DS-DE 9 LeveySTATE OF FLORIDA OFFICE USE ONLY
APPOINTMENT OF CAMPAIGN TREASURER ~« ~~ ~ ~' ~' ~ ~;r ~ ;
AND DESIGNATION OF CAMPAIGN
DEPOSITORY FOR CANDIDATES ~~~~ ~~~ 1 ~ P~ 3~ 08
(Section 106.021(1), F.S.)
(PLEASE TYPE)
CHECK APPROPRIATE BOX:
Original Appointment ^ Deputy Treasurer ~ Reappointment of Treasurer
Name of Candidate 1. Address (include post office box or street, city, state, zip code)
~.~i .G~.4c~i`. ~' 3~I ' ~
Telephone (optional) 2. Party (Partisan candidates only) 3. Office (add district, circuit, group number)
( ) ~ l~
I have appointed the following person to act as my Campaign Treasurer Deputy Treasurer
4. Name of Treasurer or Deputy Treasur r
,Q ~i,~.4 lv.~i2~ ~t°v~
5. Mailing Address (If post office box or dra dd street address) 6. Telephone
~ ~7 ,tiE~n~~- ~ ~~~-- s3, - ~ a o ~
7. City 8. County 9. State 10. Zip Code
I have designated the following named bank as my Primary Depository ~ Secondary Depository
11. Name of Bank
4
~'~9
'~
~ 12. Street Address
1,
,
/UJ
~ C'J
13. City 14. Count 15. State 16. Zip Code
17. Signature of Candidates Date
Campaign Treasurer's Acceptance of Appointment
I, ~U/~i4 ~~/~~ ~` ~/
, do hereby accept the appointment as
(Please Prin ype)
Campaign Treasurer ^ Deputy Treasurer for the campaign of 1/,~;~1 c j (/L`'/lj ~Z°VL°-
~.,.~
who is seeking nomination or election as a candidate to the office of
. ..
.
~
-T
(Party)
A ~ of ~~ ~~~
DER PENALTIES OF PERJURY, I DECLARE THAT I HAVE READ THE FOREGOING CAMPAIGN TREASURER'S
ACCEPTANCE OF APPOINTMENT AND THAT THE FACTS STATED ARE TRUE.
Date ignature of Campaign Treasurer or Dep ty Treasurer
nc_n~ o rn_.. nw i..a,