Goodrich - DS-DE 84 - Statement of Candidate 7-1-20SuzuI ijJ Vr
CA\_ 1)
(Section 106.023, FS.)
(Please print or type)
I, Lisa, Goodrich
OFFICE USE ONLY
1
EOVE
JUL 1 202p
candidate for the office of Atlantic Beach Commission e 1137
have been provided access to read and understand the requirements of
Chapter 196, Florida Statutes.
Ul )0
Siature 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), 106.26 (1), Florida
Statutes).
DS -DE 84 (05/11)