HomeMy WebLinkAboutAppt of Treasurer & Dep Treasurer ECE►QED
APPOINTMENT OF CAMPAIGN TREASURER
AND DESIGNATION OF CAMPAIGN MAY 3 l TDp3
DEPOSITORY FOR CANDIDATES City Of Sebastian
(Section 106.021(1), F.S.) eb
City Clerk's pffiae
Of
(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)
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4. Telephone 5. E-mail address
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6. Office sought (include district, circuit, group number)
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3. Address (include post office box or street, city, state, zip
code) r 1G ^ v�
7. If a candidate for a nonpartisan office, check if
applicable:
❑ My intent is to run as a Write -In candidate.
8. If a candidate for a Dartisan office, check block and fill In name of party as applicable: My intent is to run as a
Write -In �NoParty Affiliation ❑ Party candidate.
9. 1 have appointed the following person to act as my ,RL Campaign Treasurer Deputy Treasurer
10. Name
—of Lreasuor Deputy Treasurer
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11. Mailing Address
/53 Y gs �erbrD c>k Z-ranc,
13. City 14. County
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18. 1 have designated the following bank as my
19. Name of Bank
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21. City -- // 22. County
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15. State 16. Zip Code
F,/- 3�95-&-
xPrimary Depository
20. Address O
12. Telephone
17. E-mail addres
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❑ Secondary Depository
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t fi(.l� 23. State r 24. i-� Code
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 26. Signature of Candidate
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27. Treasurer's Acceptance of Appointmen the blanks and check the appropriate block)
I, o �'^ q S G' Lo Oy— J 2 Sh ` ra do hereby accept the appointment
(Please Print or Type Name)
designated above as: Campaign Treasurer. E]Deputy Treaqqer.
5 a Ct x �/p
Date Signature of Campaign Treasurer or Deputy Treasurer
DS-DE 9 (Rev. 10/10) Rule 1S-2.0001, F.A.C.
ECEIVED
APPOINTMENT 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):
❑ Initial Filing of Form Re -filing to Change: �4 Treasurer/Deputy
MAY 14 2023
City of Sebas�
City Clerk' -
OFFICE USE ONLY
❑ Depository ❑ Office ❑ Party
2. Name of Candidate (in this order: First, Middle, Last) 3. Address (include post office box or street, city, state, zip
C l ,( I.0_001f,Kf2 Y203414-T /t/U/v code) 7 b 4 � G� '9ve-
4. Telephone 5. E-mail address 5�� �b a "i y P6
('77:-) G33-xo7 ehr`Srunfi1.9 �1-6
6. Office sought (include district, circuit, group number) 17. If a candidate for a nonpartisan office, check if
r applicable:
C C oL(nG f f ❑ 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 _2 No Party Affiliation ❑
9. 1 have appointed the following person to act as my
10. Name of Treasurer or eputy Treasur
G /��/ S To �,�lEvt° ✓� ti�,v,v
Party candidate.
❑ Campaign Treasurer ZDeputy Treasurer
11. Mailing Address 12. Telephone
7c> Gov qP7 AW— 1(72L-) 633'75��
13. City 14. County 15. State 16. Zip Code 17. E-mail address
SeSaS�'r a't R' jl an Af,e Ft �ls()� �Ir"�S hwn y SeS (0 µ cod, c00' t
18. 1 have designated the following bank as my IRL Primary Depository ❑ Secondary Depository
19. Name of Bank 120. Address
SeUCaa 5 f �u-,v /80 ��fe�ahcl ,�L7
21. City 22. County 23. State 24. Zip Code
Sea nt T-nwi ah e`rveV-
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 26. Signature of Candidate
27. Treasurer's Acceptance of Appointment Mi he blanks and check the appropriate block)
I, G �� f % 6 ✓ A6 PC /f'f N4__� do hereby accept the appointment
(Please Print or Type Name)
designated above as: ❑ Campaign Treasurer. Deputy Trea us�r.�
Date ure �molgn"
asurer or Deputy Treasurer
DS-DE 9 (Rev. 10/10) Rule 1S-2.0001, F.A.C.