HomeMy WebLinkAboutElvin Villalobos - Designation of Campaign Treasurer - DS-DE 9 (2)APPOINTMENT OF CAMPAIGN TREASURER
AND DESIGNATION OF CAMPAIGN
DEPOSITORY FOR CANDIDATES
(PLEASE PRINT OR TYPE)
NOTE: This form must be on file with the qualifying
officer before opening the campaign account.
OFFICE USE ONLY
1. CHECK APPROPRIATE BOX(ES):
0 Initial Filing of Form Re -filing to Change: E110"Treasurer/Deputy Depository E] Off ice 0 Party
2. Name of Candidate (in this order: First, Middle, Last)
3. Address (include post office box or street, city, state, zip
b-5 J
6. Office sought (include district, circuit, grouKnumber)
7. If a candidate for a nonpartisan office, check if
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 E] No Party Affiliation E] Party candidate.
9. 1 have appointed the following person to act as my Campaign Treasurer Deputy Treasurer
10. Name of Treasurer or Deputy Treasurer
11. Mailing Address
12. Telephone
13. City
14. County
15. State
16. Zip Code
17. E-mail address
18. 1 have designated the following bank as my M-11—Primary Depository SecondarV-6epository
19. Name of Bank
20. Address
21. City
22. County
23. State
24. Zip Code
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
26. Signature of Candidate
C7,
27. Treasurer's A eptance of Appointment (fill in the blanks and check the appropriate block)
1 0') ow_ -)bf do hereby accept the appointment
(Please Print or Type Name)
designated above as: F Deputy Treasurer.
Campaign Treasurer
Date Signature of Campaign Treasurer or Deputy Treasurer
DS-DER Ruv.1O/1O) Rule 1S-2.00U1'F.A.O.