DS-DE 9 Amended
STATE OF FLORIDA
APPOINTMENT OF CAMPAIGN TREASURER
AND DESIGNATION OF CAMPAIGN
DEPOSITORY FOR CANDIDATES
(Section 106.021(1), F.S.)
OFFICE USE ONLY
CHECK APPROPRIATE BOX:
m Original Appointment
Name of Candidate
D Deputy Treasurer
.."
:x
D D d""T1 S:-. r-1
Reappointment of Treasurer Secon ary De~sltol'!l'"
1. Address (include post office box or street, city, s , z~ode)
(")
-l
-<
(")
I
r'"i
:.0
?":
(/)
~
c::::.
c::::.
-.I
:P-
.."
:::0
N
Ul
:::0
m
()
m
-
<
(PLEASE TYPE)
2. Party (Partisan candidates only)
tV/'
C/.r/ e. )? I ~,J7l} ,0/, /J1 '/.f. .
3. Office (add district, circuit or group number)
I have appointed the following person to act as my
4. Name of Treasurer or Deputy Treasurer
Co /'17 ',...{':..1" ~
~mpaign Treasurer D Deputy Treasurer
0.
5. Mailing Address (If post office box or drawer add street address)
(b /{7..J'z---
6. Telephone
7. City
8. County
9. State
11.
I1./K u/lJ/feo
14. County
/ ~ /.:?~#'6
Primary Depository
12. Street Address
L A'f-
10. Zip Code
;:3. 'J I ;l
Secondary Depository
I have designated the following named bank as my
11. Name of Bank
13. City
./J
15. State
/?-
16. Zip Code
:J;:II L 't?
Date
y 'J:: {/7
17. xnature of Candidate -A-.~
I,
Campaign Treasurer's Acceptance of Appointment
./ /'A/~/~ OrOf'L-
,\ (Please Print or Type)
, do hereby accept the appointment as
~
B Campaign Treasurer 0 Deputy Treasurer for the campaign of
LJ 11/~/~ b~l7---
who is seeking nomination or election as a
//(/ /J
candidate to the office of
(Party)
Cd? n, m /~ (I 'l/1/er ~ V (
.
. As a duly registered voter in
fi7 (/1 "71/ p4/.? c=-
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.
((, /~:-: 07
Date
x
~/k
Signature of Ca paign Treasure~ Treasurer
OS-DE 9 (Rev. 08/03)