DS-DE 9 Meruelo APPOINTMENT OF CAMPAIGN TREASURER R . ' F fl
AND DESIGNATION OF CAMPAIGN
DEPOSITORY FOR CANDIDATES 2111 AUG 19 PM 1:49
(Section 106.021(1), F.S.)
CITY C.t.i'Y OFF
(PLEASE PRINT OR TYPE)
NOTE: This form must be on file with the qualifying
officer before o • enin • the cam • ai • n account. OFFICE USE ONLY
1. CHECK APPROPRIATE BOX(ES):
X Initial Filing of Form Re- filing to Change: L '' Treasurer /Deputy II Depository L Office L Party
2. Name of Candidate (in this order: First, Middle, Last) 3. Address (include post office box or street, city, state, zip
� dl `f 1 a CA:rtin2el MeciA -tr t7. code) J �,�
f'e free vG
4. Telephone 5. E -mail address 144,0/1/56f#
(305) 3ii 43110 vMvv a(u,
6. Office sought (include district, circuit, group number) 7. If a candidate for a nonpartisan office, check if
O Vi -14412 applicable:
(ZEJ j ! My intent is to run as a Write -In candidate.
8. If a candidate for a partisan office, check block and fill in name of party as applicable: My intent is to run as a
r 1 Write -In I No Party Affiliation
Y Nk Party candidate.
9. I have appointed the following person to act as my L><_1 Campaign Treasurer 7 Deputy Treasurer
a
10. Name of Treasurer or Deputy Treasurer
Isaac Rosenblum
11. Mailing Address 12. Telephone
4045 Sheridan Ave., #123 ( 305 ) 434 -2376
13. City 14. County 15. State 16. Zip Code 17. E -mail address
Miami Beach Miami -Dade FL 33140
18. I have designated the following bank as my Primary Depository Secondary Depository
19. Name of Bank 20. Address A v-6eAs
- 7 -- ob 644 5 21. C y / 22. Coun 1 23. State ,1— 24. Zip Cod ev
/// VJf/ 4 "mn i _ � D
UNDER PENALTIES OF PERJURY, I DECLARE THAT 1 HAVE READ THE FOREGOING FORM FOR APPOINTMENT OF CAMPAIGN TREASURER AND
DESIGNATION OF CAMPAIGN DEPOSITORY AND THAT THE FACTS STATED IN IT ARE TRUE.
25. Date 26. of Candida
0 // X 7a -
27. Treasurer's Acceptance of Appointment (fill in the blanks and check the appropriate block)
Isaac Rosenblum , do hereby accept the appointment
(Please Print or Type Name)
Hated above as: --, �- 1.4`i* � fir
designated
9 X Campaign Treasu 1 Depu Treasurer.
X /te,t,_
At 1 71
Date Signature of Campaign Treasurer or Deputy Treasurer
DS -DE 9 (Rev. 10/10) Rule 1S- 2.0001, F.A.C.