Bole - DSDE9 - Appointment of Campaign Treasurer and Designation of Campaign - Bruce Bole - Treasurer 5-10-24APPOINTMENT OF CAMPAIGN TREASURER
AND DESIGNATION OF CAMPAIGN
DEPOSITORY FOR CANDIDATES
► RECEIVED
(Section 106.021(1), F.S.)
MAY Z0?4
(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):
1Z 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)
-71 L16 C L %9 ISE -I
4. Telephone:
5. Candidate's Voter Registration #:
6. Email Address:
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LE aa6oL° Co�,CAS, . g
(hot 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:
❑ I intend to run as a Write-In Candidate.
9. If a can idate 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:
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14. Mailing Address:
15. City:
16. State:
17. Zip Code:
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18. 1 have designated the following bank as my (check appropriate box): [2f Primary Depository ❑ Secondary Depository
19. Name of Bank:
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20. Address:
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21. City:
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22. County:
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23. State:
24. Zip Code:
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.
25. Date: J t,
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26. Si nature of Candid
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27. Treasurer's Acceptance of Appointment (fill in the blanks and check the appropriate box)
I. _bft U (✓� 'U d L� do hereby accept the appointment designated above as:
(Please Print or Type Name)
V�tampaign Treasurer. ❑ Deputy Treasurer.
28. Date: a Q a �-
29. Si ure of Campaign_T�easf' ureror Deputy Treasurer
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DS-DE 9 (Rev. 09/23) Rule 1S-2.0001, F.A.C.
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