HomeMy WebLinkAboutJones- Appointment of Campaign TreasurerAPPOINTMENT OF CAMPAIGN TREASURER
AND DESIGNATION OF CAMPAIGN
7099 JAN _3 PM 5. 30
DEPOSITORY FOR CANDIDATES
(Section 106.021(1), F.S.)
RECEIVED
(PLEASE PRINT OR TYPE)
CITY OF TAMARAC
C!'('Y CLERK
NOTE: This form must be on file with the qualifying
officer before opening the campaign account.
OFFICE USE ONLY
1. CHECK APPROPRIATE BOX(ES):
d Initial Filing of Form Re -filing to Change: 62' Treasurer/Deputy Depository Office Parry
2. Name of Candidate (in this order: First, Middle, Last)
3. Address (include post office box or street, city, state, zip
code)
IAt EIE LLF_ At,DPF=A 30AF_S
r�830 RW &4'6 AqF_-t4ve -Zia
4. Telephone
5. E-mail address
T A M A ►ZAC j FL 33319
(154) 56o 3-
L,
BHA
6. Office sought (include district, circuit, group number)
7. If a candidate for a nonpartisan office, check if
r,'_ I `{ Cro M M t 55 ► U Krr►Z
applicable:
My intent is to run as a Write-in candidate.
8. If a candidate fora partisan office, check block and fill in name of party as applicable: My intent is to run as a
Write -In ❑ No Party Affiliation 0 Party candidate.
9. 1 have appointed the following person to act as my Campaign Treasurer Deputy Treasurer
10. Name of Treasurer or Deputy Treasurer
S'ILViA TROER
11. Mailing Address
12. Telephone
W&P CDRAL. cLug bK
( 9311 ) Z39 • CiCH7
13. City
14. County
15. State
16. Zip Code
17. E-mail address
CoKAt_ SPRU46S
8R0VVAA' 1)
FL
330-1 I
J.SEKEME)AW C 6MAIL. t 6n-"t
18. 1 have designated the following bank as my Primary Depository Secondary Depository
19. Name of Bank
20. Address
tit, 1
WO N P l IJS ► SSA ND RC) AD
21. City
22. County
23. State
24. Zip Code
Pi, AV4TAT►uN
IFL-
333221
UNDER PENALTIES OF PERJURY, I DECLARE THAT I HAVE READ THE FOREGOING FORM FOR APPOI TMENT OF CAMPAIGN TREASURER AND
DESIGNATION OF CAMPAIGN DEPOSITORY AND THAT T E FACTS STATED NIT ARE TRUE.
25. Date
26. Signa re of Candidate
A
X,--//
27. Treasurer's Acceptance of Appointment (fill in the bl .4 an check the appropriate block)
I, j L V A I t2 0`(Ek do herebythe accept p appointment
(Please Print or Type Name)
designated above as: Campaign Treasurer Deputy T ea r r.
Date __--`81gnafijde of C mp Ign reasurer or Deputy Treasurer
DS-DE 9 (Rev. 10/10) Rule 1S-2.0001, F.A.C.