DS-DE 9 (2) STATE OF FLORIDA
APPOINTMENT OF CAMPAIGN TREASURER
AND DESIGNATION OF CAMPAIGN
DEPOSITORY FOR CANDIDATES
(Section 106.021(1), F.S.)
(PLEASE TYPE)
CHECK APPROPRIATE BOX:
~ Original Appointment
Name of Candidate
Deputy Treasurer
r~ Reappointment of Treasurer ~ Secondary Depository
I1. Address (include post office bo.x or street, city, state, zip code)
I have appointed the following person to act as my In Campaign Treasurer LJ Deputy Treasurer
4. ~ame of Treasurer or Deputy Treasurer
5. Mailing Address (If post office box or drawer add street address)
City 8. County
,.sC
10. Zip Code
I have designated the following named bank as my F-] Primary DepositoryI I Secondary Depository
11. Name.of Bank , I 12. Street Address
I 7, rY '
13. City · . unty. ,~ 15. State I 16. Zip Code
17..S~natu/I/e.,of~ndidate Date
) r Campaign Treasurer's Acceptance of Appointment
I, [ F , "~'~,~$ , do hereby accept the appointment as
(Please Pdnt or Type)
~ Campaign Treasurer D Deputy Treasurer for the campaign of ,
who is seeking nomination or election as a
. As a duly registered voter in
candidate to the office of
County, Flodda, I am qualified to accept this appointment.
UNDER PENALTIES OF PERJURY, I DECLARE THAT I HAVE READ~MPAIGN TREASURER'S
ACCEPTANCE OF APPOINTMENT AND THAT T/HE FACTS STATED ARE'r~RUE.
~/~/O "~' Date X~~ ~Treasurer
DS-DE 9 (Rev. 08103)