DS-DE 9 Amended 2
-b/lLd~J
STATE OF FLORIDA
APPOINTMENT OF CAMPAIGN TREASURER
AND DESIGNATION OF CAMPAIGN
DEPOSITORY FOR CANDIDATES
(Section 106.021(1), F.S.)
OFFICE USE ONLY
RECEIVED
2007 MAR 27 PH 3: 09
CITY CLE~::\ 'S UFF ICF
(PLEASE TYPE)
CHECK APPROPRIATE BOX:
~ Original Appointment
Name of Candidate
D Deputy Treasurer
D Reappointment of Treasurer
D Secondary Depository
./J/' '
"
1. Address (include post office box or street, city, state, zip code)
/ ~
If-Lgo ~AU-{lL-U.5 /J/2-/t/F
.Af /,1..}f; /3E#II FL,:3 ~ / l/-o
3. Office (add district, circuit, group number)
.HIt CJI< of Hf/Y ; Ell-
~ Campaign Treasurer D Deputy Treasurer
RA PHIJEL HEI<-)1)}
2. Party (Partisan candidates only)
I have appointed the following person to act as my
4. Name of Treasurer or Deputy Treasurer
RA PHA/?L HE/< /'1A~
5. Mailing Address (If post office box or drawer add street address)
if/3o /1//9U77'UtS /)!<-,'I/67'
7. City 8. County 9. State ,
/i'/~ i1/AN; - f)J)p f=L-o/</OA
I have designated the following named bank as my ~ Primary Depository D Secondary Depository
11. Na.!TIe of Bank, . t:J F 12. Street Address
C-1T .M'AT/OA//}-L- 13A/v,k FL 300 7/sr ST12.FET-
13. City 14. County 15. State
. I , I ,
/11.4/'11 8F/J-C- HJI)~MI .- f)~f)E R-o/4 VA
17. xnature of Candidate . /J r--... /J
RC2~.
6. Telephone
30.5" 67LfesLfl
10. Zip Code
'331 0
16. Zip Code
33/'1-1
Date
H/1RC-H 2. 7 20tJ
/
Campaign Treasurer's Acceptance of Appointment
I,
RAPHAEL
HEIZHAA/
, do hereby accept the appointment as
(Please Print or Type)
~ Campaign Treasurer
D Deputy Treasurer
for the campaign of
RA P/!/JEL IIE/<HAA/ ,
who is seeking nomination or election as a
.A/'" A .
candidate to the office of
, " (Party)
11 A }/tJ /<. 0 F /1/ A .HI BEAd/As a duly registered voter in
/
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.
H4{<.c-H 2 ?:'~ '2- 00 7 X ~~~,",ecocDep"tYT'ea,"m'
.
/il A/t11 .- f)/J-PE
OS-DE 9 (Rev. 02/06)