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DS-DE 9 Mark Weithorn APPOINTMENT OF CAMPAIGN TREASURER AND DESIGNATION OF CAMPAIGN 75 JAN -6 AN 8: 142 DEPOSITORY FOR CANDIDATES (Section 106.021(1), F.S.) Y r r, C OFF (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): El 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 Mark Weithorn code) 1130 Stillwater Dr. 4.Telephone 5. E-mail address Miami Beach, FL 33141 (305 ) 588-8313 mark @markweithorn.com 6.Office sought(include district,circuit,group number) 7.If a candidate for a nonpartisan,office,check if Miami Beach Commission, Group 5 applicable: ❑ 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 ❑ Write-In le No Party Affiliation ❑ Party candidate. 9.I have appointed the following person to act as my ® Campaign Treasurer ❑ Deputy Treasurer 10. Name of Treasurer or Deputy Treasurer Mark Weithorn 11.Mailing Address 12.Telephone 1130 Stillwater Dr. ( 305 ) 588-8313 13.City 14.County 15.State 16.Zip Code 17. E-mail address Miami Beach Miami-Dade FL 33141 mark @markweithorn.com 18. I have designated the following bank as my ® Primary Depository ❑ Secondary Depository 19. Name of Bank 20.Address City National Bank 300 71st Street 21.City 22.County 23.State 24.Zip Code Miami Beach Miami-Dade FL 33141 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 January 6, 2015 X 27. Treasurer's Acceptance of Appointment(fill in the blanks and check the appropriate block) 1, Mark Weithorn ,do hereby accept the appointment (Please Print or Type Name) designated above as: © Campaign Treasurer ❑ Deputy Treasurer. January 6, 2015 X Date Signature of Campaign Treasurer or Deputy Treasurer DS-DE 9(Rev. 10/10) Rule 1S-2.0001,F.A.C.