DS-DE9
ST A TEOF FLORIDA
APPOINTMENT OF CAMPAIGN TREASURER
AND DESIGNATION OF CAMPAIGN DEPOSITORY
FOR CANDIDATES
(Section 106.021(1), F.S.)
(PLEASE TYPE)
C..H~~K APPROPRIATE BOX
. X Original Appointment
D Deputy Treasurer
D Reappointment of Treasurer
D Secondary Depository
Name of Candidate
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1. Address (include post office box or street, city, state, zip code)
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Telephone (optional)
2. Party (Partisan candidates only)
3. Office (add district, circuit or group number)
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I have appointed the following person to act as my
mCampaign Treasurer
D Deputy Treasurer
4rf'~me o. f,Treasurer or Deputy Treas. u, rer
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5. Mailing Address f post office box or drawer add street address) 6. Telephone
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7. City 8. County 9. State
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I have designated the following named bank as my ~rimary Depository
11. Name of Bank
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13. City
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D Secondary Depository
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12. Street Address
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15. State
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14. County
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16. Zip Code
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I WILL NOTIFY YOU OF ANY ADDITIONS OR CHANGES TO THESE APPOINTMENTS.
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Debby
Campaign Treasurer's Acceptance of Appointment "~
M G4 r Ks , do hereby accept the aPpoil]t~en~'s
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(Please Frint or Type)
I)(J Campaign Treasurer D Deputy Treasurer for the campaign of L e. e
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who is seeking nomination or election as a
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_ .::andidate to the office of
(Party)
C I -+ 7 l n "" en . % · '" ne r :::s:r::-. As a duly registared votar in
County, Florida, I am qualified to accept this appointment.
fo/9/'11
Date
OS-DE 9 (Rev. 11/95)
Otl.~.
mc~
aign Treasurer or Deputy Treasurer
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STATEMENT OF CANDIDATE!"! i 0 F'ilI2: 35
(Section 106.023, F .S.)
,
, ,
. .(,;') (JFFICE
(PLEASE TYPE)
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, candidate
for the office of Q:: 1 ~ t'owvv..\ 'S~t () N S '!;> ~
have received, read and understand the requirements of Chapter 106,
Florida Statutes.
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Signature of Candidate
q I / 1[91
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. 106.09(1 )(c),
106.265(1), Florida Statutes).
OS-DE 84 (Rev. 11/95)