HomeMy WebLinkAboutHerrold - DSDE9 - Appointment of Campaign Treasurer and Designation of Campaign - John Flynn - Campaign Treasurer 2-24-26APPOINTMENT OF CAMPAIGN TREASURER
AND DESIGNATION OF CAMPAIGN
DEPOSITORY FOR CANDIDATES
(Section 106.021(1), F.S.)
(PLEASE PRINT OR TYPE)
NOTE: This form must be on file with the filing officer before
opening the campaign account.
1. CHECK APPROPRIATE BOX(ES):
RECEIVED /
FEB 2 4 2026 d�
lf:51.x'a-,#7,
OFFICE USE ONLY
E] 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)
C_ be -acV . �L 32233
4. Telephone: (( 5. Candidate's Voter Registration #: j6. Email Address:
(not required for qualifying purposes)
7. Office Sought (include district, circuit, group, or seat #): 8. If a candidate fora office, check the box
1")if applicable:
�� Llz� �` ` e ❑ I intend to run as a Write -In Candidate.
9. If a 4andidate for g6rl*san 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:
11. Name of Treasurer or Deputy Treasurer:
,J O X - +n
14. Mailing Address: 15.
Campaign Treasurer ❑ Deputy Treasurer
12. Telephone: 13. Email Address:
18. 1 have designated the following bank as my (check appropriate box):
Name of Bank• ` 20. Addre
- oua _�dC n -D ®coAlcas . H
16. State: 17. Zip Code:
�L- 3
Primary Depository ❑ Secondary Depository
o � ► f S r � off-- � ��
211. City: 22. County: 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:
27.
Treasurer's Acceptance of Appointment (fill
______7
(Please Print or Type Name)
X
ir' the anks and check the approp
do hereby accept the appointment designated above as:
❑ Campaign Treasurer. ❑ Deputy Treasurer.
29. Sig a re of C igr
28. Date: Z Z �1, p 2 /�
V r
DS -DE 9 (Rev. 9123)✓
Treasurer or Deputy Treasurer
Rule 1S-2.0001, F.A.C.