HomeMy WebLinkAboutCarol Mendelson - Designation of Campaign Treasurer - DS-DE 9APPOINTMENT OF CAMPAIGN TREASURER
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AND DESIGNATION OF CAMPAIGN
2022 FEB 17 Am9:35
DEPOSITORY FOR CANDIDATES
(Section 106.021(1), F.S.)
(PLEASE PRINT OR TYPE)
NOTE: This form must be on file with the qualifying
officer before opening the campaign account
I OFFICE USE ONLY
1. CHECK APPROPRIATE BOX(ES):
0 Initial Filing of Form Re -filing to Change: Treasurer/Deputy ® Depository Office Party
2. Name of Candidate (in this order: First, Middle, Last)
3. Address (include post office box or street, city, state, zip
Carol J. Mendelson
code) I N' kti) 72-
(1111 arc�C ; F f
4. Telephone
5. E-mail address
(954 ) 4611788
caroljmendelson@gmail.com
6. Office sought (include district, circuit, group number)
7. If a candidate for a nonpartisan office, check if
Commissioner Tamarac District 4
applicable:
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
Write-in M No Party Affiliation Party candidate.
9. 1 have appointed the following person to act as my Q Campaign Treasurer Deputy Treasurer
10. Name of Treasurer or Deputy Treasurer
Carol J. Mendelson (self)
11. Mailing Address
12. Telephone
8021 NW 72 Street
( 954 ) 4611788
13. City
14. County
15. State
16. Zip Code
17. E-mail address
Tamarac
Broward
FL
33321
caroljmendelson@gmail.com
18. 1 have designated the following bank as my 0 Primary Depository Secondary Depository
19. Name of Bank
�u
20. Address
3'7q O/V4
ru
7 mMeQjQA
21. City
22. County
23. State
24. Zip Code
-Tama cal c--
I Broward
1FL
UNDER PENALTIES OF PERJURY, I DECLARE THAT I HAVE READ THE FOREGOING FORM FOR APPOINTMENT OF CAMPAIGN TREASURER AND
DESIGNATION OF CAMPAIGN DEPOSITORY AND THAT THE FACTS STATED IN IT ARE TRUE.
25. Date
141-
26 Signature of Candidate e
27. Treasurer's Acceptance of Appointment (fill in the blanks 6Kd check the appropriate block)
Carol J. Mendelson do hereby accept the appointment
(Please Print or Type Name)
designated above as: 0 Campaign Treasurer Deputy Treasurer.
Date Signature aml5aign Treasurer or Deputy Treasurer
DS-DE 9 (Rev. 10/10) Rule 1S-2.0001, F.A.C.