Loading...
DS-DE 9 J. Malakoff Treasurer APPOINTMENT OF CAMPAIGN TREASURER AND DESIGNATION OF CAMPAIGN 2013 AUG 2 3 AH 10� DEPOSITORY FOR CANDIDATES 04 (Section 106.021(1), F.S.) Q J I ,e 1, !i, 0 F F - (PLEASE PRINT OR TYPE) NOTE: This form must be on file with the qualifying officer before opening the campaign account. OFFICE USE ONLY 1.CHECK APPROPRIATE BOX(ES): Initial Filing of Form Re-filing to Change: ® Treasurer/Deputy ❑ Depository ❑ Office ❑ Party 2. Name of Candidate(in this order: First, Middle, Last) 3.Address(include post office box or street, city, state,zip Joy Malakoff code) 6415 Pine Tree Drive 4. Telephone 5. E-mail address Miami Beach, FL 33141 (305 ) 866-1772 , beachjoy2 @gmail.com 6. Office sought(include district, circuit, group number) 7. If a candidate for a nonpartisan office,check if Miami Beach Commission Group III applicable: ❑ My intent is to run as a Write-In candidate. 8. If a candidate for a ap rtisan office, check block and fill in name of party as applicable: My intent is to run as a ❑ Write-In ❑ No Party Affiliation ® Party candidate. 9. 1 have appointed the following person to act as my 0 Campaign Treasurer ❑ Deputy Treasurer 10. Name of Treasurer or Deputy Treasurer Sanford B. Horwitz 11. Mailing Address 12. Telephone 2121 Ponce De Leon Blvd. 11 th Floor ( 305 ) 442-2200 13. City 14. County 15. State 16. Zip Code 17. E-mail address Coral Gables Miami-Dade FL 33134 sandy.horwitz @gskcpas.com 18. 1 have designated the following bank as my ® Primary Depository Secondary Depository 19. Name of Bank 20.Address BankUnited 999 Ponce De Leon Blvd. Suite#10 21. City 22. County 23. State 24. Zip Code Coral Gables Miami-Dade FL 33134 UNDER PENALTIES OF PERJURY,I DECLARE THAT I 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. Signature of Candidate � 23 Z-13 27. Treasurer's Acceptance of Appointment(fill in the lank;and check the propriate block) I Sanford B. Horvitz , do hereby accept the appointment (Please Print or Type Name) designated above as: ® Campaign Treasurer De uty Treas rer. 2� �3 X . Date Signature of Campaign Treasurer or Deputy Treasurer DS-DE 9(Rev. 10/10) Rule 1S-2.0001, F.A.C.