Kelly- Statement of Candidate 5-25-17STATEMENT OF
CANDIDATE
(Section 106.023, F.S.)
(Please print or type)
OFFICE USE ONLY
Received
MAY 252017
Office of City Clerk
i, f4nAacQ L lely I
candidate for the office of }�-i� MG x uch Crit (im/y,Ly, lar -1�4 41�
have been provided access to read and understand the requirements of
Chapter 106, Florida Statutes.
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Signa a of Candidate 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).