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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. iiiiiiiiiiiiiiiiiiiiiillillillillillillilliillillillillillillilliillillillilliillillillillillilI 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 Y „ 4 6YWm lit A 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 ��MMZSSIUNb� V)�ST2J.CT 0 ; 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)