Woods, Carolyn DSDE 84 Statement of Candidate 1-14-13 OFFleceiveONLY
STATEMENT OF ttl
CANDIDATE JAN 1 4 2013
(Section 106.023, F.S.)
(Please print or type) Office of City Clerk
1, ea'r0 t 1 00 d (6
candidate for the office of Mal o r t4' ` C
have been provided access to read and understand the requirements of
Chapter 106, Florida Statutes.
, 41. 90/5
Sign ure of C-ndidate Date
Each candidate must file a statement with the qualifying officer within 10 days after the
Appointment of Campaign Treasurer and Designation of Campaign Depository is filed. Willful
failure to file this form is a first degree misdemeanor and a civil violation of the Campaign
Financing Act which may result in a fine of up to $1,000, (ss. 106.19(1)(c), 106.265(1), Florida
Statutes).
DS-DE 84(05/11)