Harding -DSDE 9- Appt. Treasurer- Mitchell Harding- 4-22-2022APPOINTMENT OF CAMPAIGN TREASURER
AND DESIGNATION OF CAMPAIGN
DEPOSITORY FOR CANDIDATES
(Section 106.021(1), F.S.)
(PLEASE PRINT OR TYPE)
RT"'
2022
BY:
NOTE: This form must be on file with the qualifying
officer before opening the campaign account.
1. C�IECK APPROPRIATE BOX(ES):
l/ Initial Filing of Form Re -filing to Change: ❑ Treasurer/Deputy ❑
2. Name of Candidate (in this order: First, Middle, Last)
MIYG)4ELL 2 Pr {-a74
4. Telephone 5. E-mail address
(40'{ ) 3S9 -bob/ hard 4 o &We. toe
6. Office sought (include district, circuit, group number)
Depository
OFFICE USE ONLY
0 Office ❑ Party
3. Address (include post office box or street, city, state, zip
code)
3S' Ja.Srvi ►n c stre-et
et, >IAi 55 loner') S 1- 5`
,rl t-rirJ+Ic (3c1! Fl -
327_33
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 -Campaign Treasurer ❑ Deputy Treasurer
10. Name of Treasurer or Deputy Treasurer
(�(1► -�-c..h t k (l.a. 1 Ott rcl
11. Mailing Address
61c Jet-' 't ie 9--€&
13. City 14. County
18. I have designated the following bank as my
19. Name of Bank
Amer s5 0A..r. L�
21. City
ne
22. County
12. Telephone
(q )3S'Z— 4;i(o
15. State 16. Zip Code 17. E-mail address
4t, V-233 t grKa. a I,
[Primary Depository ❑Secondary Depository
20. Address
51-1,0 ATc g -vi, c give),
23. State
FL -
24. Zip Code
32233
td,^
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
v1 -A -9r)1 ?,022
26. Signature of Candidate
27. Treasurer'sernAcceptance of Appointment (fill in the blanks and check the appropriate block),,
I, M + 4 -alt t 1 P '_fit(KJ 1 Yom, , do hereby accept the appointment
(Prease Print or Type. ame)
designated above as: Er Campaign Treasurer
❑ Deputy Treasurer.
22 f t / 2412- X ✓.silblitt
Date `gnature . Campaig reasurer or Deputy/reasurer
Rule 1S-2.0001, F.A.C.
DS -DE 9 (Rev. 10/10)