HomeMy WebLinkAboutAppt of TreasurerAPPOINTMENT 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):
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OFFICE USE ONLY
0 Initial Filing of Form Re -filing to Change: 0 Treasurer/Deputy ❑ Depository 0 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)
4. Telephone 15. E-mail address
6. Office sought (include district, circuit, group number) 7. If a candidate for a nonpartisan office, check if
applicable:
Sebastian City Council Member My intent is to run as a W rite -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 n No Party Affiliation F1 Party candidate.
9. 1 have appointed the following person to act as my
10. Name of Treasurer or Deputy Treasurer
Sherrie Matthews
11. Mailing Address
Same as above
Campaign Treasurer Deputy Treasurer
12. Telephone
( 772 ) 473-6757
13. City 14. County 15. State 1 16. Zip Code 17. E-mail address
Sebastian Indian River FL 132958 1 smatt0618@comcast.net
18. 1 have designated the following bank as my 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 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
April 22, 2022
26. Signature
.of.Candidate
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.
April 22, 2022111"` X '. j /Y)atzl c�
Date Signature of Campaign Treasurer or Deputy Treasurer
DS-DE 9 (Rev. 10/10) Rule 1S-2.00,01, F.A.C.