DS-DE 9STATE OF FLORIDA
APPOINTMENT OF CAMPAIGN TREASURi~J
AND DESIGNATION OF CAMPAIGN
DEPOSITORY FOR CANDIDATES i.~tT?'
(Section 106.021(1), F.S.)
(PLEASE TYPE)
CHECK APPROPRIATE BOX:
~Original Appointment
Name of Candidate
Deputy Treasurer
Telephone (optional
2. Party (Partisan candidates only)
have
appointed
the
following person to act as my [~Campaign Treasurer
4. Name of Treasurer or Deputy Treasurer
5. Mailing Address (If post office box or drawer add street address)
OFFICE USE ONLY
C Reappointment of Treasurer [] Secondary Depository
I 1. Address (include post office box or street, city, state, zip code)
~. Office (ad~ ai~trict, cimuit ar ~r~up numker)
~ Deputy Treasurer '
6. Telephone
7. cit~ ~ ', I ~. c&~tv . , , I g. stero [ ~0. z~p coo~
I have designated the following named bank as my ~Prima~ Deposito~ ~ Seconda~ Deposito~
11, Name of Bank I 12. Street Address
F lov/
16. Zip Code
Date
-- (Please Print or Type)
~Campaign Treasurer E~ Deputy Treasurer for the campaign of
who is seeking nomination or election as a N
' (Ffarty)
{~'10,~ ~.~ ~ 0"l/0L~I.~Asadulyregisteredvoterin
County, Florida, I am qualified to accept this appointment.
Campaign Treasurer's Acceptance of Appointment
~'> ~'('~-)/ ~V"O .~ ~" , do hereby accept the appointment as
candidate to the office of
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.
Signature of Campaign Treasurer or Deputy Treasurer
DS-DE 9 (Rev. 08/03)