DS-DE9 grp 5
STATE OF FLORIDA
APP01NTMJ2N"T-'Gj}: CAMPAIGN TREASURER
AND DESIGNATION' OF CAMPAIGN DEPOSITORY
_) 'C,' -;} ;1..FOR CANDIDATES
.J l~~C~~?:~1.o6.021(1), F.S.)
,., u 0; r ._,1:
(PLEASE TYPE)
1. Address (include post office box or street, city. state. zip cod !)
Name of Candidate
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3. Office (add distnct. CIrcUIt or group num::>er
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,)(.#-70
s~Jl{o
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Telephone (optional)
2. Party (Partisan candidates only)
I have appointed the fol/owing person to act as my
~campalgn Treasurer
o Deputy Trea~;url~r
4. Name of Treasurer or Deputy Treasurer
ec..to ( &Q-(C-\~
5. Mailing Address (if post office box or drawer add street address)
6. Telephone
Yo
7. City
HI'
e&. [30s) 531-9;00
8. County 9. State 10. lip CJdE
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I have designated the following named bank as my
~ Primary Depository
12. Street Address
o Secondary Deposit Jry
11. Name of Bank
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Lfo rv A (~J( €YocDffe
14. County 15. State
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16. lip Code
3 3J ~CCI
I WILL NOTIFY YOU OF ANY ADDITIONS OR CHANGES TO THESE APPOINTMENTS.
I,
(P!ease Pnnt or Type)
, do hereby accept the appointn;en as
J2fCampaign Treasurer 0 Deputy Treasurer for the campaign of L I } i a III \--( - L or {:' -;:,-- _,
who is seeking nomination or election as a candidate to the office Jf
(Party)
- C Dill' Ij\ i.c:;,,; ; Of\f'i fs, () '-t? .q=;. / (.,,'"Jl:,AS a duly registered voter in 1--1 (aril ~ - ,DOC}
[)
1- <6-79
Date
x
County, Florida, I am qualified to accept this appointment.
OS-DE 9 (Rev. 11/95)
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5] J"'J --3,~::~~T~TEMENT OF CANDIDATE
-~:. i '."~_::..\,\ ~) 0, !-fer (Section 106.023, F.S.)
"
(PLEASE TYPE)
I, L i II'Qrf\ h. Loo e (..
,
candidate for the office of CO((\\:1',\~ i () Dt:\ 6vDVP S J1~
-'
have rece~ved, read and understand the requirements of Chapter 106,
Florida Statutes.
/--g-9j
Date
Each candidate must file a statement with the qualifying officer within 10
days after he files his Appointment of Campaign Treasurer and
Designation of Campaign Depository. 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 ), Florid a Statutes).
OS-DE 84 (Rev 11/95)
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