2/z `9 L~ ~~`3~ • ~ . ~ /~ candidate to the office of who is seek~rg nominatgn or elecction aS a (Party) - ~ ~ CGi1f7 % Il % v ~ As s dub reg~skred voter In /7! ~ n : - /x.30 e r'l~irn, t'/f~ C% County. Florida, I am qualified to accept this appointment. UNDER PENALTIES O~F~Ap ~tIR~ APPOINTMENT AND TNAT~ FiAt:TS STATED AR~TR~N TREASURER'8 7~i~~9 x. I~ ~ r, Sign re 6F Campaign Treasurer or Deputy Treasurer ' OS-DE ! (Rev. OttlW) TOTAL P.02