DS-DE 9 Elsa Urquiza
STATE OF FLORIDA
APPOINTMENT OF CAMPAIGN TREASURER
AND DESIGNATION OF CAMPAIGN DEPOSITORY FOR
CANDIDATES
(Section 108.021(1), F.S.)
(PLEASE TYPE)
CHECK APPROPRIATE BOX:
I:tI Original Appointment D Deputy Treasurer
OFFICE USE ONLY
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D Reappointment of Treasurer D Seconda/}' ~os~
Name of Candidate
EIsA
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1. Address on~ude po~ office bo>s,or street, ~, state, zip code)
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/v1~ 'rn; 1i.tLe-4 ;C / 33/3'
2. Party (Partisan candIdates only) 3. 9ffice (add district, drcuit, groU~ber)
(~"'>' ~ J~ -Si
D Deputy Treasurer
Campaign Treasurer
Telephone (optional)
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I have appointed the following person to act as my
4. Name of Treasure! or ~uty Treasurer
kdcUl"lrd If. r/1AJ faS
5. Mailing A.ddreSS)!! post office box or drawer add street address)
4 I 4/ l'b /!; ~ sAve l 509
7. City /J. 8. ~
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I have designated the following named bank as my 0' Prima/}' DepositO/}' D Seconda/}' Deposito/}'
12. Street Address /J A
)c..Je.. ~
1 rite
9rr
16. Zip Code
.33/ '3
Date
. ~ /:(/06
- Cam~ign ~u r, Acceptance of Appointment
I, ~ ~{) (I r j If . LIl A.J f os , do hereby aJhe appointment as
(Please Print or Type) .
@Campaign Treasurer D Deputy Treasurer for the campaign of E /s ,4 A{. If 6{ U I' c..c:...... .
who is seeking nomination or election as a candidate to the office of
(~.4 114 r'SS 1\t7'7~FI_!1 . ~adUlyregiste:~terin 'bet. ~
County, Florida, I am qualified to accept this ap intment.
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.
'/12/0'
Date
x
(G~1~
Signature of Campaign Treasurer or Deputy Treasurer
DS-DE 9 (Rev. 02106)
63