HomeMy WebLinkAboutMorrisey, Brandon DS-DE 9 & DS-DE 84 - 2022 11 23APPOINTMENT OF CAMPAIGN TREASURER
AND DESIGNATION OF CAMPAIGN
DEPOSITORY FOR CANDIDATES
(Section 106.021(1), F.S.)
(PLEASE PRINT OR TYPE)
NOTE: This form must be on file with the qualifying
officer before opening the campaign account.
1. CHECK APPROPRIATE BOX(ES):
❑k Initial Filing of Form Re -filing to Change: ❑ Tre
2. Name of Candidate (in this order: First, Middle, Last)
Q �andc� n M per i s�
4. Telephone Fail address
6. Office sought (include district, circuit, group number)
Lj�-� Om.�6sian �iS4fiC�4� S•
NO'J 2 3 1011
CITY OF WINTER SPRING$
ICE OF THE CITY CLERI'%
OFFICE USE ONLY
urer/Deputy ❑Depository ❑ Office [] Party
3.
cod
Address (include post office box or street, city, state, zip
e)
`( &
7. If a candidate for a nonpartisan office, check if
applicable:
❑ 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
W�II;� Mora
11. Mailing Address 12. Telephone
(`I�% > 4.7y 2777
13. City 14, County 15, State 16, Zip Code 17. E-mail address
t J,JJA %^mer S 5fl"*1/10 FL SZ709 W t II&/h , Mora Lc je Q1
18. 1 have designated the following bank as my Primary Depository ❑ Secondary Depository
19. Name of Bank 20, Address
Trust-Lo ! e*YS TVSka�w�IIOt, (zDo
21. City 22, County 23. State 24. Zip Code
I ,1)4tr S P fi n1S5 s6m1l101it FL, 4' 7no$
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, ,�ndidate
27. Treasurer's Acceptance of Appointment (fill in the blanks and check the appropriate block)
11 U I I i G/y1 Mo rn0SC-0 do hereby accept the appointment
(Please Print or Type Name)
designated above as: Campaign Treasurer ❑ Deputy Treasurer.
Date Sigria re of Campaign Tr asurer or Deputy Treasurer
DS-DE 9 (Rev. 10/10) Rule 1S-2.0001, F.A.C.
STATEMENT OF
CANDIDATE
(Section 106.023, F.S.)
(Please print or type)
r�
candidate for the office of G.i
GoMM�s�
have been provided access to read and understand the requirements of
Chapter 106, Florida Statutes.
Ignature o 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 (OS/11)