HomeMy WebLinkAboutFrancis, Stephen Malcom DS-DE 9 & DS-DE 84 - 2024 08 07APPOINTMENT OF CAMPAIGN TREASURER
AND DESIGNATION OF CAMPAIGN
DEPOSITORY FOR CANDIDATES
[URMLE C E O V E
(Section 106.021(1), F.S.)
(PLEASE PRINT OR TYPE)
AIJG 0 7 2024
NOTE: This form must be on file with the filingofficer before
CITY OF WINTER SPRINGS
OFFICE OF 711E CITY CLERK
opening the campaign account.
OFFICE USE ONLY
I. 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 PO Box or Street, City, State, Zip Code):
(Please Print or Type Name)
916 Arabian Avenue, Winter Springs, FL 32708
Stephen Malcom Francis
4. Telephone:
5. Candidate's Voter Registration #:
6. Email Address:
(407 )310-1668
e143g212?
Francis4commish@gmail.com
(not required for qualifying purposes)
7. Office Sought (include district, circuit, group, or seat #):
8. If a candidate for a nonnartisan office, check the box
if applicable:
City Commissioner - District 3
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. I 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.
Andrew Goggin
(407 )619-9922
Goggina@bellsouth.net
14, Mailing Address:
15. City:
16. State:
17. Zip Code:
618 Morgan Street
Winter Springs
FL
32708
18. 1 have designated the following bank as my (check appropriate box): Primary Depository ❑ Secondary Depository
19. Name of Bank:
20. Address:
Fairwinds Credit Union
1475 Tuskawilla Road
21. City: 22. County:
23. State:
24. Zip Code:
Winter Springs Seminole
FL
32708
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.
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26. Signa e f Candid e:
25. Date: August 7, 2024
X
27. Treasurer's Acceptance of Appointment (fill in the blank and check the appropriate box)
vljlrRLA) designated
I, do hereby accept the appointment above as:
(Please ri t r Type Name)
❑� Campaign Treasurer. ❑ Deputy Treasurer,
29. Sign ture of Campaign Treasurer of Deputy Treasurer
28. Date: t
9224
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DS-DE 9 (Eff. 10/23) Rule 1S-2.001, F.A.C.
STATEMENT OF
CANDIDATE
(Section 106.023, F.S.)
(Please print or type)
�b(OM t(AIVC
candidate for the office of
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have been provided access to read and understand the requirements of
Chapter 106, Florida Statutes.
gnature of Candidate
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)