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
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13. City 14. County 15. State 16. Zip Code17. E-mail address
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18. 1 have designated the following bank as my Primary Depository ❑ Secondary Depository
19. Name of Bank 20. Address
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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
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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)