DS-DE 9 R. Abramson APPOINTMENT OF CAMPAIGN TREASURER ��, �•- - 4 {
AND DESIGNATION OF CAMPAIGN �V^ ' F
DEPOSITORY FOR CANDIDATES 2013 SEP —5 P11 3: 06
(Section 106.021(1), F.S.)
(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 Q Party
2. Name of Candidate(in this order: First, Middle, Last) 3.Address(include post office b x or street, city, state,zip
code) / �l �114 �
4. Telephon 5. E-mail address
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6. Office sought(include district, ehlbuit, group number) 7. If a candidate for a nonp-artisarf office,check if
applicable:
C., E] My intent is to run as a Write-In candidate.
8. If a candidate fora partisan 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 Campaign Treasurer ® Deputy Treasurer
10. Name of Treasurer or De uty Treasurer
;�2p �rJh
11. Mailing A dress , 12. Telephone _
foe?� A"®j
136 ity 14. County 15. State 16. Zip Code 17. E-mail address
18. 1 have designated the following bank as my Primary Depository Secondary epository
19. Name of Bank 20.Address
21. City 22. County 23. Stat Zip Code
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. Signatu e f Can e
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r7. Treasurer's Acceptance of Appointment(fill in the blanks and check the appropriate block)
do hereby accept the appointment
(Please Print or Type Name)
designated above as: Campaign Treasurer '® v Treasurer.
2, x
Date Signature of Campaign Treasurer or Deputy Treasurer
DS-DE 9(Rev. 10/10) Rule 1S-2.0001, F.A.C.