DS-DE 9 Amended 4
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STATE OF FLORIDA
APPOINTMENT OF CAMPAIGN TREASURER
AND DESIGNATION OF CAMPAIGN
DEPOSITORY FOR CANDIDATES
(Section 1 06.021 (1), F .S.)
CHECK APPROPRIATE BOX:
:&1 Original Appointment
Name of Candidate
D Deputy Treasurer
D Reappointment of Treasurer
D Secondary Depository
Telephone (optional)
(3()S) 67/feS4
2. Party (Partisan candidates only)
/f,/,A,
1. Address (include post office box or street, city, state, zip code)
if/90 A/AILTiL-~S tJ,RiVE
. ,/
H IAN/ f)EAcll FL" 93/'10
3. Office (add district, circuit, group number)
.HA (/f< of H!AHI BE"/}e.!I
RA PHAEL HEI<J1AA/
I have appointed the following person to act as my
4. Name of Treasurer or Deputy Treasurer
~ Campaign Treasurer
D Deputy Treasurer
/<APIfAEJ-
HJERHAY
5. Mailing Address (If post office bpx or drawer add stree! address)
if/90 A/ALtT/LtLS f)AIV~
7. City. 8. County, 9. State .
HfAHI 'i?A-CIl HiAMI-/)A-DE F/-oRI DA
6. Telephone
305'67'1 85,/-/
10. Zip Code
33/1../-0
I have designated the following named bank as my ~ Primary Depository D Secondary Depository
11. Name of Bank ,. 12. Street Address
BANk ILIV/rc;[) 300 AP-'TlIllR.. GODFI<6
14. County
~ '
it/AMI -DADE
ROAD
13. City,
Ji/A
I BEACH
15. State ,
FLORIDA
16. Zip Code
33/'1-0
17. xnature of Candidate
Date
.
APIVL 30/ 2007
Campaign Treasurer's Acceptance of Appointment
RA PHAE" 1- HER/'fAY
, do hereby accept the appointment as
I,
(Please Print or Type)
~ Campaign Treasurer
D Deputy Treasurer
for the campaign of
RAPHAEL H~RHAA/
who is seeking nomination or election as a A/11 A ,.
( . (Party)
HA YtJ/<. of MIAMI BEA-ell: 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.
candidate to the office of
f ,
H/AH/.- PAP,&'
,
API</L
30/2-007
Date
xR~~
Signature of Campaign Treasurer or Deputy Treasurer
DS-DE 9 (Rev. 02/06)