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DS-DE 84 R. Abramson OFFIC.E..0„SE O,NLV STATEMENT OF `• v CANDIDATE 2013 SEP -5 PH 3: 06 (Section 106.023, F.S.) C I T Y (Please print or type) candidate for the office of as Oyl l --L, have been provided access to read and understand the requirements of Chapter 106, Florida Statutes. X A5(� Signature of Candidate 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(05111)