DS-DE 84RECE N/E. IJ
STATEMENT OF CANDIDA I [
(Section 106.023, F.S.) ,
CAi'¥ CLEP'i'(' $ OF~CE
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have received, read and understand the requirements of Chapter 106,
Florida Statutes.
~/' Signature of Candidate
Each candidate must file a statement with the qualifying officer within 10 days after the
Appointment of Campaign Treasurer and Designation of Campaign Depository is filed. Willful
fuiiuru 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. 106.19(1)(c), 106.265(1), Florida
Statutes).
DS-DE 84 (Rev. 8/99)