DS-DE 9 June E. Savage 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.
1 .. HECK APPROPRIATE BOX(ES):
RECEJVEf)
tonAUG-3 PM ~: t3
CHY tlF MIAMI BE~CH.
tWfiCF.: Of 1'ME ~:IT'( CLERK
OFFICE USE ONLY
·Initial Filing of Form Re-filing to Change: D Treasurer/Deputy D Depository 0 Office D Party
6. Office sought (include dis ict, circuit, group number)
Mayor<.._ Ma~:I ~a.c~
7. If a candidate for a nonpartisan office, check if
applicable:
D 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
D Write-In D No Party Affiliation
D ----------------Party candidate.
9. I have appointed the following person to act as my D Deputy Treasurer
11. Mailing Address 12. Telephone
l
..
18. I have designated the following bank as my
19. Name of Bank
21. City
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
x
27. . Tre:~rer's Ac;ptan~~ of Appoi~tment (fiU in the blanks and check the ap m iate block) .
~ lt..Jlfb 6 J ,'Ju, va ( ~. ·-' do hereby accept the appointment I,
(Please Print or Type Name) U
designated above as: ~--· Campaign Treasurer
g/:J/q _X-QT,~~~~~~±---
D
DS-DE 9 (Rev. 10/10) Rule 18·2.0001, F.A.C.