DS-DE 9-1 Mark Samuelian 2017APPOINTMENT OF CAMPAIGN TREASURER
AND DESIGNATION OF CAMPAIGN
DEPOSITORY FOR CANDIDATES
(Section 106.021(1), F.S.)
(PLEASE PRINT OR TYPE)
NOTE: This form must be on file with the qualifying
officer before opening the campaign account.
' i , ..
OFFICE USE ONLY
1. CHECK APPROPRIATE BOX(ES):
0 Initial Filing of Form Re-filing to Change: Treasurer/Deputy Depository Office Party
2. Name of Candidate (in this order: First, Middle, Last)
Mark George Samuelian
3. Address (include post office box or street, city, state, zip
1c8Venetian Way #1502
Miami Beach, FL 33139 4. Telephone
(305 ) , 915-4316
5. E-mail address
mark@marksamuelian.com
6. Office sought (include district, circuit, group number)
Miami Beach City Commission, Group 2
7. If a candidate for a nonpartisan office, check if
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 L,.I No Party Affiliation q Party candidate.
9. I have appointed the following person to act as my M Campaign Treasurer Deputy Treasurer
10. Name of Treasurer or Deputy Treasurer
Mark Samuelian
11. Mailing Address
10 Venetian Way #1502
12. Telephone
( 305 ) 915-4316
13. City
Miami Beach
14. County
Miami-Dade
15. State
FL
16. Zip Code
33139
17. E-mal address
Mark@marksamuelian.com
18. I have designated the following bank as my X Primary Depository Secondary Depository
19. Name of Bank
BankUnited
20. Address
1695 Alton Road
21. City
Miami Beach
22. County
Miami-Dade
23. State
FL
24. Zip Code
33139
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. Signatu,,o ndidate
_-
27. Treasurer's Acceptance of Appointment (fill in the blanks and check the appropriate block)
Mark Samuelian i , do hereby accept the appointment
(Please Print or Type Name)
designated above as: Campaign Treasurer 0 Deputy Treasurer.
_s -E-(7,,,7 x //J.? - ,
Dat Sig ature of Campaign Treasurer or Deputy Treasurer
DS-DE 9 (Rev. 10/10)
Rule 1S-2.0001, F.A.C.