HomeMy WebLinkAboutTyneka M Rene - Designation of Campaign Treasurer - DS-DE 9APPOINTMENT OF CAMPAIGN TREASURER
LLI
AND DESIGNATION OF CAMPAIGN
DEPOSITORY FOR CANDIDATES
(Section 106.021 (1), F. S.)
(PLEASE PRINT OR TYPE)
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NOTE: This form must be on file with the qualifying
I.N
officer before opening the campaign account.
2 1. (gFICE USE ONLY
1. HECK APPROPRIATE BOX(ES):
T
Initial Filing of Form Re -filing to Change: M/Treasurer/Deputy Depository 0Office E] Party
2. Name of Candidate (in this order: First dle Last)
3. Address (include post office box or street, city, state, zip
(ink. . 'Uk �Ao VU�
code)
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4. Tel phone
5. E-mail address
6. Office sought (include distrid circuit, group nAbex4
7. If a candidate for a nonpartisan office, check if—
b_�'W(U 2 Umr*A"SSj
applicable:
E] My intent is to run as a Write -In candidate.
8. If a candidate for a partisan office, check block and fill in name of party as applicable: My intent is to run as a
El Write -In No Party Affiliation Party candidate.
9. 1 have appointed the following person to act as my Campaign Treasurer E] Deputy Treasurer
10.
N me of Treasurer or Deputy Tfeasurer
—
Rof(Z o Lan
11. Mailing Address
12. Telephone
qjM 2'sr
( �S ( ) 22 2�5
13. City
14. County
15. State
16. Zip Code
17. E-mail address
18. 1 have designated the following bank as my [] Primary Depository Secondary Depository
19. Name of Bank
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20. Address
I b Layi
q001 W... CooArwot I 61A
21, City
22. Cc my
23. State
24. Zip Code
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UNDER PENALTIES OF PERJURY, I DECLARE THAT I HAVE READ THE FOREGOINGIM FOR APPOINTMENT OF CAMPAIGN TREASURER AND
DESIGNATION OF CAMPAIGN DEPOSITORY AND THAT F TSSTATED IN IT ARE TRUE.
TiM
25. Date
26, ig andiclate
3 1 20 2:2,
XI15LY
27. Treasurer's Acceptance of Appointment (fill in lank and check the appropriate block)
A ,
1, do hereby accept the appointment
(Please Frint&r Type Name)
designated above as: ts( Campaign Treasurer Deputy Treasurer'
Date Signature of 'Camp Wig—rf Treasurer orb_epuiyTreaSurer___'__
CIG,
DS-DE 9 (Rev. 10/10) Rule 1S-2,0001, F.A.C.