Ring - DSDE 9- Appt. Treasurer- Jessica Ring - 4-28-22APPOINTMENT OF CAMPAIGN TREASURER
AND DESIGNATION OF CAMPAIGN
DEPOSITORY FOR CANDIDATES
(Section 106.021(1), F.S.)
-r,
(PLEASE PRINT OR TYPE)
APR 2 r 2022
NOTE: This form must be on file with the qualifying
officer before opening the campaign account. OFFICE USE ONLY
1. `HECK APPROPRIATE BOX(ES):
Initial Filing of Form Re -filing to Change: El Treasurer/Deputy El Depository EI Office ❑ Party
2. Name of Candidate (in this order: First, Middle, Last) 3. Address (include post office box or street, city, state, zip
code)
J��1CA CLY-\\SMI
4. Telephone
5. E-mail address)
(-i(L) \IQ-((i$z rig j�•�'�Cv�0'0,1\.000')
6. Office sought (include district, circuit, group number)
C u-=vYn. n- ` ‘o' x- Se.). -}t- 5
1,31 L
toot
3 2:7/3S
7. If a candidate for a nonpartisan office, check if
applicable:
El My intent is to run as a Write -In candidate.
8. If a candidate for a partisan office, check block and fill in name of party as applicable:
EJ Write -In ❑ No Party Affiliation El
9. I have appointed the following person to act as my
10. Name of Treasurer or Deputy Treasurer
T s cc,, 1 ► k r)vv rc,)
14. County
bu-t a\
11. Mailing Address
t C)
13. City
OA\an-,1,
Er Campaign Treasurer
18. I have designated the following bank as my
19. Name of Bank
We.S F c s
21. City 22. ounty
14A-1 CO(m- C-1 ) t, \i
15. State
FL
16. Zip Code
32_z )3
My intent is to run as a
Party candidate.
Deputy Treasurer
12. Telephone
(C/CA )44y - ('O g2
17. E-ma'I address
C-1\1)9 vY\-CA- 1. CO m
Primary Depository -1011 Secondary Depository
20. Address
( 3-4'1an+,c '$ivy`! .
23. State
24. Zip Code
3Z,Z3��
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
/1(6 / az-
26. Signature of Candidate
27. Treasurer's Acceptance of Appointment (fill i
i, �� ► Co. \ P
(Please Print orlfype Name)
designated above as: 51 Campaign Treasurer
�1tn 9%
blanks and check the appropriate block)
, do hereby accept the appointment
CIDeputy Treasurer.
4 12.5 /2-7— X
` Date ature of Campaign Treasurer or eputy Treasurer
DS -DE 9 (Rev. 10/10) Rule 1S-2.0001, F.A.C.