Loading...
Carper- DSDE 9- Changed Depository- 12-5-19 • DECE D V E APPOINTMENT OF CAMPAIGN TREASURER DEC 5 2019 AND DESIGNATION OF CAMPAIGN DEPOSITORY FOR CANDIDATES (Section 106.021(1), F.S.) I/C57J. (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): ❑ Initial Filing of Form Re-filing to Change: ❑ Treasurer/Deputy X❑ Depository ❑ Office ❑ Party 2. Name of Candidate (in this order: First, Middle, Last) 3.Address (include post office box or street, city, state, zip Ricky Lowell Carper code) 1810 Selva Grande Drive 4. Telephone 5. E-mail address Atlantic Beach, Fl. 32233 (904 ) 545-3125 rickeng54@yahoo.com 6. Office sought(include district, circuit, group number) 7. If a candidate for a nonpartisan office, check if Mayor, Seat 1 applicable: E] 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 El Party candidate. 9. I have appointed the following person to act as my ❑ Campaign Treasurer ❑ Deputy Treasurer 10. Name of Treasurer or Deputy Treasurer Ricky L. Carper 11. Mailing Address 12. Telephone 1810 Selva Grande Dr. ( 904 ) 545-3125 13. City 14. County 15. State 16. Zip Code 17. E-mail address Atlantic Beach Duval Fl. 32233 rickeng54@yahoo.com 18. I have designated the following bank as my ❑X Primary Depository ❑ Secondary Depository 19. Name of Bank 20.Address BB&T Co. 363 Atlantic Blvd, Suite 16 21. City 22. County 23. State 24. Zip Code Atlantic Beach Duval Florida 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. Signa - •f Candi to is" _10 27. Treasurer's Acceptance of Appointment(fill in the blanks and check the appropriate block) Ricky L. Carper , do hereby accept the appointment (Please Print or Type Name) designated above as: X❑ Campaign Treasurer fl eputy Treasurer. I J-/ Date Sign Campaign treasurer or Deputy Treasurer DS-DE 9 (Rev. 10/10) Rule 1S-2.0001, F.A.C.