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Kelly - DSDE84 - Statement of Candidate -7-8-22 OFFICE USE ONLY STATEMENT OF CANDIDATE Ri' a (Section 106.023, F.S.) JUL 0 8 2 2 (Please print or type) BY: 0 Aark candidate for the office of JOiTh5) 11e ' cA1' k/ / 7 c4(3- C / have been provided access to read and understand the requirements of Chapter 106, Florida Statutes. x CL 31 Sigrlat 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). DS-DE 84(05/11)