DS-DE 9 Amended 3
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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)
RECEIVED
Z001 APR -5 PM 3: '3
CITY CLERK'S OFF ICE
CHECK APPROPRIATE BOX:
~ Original Appointment
Name of Candidate
D Deputy Treasurer
D Reappointment of Treasurer
D Secondary Depository
Telephone (optional)
(305) 67lf8S
1. Address (include post office box or street, city, state, zip code)
lJ-J.90 HAlL/ii-US ORiv5
RAPHAEL HEfl.I1AtV HiAH/ BEAC!-fI FL~ 33/4-0
3. Office (add district, circuit, qroup number)
/'1A- 'PI< ~F )1/IINI BElle'lf
I have appointed the following person to act as my ~ Campaign Treasurer D Deputy Treasurer
4. Name of Treasurer or Deputy Treasurer
2. Party (Partisan candidates only)
,A/, A '
5. Mailing Address (If post officr box or drawer add street address)
IgtJ /VAlL/Ii-US PA.tV/=
7. City. 8. County 9. State I
.' I'
MIAMI BE"tfcfl I1IAMI-()AfJE Fi-ORi DA
RA PHAE I- HE /<.HA/V"
6. Telephone
305" 6 7'1 85'1/
10. Zip Code
33/4-0
I have designated the following named bank as my Primary Depository D Secondary Depository
11. Name of Bank, 12. Street Address
RlEff/oA/S BAA/k 780 ARTlltLR. GotJF/{E RO,
13. City., 14. County 15. State ~ 16. Zip Code
/1/1-)11/ BEACH I1IAHi-DAD!7 FLO/<./ D4 '33/tfo
17. xnature of Candidate !<
Date
,
A PR IL- 5 2,0 tJ7
Campaign Treasurer's Acceptance of Appointment
I,
RAPHAEl- HI=AMA/V'"
, do hereby accept the appointment as
(Please Print or Type)
~ Campaign Treasurer D Deputy Treasurer for the campaign of R. A PH IJ F 1- II ERN A y ,
who is seeking nomination or election as a /1/, A ' candidate to the office of
t I (Party) I'
J1AYtJ!<. of.HIAM/ BEACHAsadulyregisteredvoterin Ii/AH/ -DAPE"'
,
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.
.
APRIL 5J '2. 00 7
Date
X ~g~~,"a'"cec DC Dep"ty T cea'"cec
DS-DE 9 (Rev. 02/06)