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HomeMy WebLinkAboutMorrisey, William Brandon Michael DS-DE-9 & DS-DE 84 - 2022 07 08 APPOINTMENT OF CAMPAIGN TREASURER RECEIVE® AND DESIGNATION OF CAMPAIGN SOL Q 8 2a?? DEPOSITORY FOR CANDIDATES (Section 106.021(1), F.S.) CITY OF WINTER SPRINGS OFFICE OF THE CITY CLERK (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): 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 V, I)iam &11J0n M)e*OL-e- code)) Mofr;Sa° ( . morr..se-y 6. Office sought (include district, circuit, group number) 7. If a candidate for a nonpartisan office, check if applicable: (An,II G%� �}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 U Write-In ❑ No Party Affiliation - __ .; __ __ _I1T.. 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 _ ( 13. City 14. County 15. State 16. Zip Code17. E-mail address tv1/j�'�l S��'�s ,SZA'1 40 el �'L ?J2?og 18. 1 have designated the following bank as my Primary Depository ❑ Secondary Depository 19. Name of Bank 20. Address TrUS4- )� j- vs�-ca,w� 21. City 22. County 23. State 24. Zip Code C�1�-� fir.�S 3270.9 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 7 /7 / Z2 X 14"18 27. r A I Treasurer's Acceptance of Appointment (fill in the blanks and check the appropriate block) 1, `!v �, 1 1I�W�, /_\ / • � " ti 0 j—f-(,k5(�-`,? , do hereby accept the appointment (Please Print or Type Name) designated abov a Campaign Treasurer ❑ puty Treasurer. X Date Sign ur f 0ampaign Treasurer or D uty Treasurer DS-DE 9 (Rev. 10/10) Rule 1S-2.0001, F.A.C. OFFICE USE ONLY STATEMENT OF CANDIDATE RECZ-pVED (Section 106.023, F.S.) JUL 0 8 2022 (Please print or type) CITY OF WINTER SPRINGS OFFICE OF THE CITY CLERK i, �j i J 1 r C..x'an�loV) candidate for the office of M4lYn(' have been provided access to read and understand the requirements of Chapter 106, Florida Statutes. X W 71 zz. Signa ure 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(05/11)