HomeMy WebLinkAboutFord - DSDE9 - Appointment of Campaign Treasurer and Designation of Campaign - Curtis Ford - Deputy Treasurer 6-1-26APPOINTMENT OF CAMPAIGN TREASURER
►RECEIVED/
AND DESIGNATION OF CAMPAIGN
DEPOSITORY FOR CANDIDATES
JUN 0 120
(Section 106.021 (1), F. S.)
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(PLEASE PRINT OR TYPE)
NOTE: This form must be on file with the filing officer before
opening the campaign account.
OFFICE USE ONLY
1. CH CK APPROPRIATE BOX(ES):
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)
A414Ac t4c�,� L 3 233
4. Telephone:
S. Candidate's Voter Registration #:
6. Email Address:
3 3
C-146-chi4vi
(not required for qualifying purposes)
7. Office Sought (include district, circuit, group, or seat #):
8. If a candidate for a nonpartisan offielli, check the box
�qvif
if applicable:
❑ I intend to run as a Write -In Candidate.
9. If a candidate for Ortisah office, check the box and fill in fhe 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:
Cu
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14. Mailing Address:
2
15. City:
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16. State:
17. Zip Code:
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L
�� 233
18. 1 have designated the foliowing bank as my (check appropriate box): VPrimary Depository ❑ Secondary Depository
19. Name of Bank:
20. Address:
21. City:
22. County:
23. State:
24. Zip Code:
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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.
26. Sign��f Ca
25. Date: �11 2
v
27. Treasurer's Acceptance of Appointment (fill in the blanks and check thi appropriate box)
/ r
I,y�Tl`� / .i` �- do hereby accept the appointment designated above as:
(Please Print or Type Name)
❑ Campaign Treasurer. ZDputy Treasurer.
29. Sig ure f Cam re rer or Deputy Treasurer
28. Date:9//Vu
I /�
DS -DE 9 (Rev. 09123) Rule 1S-2.0001, F.A.C.