DS-DE 9 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:
N OriginalAppointment E~ Deputy Treasurer
Na~m~ of Candidat~ \
~F, EICE_USE ONLY
..... o OFF ICE
~] Reappointment of Treasurer [~ Secondary Depository
1. Address (include post office box or street.~ city, state, zip code)
Telephone (optional)
( )
I have appointed the following person to act as my Campaign Treasurer
4. N~-n~ of Treasuret~r Deputy Treas/urer
5. Mailing Address (I,-I' post office box or draw~er add street address)
'.City~~~:ku JO.~unty~::::~c. O'State ¢L
"-J Deputy Treasurer
J6. Telephone
10. Zip Code
I have designated the following named bank as my N' Primary Depository ['~ Secondary Depository
11, Name of Ba0k~ ~ \ t~ I 12. Street Address
I x
x
Campaign Treasurer's Acceptance of Appointment
l, ¢~'~ ~~'~ ~~'~ , do hereby accept the appointment as
(Please Print or Type)
Campaign lroasuror Doputy lmasuror for tho campaign of
who is sookin~ nomination or oloction as a ~~ cand~dato to tho offico of
~~~ ~ ~~ ~-- ~~'~s a duly registered voter in'(P~)'
County, Florida, I am qualified to accept this appointment.
UNDER PENALTIES OF PERJURY, I DEC.RE THAT I HAVE IE FOEEGOIN6 C~PN6N TREASURER'S
ACCEPTANCE OF APPOINTmEnT AND THAT iD ARE TRUE.
i oS x
DS-DE 9 (Rev. 08/03)
Date
7]
Treasu Treasurer