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HomeMy WebLinkAboutAppt of Treasurer EC�/VFp APPOINTMENT OF CAMPAIGN TREASURER JVAJ AND DESIGNATION OF CAMPAIGN City:'� DEPOSITORYFOR Cit ,0hebasti ORICANDIDATES n n (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): ® 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 Sherrie Matthews code) S Yearling Trail 4. Telephone 5. E-mail address Sebsatian, FL 32958 e ( 772 )473-6757 1 smatt06l8@comcast.net 6. Office sought (include district, circuit, group number) 7. If a candidate for a nonoartisan office, check if applicable: Sebastian City Council Member ❑ 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 ❑ Party candidate. 9. 1 have appointed the following person to act as my ® Campaign Treasurer ❑ Deputy Treasurer 10. Name of Treasurer or Deputy Treasurer Sherrie Matthews 11. Mailing Address 12. Telephone 800 Yearling Trail (772 )473-6757 13. City Y 14. Count 15. State 16. Zip Code 17. E-mail address Sebastian Indian River FL 32958 smatt0618@comcast.net 18. 1 have designated the following bank as my % Primary Depository Secondary Depository 19. Name of Bank 20. Address SunTrust 9601 US Hwy 1 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 0&—/1-0Da( 26. Sig a re of Candidate X 27. Treasurer's Acceptance of Appointment (fill in the blanks and check the appropriate block) Sherrie Matthews do hereby accept the appointment (Please Print or Type Name) designated above as: ® Campaign Treasurer Deputy Treasurer. O( -1l -�Da X J&AL, �M Date Signature of Campaign Treasurer or Deputy Treasurer DS-DE 9 (Rev. 10110) Rule 1S-2.0001, F.A.C.