HomeMy WebLinkAboutAppt of Treasurer PPOINTMENT OF CAMPAIGN TREASURER RECEiVED
AND DESIGNATION OF CAMPAIGN
DEPOSITORY FOR CANDIDATES JUL 3� ?015
(Section 106.021(1), F.S.)
(PLEASE PRINT OR TYPE) C''ry C/e Sebastian
ks Offie
NOTE: This form must be on file with the filing officer before e
opening the campaign account. OFFICE USE ONLY
1. CHECK APPROPRIATE BOX(ES):
10 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 PO Box or Street, City, State, Zip Code):
(Please Print or Type Name) 800 Yearling Trl
Sherrie Matthews Sebastian, FL 32958
4. Telephone: 5. Candidate's Voter Registration #: 6. Email Address:
(772 )473-6757 smatt0618@comcasi:.net
(not required for qualifying purposes)
7. Office Sought (include district, circuit, group, or seat #): 8. f a candidate for a nonpartisan office, check the box
if applicable:
Sebastian City Council ❑ I intend to run as a Write -In Candidate.
9. If a candidate for parIsan office, check the box and fill in the name of the party as applicable: I intend to run as a
❑ Write -In Candidate. ❑ No Party Affiliation Candidate.
❑ Party candidate.
10. 1 have appointed the following person to act as my:
❑N Campaign Treasurer ❑ Deputy Treasurer
11. Name of Treasurer or Deputy Treasurer:
12. Telephone: 13. Email Address:
Sherrie Matthews
(772 ) same as above
14. Mailing Address: 15.
City: 16. State: 17. Zip Code:
same as above
18. 1 have designated the following bank as my (check appropriate box): ❑ Primary Depository ❑ Secondary Depository
19. Name of Bank:
20. Address:
Truist
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 I HAVE
READ THE FOREGOING FORM FOR THE APPOINTME14T OF THE
CAMPAIGN TREASURER AND DESIGNATION OF THE CAMPAIGN DEPOSITORY AND THAT THE FACTS STATED IN rr ARE TRUE.
25. Date: L J L/ 30, io ZJ
26. Signature of Candidate:
I
l
X NAL �
27. Treasurer's Acceptance of Appointment (fill in the blanks and check the appropriate box)
Sherrie Matthews
do hereby accept the appointment designated above as:
(Please Print or Type Name)
Campaign Treasurer. ❑ Deputy Treasurer.
p 29. Si nature of Campaign Treasurer or Deputy Treasurer
28. Date:f d t 2U X /a (�-)
DS-DE 9 (Rev. 09/23) Rule 1S-2.0001, F.A.C.