Appointment of Treasurer_Jayson French_9/25/2023 APPOINTMENT OF CAMPAIGN TREASURER RECEIVED
AND DESIGNATION OF CAMPAIGN
DEPOSITORY FOR CANDIDATES SEP 2 5 2023
(Section 106.021(1), F.S.) VILLAGE CLERKS OFFICE
(PLEASE PRINT OR TYPE)
NOTE: This form must be on file with the qualifying officer
before opening the campaign account. OFFICE USE ONLY
1.CHECK APPROPRIATE BOX(ES):
[2,—Initial Filing of Form Re-filing to Change: ❑ Treasurer/Deputy ❑ Depository ❑ Office ❑ Party
2. Name of Candidate(in this order: First, Middle, Last) 3. Address (include post office box or street, city, state,
zip code)
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4. Telepho a 5. Candidate's Voter Registration#:
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(Not required for Qualifying Purposes)
(Not required for Qualifying Purposes)-Phonetic spelling for audio ballot: Print name phonetically on the line below as you wish it to be pronounced on
the audio ballot as maybe used by ersons with disabilities(see instructions on page 2 of this form):
CAI' 5 Un i«n C,
6. Office sought(include district, circuit, group number) 7. If a candidate for a nonpartisan office, check if
V 1l1 r_ Cd ^G v 1 e c�- 1 applicable:
l G •J ❑ My intent is to run as a Write-In candidate.
a candidate fora partisan office, check block and fill in name of party as applicable: My intent is to run as a
Write-In 2 No Party Affiliation ❑ Party candidate.
9. 1 have appointed the following person to act as my Campaign Treasurer ❑ Deputy Treasurer
10. Name of Treasurer or Deputy Treasurer 11. Telephone
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12. Mailing Address 13. City 14. State 15. Zip Code
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16. 1 have designated the following bank as my Primary Depository ❑ Secondary Depository
17. Name of B nk �- 18.Address
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19. City 20. County 21. State 22.Zip Code
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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.
23. Date ate 24. Signatu of Candid
3 X �- � ��
25. Treasurer's Acceptance of Appointment(fill in the blanks and check the appropriate block)
do hereby accept the appointment
(Please Print or Type Name)
,ignated above as: [ ampaign Treasurer. ❑ Deputy Treasurer.
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Date ature of Campaign Treasurer or Deputy Treasurer
ns.nF a tPow m1911 Rule 1S-2.0001. F.A.C.
OFFICE USE ONLY
STATEMENT OF
CANDIDATE RECEIVED
(Section 106.023, F.S.) SEP Z 5 2023 �A--
(Please print or type) VILLAGE CLERKS OFFICE
U�So Ff I C,
candidate for the office of �j 1 G C our\c {e(D
have been provided access to read and understand the requirements of
Chapter 106, Florida Statutes.
X �: G? C� S 2�
Ignature 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(05111)
2024 list of Candidate Forms/ Books
TAB#
t of Candidate Forms 1
The following form must be filed with the Clerk prior to opening a campaign account or collecting/accepting
contributions:
DS-DE 9 Appointment of Campaign Treasurer 2
The following form must be signed and returned to the qualifying officer within 10 days after the appointment of
campaign treasurer(Form DS-DE 9) is filed:
DS-DE 84 1 Statement of Candidate/ F.S. 106 3
The following are to be filed per the dates listed in Tab 2
Campaign Treasurer Reporting Dates 4
DS-DE 12 Campaign Treasurer's Report Summary 5
https•//dos.myflorida.com/media/693241/dsdel2.pdf
DS-DE 13 Campaign Treasurer's Report—Itemized Cont. 6
httt)s://dos.myflorida.com/media/69324yqsdel3.pdf
DS-DE 14 Campaign Treasurer's Report—Itemized Expend. 7
https•//dos.myflorida.com/media/693244/dsde14.pdf
DS-DE 87 Waiver of Report 8
https•//dos.myflorida.com/media/693282/dsde8Z.2df
DS-DE 73 Campaign Loans Report 9
https:/Idos.myflorida.com/media/693276/dsde73.pdf
The following forms must be turned in during the qualifying period:
NOON,TUESDAY, NOVEMBER 7, 2023 THROUGH
NOON,TUESDAY, NOVEMBER 21, 2023
FS 99.021(a) Candidate Oath 10
CE Form 1 2022 Statement of Financial Interests 11
Village Form Nominating Petitions (Clerk will provide these after you have filed the DS-DE 9) 12
Village Form Notice of Candidacy 13
Village Form Notice of Logistics &Accuracy Test* 14
Village Form Residency Affidavit 15
General Information
DS-DE 100 Telephone Solicitation 16
https•//dos.mvflorida.com/media/693289/dsdel00.Pdf
DS-DE 125 Designation of Poll Watchers 17
https://dos.myflorida.com/media/696684/dsdel25.pdf
Council 18
Procedures
Charter https•//li bra ry municode com/fl/teguesta/codes/code of ordinances?nodeld=PTICH 19
Political 20
Signs
nshine http•//myfloridalegal com/pages nsf/Main/DCOB20B7DC22B7418525791B006A54E4 21
N
CTION CODE (State of Florida) 22
the responsibility of each candidate to read and understand all the Election Statutes and laws
ittp://www lei state f1 us/Statutes/index.cfm?App mode=Display Index&Title Request=iXi#Title1X
CANDIDATE HANDBOOK ON CAMPAIGN FINANCING 23
Not available yet
COUNTY ETHICS ORDINANCE 24
https://www.teguesta.org/DocumentCenter/View/10734/Commission on Ethics Ordinance-
effective 9-22-15
1 acknowledge that I have received all the forms and documents referenced on the "Candidate Forms List" and I
acknowledge that the information contained here is intended as a reference guide only. The Clerk's Office will assist
candidates; however, performs a ministerial function and cannot interpret Florida Statutes or determine whether the
contents oft ualifying:=reaccurate.
. P/2S 2 3
(Can e Signature) Date
Candidate Declined to sign acknowledging he/she received the forms.
Jerk Signature: Witness: