Spencer - DSDE9 - Appointment of Campaign Treasurer and Designation of Campaign -Treasurer Matthew Spencer - 2-29-24APPOINTMENT OF CAMPAIGN TREASURER
AND DESIGNATION OF CAMPAIGN
RECEIVED
DEPOSITORY FOR CANDIDATES
(Section 106.021(1), F.S.)
FEB 2 91014
(PLEASE PRINT OR TYPE)
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 ❑ 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)
Krn�<V�t, An She n� �✓
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4. Telephone:
5. Candidate's Voter Registration #:
6. Email Address:
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(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
C� kCj"y �—
if applicable:
❑ I intend to run as a Write -In Candidate.
9. If ikandidate 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 Udeputy Treasurer
11. Name of Treasurer or Deputy Treasurer:
12. Telephone:
13. Email Address:
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14. Mailing Addre1
Cie e u �rs�' Dl ,
City:
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16. State:
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17. Zip Code:
18. 1 have designated the following bank as my (check appropriate box): ❑ Primary Depository ❑ Secondary Depository
19. Te of Bank:
20. A���: tG J
21. City:
22. County:
vT-A
23. Se:
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24Zip Code:
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UNDEIZ 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.
25. Date: a Z 9 f
26. gnature of Candidate:
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27. Treasurer's Acceptance of Appointment (fill ik_thAis and the he appropriate box
I, K�� ( � /—\h 0 J1`�'t n C c� do hereby accept the appointment designated above as:
(Please Prinf or Type Na e)
Treasurer. /Deputy Treasurer.
❑ Campaign
29. Sign ture of Campaign Treasur o Deputy Treasurer
28. Date:
7
DS -DE 9 (Eff.10/23) Rule 1S-2.001, F.A.C.