DS-DE 9 Michael A. Stern Group VI
STATE OF FLORIDA
APPOINTMENT OF CAMPAIGN TREASURER
AND DESIGNATION OF CAMPAIGN
DEPOSITORY FOR CANDIDATES
(Section 106.021(1), F.S.)
OFFICE USE ONLY
(PLEASE TYPE)
CHECK APPROPRIATE BOX:
Original Appointment
Name of Candidate
D Deputy Treasurer
D Reappointment of Treasurer D Secondary Depository
1. Address (include post office box or street, city, state, zip code)
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2. Party (Partisan candidates only) 3. Office (add district, circuit or group number)
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gcampaign Treasurer D Deputy Treasurer
Telephone (optional)
I have appointed the following person to act as my
4. Name of Treasurer or Deputy Treasurer
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5. Mailing Address (If post office box or drawer add street address)
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7. City
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8. County
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9. State
'P-lA-
6. Telephone
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10. Zip Code
:53111
I have designated the following named bank as my
11. Name of Bank
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13. City
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14. C~nty
DkDe
Primary Depository
12. Street Address
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Secondary Depository
15. State
17-1 A-
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16. Zip Code
3.Dis
Date
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ampaign Treasurer's Acceptance of Appointment
ft. ~-IZI'/
(Please Print or Type)
D Deputy Treasurer for the campaign of l/lJeio.d A . S7?:##
lVIA-'
(Party)
, do hereby accept the appointment as
~ Campaign Treasurer
who is seeking nomination or election as a
candidate to the office of
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. As a duly registered voter in
f)Mf
County, Florida, I am qualified to accept this appointment.
OS-DE 9 (Rev. 08/03)