HomeMy WebLinkAboutHerrold - DSDE9 - Appointment of Campaign Treasurer and Designation of Campaign - Jackie Beckenbach - Deputy Treasurer 2-25-26APPOINTMENT OF CAMPAIGN TREASURER
AND DESIGNATION OF CAMPAIGN
/ RECEIVED /
DEPOSITORY FOR CANDIDATES
FEB 2 51026
(Section 106.021(1), F.S.)
G� • 5 ( ��
(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):
X 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)
659 Sherry Drive
Lisa Herrold
Atlantic Beach, Florida 32233
4. Telephone:
5. Candidate's Voter Registration #:
6. Email Address:
( 904 ) 386-3325
l i s a h e rro l d @ g mail. co m
(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
City Commissioner Seat 4
if able:
El I intendto 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:
Jackie Beckenbach
(904 )472-7432
jackie1beckenbach@gmaii.com
14. Mailing Address:
15. City:
16. State:
17. Zip Code:
2210 Oceanwalk Dr. W.
Atlantic Beach
Florida
32233
18. 1 have designated the following bank as my (check appropriate box): F Primary Depository ❑ Secondary Depository
19. Name of Bank:
20. Address:
Community First Credit Union of Florida
11425 Atlantic Boulevard
21. City:
22. County:
23. State:
24. Zip Code:
Neptune Beach
Duval
Florida
32266
UNDER PENALTIES OF PERJURY, I DECLARE THAT 1 HAVE READ THE FOREGOING FORM FOR THE APPOINTMENT OF THE
CAMPAIGN TREASURER AND DESIGNATION OF THE CAMPAIGN DEP (TORY AND THAT E FACTS STATED IN IT ARE TRUE.
gnat u e f Candi te:
25. Date: February 25, 2026
27. Treasurer's Acceptance of Appointment (fill in the an s and check the appropna box)
C do hereby accept the appointment designated above as:
(Plleaseas e Print or Type Name)
❑ Campaign Treasurer.❑ Deputy Treasurer.
29. Signature of Campaign Treasurer of Deputy Treasurer
28. Date:
DS -DE 9 (Eff. 10/23) Rule 1S-2.001, F.A.C.