DS-DE 6 Save Miami Beach 2016 �.�` F:a l Y u 6""
tl � ri
2016 NAR —9 P}= -• 36
APPOINTMENT OF CAMPAIGN TREASURER
AND DESIGNATION OF CAMPAIGN L i�-' `:` 0` ±`�-
DEPOSITORY FOR
POLITICAL COMMITTEES
(Sections 106.011(1)and 106.021(1),F.S.)
CHECK APPROPRIATE BOX: OFFICE USE ONLY
ElOriginal Appointment of Treasurer El Reappointment of Treasurer Deputy Treasurer
1.Committee or Organization 2.Telephone
6A;c g ■ )'‘Dl (31)-C )'-1`1‘
3.Name of Treasurer or Deputy Treasurer 4. Email(optional) 5.Telephone(optional)
Oc'vv0e/fC, . . , e r CaD-3 o-� , ( )
6.Mailing Address
� �5
331 -3
7.Street Address
1r`C_
8.The following bank has been designated as the Oil Primary Depository [J Secondary Depository
9. Name of Bank 10.Street Address
l
11.City 12.State 13.Zip Code
rvu .82-0"—A
14.Sign re of Ch 'rman 15. Name of Chai an(Print or Type)
X
C/ Jsc
Camoaian Treasurer's Acceptance of Appointment
I, ,do hereby accept the appointment as
(Please Print or Type)
treasurer or deputy treasurer for J C (lAik/Nft-; "' 001 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.
X /14."4"-e, 61\42'4)
Date Signature of Campaign Treasurer or Deputy Treasurer
DS-DE 6(Rev.7/10)