DS-DE 9 DeputySTATE OF FLORIDA OFFICE USE ONLY
APPOINTMENT OF CAMPAIGN TREASURER
AND DESIGNATION OF CAMPAIGN DEPOSITORY FOR
CANDIDATES
(Section 106.021(1), F.S.) ~-~ o
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(PLEASE TYPE) .__
CHECK APPROPRIATE BOX: ~ ~ r
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Original Appointment Deputy Treasurer ~ Reappointment of Treasurer ~ Secondaryy De~sitory
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Name of Candidate 1. Address (include post office box or street, city, state, zip ~ddde) ~
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Telephone (optional) 2. Party (Partisan candidates only) 3. Office (add district, circuit, group number)
I have appointed the following person to act as my ~ Campaign Treasurer Deputy Treasurer
4. Name of Treasurer or Deputy Treasurer
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5. Mailing Address (If post office box or drawer add street address) 6. Telephone
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7. City
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~~ 10. Zip Code
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I have designated the following named bank as my Primary Depository ~ Secondary Depository
11. Name of Ban/k~ ~ _
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13. Ci//ty / 14. C~onunty 15. State 16. Zip Code
17. Signature of Candidate Da
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Campaign Treasurer's Acceptance of Appointment
do hereby accept the appointment as
(Please Print or Type)
Campaign Treasurer ~ Deputy Treasurer for the campaign of ~~(,~; (((~~ C' : S ~y~ ,,~'~
who is seeking nomination or a ection as a N / ~ candidate to the office of
(Party)
/"~ ~~ ~ ~' /~ As a duly registered voter in ~°/'/~~G~~~l F
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.
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ate gnatur f Campaig reasurer or Deputy Treasurer
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