DS-DE 9 Jonah WolfsonSTATE OF FLORIDA OFFICE USE ONLY
APPOINTMENT OF CAMPAIGN TREASURER
AND DESIGNATION OF CAMPAIGN
DEPOSITORY FOR CANDIDATES
(Section 106.021(1), F.S.)
(PLEASE TYPE)
CHECK APPROPRIATE BOX:
~ Original Appointment ~ Deputy Treasurer ~ Reappointment of Treasurer ~ Secondary Depository
Name of Candidate 1. Address (include post office box or street, city, state, zip code)
-~ ~
~ ~~J ~'-~' ~( G~`{'`` '~ `~,"~'c
~~c~v1a1~ t~ ~~ v~ >
w~; ~
~
m:u
%
a
~'
~1
C
.
,
~ t ~
.,
j
~ ~
Telephone (optional) 2. Party (Partisap~ candidates only) 3. Office (add district, circuit or group number)
~ ~.lt„~VV1 J-'i~ ~J~~ ~b~~~~ " `~
I have appointed the following person to act as my ~ Campaign Treasurer ~ Deputy Treasurer
4. Name of Treasurer or Deputy Treasurer
(G+1r1 i9--1~ I..ZJ ~% ~ i ''~: ~ ~
5. Mailing Address (If post office box or drawer add street address) 6. Telephone
~3~(u ~ 6 ~`~h ~ ~~ z~~-i~r
7. City
~
~ 8. Co ty
~ ' 9. State
:
~~ 10. Zip Code
~
~ ~ ~ ~'i
~~. iA,'vV~ ~
~(.
r\ ~D~ .
I have designated the following named bank as my Primary Depository Secondary Depository
11. Name of Bank
~
_ l ' ~.J r~l \ °'' 12. Str~et Address
~ ~/~
~~~~ ,i Y 1~'/i~1(.Ev~ v~~°~-
13. City
~ " 14. Coun~ 15. State
~~~~'~t~~ 16. Zip Code
~~ i j?~
~r~~(~VYL
17. Signature of didate
X ^ Date
~1 ~~a~,
Campaign Treasurer's Acceptance of Appointment
~ ~~'~~,~~ ~g ~~,,~y.~ , do hereby accept the appointment as
(Please Print or Type)
a Campaign Treasurer ~ Deputy Treasurer for the campaign of ~~~~w~ ~~\ i`7V ~"1
who is seeking nomination or election as a 1 ~ ~ candidate to the office of
~~J
(Parry)
~~~,~.~~ ~,~~,~,~ ~~/ _ . As a duly registered voter in ! ' ~~ ~~V~ ~ ~ ~~~~~
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.
~,.' ~ X .~ (.~~a~l~~l1~n~.
1 ~
,
Date Signature f Campaign Treasurer or Deputy Treasurer
DS-DE 9 (Rev. 08/03)