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HomeMy WebLinkAboutDSDE 9APPOINTMENT OF CAMPAIGN TREASURER AND DESIGNATION OF CAMPAIGN 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. 1. CHECK APPROPRIATE BOX(ES): ❑X Initial Filing of Form Re -filing to Change: ❑ 2. Name of Candidate (in this order: First, Middle, Last) Christopher, Robert, Nunn 4. Telephone 1 5. E-mail address ccity s , ?020 C/cq , bdsba C` "CC? OFFICE USE ONLY Treasurer/Deputy ❑ Depository ❑ Office ❑ Party 3. Address (include post office box or street, city, state, zip code) 709 Jordan Avenue, Sebastian, FL, 32958 (772 ) 633-7507 1chrisnunn4sebastian@outlo81 6. Office sought (include district, circuit, group number) 7. If a candidate for a nonoartisan office, check if City Council Member at large 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 Q No Party Affiliation ❑ Party candidate. 9. 1 have appointed the following person to act as my ❑X Campaign Treasurer ❑ Deputy Treasurer 10. Name of Treasurer or Deputy Treasurer Thomas George Shira 11. Mailing Address 12. Telephone 1534 Esterbrook Lane ( 863 ) 206-5396 13. City 14. County 15. State 16. Zip Code 17. E-mail address Sebastian Indian River FL 32958 1 tomshira@bellsouth.net 18. 1 have designated the following bank as my ❑X Primary Depository ❑ Secondary Depository 19. Name of Bank 20. Address 21. City 22. County 23. State 24. Zip Code Sebastian Indian River FL 32958 UNDER PENALTIES OF PERJURY, I DECLARE THAT 1 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 Cand' / 07/25/2020 �( 27. Treasurer's Acceptance of Appointment (fill in the blanks and check the appropriate block) Thomas George Shira do hereby accept the appointment (Please Print or Type Name) designated above as: Q Campaign Treasurer ❑ Deputy Treasurer. '`,_ � -SL Date Signature of Campaign Treasurer or Deputy Treasurer DS-DE 9 (Rev. 10110) Rule 1S-2.0001, F.A.C.