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Home My WebLink AboutAppointment of Treasurer_Patrick Painter_10/17/2024 (2) APPOINTMENT OF CAMPAIGN TREASURER Note: All information on this AND DESIGNATION OF CAMPAIGN form is public information and DEPOSITORY FOR CANDIDATES will be provided to the public. (Section 106.021(1), F.S.) RECEIVED (PLEASE PRINT OR TYPE) 0 C T 17 2024 NOTE: This form must be on file with the filing officer before VILLAGE CLERKS OFFICE opening the campaign account. OFFICE USE ONLY 1. CH APPROPRIATE BOX(ES): 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 PO Box or Street, City, State, Zip Code): `/(Please Print or Type Name) //j;;g �%✓�� V� ve_SA/ )g: G 33V6`l 4. Telephone: 5. Candidate's Voter Registration#: 6. Email Ad ress: c1.1 (not required for qualifying purposes) 7. Office Sought(include/ G (�a Iistrict/cl;cuit, group, or seat# : 8. If a candidate for a nonpartisan office, check the box Council Seat No.: //a v#tc W if applicable: ❑ I intend to run as a Write-In Candidate. 9. If a candidate for gj7-No e,check the box and fill in the name of the party as applicable: I intend to run as a ❑ Write-In Candidate. Party Affiliation Candidate. ❑ Party candidate. have appointed the following person to act as my: Campaign Treasurer ❑ Deputy Treasurer Name of Treasurer or Deputy Treasurer: 12.Telephone: 13. Email Addrre�ss: 9004'./.-01 14. Mailing Address: 15. City: 16. Sta e: 17. Zip Code: i vQr r:►� /e v-es 18. 1 have designated the following bank as my (check appropriate box): Primary Depository ❑ Secondary Depository 19. Name of Bank: 20. Address: h� Z/.s Us 2 21. City: J 22. County: 23. State: 24. Zip Code: UNDER OENALTIES OF PERJURY, I DECLARE THAT I HAVE READ THE FOREGOING FORM FOR THE APPOINTMENT OF THE CAMPAIGN TREASURER AND DESIGNATION OF THE CAMPAIGN DEPOSITORY AND THAT THE FACTS STATED IN IT ARE TRUE. 26. Si f C 25. Date: /0/7 ZOZ`/ X 77�_ — 27. Treasurer's Acceptance of Appointment(fill in the blanks and chec the appropriate box) I, � c� 4 .7 4 —do hereby accept the appointment designated above as: (Please Print or Type Na ) Campaign Treasurer. ❑ Deputy Treasurer. 29. nature of Campaign Treasurer or Deputy Treasurer Date: /D / 2ce X DS-DE 9(Rev.09/23) Rule 1S-2.0001, F.A.C. APPOINTMENT OF CAMPAIGN TREASURER RECEIVED AND DESIGNATION OF CAMPAIGN DEPOSITORY FOR CANDIDATES NOV 1 3 2024 (Section 106.021(1), F.S.) (PLEASE PRINT OR TYPE) VILLAGE CLERKS OFFICE NOTE: This form must be on file with the filing officer before opening the campaign account. OFFICE USE ONLY 1. CHECK APPROPRIATE BOX(ES): ❑ 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 PO Box or Street, City,State,Zip Code): (PleasePrin, rTyps Name) 4. Telephone: 5. Candidate's Voter Registration#: 6. Email Address: (not required for qualifying purposes) 7.Office Sought(in-clludde district, Lcircuit, ,ggroup,or eat#): / 8. If a candidate for a nonpartisan office,check the box G�? /sic,Y�S'T� L ov✓�C _'. '<,.T y if applicable: ❑ I intend to run as a Write-In Candidate. 9. If a candidate for partisan office, check the box and fill in the name of the party as applicable: I intend to run as a ❑ Write-In Candidate. B-$$o Party Affiliation Candidate. ❑ Party candidate. 10. 1 have appointed the following person to act as my: ❑ Campaign Treasurer ❑ Deputy Treasurer 11. Name of Treasurer or Deputy Treasurer: 12.Telephone: 13. Email Address 14. Mailing Address: 15. City: 16. State. 17. Zip Code: 18. 1 have designated the following bank as my (check appropriate box): rimary Depository ❑ Secondary/Depository 19. Name of Bank: 20. Address:/ 21. City- 22. County: 23. State: 24. Zip Code: UNDER PENALTIES OF PERJURY, I DECLARE THAT I HAVE READ THE FOREGOING FORM FOR THE APPOINTMENT OF THE CAMPAIGN TREASURER AND DESIGNATION OF THE CAMPAIGN DEPOSITORY AND THAT THE FACTS STATED IN IT ARE TRUE. 26. Signature of Candidate: 25. Date: v /� w---- c-�^ 27. Treasurer's Acceptance of Appointment(fill in the blanks and check the appropriate box) I, �' �`� �'� do hereby accept the appointment designated above as: (Please Print or Type Name) a� Cj Campaign Treasurer. ❑ Deputy Treasurer. l 29. Signature of Campaign Treasurer or Deputy Treasurer 28. Date: V f /// /� DS-DE 9(Rev.09/23) Rule 1S-2.0001,F.A.C. OFFICE USE ONLY STATEMENT OF CANDIDATE RECEIVED (Section 106.023, F.S.) 0 C T 17 2024 (Please print or type) VILLAGE CLERKS OFFICE I ,C� candidate for the office of have been provided access to read and understand the requirements of Chapter 106, Florida Statutes. X o / zoz Signature f 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) 2025 List of Candidate Forms / Books TAB# List 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 1 Appointment of Campaign Treasurer Ll 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 https://dos.myflorida.com/media/693243/dsdel3.pdf DS-DE 14 Campaign Treasurer's Report—Itemized Expend. 7 https://dos.myflorida.com/media/693244/dsdel4.pdf DS-DE 87 Waiver of Report 8 https://dos.myflorida.com/media/693282/dsde87.pdf DS-DE 73 Campaign Loans Report 9 https://dos.myflorida.com/media/693276/dsde73.pdf The following forms must be turned in during the qualifying period: NOON,TUESDAY, NOVEMBER 5, 2024 THROUGH NOON,TUESDAY, NOVEMBER 19, 2024 FS 99.021(a) Candidate Oath 10 *Form 1 2023 Statement of Financial Interests 11 Village Form Nominating Petitions (Clerk will provide these after you have filed the DS-DE 9) I/ 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.myflorida.com/media/693289/dsdelOO.pdf DS-DE 125 Designation of Poll Watchers 17 https://dos.myfiorida.com/media/696684/dsdel25.pdf Council 18 Procedures Charter https://library.municode.com/fl/teguesta/codes/code of ordinances?nodeld=PTICH 19 Political 20 Signs Sunshine http://myfloridalegal.com/pages.nsf/Main/DCOB2OB7DC22B7418525791BO06A54E4 21 Law " LECTION (State of Florida) 22 CODE It is the responsibility of each candidate to read and understand all the Election Statutes and laws http://www.leg.state.f1.us/Statutes/index.cfm?App mode=Display Index&Title Request=lX#TitlelX HANDBOOK CANDIDATE HANDBOOK ON CAMPAIGN FINANCING 23 ETHICS COUNTY ETHICS ORDINANCE 24 https://www.teguesta.org/DocumentCenter/View/10734/Commission on Ethics Ordinance- effective 9-22-15 Acknowledgment I 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 of the alit) ape are accurate. (Canc ildate Signatur Da e ❑ Candidate declined to sign acknowledging he/she received the forms. Clerk Signature: Witness: Contact Information It is important to understand your email and phone number as well as all elements of the qualifying packet are public record. Email you wish our office to publish:: Phone number you wish our office to publish: Cl r/CX— e C a C7 J ler__OJ�0411�zclvl *As a candidate, you are required to submit Form 1 as part of your qualification paperwork. If elected, you will need to file this form on an annual basis. However, please be advised that there is a significant possibility you may be required to file Form 6 instead, contingent upon the resolution of ongoing state-level litigation. We recommend that you carefully review Form 6 to determine your willingness to file this document should it become necessary.