DS-DE 9 Group VI
STATE OF FLORIDA
APPOINTMENT OF CAMPAIGN TREASURER
AND DESIGNATION OF CAMPAIGN
DEPOSITORY FOR CANDIDATES
(Section 106.021(1), F.S.)'
OFr~e'f!rv>~TJ
2001 JAN -9 PM 3: 00
CITY CLERK'S OFF ICE
(PLEASE TYPE)
CHECK APPROPRIATE BOX:
D Original Appointment
o Deputy Treasurer
o Reappointment of Treasurer
o Secondary Depository
Nan>> of Cand~am, ) 1.;d'"; (i;;~lJ: bO'4 il' A-~le, zip rode)
K /S/4 !/I)Q'}/7ct- ,'p'mi' . ~I 33/3
2. Party (Partisan candidates only) 3~ce (add, distric~, circuit, grou~mber) -rrr=-
l 0111 IS> I cJ tJe r - :::7 ;et1{~ JC.A
D Deputy Treasurer
6. Telephone
(305 ~q/f- C/ObO
10, Zip Code
3.8/31
I have designated the following named bank as my
11.p'8(ne of B nk -
tv/);;:s i
13. Cityf/ 6
14. County ~
D Primary Depository D Secondary Depository
12. SYret Addres
.~dk
15.S~
17. ~nature of
Date
-...
~~mpai Tr urer's Acceptance of Appointment
E k rJ U II ~J I~,- , do hereJ:Y a pt the appointment as
(Please Print or Type)
ifeampeignTreasurer D DeputyTreasurer rorlh~JgnOf K /.5-,;9 r?a.V; ~
who Is seeking nomination or electlon as a ~~h ;J Iii candidate to tha O~flce of
(Party) I
I,
.a 1-1 tV/ /'S'$ ; 0 J.Je r
~
-
. As a duly registered voter in
'DAJ
G,~
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.
I ! q/~'1
x
uty Treasurer
DS-DE 9 (Rev. 02/06)