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HomeMy WebLinkAboutElliot, Robert DS-DE 9 - New Bank (2020 08 07) [SUPERSEDED]APPOINTMENT OF CAMPAIGN TREASURER ry ""CEm:1 VE AND DESIGNATION OF CAMPAIGN 4,�,G 0 7 DEPOSITORY FOR CANDIDATES a 17Y �I �/'w41��1"1"4' 1"R]Ni w';"a (Section 106.021(1), F.S.) r �,:.;i r - G1 E cairn° (PLEASE PRINT OR TYPE) NOTE: This form must be on file with the qualifying officer beforeopening, enin the cam si n account. OFFICE USE ONLY 1. CHECK APPROPRIATE BOX(ES): Initial Filing of Form Re -filing to Change: rj 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 Robert Miles Elliott code) 925 Chokecherry Court 4. Telephone 5 E-mail address Winter Springs, FL 32708 (407 ) 848-9828 elliotr8689@gmail.com 6. Office sought (include district, circuit, group number) _ 7. If a candidate for a non partisan office, check if Winter Springs City Commissioner applicable: District 5 R 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 Sarah Alethe Elliott 11. Mailing Address 12. Telephone 925 Chokecherry Court ( 407 ) 314-6922 13. City 14. County 15. State 16. Zip Code 17. E-mail address Winter Springs Seminole FL 32708 elliott8689@gmail.com 18. 1 have designated the following bank as my ® Primary Depository Secondary Depository 19. Name of Bank 20L. Address Bank of America 1445 Tuskawilla Road 21. City 22. County 23. State 24. Zip Code Winter Springs Seminole FLii32708 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. Sicture of Candidate 8/6/2020 27. Treasurer's Acceptance of Appointment (fill in the blanks and check the appropriate block) Sarah Alethe Elliott do hereby accept the appointment (Please Print or Type Name) designated above as: © Campaign Treasurer Deputy Treasurer. 8/6/2020 Date Signature of Campaign Treasurer or Deputy Treasurer S- E 9 (Rev. 1 10) Rule 1S-2.0001, F.A.C.