DS-DE9 8/16/1999./
STATE OF FLORIDA
AppOINTMENT OF CAMPAIGN TREASURER
AND DESIGNATION OF CAMPAIGN DEPOSITORY
FOR CANDIDATES
(Section 106.021(1), F.S.)
(PLEASE TYPE)
Name of Candidate
Telephone (optional) 2. Party (Partisan candidates only)
CHECK APPROPRIATE BOX
Original Appointment
Deputy Treasurer
D Reappointment of Treasurer
D Secondary Depository
1. Address (include post office box or street, city, state, zip code)
///- /
3. Office (add district, circuit or grd.Ul~ number)
Campaign Treasurer
I have appointed the following person to act as my D
4. Name of Treasurer or Deputy Treasurer
5. Mailing Address (if post office box or drawer add street address)
7. City 8. County 9. State
.. r"-~
6. Telephone
10 Zip Code
~ '~/~7
have designated the following named bank as my
1. Name of Bank
13 City 14. County
,z/l/,,,, ,d;,',,f dl
E2~"Primary Depository
12. Street Address
D Secondary Depository
15. State 16 Zip Code
I WILL NOTIFY YOU OF ANY ADDITIONS OR CHANGES TO THESE APPOINTMENTS.
Campaign Treasurer
of Candi Date
17. Signature
X .... : ,:'
I, , do hereby accept the appointment as
lease Pnnt or Type)
r'~Deputy Treasurer for the campaign of~-~ L~ t~ (,,r'~(~ d__ ~,~,~
who is seeking nomination or election as a
candidate to the office of
(Party)
AS a duly registered voter in ~J~,~
County, Florida, I am qualified to accept this appointment.
or Deputy Treasurer
DS-DE 9 (Rev. 11/95)