HomeMy WebLinkAboutWatkins, Barbara DS-DE 9APPOINTMENT OF CAMPAIGN TREASURER
AND DESIGNATION OF CAMPAIGN
DEPOSITORY FOR CANDIDATES
(Section 106.021(1), F.S.)
(PLEASE PRINT OR TYPE)
REC."JEIVED
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C�TYOFV MN � FR SFIRIIK'�S
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01::: 11) C,j '11 CLERK
NOTE: This form must be on file with the qualifying
officer before opening the campaign account. OFFICE USE ONLY
1. CHECK APPROPRIATE BOX(ES):
Initial Filing of Form Re -filing to Change: 0 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)
ILL re,
4 Telephone 6. E-mail address6. to
sought (include district, circuit, group number) 7. If a candidate for a non artisan office, check if
applicable:
V S/Qoer see,) ,--s Ej My intent is to run as a Write -In candidate.
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8. If a candidate for a partisan office, check block and fill in name of party as applicable: My intent is to run as ✓
Write -In No Party Affiliation
9. 1 have appointed the following person to act as my
ame oVreasurer or Deputy Treasurer
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na
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'T1 Mailing Address
Party candidate.
Campaign Treasurer Deputy Treasurer
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13. City
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14. Co.j ty
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7State
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18. 1 have designated tie following bank as my
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Primary Depository
19. Name PT B nkK
--Ad`d
12. Telephone
17. E-mail address
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Secondary Depository
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22. County 2N.it ate 24. Zip Qode
O v i t a o
765,
UNDER PENALTIES OF PERJURY, I DECLARE THAT I HAVE READ THE FOREGOING FORM FOR APPOINTMENT OF CAMPAIGN TREASURER AND
NO
F CAMPAIGN DEPOSITORY AND THAT THE FACTS STATED IN IT ARE TRUE.
25. Date 26. Signature Of Candidate
27 Treasurer's Acceptance of Appointment (fill in the blanks and check the appropriate block)
(Please Print or Type Name)
designated above as: Campaign Treasurer
- ------------
Date Rinr
do hereby accept the appointment
71 Deputy Treasurer.
ture
mpaign Treasurer or Deputy Treasurer
DS-DE 9 (Rev. 10/10) Rule 1S-2.0001, F.A.C.