HomeMy WebLinkAboutAppointment of Treasurer_Richard Sartory_12/28/2022 I.PPOINTMENT OF CAMPAIGN TREASURER RECEIVED
AND DESIGNATION OF CAMPAIGN
DEPOSITORY FOR CANDIDATES
(Section 106.021(1), F.S.) E 2 3 2022
(PLEASE PRINT OR TYPE) VILLAGE CLERKS OFFICE. ��
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NOTE: This form must be on file with the qualifying
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 post office box or street, city, state, zip
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4. Telephone 5. E-mail address
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6. Office sought(include district, circuit, group number) 7. If a candidate for a nonpartisan office, check if
T2, (A 4,5 -I A- V lt,� C Cad r•�G('(� applicable:
CA/A_T I_1� ❑ 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 Campaign Treasurer ❑ Deputy Treasurer
10. Name of Treasurer or Deputy Treasurer
R l L fit �_ .
11. Mailing Address 12. Telephone
Sly N PL
13. City 4. County 15. State 16. Zip Code 17. E-mail address
18. 1 have designated the following bank as my , Primary Depository ❑ Secondary Depository
19. Name of Bank 20.Address
C I(L N ! (A5 i -
21._City 22. County 23. State 24. Zip Code
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 FAC)s STATED NIT ARE TRUE.
25. Date 26. Signature of a d
12_'24 / 7,07,v X
27. Treasurer's Acceptance of Appointment(fill in the blanks and c eck t a propriate block)
I, ���� � ���G�' /' 1 �) V�� do hereby accept the appointment
(Please Print or Type Name)
Designated above as: Campaign Treasurer. ❑ Deputy Treasurer.
l�l L � Z6Z2,— X If/,/t
Date Signature of Campaign Treasurer or Deputy Treasurer
DS-DE 9(Rev. 10/10) Rule 1S-2.0001, F.A.C.
APPOINTMENT OF CAMPAIGN TREASURER RECEIVED
AND DESIGNATION OF CAMPAIGN
DEPOSITORY FOR CANDIDATES DEC 28 202%
(Section 106.021(1), F.S.) r
VILLAGE CLERKS OFFICE
(PLEASE PRINT OR TYPE) 3 i3
NOTE: This form must be on file with the qualifying
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 post office box or street, city, state, zip
jZ 16,,q 4 n L!}W Ki!� code) (� I S fiJ � ��� t � �iJ'�)
4. Telephone 5. E-mail address -r a(A4_S / A-1 FL _3 3 -[ �
00 AA Cl�-s`i t tj 4.
6. Office sought(include district, circuit, group number) 7 If a candidate for a nonpartisan office, check if
applicable:
S L� 'f-- ❑ My intent is to run as a Write-In candidate.
8. If a candidate fora partisan office, check block and fill in name of party as applicable: My intent is to run as a
❑ Write-In ❑ No Parry Affiliation ❑ Party candidate.
9. 1 have appointed the following person to act as my :Kj Campaign Treasurer ❑ Deputy Treasurer
'0. Name of Treasurer r Deputy Treas rer
Grp .
11. Mailing Address 12. Telephone
fV
13. City 14. Coun 15. State 16. Zip Code 17. E-mail address
n�i vO,STA' P.�iW �_kW L T3�Ck (`Ic,��A �i o. �{e—00MCA r;•NET,
18. 1 have designated the following bank as my $ Primary Depository ❑ Secondary Depository
19. Name of Bank 20.Address
21. City 2. County 23. State 24. Zip Code
TU
UNDER PENALTIES OF PERJURY,I DECLARE THAT I HAVE READ THE FOREGOING FORIIJ FOR APPOINTMENT OF CAMPAIGN TREASURER AND
DESIGNATION OF CAMPAIGN DEPOSITORY AND THAT THE FA TS TATE IN IT ARE TRUE.
25. Date 26. Signature n id
l I1 zv �z X /7
27. Treasurer'sp � /Acceptance` ��` (of Appointment(fill in the blank an heck the propriate block)
I, I41 /` & do here y accept the appointment
(Please Print or Type Name)
designated above as: Vq- Campaign Treasurer. ❑ Deputy TreasurADp
T##;9L--2_ l Z/2 /20 L2 _ X
Date Signature of Campaign Treurer
DS-DE 9 (Rev. 10/10) Rule 1S-2.0001, F.A.C.
OFFICE USE ONLY
STATEMENT OF RECEIVED
CANDIDATE DEC 2 3 202?
(Section 106.023, F.S.)
VILLAGE CLERKS OFFICE
(Please print or type)
4 S
candidate for the office of I;ZM5 l 1d�jrL (�� �'t)t� A)&:U, clfj ;
have been provided access to read and understand the requirements of
Chapter 106, Florida Statutes.
X
S na re kpindidate Date
J
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)
ELECTION LAWS (State of Florida) (Chapter 99, 101, 104, 105 & 106) 21
the responsibility of each candidate to read and understand all the Election Statutes and laws.
.p://www.leg.state.fl.us/Statutes/index.cfm?App mode=Display Index&Title Request=lX#Title IX
CANDIDATE HANDBOOK ON CAMPAIGN FINANCING 22
https:/Iteguesta.or,g/DocumentCenter/View/12093/candidate-campaign-treasurer-handbook-2022-04-
27-2022-nl-9
FAQ's- https://dos.myflorida.com/elections/contacts/frequently-asked-questions/fag-campaign-finance/
COUNTY ETHICS ORDINANCE 23
https://www.teguesta.org/DocumentCenter/View/10734/Commission on Ethics Ordinance-
effective 9-22-15
I acknowledge that I have received all the forms and documents referenced on the "Candidate Forms List" and I
acknowledge at t etinfmation contained here is intended as a reference guide only. The Clerk's Office will assist
candidates; wee , a ministerial function and cannot interpret Florida Statutes or determine whether the
contents of a al fys are accurate.
( z-[ ZU4
(Candidate nat r ) Date
i^O
y ❑ Candidate Declined to sign acknowledging he/she received the forms.
Clerk Signature: Witness: RECEIVED
VILLAGE CLERKS OFFICE
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