HomeMy WebLinkAboutHerlihy Pre-Qualifying Docs-DSDE9,84, EligibilityDS -DE 9 (Rev. 10110) Kum -i*.uuu-i, r.r►.%o.
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APPOINTMENT OF CAMPAIGN TREASURER
AND DESIGNATION OF CAMPAIGN
DEPOSITORY FOR CANDIDATES
C. �1
(Section 106.021(1), F.S.)
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(PLEASE PRINT OR TYPE)
NOTE: This form must be on file with the qualifying
officer before opening the campaign account.
I OFFICE USE ONLY
1. CHECK APPROPRIATE BOX(ES):
XD Initial Filing of Form Re -filing to Change: ❑ Treasurer/Deputy ❑X Depository ❑ Office ❑ Party
2. Name of Candidate (in this order: First, Middle, Last)
3. Address (include post office box or street, city, state, zip
EDWARD H. HERLIHY
code)
474 SEA GRASS AVENUE
SEBASTIAN, FL 32958
4. Telephone
5. E-mail address
(772 ) 388-0665
edherlihy@bellsouth.net
6. Office sought (include district, circuit, group number)
7. If a candidate for a nonpartisan office, check if
SEBASTIAN CITY COUNCIL MEMBER
applicable:
❑ 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 El Party candidate.
9. 1 have appointed the following person to act as my Q Campaign Treasurer ❑ Deputy Treasurer
10. Name of Treasurer or Deputy Treasurer
EDWARD H. HERLIHY
11. Mailing Address
12. Telephone
474 SEA GRASS AVENUE
( 772 ) 388-0665
13. City
14. County
15. State
16. Zip Code
17. E-mail address
SEBASTIAN
INDIAN RIVER
FLORIDA
32958
edherlihy@bellsouth.net
18. I have designated the following bank as my ❑X Primary Depository ❑ Secondary Depository
19. Name of Bank
20. Address
SEACOAST NATIONAL BANK
1110 ROSELAND ROAD
21. City
22, County
23. State
24. Zip Code
132958
SEBASTIAN
INDIAN RIVER
FLORIDA
UNDER PENALTIES OF PERJURY, 1 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. Signaivre of Can id
V
�P-
AUGUST 1, 2014
X(���.
27. Treasurer's Acceptance of Appointment (fill in the blanks and check the appropriate block)
EDWARD H. HERLIHY do hereby accept the appointment
(Please Print or Type Name)
designated above as: Q Campaign Treasur Deputy Tr urer.
7KAf
. j 4
AUGUST 1, 2014 XW.
Date Ignature o Campaign Treasurer or Deputy Treasurer
DS -DE 9 (Rev. 10110) Kum -i*.uuu-i, r.r►.%o.
STATEMENT OF
CANDIDATE
(Section 106.023, F.S.)
(Please print or type)
1, EDWARD H.HERLIHY ,
candidate for the office of SEBASTIAN CITY COUNCIL
have been provided access to read and understand the requirements of
Chapter 106, Florida Statutes.
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 $1,000, (ss. 106.19(1)(c), 106.265(1), Florida
Statutes).
DS -DE 84 (05/11)
RECEIVED
AUG - 1 2014
City of Sebastian
City Clerk's Office
• b
ELIGIBILITY TO HOLD OFFICE
OF COUNCILMEMBER
Charter Section 2.02 - ELIGIBILITY
"No person shall be eligible to hold the office of council member
unless he or she is a qualified elector* in said city and actually
continually resided in said city for a period of one (1) year
immediately preceding the final date for qualification as a
candidate for said office."
I, F -D 'k) P &)D P - H E R L 114 y , candidate for the office
of Council Member, meet the eligibility qualifications to hold office as
required in Section 2.02 of the City of Sebastian Charter, above.
Sworn to and subscribed before me this 1'5T-
2014.
otary Public JEANETTEWILLlAMS
State of Florida Commission # EE 038067
Expires February 28, 2015
SEAL , BadedTWTmyF*wcaw$WX39`rJD,O
day of I*q u 9 u s t
*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 ofthe municipality.
Ms-wordlelectionlcharter eligibility