Wieder DS-DE 9 •
APPOINTMENT OF CAMPAIGN TREASURER
AND DESIGNATION OF CAMPAIGN
DEPOSITORY FOR CANDIDATES 2015 U:3 26 12•
(Section 106.021(1), F.S.) J
(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):
MI Initial Filing of Form Re-filing to Change: ❑ Treasurer/Deputy El Depository El Office D Party
2. Name of Candidate(in this order: First, Middle, Last) 3. Address (include post office box or street, city, state, zip
David S. Wieder code)
4. Telephone 5. E-mail address
•
(305 ) 371-7111
6. Office sought(include district, circuit, group number) , 7. If a candidate for a nonpartisan office, check if
Miami Beach Mayor applicable:
EI 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 [] N/A Party candidate.
9. I have appointed the following person to act as my 0 Campaign Treasurer Ei Deputy Treasurer
10. Name of Treasurer or Deputy Treasurer
David S. Wieder
11. Mailing Address 12. Telephone
1390 Bay Drive ( 305 ) 371-7111
13. City 14. County 15. State 16. Zip Code 17. E-mail address
Miami Beach Miami-Dade FL 33141 dwieder@wiederlaw.com
18. I have designated the following bank as my 151 Primary Depository El Secondary Depository
19. Name of Bank 20. Address
City National Bank of Florida 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 APPOINT S. T OF CAMPAIGN TREASURER AND
DESIGNATION OF CAMPAIGN DEPOSITORY AND THAT THE FACTS STATED RE T-UE.
25. Date 26. Sig - •,. Candid-
8/24/2015 X 0/0,6 l (./1,/
27. Treasurer's Acceptance of Appointment(fill in the blanks an• check the appropriate block)
David S. Wieder , do hereby accept the appointment
(Please Print or Type Name)
designated above as: IN Campaign Treasurer = uty Tre.
8/24/15 X / /
JAb
Date Signature of Cam•:ign Treasurer or Deputy Treasurer
DS-DE 9(Rev. 10/10) Rule 1S-2.0001, F.A.C.