DS DE 9 WeissSTATE OF FLORIDA OFFICE USE ONLY
APPOINTMENT OF CAMPAIGN TREASURER
AND DESIGNATION OF CAMPAIGN ~ F ~ ~ ~ ~+' F
DEPOSITORY FOR CANDIDATES
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(Section 106.021(1),
(PLEASE TYPE) CITY CLtl;i~~'S Uf }'ICt
CHECK APPROPRIATE BOX:
Original Appointment ~ Deputy Treasurer ~ Reappointment of Treasurer
Name of Candidate 1. Address (include post office box or street, city, state, zip code)
Telephone (optional) 2. Party (Partisan candidates only) 3. ffice (add district, circuit, gr,QuRnu er)
I have appointed the following person to act as my ~ Campaign Treasurer ~ Deputy Treasurer
4. Name of Treasurer or a uty Treasurer
5. Mailing Address (If post office box or drawer add street address) 6. Telephone
7. City
E~,¢<,~ 8. County
~.~-a~~' 9. State
~~ - 10. Zip Code
33032
I have designated the following named bank as my ~ Primary Depository ~ Secondary Depository
11. Name of Bank
4,, ~ 1<C~~j~ 1 . Street Address
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13. City
~ I ~ c~-~ ~t~~ 14. County
111 ~ ~~ - ~ ~~ 15. State
~h 16. Zi Code
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17. Si natur of Candid Date
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Campaign Treasurer's Acceptance of Appointment
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•4 , do hereby accept the appointment as
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(Please Print or Type)
Treasurer for the campaign of ~~~
n Treasurer ®De
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who is seeking nomination or election as a candidate to the office of
(Party)
~ t ~ ~ a~~~ ~ ~UP_t~
UNDER PENALTIES OF PERJURY, 1 DECLARE THAT I HAVE READ THE FOREGOING CAMPAIGN TREASURER'S
ACCEPTANCE OF APPOINTMENT AND THAT E FACTS STATED ARE TRUE.
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Date Signature of Campaign Treasurer or Deputy Treasurer
DS-DE 9 (Rev. 01!08)