DS-DE 9 STATE OF FLORIDA
APPOINTMENT OF CAMPAIGN TREASURER
AND DESIGNATION OF CAMPAIGN DEPOSITORY
FOR CANDIDATES
(Section 106.021(1), F.S.)
(PLEASE T~PE)
PPROPRIATE BOX
nal Appointment
[--J Deputy Treasurer
[] Reappointment of Treasurer
r-~ Secondary Depository
Name of Candidate
1. Address (include post office box or street, city, state, zip code)
AWl
3. Office (~dd district, circuit or group number)
[CampaignTreasurer ~ Deputy Treasurer
Telephone (optional) 2. Party (Partisan candidates only)
I have appointed the following person to act as my
4. Name of Treasurer or Deputy Treasurer
5. Mailing Address (If post office box or drawer add street address)
Ave-., 2o t
7. City , [ 8. Coun~ - ' ' ~ --I 9. State
~ave ~esignated t~e follo~ng named bank as my ~ Prima~ DeposJto~
a J. Name of Bank I J 2. Street A~dress
6. Telephone
10. Zip Code
[-~ Secondary Depository
17. Slgnature of Candidate .---~ ~
Campaign Treasurer's Acceptance of Appointment
I, ~~ ~~t' ~ , do hereby accept the ap~intment as
(Please PHnt or Type)
~Cam~gnTreasurer ~ Deputy Treasurer for the campaign of ~~ ~~~ ,
who is seeking nomination or election as a /V~ candidate to the office of
55! one r . As a duly registered voter in
County, Florida, I am qualified to accept this appointment.
UNDER PENALTIES OF PERJURY, I DECLARE THAT I HAVE READ THE FOREGOING CAMPAIGN TREASURER'S
ACCEPTANCE OF APPOINTMENT AND THAT THE FACTS STATED ARE TRUE.
DS-DE 9 (Rev. I
X
~asurer or Deputy Treasurer