HomeMy WebLinkAboutFord - DSDE9 - Appointment of Campaign Treasurer and Designation of Campaign - John McCarthy - Campaign Treasurer 4-28-26APPOINTMENT 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):
E Initial Filing of Form ❑ Re -filing to Change
2. Name of Candidate (in this order: First, Midd
(Please Print or Type Name)
Cdrli s 1�-4$I d, i r-J"l4
4.
5. Candidate's
/ RECEIVED 4
APR 18 20
-9 (q
OFFICE USE ONLY
13 Treasurer/Deputy ❑ Depository ❑ Office ❑ Party
Last): 3. Address (include PO Box or Street, City, State, Zip Code):
536 B «eti AVenvt°
/1-�1� ; , J� L.Id, FL 3,2233
Foter Registration #: 6. Email A7dd�reess: 1 /j
� lera 14V
(10AV 333 45650' (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
if applicable:
1 'I q vei ❑ I intend to run as a Write-in Candidate.
9. If a candidalifi for partisan office, check the box and fill in the name of the party as applicable: 1 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:
c kIAJ E 7V �' ('ga )3 2-3 �6111) ^7L SRO 4el -A.,
14. Mailing Address: 15. City: 16. State: 17. Zip Code:
18. 1 have designated the following bank as my (check appropriate box): Primary Depository ❑ Secondary Depository
19. Name of Bank: 20. Address:
Ali A r" r 3 t2D 75T2ee 7
21. ity: 22. County: 23. State: 24. Zip Code:
e Tv�v g� v v q c__ F:2-- 3 z L
UNDE 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 E&CMLSTATED IN IT ARE TRUE.
26. Signature"'ofan/d-ida e:
25. Date: u Zo V C ,
27. Treasurer's Acceptance of Appointment (fill in the blanks and check the appropriate box)
I /GC0A77-?
(Please Print or Type Name)
0 Campaign Treasurer.
28. Date: Ylo?? I 2_0 Z46
DS -DE 9 (Rev.
do hereby accept the appointment designated above as:
❑ Deputy Treasurer.
(nature of Campaign
Treas er or D pTreasurer
�- Y (-G.
Rule I S -2.0W1, F. .C.