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DS-DE 94 MBowerOFFICE USE ONLY STATEMENT OF CANDIDATE (Section 106.023, F.S.) ~, ° .-,~~ (Please Type) r, ~ r' °~ ;'J ~.; CrJ c~ r I f _'!_ ~G ~~~' T f r•-' candidate for the office of o o : l~~ ~ ; have received, read and understand the requirements of Chapter 106, Florida Statutes. X o ~ Signat re of Candidate D to 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, (ss. 106.19(1)(c), 106.265(1), Florida Statutes). DS-DE 84 (Rev. 03/08)