DS-DE 9 Saul Gross
STATE OF FLORIDA
APPOINTMENT OF CAMPAIGN TREASURER
AND DESIGNATION OF CAMPAIGN
DEPOSITORY FOR CANDIDATES
(Section 106.021 (1), F .S.)
OFFICE ~~J:YI V E 0
2007 JAN 19 PH 12: 26
CITY CLERK'S OF
FICE
(PLEASE TYPE)
CHECK APPROPRIATE BOX:
g Original Appointment D Deputy Treasurer
Name of Candidate
5 a. V [ &'('05S
D Reappointment of Treasurer
Telephone (optional)
2. Party (Partisan candidates only)
I have appointed the following person to act as my Campaign Treasurer
4. Name of Treasurer or Deputy Treasurer
SQ.u \ Gio D
5. Mailing Address (If post office box or drawer add street address)
11.~ Wa' Ave
7. City 8. unty. 9. State
fl1 fClAMA tv) r OMM. -~ ak fl Wf
6. Telephone
'30{ - f32.- 73Gf
10. Zip Code
I have designated the following named bank as my
11. NameofBa~~ UL11 t
13.CiM'~ Buut
17. )Cnature ofcandidat~ ~. ~ ~
Rprimary DepOSitory D Secondary Depository
12. Street Address
3o(() ftv~ God {.
15. State
L-.
Date
I,
Su.Jt
Campaign Treasurer's Acceptance of Appointment
(riOS.>
. do hereby accept the appointment as
(Please Print or Type)
s ~~.J\ Gro~
@ Campaign Treasurer D Deputy Treasurer for the campaign of
who is seeking nomination or election as a ~ I ft
J ~M0
M. fA ~ 011 C I , 1 rrf tv\ If~ Ms a duly registered voter in
County, Florida, I am qualified to a~ePt 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.
candidate to the office of
iYll~ -~
I ~~10l
ate
x
SJ.
Signature of Campaign Treasurer or Deputy Treasurer
DS-DE 9 (Rev. 02/06)