HomeMy WebLinkAboutDSDE 84STATEMENT OF
CANDIDATE
(Section 106.023, F.S.)
(Please print or type)
OFFICE USE ONLY
R
C
F
�(i� l FO
01 j
C'"I& ?QUO
o
candidate for the office of Calk Q_ f
have been provided access to read and understand the requirements of
Chapter 106, Florida Statutes.
ignature of andidate
�///'-p
210
Each candidate must file a statement with the qualifying officer within 10 days after the
Appointment of Campaign Treasurer and Designation of Campaign Depository is filed. Willful
failure to file this form is a first degree misdemeanor and a civil violation of the Campaign
Financing Act which may result in a fine of up to $1,000, (ss. 106.19(1)(c), 106.265(1), Florida
Statutes).
DS-DE 84 (05!11)