HomeMy WebLinkAboutDSDE 9RECEIVED
APPOINTMENT OF CAMPAIGN TREASURER
AND DESIGNATION OF CAMPAIGN AUG 18 2023
DEPOSITORY FOR CANDIDATES
(Section 106.021(1), F.S.) City of Sebastian
(PLEASE PRINT OR TYPE) City Clerk's Office
NOTE: This form must be on file with the qu#Ahying officer
before onenhta the camsslan aoeourd. OFFICE USE ONLY
1. CHECK APPROPRIATE BOX(ES):
® Initial Filing of Form Refigng to Change: ❑ Treaeurer/Depuy ❑ Repository ❑ Office ❑ Pany
2. Name of Candidate On this order. First, Middle, Last) 3. Address Qnciude post office box or street, city, state.
zip code)
Sherrie Matthews
4. Telephone S. Candidate's Voter Registration #
Sebastian, FI 32958
( 772 ) 473 6757
(Not required for Qualll M Purposes)
(Not required for QueNy6q Purposes) - Phonetic spsaing for sudb ballot Paid rrans odawficegy on to bar below as you vAsh It to be pmnadrwsd on
thaau�db�¢� aamaybeusedbypersoruwllhd"WAses(aesinana manPop 2dthbformk
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6. Office sought (include district, drank, group number) I
7. If a candidate for a gonoarfiean office, cheek N
applicable:
Sebastian City Council ❑ My intent Is to run as a Write-in candidate.
B. 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 ❑
9.1 have appointed the following person to act as my 0 Campaign Treasurer ❑
10. Name of Treasurer or Deputy Treasurer
Sherrie Matthews
12. Mailing Address 113. City 114. State
800 Yearling Tr1
1 have designated the following bank as my 10 Primary Depository
17. Name of Bank 118. Address
19. CRY 120. Courry, 121. State
Sebastian Indian River FL
Party candidate.
Deputy Treasurer
11. Telephone
( 772 ) 473-6757
15. Zip Code
32958
❑ Secondary Depository
22. Zip Code
32958
UNDER PENALTOB OF PERJURY, I DECLARE THAT I HAVE READ THE FOREGOING FORM FOR APP0WrMI7ir OF CAMPAIGN TREASURER
AND DESIGNATION OF CAMPAIGN DEPOSRORY AND THAT THE FACTS STATED IN R ARE TRUE
23. Date 24. Signature of Candidate
August 18, 2023 X
25. Treasurer's Acceptance of Appointment (fill in the blanks and check the appropriate block)
Sherrie Matthews , do hereby accept the appointment
(Please Pdm or Type Nsma)
designated above as: ® Campaign Treasurer. ❑ Deputy Treasurer.
August 18, 2023 x A' t-e-
Data award" or ( or Deputy Traaww
DS-DE 9 (Rev. 07123) Rub 1"0001, F.A.C.