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Appointment of Campaign Treasurer
APPOINTMENT OF CAMPAIGN TREASURER AND DESIGNATION OF CAMPAIGN DEPOSITORY FOR CANDIDATES (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. OFFICE USE ONLY 1. M CHECK APPROPRIATE BOX(ES): Initial Filing of Form Re -filing to Change: ❑ Treasurer/Deputy [] Depository ■ Office p Party 2. Name of Candidate (in this order: First, Middle, Last) Aretha Janine Olivarez 3. Address (include post office box or street, city, state, zip code) P.O. Box 618585 Orlando, FL 32861 4. Telephone ('1t,1 ) 505-9515 5. E-mail address mti535@yahoo.com 6. Office sought (include district, circuit, group number) City Commissioner, District 4 7. If a candidate for a nonpartisan office, check if applicable: 0 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. 9. I have appointed the following person to act as my Mi Campaign Treasurer ❑ Deputy Treasurer 10. Name of Treasurer or Deputy Treasurer Aretha Olivarez 11. Mailing Address 4668 Pembrook Place 12. Telephone ( 407 ) 505-9515 13. City Orlando 14. County Orange 15. State FL 16. Zip Code 32811 17. E-mail address mti535@yahoo.com 18. I have designated the following bank as my rj Primary Depository ❑ Secondary Depository 19. Name of Bank Suntrust 20. Address 4582 Kirkman Rd 21. City Orlando 22. County Orange 23. State FL 24. Zip Code 32811 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 4-4-2015 26. Si ture of Candid to x 27. Treasurer's Acceptance of Appointment (fill in the blanks and check the appropriate block) Aretha Olivarez , do hereby accept the appointment (Please designated above as: 4-4-2015 Print or Type Name) E.13 Campaign Treasure ❑ Deputy Trees rer. X Date Signature of Campaign Trea r or Deputy Treasurer