DS-DE9
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STATE OF FLORIDA D I \'Tn zS ~,H '): \ '.3
APPOINTMENT OF CAMPAIGN TRE~~U,~~n., C r F \ CE
AND DESIGNATION OF CAMPAIGN DEPOSitORY
FOR CANDIDATES
(Section 106.021(1), F.S.)
(PLEASE TYPE)
Name of Candidate
CHECK APPROPRIATE BOX
Bf" Original Appointment
o Deputy Treasurer
o Reappointment of Treasurer
o Secondary Depository
1. Address (include post office box or street, city, state, zip code)
I~ -rlland !tv 1c Iid1/..{ { Bf'AcAf
~ fL 331'!}
3. Office (add district, circuit or group number)
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Aanc
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Telephone (optiona
(.3v.r') 5'8'(-(X$:J-
2. Party (Partisan candidates only)
I have appointed the following person to act as my ,
[5a Campaign Treasurer
5, Mailing Address (If post office box or drawer add street address)
-
9. State
Deputy Treasurer
6. Telephone
30S" - 1t.fS: 4 (S' /
10. Zip Code
~ Primary Depository
12, Street Address
I have designated the following named bank as my
It ~'iS
15. State
I
14. County
DA-D~
L
o Secondary Depository
A-v
16, Zip Code
33/3
I WILL NOTIFY YOU OF ANY ADDITIONS OR CHANGES TO THESE APPOINTMENTS.
Date
Campaign Treasurer's Acceptance !)f Appointment
I,
hARt: Lie.6"f4w'
(Please Printer Type)
~paign Treasurer
, do hereby accept the appointment as
o Deputy Treasurer for the campaign of
h"'<toe-,/-(
I (Party)
;fAN! L icl(~",,^,
candidate to the office of
who is seeking ~omination or election as a
~(.~ DR Itiw; r5erJ.
County, Florida, I am qualified to accept this appointment.
, As a duly registered voter in
~-l\~DI
x
8~ol.UJted
ignatur of Campaign Treasurer or Deputy Treasurer
Date
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.
.
ECFi\!ED
STATEMENT OF cANDIDA'Eu\l'i'~; OFfICE
(Section 106.023, F.S.)
(Please Type)
I, JIAu./.f 1,1 t:"P;1-f t1v
candidate for the office of t{(j.~ W,. Uf A-l// F3f:J"1Jo~;
have received, read and understand the requirements of Chapter 106,
Florida Statutes.
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A'b6 ) Of
( Dat~
Each candidate must file a statement with the qualifying officer within 10 days after the
Appointment of Campaign Treasurer and Designation of Campaign Depository is filed. Willful
failure to ',file this form is a first degree misdemeanor and a civil violation of the Campaign
Financing Act which may result in a fine of up to $1,000, (55. 106.19(1 )(c), 106.265(1), Florida
Statutes).
DS-OE 84 (Rev. 8/99)