DS-DE 6-1 UNITE HERE Miami Fund APPOINTMENT OF CAMPAIGN TREASURER ��
AND DESIGNATION OF CAMPAIGN
DEPOSITORY FOR - CITY `:• {:; ; U F%
POLITICAL COMMITTEES
(Sections 106.011(1)and 106.021(1),F.S.)
CHECK APPROPRIATE BOX: OFFICE USE ONLY •
0 Original Appointment of Treasurer 0 Reappointment of Treasurer 11.41 Deputy Treasurer
1. Committee or Organization 2.Telephone
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3. Name of Treasurer or Deputy Treasurer 4. Email(o tR io al) 5.Telephone(optional)
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6. Mailing Address
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7. Street Address
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8. The following bank has been designated as the IfEn Primary Depository • Secondary Depository
9. Name of Bank 10. Street Address
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it City 12. State 13.Zip Code
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14. Signat.r.- of 77 airm 15. Name of ha man(Print or re)
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mpaian Treasurer's Acceptance of Appointment
I, v\.0, ‘ ..\AOLTI , do hereby accept the appointment as
(Please Print or Type)
treasurer or deputy treasurer for UNA`E- ® ' \-\33,A.4
(Committee or Organization)
UNDER PENALTIES OF PERJURY, I DECLARE THAT I HAVE READ THE FOREGOING CAMPAIGN TREASURER'S
ACCEPTANCE OF APPOINTMENT AND THAT THE FACTS STATED ARE TRUE.?V1,,cA
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Date Signature of Campaign Treasurer or Deputy Treasurer
DS-DE 6(Rev.7/10)