DS-DE 9 1 Grieco C-) N
APPOINTMENT OF CAMPAIGN TREASURER
AND DESIGNATION OF CAMPAIGN m
DEPOSITORY FOR CANDIDATES
(Section 106.021(1),F.S.)
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(PLEASE PRINT OR TYPE)
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NOTE: This form must be on file with the qualifying
officer before opening the cam i n account. OFFICE USE ONLY
1.CHECK APPROPRIATE BOX(ES):
[] Initial Filing of Form Re-filing to Change: ® Treasurer/Deputy ❑ Depository ❑ Office ❑ Parry
2.Name of Candidate(in this order:First,Middle, Last) 3.Address(include post office box or st eet,cp ,state,zip
,� code) N G f6lV or �S0O
4.Telephone 5.E-mail address L 515/3
(30S )9-f7 0o3 Cr fe.ff,tt L GX,��1,
6. Office sought(include district, circuit,group number) 7.If a candidate for a non partisan office,check If
f`
applicable:
iox 3 ❑ My intent is to run as a Write-In candidate.
8. If a candidate fora partisln office,check block and fill in name of party as applicable: My intent is to run as a
❑
Write-in ❑ No Party Affiliation ❑ Party candidate.
9. I have appointed the following person to act as my E,/] Campaign Treasurer ❑ Deputy Treasurer
10. Name e Treasurer or Deputy Treasurer
C�
11.Mailing Address 12.Telephone
60/ % � /boo 1G305 ) .3-7[ 62oa
13.Ci 14.County 15.State 16.Zip Code 17.E-mail address
3313 I a,ccb e_�r'elp"t - N f�r-n0nN,co
18.1 have designated the following bank as my Q Primary Depository ❑ Secondary Depository
19.Name of Bank 20.Ad ress
_5 ' 2 Ni �n 6 g -
21.Ci 22.Cou.nt� 23.State 24. Zip Code
33
�i97;
UNDER PENALTIES OF PERJURY,I DECLARE THAT I HAVE READ THE FOREGOING FORM FOR APPOINTMENT OF CAMPAIGN TREASURER AND
DESIGNATION OF CAMPAIGN DEPOSITORY AND THAT THE FAC STATED IN IT ARE TRUE.
25. Date 26. Signature Ca
z 11-5
27. Treasurer's Acceptance of Appointment(fill' the blanks and check the appropriate biock
i, Adam A. Cedrati ,do hereby accept the appointment
(Please Print or Type Name)
designated above as: 0 Campaign Treasurer ❑ Deputy Treasurer.
February 15, 2013 X
Date gnature of Campaign asurer or Deputy Treasurer
DS-DE 9(Rev.10/10) Rule 1S-2.0001,F.A.C.