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CHECK APPROPRIATE BOX
KQriginal Appointment
o Deputy Treasurer
o Reappointment of Treasurer
o $eCondary Depository
r .. - STATE OF FLORIDA
'..u APPoiNTMENT OF CAMPAIGN TREASURER
~ND;DES~NATlON OF CAMPAIGN DEPOSITORY
.". ,." - FOR CANDIDATES
(Section 106.021(1), F.S.)
(PLEASE TYPE)
Name of Candidate
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Telephone (optional)
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1. Address (include post office box or street, city, state, zip code)
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2. Party (partl..n candidate. only)
3. Office (add district. circuit or group numbEl1r)
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I have appointed the following person to act as my
~ Campaign Treasurer
D Deputy TreasL re
4. Name of Treasurer or Deputy Treasurer
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5. Mailing Address (if post office box or drawer add street address)
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6. Telephone
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10. Zip Cede
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8. County
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9. State
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I have designated the following named bank as my ~ Primary Depository
11. Name of Bank
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13. City
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12. Street Address
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16. Zip Cede
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14. County
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15. State
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I WILL NOTIFY YOU OF ANY ADDITIONS OR CHANGES TO THESE APPOINTMENTS.
17. Signature of C~didate
Date
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Campaign Treasurer's Acceptance of Appointment
I. ::T6S~i.. (;:!b€-) ~^" ~~ . do hereby accept the appointme
(Please Print Of Type)
~ Campaign Treasurer D Deputy Treasurer for the campaign of Jo~ I'/... ( ..:Ji;,,,) ';::;.v k~..,
who is seeking nomination or election as a
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candidate to the affic
(Party)
#~/ ~ L1N""'//;'.s;C/'V~~sadulyregisteredvoterin ~~/ ~~.~
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County, Florida, I am qualified to accept this appointment.
~6~~Y f /9.99' .//~
Date r
OS-DE 9 (Rev. 11/95)
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STATEMENT OF CANDIDATE
(Section 106.023, F .S.)
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12' L€..f J.. (Joe.) Y:;N~,ua:.. . candidate
for the office of #~;. 3e..(Zcl. aNH/:rS/oA.Je,e C..fI'PpCi~"
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have received, read and understand the requirements of Chapter 1 OB,
Florida Statutes.
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"k~eY 9-/9??
Date
Each candidate must file a statement with the qualifying officer within 1 0
days after he files his Appointment of Campaign Treasurer and
Designation of Campaign Depository. Willful failure to file this form isa
first degree misdemeanor and a civil violation of the Campaign Financinig
Act which may result in a fine of up to $1,000, (55. 106.09(1 )(cL
106.265(1), Florida Statute5)~
OS-DE 84 (Rev. 11/95)