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DS-DE 9-1 Isaiah Mosley APPOINTMENT OF CAMPAIGN TREASURER - , , , ; AND DESIGNATION OF CAMPAIGN DEPOSITORY FOR CANDIDATES 2015 FEB 20 AM 8: 44 (Section 106.021(1), F.S.) C;�.... : .i.� .i;i{t ir� F 'CI'_ . - (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 El Depository ❑ Office p Party 2. Name of Candidate(in this order: First, Middle, Last) 3.Address(include post office box or street, city, state,zip Isaiah Mosley code) 1038 11 Street#18 4. Telephone 5. E-mail address Miami Beach, FL 33139 (305 ) 514-2468 Isaiahwins @gmail.com 6. Office sought(include district, circuit, group number) 7. If a candidate for a nonpartisan office, check if Miami Beach City Commissioner, Group 4 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 ❑ 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 Isaiah Mosley 11. Mailing Address 12.Telephone 1038 11 Street#18 ( 305 ) 514-2468 13. City 14. County 15. State 16. Zip Code 17. E-mail address Miami Beach Miami-Dade FL 33139 Isaiahwins @gmail.com 18. I have designated the following bank as my © Primary Depository ❑ Secondary Depository 19. Name of Bank 20.Address Suntrust 1665 Alton Road 21. City 22. County 23. State 24.Zip Code Miami Beach Miami-Dade FL 33139 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 •f Candidate 2I7 'c 27. Treasurer's Acceptance of Appointment a blanks and check the appr•`j iate block) Isaiah Mosley , do hereby accept the appointment (Please Print or Type Name) designated above as: ❑ Campaign Treasurer © Deputy Treasurer. Z — / - 5- C)<"--s"4 1 Date Signature of Campaign Treas er or Deputy Treasurer DS-DE 9(Rev. 10/10) Rule 1S-2.0001, F.A.C.