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Home My WebLink AboutMCWHORTER, HAMILTONDS -DE 9 (Rev. 10110) Rule 1S- 2.0001, F.A.C. P?e0elt'�466 APPOINTMENT OF CAMPAIGN TREASURER AND DESIGNATION OF CAMPAIGN API? DEPOSITORY FOR CANDIDATES 9 City (Section 106.021(1), F.S.) o f cityCteseh,Sj��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): N 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 AlaI22 Q //G h O/1� code) 33S Scro !l SfYee-{ n ,HA* 4. Telephone E-mail address ,b,V �H0e7eP (774 ) 4?13 -11�/ e 1406. YA "M 6. Office sought (include district, circuit, group number) 7. If a candidate for a nonpartisan office, check if applicable: 6"N &aP?ed ❑ My intent is to run as a Write -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 ❑ 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 11. Mailing Address 12. Telephone !33 8 (7 "C) CV'6 -4sco 13. City 14. County 15. State 16. Zip Code 17. E -mail address _Sep as -lion l R6 FL 3?—gY,6 M L ss tAE_ L`l t S-1 P Rte- -Cdn�/t 18. 1 have designated the following bank as my Primary Depository ❑ Secondary Depository 19. Name of Bank 20. Address 15541 eJs 1-14 #WAVr 2 21. City 22. County 23. State 24. Zip Code 5e IAe F/_ 32.Q�� UNDER PENALTIES OF PERJURY, 1 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 26. Signature of Candidate ?10e ( X 0.1/ 27. Treasurer's Acceptance of Appointment (fill in the blanks and check the appropriate block) I, ms V SsQ , do hereby accept the appointment (Please Print or Type Name) designated above as: Campaign Treasurer ❑ Deputy Treasurer. Date Sign tore of Campaign Treasurer or Deputy Treasurer DS -DE 9 (Rev. 10110) Rule 1S- 2.0001, F.A.C. DS -DE 9 (Rev. 10110) Rule 1S- 2.0001, F.A.C. RFC�cJ�� APPOINTMENT OF CAMPAIGN TREASURER AND DESIGNATION OF CAMPAIGN 4Ap O DEPOSITORY FOR CANDIDATES C� O y �' �OJy (Section 106.021(1), F.S.) C, of C /er (PLEASE PRINT OR TYPE) ce NOTE: This form must be on file with the qualifying officer before opening the campaign account. OFFICE USE ONLY 1. CHECK APPROPRIATE BOX(ES): Q 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 code) 1335 Sc ra It 4 �uxL��C l4J\ 4. Telephone E -mail address W'M�L -ice ..IfvlC P 6. Office sought (include district, circuit, group number) 7. If a candidate for a nonpartisan office, check if applicable: C F] My intent is to run as a Write -In candidate. 8. If a candidate for a ap rtisan office, check block and fill in name of party as applicable: My intent is to run as a ❑ Write -In ❑ No Party Affiliation ❑ Parry candidate. 9. 1 have appointed the following person to act as my Campaign Treasurer Deputy Treasurer 10. Name of Treasurer or Deputy Treasurer r10�4VL, �e \t�U 11. Mailing Address 12. Telephone 0172 ) % A%qq 13. City 14. County 15. State 16. Zip Code 17. E -mail address _ - n2't i<R ve 2qj Ca 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 �cask a r\ 11�'C- I _ 5 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 \ Zn X J 27. Treasurer's Acceptance of Appointment (fill in the blanks and check the appropriate block) I, \—\oa- �•Wc'J\ SM + c� V\.O 4'a' r , do hereby accept the appointment (Please Print or Type Name) designated above as: ❑ Campaign Treasurer to Deputy Treasurer. r Date Signature of Campaign Treasurer or Deputy Treasurer DS -DE 9 (Rev. 10110) Rule 1S- 2.0001, F.A.C. STATEMENT OF CANDIDATE (Section 106.023, F.S.) (Please print or type) j candidate for the office of ?4!?/' have been provided access to read and understand the requirements of Chapter 106, Florida Statutes. X ate,/ 1!� &IA( Signature of Candidate Date Each candidate must file a statement with the qualifying officer within 10 days after the Appointment of Campaign Treasurer and Designation of Campaign Depository is filed. Willful failure to file this form is a first degree misdemeanor and a civil violation of the Campaign Financing Act which may result in a fine of up to $1,000, (ss. 106.19(1)(c), 106.265(1), Florida Statutes). DS -DE 84 (05111) ELIGIBILITY TO HOLD OFFICE OF COUNCILMEMBER Charter Section 2.02 - ELIGIBILITY C" � 0 9 2014 Clty Cl. k S astian ffl,ce 44/L/ "No person shall be eligible to hold the office of council member unless he or she is a qualified elector* in said city and actually continually resided in said city for a period of one (1) year immediately preceding the final date for qualification as a candidate for said office." tau AA G✓Glol-A--r , candidate for the office of Council Member, meet the eligibility qualifications to hold office as required in Section 2.02 of the City of Sebastian Charter, above. Sworn to and subscribed before me this q day of 19 Pri P/ 11� Pam McGil1lt j* Notary Public !� $we of Edda State of Florida WCOMMISSION # FF24463 EVhu 52011 SEAL *166.032 Electors. Any person who is a resident of a municipality, who has qualified as an elector of this state, and who registers in the manner prescribed by general law and ordinance of the municipality shall be a qualified elector of the municipality. Ms- word/election / charter eligibility LIGIBILITY TO HOLD OFFICE OF COUNCILMEMBER Charter Section 2.02 - ELIGIBILITY c�4PR Cttl, "No person shall be eligible to hold the office of council member unless he or she is a qualified elector* in said city and actually continually resided in said city for a period of one (1) year immediately preceding the final date for qualification as a candidate for said office." I, RaA�, A k-bj\ o I'� 2 _,candidate for the office of Council Member, meet the eligibility qualifications to hold office as required in Section 2.02 of the City of Sebastian Charter, above. Signature of Candidate subscribed before me this /5*5- Notary Pupjit State of Florida s SALLY A. MAIO '�= Commission # EE 024350 SEAL Expires October5, 2014 � � �Q�' Bor" TMu Troy Fah It imm M335-7019 day of , *166.032 Electors. - -Any person who is a resident of a municipality, who has qualified as an elector of this state, and who registers in the manner prescribed by general law and ordinance of the municipality shall be a qualified elector of the municipality. Ms- word/election/charter eligibility