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DS-DE 9-1 Group II Zachary M. Eisner 2017 APPOINTMENT OF CAMPAIGN TREASURER AND DESIGNATION OF CAMPAIGN an 1 F'[ ; 2 1 P:; 1 : 03 DEPOSITORY FOR CANDIDATES (Section 106.021(1), F.S.) ',: . 1 i,l . ;: , t-, ;.• (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): ID Initial Filing of Form Re-filing to Change: © Treasurer/Deputy ® Depository Office Party 2. Name of Candidate(in this order: First, Middle, Last) 3. Address(include post office box or street, city, state, zip Zachary Max Eisner code) 825 W. 40th Street, #1 4. Telephone 5. E-mail address Miami Beach, FL 33140 (786 ) 245-2319 zackelaw @gmail.com 6. Office sought(include district, circuit, group number) 7. If a candidate for a nonpartisan office, check if City of Miami Beach Commissioner Group 2 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 El Write-In © No Party Affiliation Party candidate. 9. I have appointed the following person to act as my 0 Campaign Treasurer © Deputy Treasurer 10. Name of Treasurer or Deputy Treasurer Carlos M. Trueba 11. Mailing Address I 12. Telephone . 1985 NW 88th Court, Suite 101 ( 305 ) 593-2644 13. City 14. County 15. State 16. Zip Code 17. E-mail address Doral Miami-Dade Florida 33172 cpazos @rtc-cpa.com 18. I have designated the following bank as my © Primary Depository Secondary Depository 19. Name of Bank 20. Address City National Bank 8725 NW 18th Terrace 21. City 22. County 23. State 24. Zip Code Miami Miami-Dade Florida 33172 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 of Candidate X 27. Treasurer's Acceptance of Appointment (fill in the blanks and check the appropriate block) Carlos M. Trueba , do hereby accept the appointment (Please Print or Type Name) designated above as: ❑ Campaign Treasurer © D-.uty4surer. 1, I X - Date Signature of Ca .aign Treasurer or Deputy Treasurer DS-DE 9(Rev. 10/10) Rule 1S-2.0001, F.A.C.