HomeMy WebLinkAboutDS-DE 9 Amended STATE OF FLORIDA
APPOINTMENT OF CAMPAIGN TREASURER
AND DESIGNATION OF CAMI~AIGN
DEPOSITORY FOR CANDIDATES
(Section 106.02t(1), F.S.)
(PLEASE TYPE)
CHECK APPROPRIATE BOX: ~'~~1~
~ginal Appointment Tre~asurer
Name of Candidate
OFFICE USE ONLY
~ Reappointment of Treasurer ~ Secondary Depository
1. Address (include pest of~ce box or street, city, state, zip code)
Telephone (optional) I 2. Party (Partisan c=andidates only) I .3..,Office (add district, circuit or group number)
have appointed the following person to act as m~ i[~ampaign Treasurer O Deputy Treasurer
4. Name of,,Tre~surer or Deputy. Treasurer
5. Uail~ ~=~e-~ (,~ Fast,~m U=x or ~a~.~ street a~,e~s)
7 [, ~ 8.~ , 9. State
have designated the following named bank as rm~y ~ Primary Depository
li. Named~ Bmlk , ,
17.
~ Secondary Depository
(Please Printt(or Type)
who is seeking nomination or election as a
(Party)
, do hereby accept the appointment as
candidate to the office of
County, Flodda, I am qutlified to accept this appo~intment. /
UNDER PENALTIES OF PERJURY, I DEClLARE THAT I,,flAVE READ TItlE FOREGOING CAMPAIGN ~EA~[~REI~J~I~
ACCEPTA.CE OF APPe..mE.T THAT, E CACTS STATED ARE TRUE.
ua~e ~ Sig~e"of Campaign Treasurer or Dep~rea~Ser
DS-DE 9 (Rev. 08/0~)