DS-DE 9-1 Mark Samuelian Amended 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.
°
OFFICE USE ONLY
1. CHECK APPROPRIATE BOX(ES):
X Initial Filing of Form Re- filing to Change: Treasurer /Deputy Depository 0 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
1c8 Venetian 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
L_.1 Write -In ® No Party Affiliation ® Party candidate.
9. I have appointed the following person to act as my Campaign Treasurer Li 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 -ma] 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. Signatur -of ndidate
X
27. Treasurer's Acceptance of Appointment (fill in the blanks and check the appropriate block)
Mark Samuelian , do hereby accept the appointment
(Please Print or Type Name)
designated above as: ❑ Campaign Treasurer Fl Deputy Treasurer. e7/ X
Dat7 Sig ature of Campaign Treasurer or Deputy Treasurer
DS -DE 9 (Rev. 10/10)
Rule 1S- 2,0001, F.A.C.