HomeMy WebLinkAboutAppointment of Treasurer_Kyle Stone_9/2/2022 PPOINTMENT OF CAMPAIGN TREASURER RECEIVED
AND DESIGNATION OF CAMPAIGN SEP - 2 2022
DEPOSITORY FOR CANDIDATES VILLAGE CLERKS OFFICE
(Section 106.021(1), F.S.)
(PLEASE PRINT OR TYPE)
NOTE: This form must be on file with the qualifying
officer before opening the campaign account. I OFFICE USE ONLY
1. CHECK APPROPRIATE BOX(ES):
M 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
1 code)
KY e- �L n/►Lt-`. S- O 02l 1 F.�:r w�47 t'7h J
4, Telephone 5. E-mail address
( S(P I ) S;0 - 016 KST0AE0Tciv49 OC4)
6. Office sought(include district, circuit, group number) 7. If a candidate for a nonpartisan office, check if
1 /' applicable:
IG vGS�hq � —I ❑ My intent is to run as a Write-In candidate.
8. If a candidate for a partisan office, check block and fill in name of party as applicable: My intent is to run as a
❑ Write-In ❑ No Party Affiliation ❑ Party candidate.
have appointed the following person to act as my 1K Campaign Treasurer eputy Treasurer
10. Name of Treasurer or Deputy Treasurer
Ky I..— S�10
11. Mailing Address 12. Telephone
13. City 14. County 15. State 16. Zip Code 17. E-mail address
k�,, j FL 33yf,p KS T o^E oC
18. 1 have designated the following bank as my Primary Depository ❑ Secondary Depository
19. Name of Bank 20. Address
I D "2 1 S .r4-L U S a-
21. City 22. County 23. State 24. Zip Code
Te .<4, Qak"- 6G.. � xL 33 q 69
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.
25. Date 126. Signature of Candidate
9 z X L14 1���
27. Treasurer's Acceptance of Appointment(fill in the blanks and check the appropriate block)
I, Kyi It S4-oete: , do hereby accept the appointment
(Please Print or Type Name)
N uesignated above as: Campaign Treasurer, Deputy Treasurer.
y�2 Z0 X
Date Signat re of Campaign Treasurer or Deputy Treasurer
DS-DE 9 (Rev. 10110) Rule 1S-2.0001, F.A.C.
OFFICE USE ONLY
STATEMENT OF RECEIVED
CANDIDATE SEP - 2 2022
(Section 106.023, F.S.) VILLAGE CLEMOF=
(Please print or type)
candidate for the office of 1 eroe5-�-.
have been provided access to read and understand the requirements of
Chapter 106, Florida Statutes.
X
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(05111)