HomeMy WebLinkAboutLagner - DSDE9 - Appointment of Campaign Treasurer and Designation of Campaign - Jennifer Lagner - Deputy Treasurer 4-27-26APPOINTMENT 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 RECEIVED 1
APR 171816
OFFICE USE ONLY
1. CHECK APPROPRIATE BOX(ES):
0 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) 278 Seminole Road
Jennifer Deery Lagner Atlantic Beach, FL 32233
4. Telephone: 5. Candidate's Voter Registration #: 6. Email Address:
( 904 ) 610-6202 103314391 _ e n n l a n e ra b m a i l . co m
(not required for qualifying purposes) V
7. Office Sought (include district, circuit, group, or seat #): 8. If a candidate for a nonpartisan office, check the box
Cit Commissioner - Seat 4 F1
I intend to 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:
Jennifer Deery Lagner (904 ) 610-6202 jennlagnerab@gmail.com
14. Mailing Address: 15. City: 16. State: 17. Zip Code:
278 Seminole Road Atantic Beach FL 32233
18. 1 have designated the following bank as my (check appropriate box): 0 Primary Depository ❑ Secondary Depository
19. Name of Bank: 20. Address:
Wells Fargo 1031 Atlantic Blvd
21. City: 22. County: 23. State: 24. Zip Code:
Atlantic Beach Duval FL 32233
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 FACT STATED IN IT ARE TRUE.
04/27/26
26. Sig ture of ndidate:
25. Date:
v
1 � A 1/1 (/ Lill
27. Treasurer's Acceptance of Appointment (fill in the bl4nk an check the appropriate b )
I
1, Jennifer Deery Lagner do hereby accept the appointment designated above as:
(Please Print or Type Name)
❑■ Campaign Treasurer. ❑ Deputy Treasurer.
04/27/26
29. ature of paign Trea rer or Deputy Treasurer
28. Date:
r ''
DS -DE 9 (Rev. 09/23) le 1S-2.000 , .A.C.
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