Norris -DSDE 9- Appt. Treasurer- Lauren Spencer 1-24-22APPOINTMENT OF CAMPAIGN TREASURER
AND DESIGNATION OF CAMPAIGN
DEPOSITORY FOR CANDIDATES
(Section 106.021(1), F.S.)
(PLEASE PRINT OR TYPE)
NOTE: This form must be on file with the qualifying
officer before opening the campaign account.
1. CHECK APPROPRIATE BOX(ES):
Initial Filing of Form Re -filing to Change: ❑
2. Name of Candidate (in this order: First, Middle, Last)
-6C1/4Nav�y (11 (l�s
Telephone 5. �_m„
address
4. E-mail
\�nl t@ C �aevz 6
JAN 2 4 2022
OFFICE USE ONLY
Treasurer/Deputy ❑ Depository ❑ Office ❑ Party
3. Address (include post office box or street, city, state, zip
code)
(m\"q_3- Z3
(q1t ) (Ne�CQo'1-
6. Office sought (include district, circuit, group number)
,fYlm,0i IfA}
7. If a candidate for a nonpartisan office, check if
applicable:
❑ 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 ❑ Party candidate.
9. I have appointed the following person to act as my
10. Name of Treasurer or Deputy Treasurer
11. Mailing Address 1'
\Z2-\ (k\\Gv\)
Campaign Treasurer ❑ Deputy Treasurer
13. cy \t �`� 14. County
`Uu\
18. I have designated the following bank as my
19. NameBank
GU S-0ua0/0
21. City
22. County
AWA\
1 State
12. Telephone
( 3Z\ )124Stit'
16. Zip Code 17. E-mail address
� S L5(X),,1Ce2 k' v \yl , (s2vtik.
Primary Depository ❑ Secondary Depository
20. Address
l S AcV.WM--e g`
23. State
24. Zip Code
X773-5
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 Cand. ate
tl ?12 -Z X //
27. Treasurer's Acceptance of Appointment (fildpWe b(arrl s and check the appropriate block)
I, L—C,WO eiN SPevIC-1/402__
(Please Print or Type Name)
designated above as:
Campaign Treasurer
/23 t Z 67,2 X
Date
DS -DE 9 (Rev. 10/10)
, do hereby accept the appointment
❑ Deputy Treasurer.
cs) t'
Signature of Campaign Tre surer or Deputy Treasurer
Rule 1S-2.0001, F.A.C.