HomeMy WebLinkAboutAppointment of Treasurer_Jahnel Kinnebrew_10/30/2025 APPOINTMENT OF CAMPAIGN TREASURER
AND DESIGNATION OF CAMPAIGN
DEPOSITORY FOR CANDIDATES RECEIVED
/1 (Section 106.021(1), F.S.)
(PLEASE PRINT OR TYPE) A�a 2025
NOTE: This form must be on file with the filing officer before VILLAGE CLERKS OFME
opening the campaign account. OFFICE USE ONLY
1. C ECK 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) 2m �0[f Vlf w �Yl v _
Joylfl 4I9 h I Innebvcw T,e qA -VL 3344f1
4. Telephone: 5. Candidate's Voter Registration#: 6. Email Address:
I It q3 (10 5II-
(not required for qualifying purposes) J Q hn GI11m r e
�I a 1 U✓h
7. Office Sought(include district, circuit, group, or seat#): 8. If a candidate r a nonpartisan office, check the box
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. ❑ No Parry Affiliation Candidate. ❑ Party candidate.
1�1 have appointed the following person to act as my: [Campaign Treasurer ❑ Deputy Treasurer
Name of Treasurer or Deputy Treasurer: 12.Telephone: 13. Email Address:
14. Mailing Address: 15. City: 16. S1 e: 1 Z' Code:
?III o IfvAtkJ C}Y►V Tt uec;{h �i- �3acod
18. 1 have designated the following bank as my (check appropriate box): rimary Depository ❑ Secondary Depository
19. Name of Bank: 20. Address:
2 M chklic/ I
21. City: 22. County: 230 State: 24. Zip Code:
ups R, 33wq
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 o Candidate:
25. Date: W. 3O.P 45, v
27. Treasurer's Acceptance of Appointment (fill in the blanks and check the appropriate box)
I, �. Glh ) 6n"",_) do hereby accept the appointment designated above as:
(Please Print or Ty Name)
Campaign Treasurer. ❑ Deputy Treasurer.
29. Signature Lmpaign Treasurer or Deputy Treasurer
28. Date: v DS-DE 9(Rev.09123) J� Rule 1S-2.0001, F.A.C.
OFFICE USE ONLY
STATEMENT OF
CANDIDATE RECEIVED
(Section 106.023, F.S.) 0�1 .S � 2025
(Please print or type)
VILl.AC�CLERKS Ct��
1, �o Ono Kinnebrmi
candidate for the office of q �OUO(4 )l ;
have been provided access to read and understand the requirements of
Chapter 106, Florida Statutes.
X 1pw ui<
Signature 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)
The Sunshine Law regarding open government can be found in Chapter 286 of the Florida
Statutes.These statutes establish a basic right of access to most meetings of boards,
commissions and other governing bodies of state and local governmental agencies or
authorities.
Election It is the responsibility of each candidate to read and understand all the Election Statutes and 22
Code laws
http://www.leg.state.fl.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 he co is of he qualifying papers are accurate
(Candidate Signature) Date
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:
* IMPORTANT: 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 possibilityyou 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.