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)
OFFICE USE ONLY
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CHECK APPROPRIATE BOX:
Original Appointment
Name of Candidate
"-.). neec\e. ~'(+ntf (\..
D
Deputy Treasurer
o Reappointment of Treasurer D Sec:i~ary ~positOry
1. Address (include post office box or street, city, state, zip code)
\ I~O "S-t I \llA.)a..+-~r Or
rfhQ.,r'N &0 CJ.- 1=\ '~~Il-f
3. Office (add district, circuit or group number)
Cor"",f{,,~::s IDI)€r C:xDc.L Y
IRl Campaign Treasurer 0 Deputy Treasurer
Telephone (optional)
2. Party (Par6san candidates only)
I have appointed the following person to act as my
4. Name of Treasurer or Deputy Treasurer
cto.()l~\ 1\( CP+\
5. Mailing Address (If post office box or drawer add street address)
\ I SO r)v.) '1' tl-/ "-0
7. City 8. County,
(1lIQ~ mlQfn.. O~dQ
9. State
F)
6. Telephone
~S _. SC)d. - ~qS
1 Q. Zip Code
331 ~"
I have designated the following named bank as my
11.~ame of Bank .
.J::cuJ- \0 III 1e<\
13. City
\'Y\ \ a (t\J
Primary Depository
12. Street Address
ci110 nw l~
Secondary Depository
Av€..
14. County
('C\ I Q (t\..\ - Do.~
15, State
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16. Zip Code
'-j~ 1.:1 J..
17. ~~nature of Candidate
A lJ-t.
Date
t-11-tJ{,
Campaign Treasurer's Acceptance of Appointment
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(Please Print or Type)
, do hereby accept the appointment as
,
'0 Campaign Treasurer 0 Deputy Treasurer for the campaign of 3 J:)ex:-de. w'?~ -t hD( f\.
who is seeking nomination or election as a
candidate to the office of
(Party)
~{, a r1\.\
Dade
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. As a duly registered voter in
County, Florida, I am qualified to accept this appointment.
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.
?:1?/pt5
Date
Signature
OS-DE 9 (Rev. 08/03)