HomeMy WebLinkAboutDepository PPOINTMENT OF CAMPAIGN TREASURER RF�Fi�
F
AND DESIGNATION OF CAMPAIGN
DEPOSIeORY ction 60R1CANDIDATES C��rCi`Sebasf(�7�
(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)
X❑ 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
ALBERT IOVINO code)
980 FRANCISCAN AVE
4. Telephone 5. E-mail address SEBASTIAN, FL 32958
(772 ) 584-2073
6. Office sought (include district, circuit, group number) 7. If a candidate for a nonpartisan office, check if
CITY OF SEBASTIAN COUNCILMAN 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 ❑X No Party Affiliation ❑ Party candidate
9. 1 have appointed the following person to act as my Campaign Treasurer ❑ Deputy Treasurer
10. Name of Treasurer or Deputy Treasurer
ALBERT IOVINO
11. Mailing Address
12. Telephone
980 FRANCISCAN AVE
( 772 ) 584-2073
13. City
14. County 15.
State 16. Zip Code 17.
E-mail address
SEBASTIAN
INDIAN RIVER FL
32958
18. 1 have designated the following bank as my
❑X Primary Depository
❑ Secondary Depository
19. Name of Bank
20. Address
CENTERSTATE BANK
855 21ST STREET
21. City
22. County
23. State
24. Zip Code
VERO BEACH
INDIAN RIVER
Fl-
32960
UNDER PENALTIES OF PERJURY, 1 DECLARE THAT 1 HAVE READ THE FOREGOING FORM FOR APPOINTMENT OF CAMPAIGN TREASURER AND
DESIGNATION OF CAMPAIGN DEPOSITORY AND THAT F TS TATED IN IT ARE TRUE.
25. Date 26. Sign ture f Can e
27. Treasurer's Acceptance of Appointment (fill in the blanks and check the appropriate block)
I, ( �,E,S--—(_N)I Y\' do hereby accept the appointment
(Please Print or Type Name)
designated above as: Q Campaign TreasureOz
eputy Treasurer.
X J-v—
Date Signature of Campaign Treasurer or Deputy Treasurer
DS-DE 9 (Rev. 10/10) Rule 1S-2.0001, F.A.C.