DS-DE 9 Luis Salom Group IV
ST ATE OF FLORIDA
APPOINTMENT OF CAMPAIGN TREASURER
AND DESIGNATION OF CAMPAIGN
DEPOSITORY FOR CANDIDATES
(Section 106.021(1), F.S.)
OFFICE U~ Q,NL Y
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2007 JAN -5 PM~:, I
CITY CLERK'S OFF ICE
(PLEASE TYPE)
CHECK APPROPRIATE BOX:
[{] Original Appointment
Name of Candidate
o Deputy Treasurer
o Reappointment of Treasurer 0 Secondary Depository
1. Address (include post office box or street, city, state, zip code)
Luis Salom
815 North Shore Drive, Miami Beach, FL 33141
Telephone (optional)
305 868-8125
2. Party (Partisan candidates only)
N/A
3. Office (add district, circuit or group number)
Commission Group IV
[{] Campaign Treasurer 0 Deputy Treasurer
I have appointed the following person to act as my
4. Name of Treasurer or Deputy Treasurer
Alan Lips, CPA
5. Mailing Address (If post office box or drawer add street address)
666 71 st Street
7. City
Miami Beach
8. County
Miami-Dade
9. State
Florida
6. Telephone
305 868-3600
10. Zip Code
33141
I have designated the following named bank as my
11. Name of Bank
Bank United
13. City
Miami Beach
14. County
./ Primary Depository Secondary Depository
12. Street Address
300 Arthur Godfrey Road
15. State
Florida
17. i(nature of Candi e
Date
I
Campaign Treasurer's Acceptance of Appointment
I,
Alan Lips, CPA
(Please Print or Type)
o Campaign Treasurer 0 Deputy Treasurer for the campaign of
, do hereby accept the appointment as
Luis Salom
Commission Group IV
N/A
(Party)
. As a duly registered voter in Miami-Dade
candidate to the office of
who is seeking nomination or election as a
I / S/07-
f ( Date
DS-DE 9 (Rev. 08103)
x
County, Florida, I am qualified to accept this appointment.
UNDER PENALTIES OF PERJURY, I DECLARE THAT I HAVE AD T OREGOING CAMPAIGN TREASURER'S
ACCEPTANCE OF APPOINTMENT AND T T TH TS STATED ARE TRUE.