HomeMy WebLinkAboutKulik - DSDE9 - Appointment of Campaign Treasurer and Designation of Campaign - Jordan Reemsnyder - Campaign Treasurer 4-17-26APPOINTMENT OF CAMPAIGN TREASURER
/ RECEIVED /
AND DESIGNATION OF CAMPAIGN
DEPOSITORY FOR CANDIDATES
APR 1 7 2M
(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.
OFFICE USE ONLY
1. CHECK APPROPRIATE BOX(ES):
.initial Filing of Form ❑ Re -filing to Change: Afreasurer/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)
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, grou
, 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 candidate for gran 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: 0 Campaign Treasurer ❑ Deputy Treasurer
11.ame of Treasurer or Deputy Treasurer:
12. Telephone:
13. Email Address:
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14. Mailing Address:
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State:
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17. Zip Code:
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18. 1 have designated the following bank as my (check appropriate box): Primary Depository ❑ Secondary Depository
19. Name of Ban
20. Address:
21. City:
22. County:
23. State:
24. Zip Code:
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UNDER OENALTIES 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. D!1�1)c, 2(-,
26. Signature of Candidate:
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27. Treasurer's Acceptance of Appointment (fill in the blanks and check the appropriate box)
I. VOtf do hereby accept the appointment designated above as:
(Please Print or Type me)
Campaign Treasurer. ❑ Deputy Treasurer.
29. Signa a of Cam aign Treasurer or Deputy Treasurer
28. Date:IV
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DS -DE 9 (Rev. 0 /23) Rule 1S-2.0001, F.A.C.
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