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DS-DE 84 Bower Statement of Candidate • -. riLY i STATEMENT OF CANDIDATE 2010 NOV 19 AM II: 38 (Section 106.023, F.S.) CITY CLERK'S OFF ICE (Please Type) I, Ali Al/ 04'.6 candidate for the office of / ®, 3 have received, read and understand the requirements of Chapter 106, Florida Statutes. X 59740 AgY /0 io Signature of Candidate ate 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 -DE84 (Rev. 03/08)