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DS-DE 9-3 D Crystal APPOINTMENT OF CAMPAIGN TREASURER AND DESIGNATION OF CAMPAIGN DEPOSITORY FOR CANDIDATES 2013 AUG --5 AM 11: 15 73 (Section 106.021(1), F.S.) r, c SIT Y C'LL ,; 0 F f ICE: (PLEASE PRINT OR TYPE) cn NOTE: This form must be on file with the qualifying =X: ..,� officer before opening the campaign account. &FIC�US NLY 1.CHECK APPROPRIATE BOX(ES): — T, Initial Filing of Form Re-filing to Change: ❑ Treasurer/Deputy ❑ Depository Office ❑ Party 2. Name of Candidate(in this order: First, Middle, Last) 3.Address(include post office box or street, city, state,zip DAVE CRYSTAL code) POST OFFICE BOX 416151 4. Telephone E-mail adddres s� MIAMI BEACH, FLORIDA 33141 (305 } 330-5297 V O YA 6. Office sought(include district, circuit, group number) 7. If a candidate for a nonpartisan office,check if CITY OF MIAMI BEACH COMMISSION GROUP#2 applicable: ❑ My intent is to run as a Write-In candidate. 8. If a candidate for a ap rtisan 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. 1 have appointed the following person to act as my 0 Campaign Treasurer ❑ Deputy Treasurer 10. Name of Treasurer or Deputy Treasurer DAVE CRYSTAL 11. Mailing Address 12.Telephone POST OFFICE BOX 416151 ( 305 ) 330-5297 13. City 14. County 15. State 16.Zip Code 17. E-mail address MIAMI BEACH MIAMI-DADE FLORIDA 33141 18. 1 have designated the following bank as my XO Primary Depository ❑ Secondary Depository 19. Name of Bank 20.Address TD BANK 500 SOUTH POINTE DRIVE 21. City 22. County 23. State 24. Zip Code MIAMI BEACH MIAMI-DADE FLORIDA 33139 UNDER PENALTIES OF PERJURY,1 DECLARE THAT I HAVE READ THE FOREGOING FORM FOR APPOINTMENT OF CAMPAIGN TREASURER AND DESIGNATION OF CAMPAIGN DEPOSITORY AND THAT THE FACTS STATED IN IT ARE TRUE. 25. Date 26. Signature of 08/05/2013 X 27. Treasurer's Acceptance of Appointment(fill in the blanks and check the appropriate block) I, DAVE CRYSTAL ,do hereby accept the appointment (Please Print or Type Name) designated above as: © Campaign Treasurer ❑ D reasurer. 08/05/2013 X Date Signature of Campaign Treasurer or Deputy Treasurer DS-DE 9(Rev. 10/10) Rule 1 S-2.0001, F.A.C.