DS-DE 84 Adrian Gonzalez 2017 OFFICE USE ONLY
STATEMENT OF
CANDIDATE
2011 JAN 25 F` 8' 36
(Section 106.023, F.S.)
(Please print or type)
I, Adrian Gonzalez •
candidate for the office of City of MB Commissioner Group III ;
have been provided access to read and understand the requirements of
Chapter 106, Florida Statutes.
4
1 /25/17
Si•.:ture of Candidate Date
Each candidate must file a statement with the qualifying officer within 10 days after the
Appointment of Campaign Treasurer and Designation of Campaign Depository is filed. Willful
failure to file this form is a first degree misdemeanor and a civil violation of the Campaign
Financing Act which may result in a fine of up to $1,000, (ss. 106.19(1)(c), 106.265(1), Florida
Statutes).
DS-DE 84(05/11)