DS-DE 84 Statement of Cand. RECEIVED
STATEMENT OF CANDIDA~Pr2
A~IO:
50
(Section 106.023, F.S.) CITY CLERK'S OFFICE
(PLEASE TYPE)
candidate for the office of
have received,
read and understand the
requirements of Chapter 106,
Florida Statutes.
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 fi~e this form is a
first degree misdemeanor and a civil violation of the Campaign Financing
Act which may result in ~ fine of up to $1,000, (ss. 106.19(1)(c),
106.265(1), Florida Statutes). '
DS-DE 84 (Rev. 11/95)