DS-DE 9
STATE OF FLORIDA
APPOINTMENT OF CAMPAIGN TREASURER
AND DESIGNATION OF CAMPAIGN
DEPOSITORY FOR CANDIDATES
(Section 106.021(1), F.S.)
n it> L Y
05 FEB .- J PM 2: 53
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(PLEASE TYPE)
CH¡CK APPROPRIATE BOX:
o Original Appointment 0 Deputy Treasurer
Name of Candidate
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GÞe,L~A
D Reappointment of Treasurer 0 Secondary Depository
1. Address (include post office box or street, city, state, zip code)
5' 3 ç- IJ '-Ie) <JÎ ¡n JAM) ~eoc,<
fl. ? 5/'-/0 /1111>'
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2. Party (Partisan candidates only)
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I have appointed the following person to act as my
4. Name of Treasurer or Deputy Treasurer
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5. Mailing Address (If p t office box or drawer add street address) I::f., J- S
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8~nty 9. Stat'll
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6. Telephone
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10. Zip Code
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7. City
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I have designated the following named bank as my
11. Name of Bank /'7 I '! 13
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13. City /J 14. County
J/(J T?r a- )11/" t11i
Primary Depository
12. Street Address
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15. State
.{I
Secondary Depository
ptance of Appointment
Date
;;2
(Please Print or Type)
~paign Treasurer 0 Deputy Treasurer for the Campaign~ c:;f)1¡.
candidate to the office of
I,
who is seeking nomination or election as a
~ (Part0
(3;-11 ;¿11 55)'1 ,w-rL- I~,r? /. As a duly registered voter in
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County, Florida, I am qualified to accept this appointment.
UNDER PENAL TIES OF PERJURY, I DECLARE THAT I HAVE READ THE FOREGOING CAMPAIGN TREASURER'S
ACCEPTANCE OF APPOINTMENT AND THAT THE FACTS STATED ARE TRUE.
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DS·DE 9 (Rev. 08/03)