DS-DE 84 TobinOFFICE--US~~ONLY
STATEMENT OF ~ ~ ~ ~ : ; ; ~~,, ~A~ ~..3
CANDiDAT~ zosoh~~~.2s ~ ~~
(Section 106.023, F.S.) ~-I1 '~' t ~ ~Is'i ` l:~f~~ IGf..
(Please Type)
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candidate for. the office of 1:4. orw,~/,
have received, read and understand the requirements of Chapter 106,
Florida Statutes. .
.. .
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Signature o Candi ate Date
Each .candidate must file a statement with the qualifying officer within 10 days after the
Appointment of Campaigns 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).