HomeMy WebLinkAboutColangelo, Victoria DS-DE 9 & DS-DE 84 - 2022 06 01 APPOINTMENT OF CAMPAIGN TREASURER
AND DESIGNATION OF CAMPAIGN ?-�P'CEIVED
DEPOSITORY FOR CANDIDATES
(Section 106.021(1), F.S.) JUN 0 12022
CITY OF WINTER SPRINGS
(PLEASE PRINT OR TYPE) OFFICE OF THE CITY CLERK
NOTE: This form must be on file with the qualifying
officer before opening the campaign account. OFFICE USE ONLY
1. HECK APPROPRIATE BOX(ES):
Initial Filing of Form Re-filing to Change: ❑ Treasurer/Deputy ❑ Depository ❑ Office ❑ Party
2. Name f Candidate (in this order: First, Middle, Last) 3.Address (include post office box or street, city, state, zip
M✓CvIC h n b code) Gh2 "� � 2eX..brr-
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4. Telephone 5. E-mail addresselo 1 r sj ) L
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6.
6. Office sought (include district, circuit, group numbe ,, 7. If a candidate for a nonpartisan office, check if
applicable:
E] My intent is to run as a Write-In candidate.
8. If a candidate for a partisan office, check block and fill i 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 EfCampaign Treasurer ❑ Deputy Treasurer
10. Name of Treasurer o0�,w&t
ty Treasurer
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11. Mailing Address Qj 12.Telephone
1 Ch A,r� Cfee I_ dy,-6 (�7W-
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13. ity 14. County 15. State 16. Zip Code 17. E-mail address
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18. 1 have designated t e following bank as my Primary Depository ❑ Secondary Depository
19. Name of Bank 20. Address
21. Ci`ty� 22. County 23. State 24. Zip Code
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UNDER PENALTIES OF PERSUiY,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 Candi ate
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27. Treasurer's Acceptance of Appointment(fillinthe blanks and check the appropriate block)
I, �ilt � �' )k e� , do hereby accept the appointment
(Please Print or Type Nam'
designated above as: [Campaign Treasurer ❑ Deputy Treasurer.
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Date Signatur ampaign Treasurer or Deputy Treasurer
DS-DE 9 (Rev. 10/10) Rule 1S-2.0001, F.A.C.
OFFICE USE ONLY
STATEMENT OF
CANDIDATE �°"�" ``
(Section 106.023, F.S.) JUN 0 12022
(Please print or type) OFFICE OFF CITY OF ITER LE S
THE CITTYY CLE
CLERK
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candidate for the office of
have been provided access to read and understand the requirements of
Chapter 106, Florida Statutes.
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Signature of Candidate tDafe
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)