DS-DE 9~ ' ' CLH/ECK APPROPFUATE BOX
-- STATE OF FLORIDA
APPOINTMENT OF CAMPAIGN TREASURER ,]~ Original Appointment
AND DESIGNATION OF CAMPAIGN DEPOSITORY I'"1 DeputyTreasumr
FOR CANDIDATES D Re~opoinlment of Tm.surer
(Section 106.021(1), F.$.) ~ Secondary DepeeiJ~ty
(PLEASE TYPE)
.... 1. Address (include I~OSt off,~ box or ~l~eet. ci~.
Name of Candic~te
"'
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,...._..~o,.,,. t.. ~o,,.....e-o.,....,.~ IY-I Campaign ,maaurer ! IDeputy Tmaaure,
4. Name of Treasurer or Deputy Treasurer ~-C:.~ ~)
5. Maiiing Adclres~(if post office boxy,, or drawer add strdetJidclress) 6. Telep~,~r,~.~_.
7. City 8. County ' 9. State 10. Zip Code
~,ve ,.s~...,., ,.. ,o,,o*., .~ad b..k.,., _!;4..,,.,.., De-.itor¥
13. ' 1 ~ Code
17. . .... - ~. Date
Campaign Treasurer's Acceptance of Appointment
who is seeking nomination or election as a candidate Io lhe office of
(Party)
Co~.ty. Florida. I am qualified Io aCCel~ ~hi~ ~ppointmenl.
UNDER PENALTIES DF I~RJURY, I DECLARE 'fHA? I HAVE R~E~OING C&MPAIGN TI~.ASUR£1~'$
A¢¢EP?ANCE OF APPOINTMENT AND THAT THE FACTS
~ 2~-~ x ~ "-, ~------~'
Data " $ignalure of campaign TreaSurer or DePuty Treasurer
DS-DE g (Rev. 11/01)