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Reeves, Mitchell Deputy Treasurer Appt. 11-20-12 Received APPOINTMENT OF CAMPAIGN TREASURER AND DESIGNATION OF CAMPAIGN NOV 2 0 2012 DEPOSITORY FOR CANDIDATES (Section 106.021(1), F.S.) Office of City Clerk (PLEASE PRINT OR TYPE) NOTE: This form must be on file with the qualifying officer before opening the campaign account. OFFICE USE ONLY 1.CHECK APPROPRIATE BOX(ES): Da Initial Filing of Form Re-filing to Change: Treasurer/Deputy Depository 0 Office 0 Party 2. Name of Candidate(in this order: First, Middle, Last) 3. Address(include post office box or street, city, state, zip Mitchell E. Reeves code) 1663 Sea Oats Drive 4. Telephone 5. E-mail address Atlantic Beach, Florida 32233 (904 ) 234-3075 mitch @mitchreeves4mayori 6. Office sought(include district, circuit, group number) 7. If a candidate for a nonpartisan office,check if Atlantic Beach Mayor, Seat 1 applicable: El My intent is to run as a Write-In candidate. 8. If a candidate for a partisan office,check block and fill in name of party as applicable: My intent is to run as a Write-In El No Party Affiliation El Party candidate. 9. I have appointed the following person to act as my LI Campaign Treasurer © Deputy Treasurer 10. Name of Treasurer or Deputy Treasurer Mitchell E. Reeves 11. Mailing Address 12. Telephone 1663 Sea Oats drive ( 904 ) 234-3075 13. City 14. County 15. State 16. Zip Code 17. E-mail address Atlantic Beach Duval Florida 32233 mitch @mitchreeves4mayor.com 18. I have designated the following bank as my © Primary Depository Di Secondary Depository 19. Name of Bank 20. Address Jacksonville Bank 560 Atlantic Blvd. 21. City 22. County 23. State 24. Zip Code Neptune Beach Duval Florida 32266 UNDER PENALTIES OF PERJURY,I DECLARE THAT I HAVE READ THE FOREGOING FORM FOR APPOINTMENT OF CAMPAIGN TREASURER AND DESIGNATION OF CAMPAIGN DEPOSITORY AND THAT THE FACTS STATED IN IT ARE TRUE. 25. Date 26. Signature of Candidate November 20, 2012 X 27. Treasurer's Acceptance of Appointment(fill in the blanks and check the appropriate block) Mitchell E. Reeves , do hereby accept the appointment (Please Print or Type Name) designated above as: El Campaign Treasurer © Deputy Treasurer. November 20, 2012 X Date Signature of Campaign Treasurer or Deputy Treasurer DS-DE 9(Rev. 10/10) Rule 1S-2.0001,F.A.C.