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HomeMy WebLinkAbout2026 05 12 - McCann, Kevin DS-DE 9/84 UPDATED.pdfAPPOINTMENT OF CAMPAIGN TREASURER RECEIVED AND DESIGNATION OF CAMPAIGN DEPOSITORY FOR CANDIDATES (Section 106.021(1), F.S.) MAY 12 2026 (PLEASE PRINT OR TYPE) CITY OF WINTER SPRINGS CITY CLERK DEPARTMENT NOTE: This form must be on file with the filing officer before 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) t l o p P Nd :5� 4. Telephone: 5. Candidate's Voter Registration #: 6. Email Address: ( ID7 ) n (not required for qualifying purposes) V/ DG 74' 7. Office Sought (include district, circuit, group, or seat #): 8. If a candidate for a nonpartisan office, check the box if applicable: M4WIL 4 I rY mf 4 1AArZr2 .1,VX/•J!r.5 ❑ 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: K15 all a r4f C*a4 r l ( Y49 F7 ) s 3 `! �4e4 7 5� J<0l/ tic G�*to (5,)0APd 14. Mailing Address: 15. City: 16. State: 17. Zip Code: I10,1 V 1&.S.�iT� C,, c "t_0 LjuJ`1 of 6 llk2 l 'S Fz- 3zt 708 18. 1 have designated the following bank as my (check appropriate box): 21 Primary Depository ❑ Secondary Depository 19. Name of Bank: 20. Address: som E . 4 l e .✓ G c✓ee 21. City: 22. County: 23. State: 24. Zip Code: l.m�� c�61D�j ��ifj 1,��1LE f'Jli 3 •'L'Z �� 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. 26. Signature of Candidate: 25. Date: s /0;1 v���lf X � q . 7V G�� 27. Treasurer's Acceptance of Appointment (fill in the blanks and check the appropriate box) I, X �yl � PoL 0 � ee.t do hereby accept the appointment designated above as: (Please Print or Type Name) Lj-t'rampaign Treasurer. ❑ Deputy Treasurer. 29. Signature of Campaign Treasurer or Deputy Treasurer 28. Date: X �`%� �� --=r DS-DE 9 (Rev. 09/23) Rule 1S-2.0001, F.A.C. STATEMENT OF CANDIDATE (Section 106.023, (Please print or type) candidate for the office of RECEIVED MAY 1 2 2026 C TTY OF WINTER SPRINGS CITY CLERK DEPARTMENT OFFICE U5E O�JLY have been provided access to read and understand the requirements of Chapter 106, Florida Statutes. I swear or affirm that I meet, or will meet at the time of election for the office sought or at the time of assuming the office, as applicable, all statutory and constitutional qualifications for the office sought. Signature of Candidate STATE OF FLORIDA = COUNTY OF .KL.iJ4L,� � Sworn to (or affirmed) and subscribed before me by means of online notarization ❑ OR physical presence I � { v his day of iJ v l 20 �(0 . t � Personally Known OR Produced Identification s� �a- te Da Signature of Officer Administering Oath Affix Seal Below or, if judge, provide name, title, and court (S. 92.50, F.S.) Notary Public State of Florida Tristin M Tarrant ���� My Commisslon HH 491305 Expires 2/11/2028 Type of Identification Produced: Each candidate must file a statement with the qualifying officer Appointment of Campaign Treasurer and Designation of Campaign failure to file this form is a first degree misdemeanor and a civil Financing Act which may result in a fine of up to $1,000, (ss. 106.11 Statutes). DS-DE 84 (Eff. within 10 days after the Depository is filed. Willful violation of the Campaign )(1)(c), 106.265(1), Florida