HomeMy WebLinkAboutDiaz, Paul DS-DE 9 - Updated 2024 06 10.pdfAPPOINTMENT OF CAMPAIGN TREASURER
AND DESIGNATION OF CAMPAIGN
RECEIVED
DEPOSITORY FOR CANDIDATES
(Section 106.021(1), F.S.)
AN 0 2024
(PLEASE PRINT OR TYPE)
CITY OF WINTER SPRINGS
OFFICE OF THE CITY CLERK
NOTE: This form must be on file with the filing officer before
opening the campaign account.
OFFICE USE ONLY
1. CHECK APPROPRIATE BOX(ES):
❑ Initial Filing of Form ❑■ Re -filing to Change: ❑ Treasurer/Deputy 9 Depository ❑ Office ❑ Party
2. Name of Candidate (in this order: First, Middle, Last):
3. Address (include PO Box or Street, City, State, Zip Code):
(Please Print or Type Name)
1170 Tree Swallow Dr., #343
PAUL DIAZ
Winter Springs, FL 32708
4. Telephone:
5. Candidate's Voter Registration #:
6. Email Address:
( 888 ) 429 S45 9"
contact@ ElectPaulDiaz.com
(not required for qualifying purposes)
7. Office Sought (include district, circuit, group, or seat #):
8. If a candidate for a nonpartisan office, check the box
if applicable:
Commissioner, District 1, Winter Springs
❑ I intend to run as a Write -In Candidate.
9. If a candidate for partisan office, check the box and fill in the name of the party as applicable: I intend to run as a
❑ Write -In Candidate. ❑ No Party Affiliation Candidate. ❑ Party candidate.
10. 1 have appointed the following person to act as my: ■❑ Campaign Treasurer ❑ Deputy Treasurer
11. Name of Treasurer or Deputy Treasurer:
12. Telephone:
13. Email Address:
PAUL D. DIAZ, EA
(689 ) 400-1040
1040@taxcuttery.com
14. Mailing Address:
15. City.
16. State:
17. Zip Code:
P.O. BOX 195418
WINTER SPRINGS
FLORIDA
32719-5418
18. 1 have designated the following bank as my (check appropriate box): ❑■ Primary Depository ❑ Secondary Depository
19. Name of Bank:
20. Address:
FAIRWINDS
156 GENEVA DR
21. City:
22. County:
23. State:
24. Zip Code:
OVIEDO
SEMINOLE
FLORIDA
32765
UNDER PENALTIES OF PERJURY, I DECLARE THAT I HAVE READ THE FOREGOING FORM FOR THE APPOINTMENT OF THE
CAMPAIGN TREASURER AND DESIGNATION OF THE CAMPAIGN DEPOSITORY AND THAT THE FACTS STATED IN IT ARE TRUE.
06/10/2024
26. Sig a of Candidate:
25. Date:
v (/
27. Treasurer's Acceptance of Appointment (fill in the blanks and check the appropriate box)
11 PAUL D. DIAZ, EA do hereby accept the appointment designated above as:
(Please Print or Type Name)
■❑ Campaign Treasurer. ❑ Deputy Treasurer.
06/10/2024
29. 1Na r of amp ' n T asurer or Deputy Treasurer
28. Date:
v
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DS-DE 9 (Rev. 09123) Rule 1S-2.0001, F.A.C.