HomeMy WebLinkAboutDS-DE9 STATE OF FLORIDA CHECK APPROPRIATE BOX
APPOINTMENT OF CAMPAIGN TREASURE~E C E IVEOriginal Appointment
AND DESIGNATION OF CAMPAIGN DEPOSI~ 19 ~J~ ~!:[~ Deputy Treasurer
FOR CANDIDATES~ Reappointment of Treasurer
(Section 106.021(1), F.S.) CITY CLERK'S 0F~[Secondary DeposLory
(PLEASE TYPE)
Name of Candidate 1. Address (include post office box or street, cily, state, 7.Jp code)
Telephone (optional) 2. Party (Partisan candidates only) 3. Office (add district, circuit or group number)
i
4. Name of Treasurer or Depu. ty Treasurer ._.__. __
5. Mai'lin~ ^ddr~'s (lf post office box Or drawer add street address) 6. Telephone
7. City. / / 8. C(~unty 9. State 10. Zip Code
11. Name of Bank, 12 Street Address
14. County ~. St~/ 16, Zip Code
' ~ ~ampaign, Treasurer's Acceptance of Appointment
I, ' , do hereby accept the appointment as
. - "-'(Ple~PdntorTy~e)~ --/
~ campaign Treasurer ~ Deputy Treasurer for the campaign of .
who is seeking nomination or election a, a ~ap__( .an, id ale to the o,.
of
.... ~ , .. ~ ~ As a d~ly r~istered voter in
County. Florida. I am qualified to accepl this appointment.
UNDER PENALTIES OF PERJURY, I DEC.RE THAT I HAVE READ THE FOREGOING CAMPAIGN TREASURER'S
ACCEPTANCE OF APPOINTMENT AND THAT THE FACTS STATED ARE TRUE.
DS-DE 9 (Rev. 11/01)