DS-DE 9 D. SugarmanSTATE OF FLORIDA OFFICE USE ONLY
APP
RER ~~~' ~ ~
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AND DES GNATION OF CAMPAIGN
DEPOSITORY FOR CANDIDATES ZQpgQ~~
30
(Section 106.021(1), F.S.)
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CITY G~~h~t.
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CK APPROPRIATE BOX:
Original Appointment ^ Deputy Treasurer ^ Reappointment of Treasurer
ame of Candidate 1. Address (include post office box or street, city, state, zip code)
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Telephone (optional) 2. Party (Partisan candidates only) 3. Office (add district, circuit, group number)
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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. ailing Address (If post office box or drawer add street address) 6. Telephone
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7. City 8. County 9. State 10. Zip Code
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I have designated the following named bank as my ~ Primary Depository ~ Secondary Depository
11. Name of Bank 12. Street Address
13. City 14. County 15. State 16. Zip Code
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17. Signature of Candidate
~ Date
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mpaign Treasurer's Acceptance of Appointment
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~v ~~, , do hereby accept the appointment as
(Please Pnnt or Type)
~ampaign Treasurer Deputy Treasurer for the cam '
paign of
~y
who is seeking nomination or election as a ~/~ candidate to the office of
(Party)
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UNDER PENALTIES OF PERJURY, I DECLARE THAT I HAVE READ THE FOREGOING CAMPAIGN TREASURER'S
ACCEPTANCE OF APPOINTMENT AND THAT THE FACTS STATED A TRUE.
Date ature of mpa' n Treasurer or Deputy Treasurer
nc_nG o ion., .,. ~~o~