Stinson- Campaign Treasurer Appt. - Jennifer Lada 1-21-15 APPOINTMENT OF CAMPAIGN TREASURER Received
AND DESIGNATION OF CAMPAIGN
DEPOSITORY FOR CANDIDATES JAN 2 1 2015
(Section 106.021(1), F.S.)
(PLEASE PRINT OR TYPE) Office of City Clerk
NOTE: This form must be on file with the qualifying
officer before opening the campaign account. OFFICE USE ONLY
1. CHECK APPROPRIATE BOX(ES):
IN Initial Filing of Form Re-filing to Change: 0 Treasurer/Deputy ❑ Depository ❑ Office p Party
2. Name of Candidate (in this order: First, Middle, Last) 3. Address (include post office box or street, city, state, zip
John M. Stinson code)
4. Telephone 5. E-mail address 150 12th Street, P.O. Box 331580, Atlantic Beach,
(904 ) 655-5250 Jms1776 @msn.com FL 32233
6. Office sought (include district, circuit, group number):Toil 7. If a candidate for a nonpartisan office, check if
applicable:
City Commissioner, -Se6ct ❑ 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 No Party Affiliation C] Party candidate.
9. I have appointed the following person to act as my 0 Campaign Treasurer El Deputy Treasurer
10. Name of Treasurer or Deputy Treasurer
Ms. Jennifer Lada
11. Mailing Address 12. Telephone
1224 Ocean Blvd. ( 904 ) 412-6141
13. City 14. County 15. State 16. Zip Code 17. E-mail address
Atlantic Beach Duval FL 32233 JLL030 @yahoo.com
18. I have designated the following bank as my ig Primary Depository ❑ Secondary Depository
19. Name of Bank 20. Address
BB&T 363 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 APPOINTMENT OF CAMPAIGN TREASURER AND
DESIGNATION OF CAMPAIGN DEPOSITORY AND THAT THE FACTS STATED IN IT ARE TRUE.
25. Date 26. S' of Candidate
20 Jan 2015 ri
27. Treasurer's Acceptance of Appointment (fill in the blanks and check he appropriate block)
I, Senn r Utdk , do hereby accept the appointment
(Please Print or Type Name)
designated above as: 0 Campaign Treasurer ❑ Deputy Treasurer.
AO
Date =ignrof mpaign Treasurer or Deputy Treasurer