HomeMy WebLinkAboutDS-DE 9 STATE OF FLORIDA OFFICE USE ONb~Y
APPOINTMENT OF CAMPAIGN TREASURER
AND DESIGNATION OF CAMPAIGN
DEPOSITORY FOR CANDIDATES r~ r,o
(Section 106.021 (1), F.S.)
(PLEASE TYPE)
CHECK APPROPRIATE BOX:
[] OriginalAppointment [] Deputy Treasurer ~'] Reappointment of Treasurer J--"] Secondary Depository
Name of Candidate 1. Address (include post office box or street, city, state, zip code)
David Dermer 4195 North Bay Road
Miami Beach, FL 33140
Telephone (optional) 2. Party (Partisan candidates only) 3. Office (add district, circuit or group number)
Mayor of Miami Beach
have appointed the following person to act as my [] Campaign Treasurer r--'] Deputy Treasurer
4. Name of Treasurer or Deputy Treasurer
Yaffa Dermer
5. Mailing Address (If post office box or dra~r add street address) 6. Telephone
2525 Flamingo Place 305-532-5804
7. City 8. County 9. State 10. Zip Code
Miami Beach Miami-Dada Florida 33140
designated the following named bank as my r'~ Primary Depository r'~ Secondary Depository
I
have
11. Name of Bank 12. Street Address
Bank of/T~me~ica 407 Lincoln Road
13. City / / ./ 14. County 15. State 16. ZipCode
Mia~& ~ea~ ~ Miami-Dada Florida 33139
01/17/05
Campaign Treasurer's Acceptance of Appointment
I, Yaffa Dermer , do hereby accept the appointment as
-- (Please Pdnt or Type)
r-'-~ Campaign Treasurer ~-] Deputy Treasurer for the campaign of David Dermer
who is seeking nomination or election as a N/A candidate to the office of
(Party)
Mayor of Miami Beach . As a duly registered voterin Miami Beach
County, Florida, I am qualified to accept this appointment.
UNDER PENALTIES OF PERJURY, I DECLARE THAT I HAVE READ THE FOREGOING CAMPAIGN TREASURER'S
ACCEPTANCE OF APPOINTMENT AND THAT THE FACTS~,~TrA-T..ED ARE TRUE.
Date ~ .S~natu~ ~/f Campaign Treasurer or Deputy Treasurer
DS-DE 9 (Rev. 08103)