DS-DE 9 Kristen R. Gonzalez APPOINTMENT OF CAMPAIGN TREASURER
AND DESIGNATION OF CAMPAIGN
DEPOSITORY FOR CANDIDATES -�
(Section 106.021(1), F.S.)
(PLEASE PRINT OR TYPE) y; cn
NOTE: This form must be on file with the qualifying
officer before opening the campaign account. TQFF.SE USE ONLY
1. CHECK APPROPRIATE BOX(ES): �� N
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Initial Filing of Form Re-filing to Change: Treasurer/Deputy Depository Office Party
2. N of Candida this order: t, Middle, Last) 3. Address(include post office box or street, city, state, zip
code) a
4. Tee P one 5. E-mail ad ress �✓�� �O f I f�� `��
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6. Office sought(include district, circuit, group number) 7. If a candidate for a nonpartisan office, check if
�n '�' applicable:
1 Y M M(SS(OV)V,l- qro _� My intent is to run as a Write-In candidate.
8. If a candidate for a partisan office, check block ar d�f_ill in name of party as applicable: My intent is to run as a
r
Write-In No Party Affiliation _ Party candidate.
9. 1 have appointed the following person to act as my tacampaign Treasurer Deputy Treasurer
10. Name f easurer,or Deput Treasurer
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11. Mailing Address 12. Telephone
ai �� �o �� (��i) zoo
1 . City 14. County 15. tate j 16. Zip Code 17. E-mail address
18. 1 have designated the following bank as my Primary Depository Secondary Depository
19 Name of Bank 20.Address
21. City 22. County 23. State 24. Zip Code
) -11 I V/Ori
UNDER PENALTIES OF PERJURY,I DECLARE THAT I HAVE READ THE FOREGOING FQftM FOR APPOINTMENT OF CAMPAIGN TREASURER AND
DESIGNATION OF CAMPAIGN DEPOSITORY AND THAT V F CTS STATED IN IT ARE TRUE.
25. Date 26. Signat r o didate
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27. Treasurer's Acceptance of Appointment(fill in the I s and c eck the appropriate block)
I, Y/G� ��� C'O OJ 51,
1 do hereby accept the appointment
(Please Print or Type Name)
designated above as: Campaign Treasurer Depu Tre surer. r�
A S C
Date Si ature of Campaign Treasurer or Deputy Treasurer
DS-DE 9(Rev. 10110) Rule 1S-2.0001, F.A.C.