DS-DE 9 -3STATE OF FLORIDA o~+£~~~~9+~~
i4PPOINTMENT OF CAMPAIGN TREASURER
AND DESIGNATION OF CAMPAIGN ~~~$ .~Ui* ' ~ QM t0: 30
DEPOSITORY FOR CANDIDATES
(Section 106.021(1), F.S.) CITY C(-r~~~~ af-~~~J~.
(PLEASE TYPE)
CHECK APPROPRIATE BOX:
Original Appointment ^ Deputy Treasurer ^ Reappointment of Treasurer ^ Secondary Depository
Name of Candidate 1. Address (indude post office box or street, city, state, zip code)
~~.~~~1~ ~~~~ ~® ~~ 4~~~~~
111 ~n ~ ~~ft-- ~ ~3r~.~
Telephone (optional) 2. Party (Partisan candidates only) 3. Office (add district circuit or group number
G~ r~ C ~-rn~~s~>
I have appointed the following person to act as m
Y ampaign Treasurer
4. Name of Treasurer or Deputy Treasu .
5. Marlin Address (If post office/ c~o~c or drawer add street address)
Y~ ~ ~alr~ o~1sr~
7. ity 8. Cou ty 9. State
1 arn~ ~3e _ ~~z~~ ~~~i~c
^ Deputy Treasurer
6. Telephone
~D ~6/
10. Zip Code
~~~
I have designated the following named bank as my ^ Primary Depository ~ Secondary Depository
111 Name of Bank 12. Street Address 7
13. City 14. County
for the campaign of
15. State
17. nature of Candidate Date
6.~~~ ~
n Treasurer's Acceptance of Appointment
do hereby accept the appointment as
^ Deputy Treasurer
who is seeking nomination or election as a
16. Zip Code
candidate to the office of
~y] I ,ram,, ~~~~
_, .~ ~ tluly is ere voter in _~~~ ~ j y~~~ ~p ~~
UNDER PENALTIES OF PERJURY, I DECLARE THAT I HAVE READ THE FOREGOING CAMPAIGN TREASURER'S
ACCEPTANCE OF APPOINTMENT AND THAT THE FACTS STATED ARE TRUE.
Date _
Treasurer or Deputy Treasurer
DS-DE 9 {Rev. 08103)
County, Florida, I am qualified to accep# this appointment.