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HomeMy Public PortalAboutAppointment of Campaign TreasurerAPPOINTMENT 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. CHECK APPROPRIATE BOX(ES): 0 Initial Filing of Form Re -filing to Change: Q Treasurer/Deputy 0 Depository Office Party 2. Name of Candidate (in this order: First, Middle, Last) Ka'Juel Jamal Washington 3. Address (include post office box or street, city, state, zip code) 1521 Crooms Ave. Orlando, FL 32805 4. Telephone (407 ) 822-1130 5. E-mail address KajuelWashington@gmail 6. Office sought (include district, circuit, group number) City Commissioner, District 6 7. If a candidate for a non 'artisan office, check if applicable: 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 III Write -In II No Party Affiliation ® Party candidate. 9. I have appointed the following person to act as my 0 Campaign Treasurer X❑ Deputy Treasurer 10. Name of Treasurer or Deputy Treasurer Ka'Juel Jamal Washington 11. Mailing Address 1521 Crooms Avenue 12. Telephone ( 407 ) 822-1130 13. City Orlando 14. County Orange 15. State FL 16. Zip Code 32805 17. E-mail address KajuelWashington@gmail 18. I have designated the following bank as my X Primary Depository Secondary Depository 19. Name of Bank Orlando Federal Credit Union 20. Address 400 S. Orange Ave. 21. City Orlando 22. County Orange 23. State FL 24. Zip Code 32802 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 July 1,2015 26. Signat f C idate X 27. Treasurer's Acceptance of Appointment (fill in the blanks and check the appropriate block) Ka'Juel Jamal Washington , do hereby accept the appointment (Please Print or Type Name) designated above as: Campaign Treasurer July 1, 2015 X X Deputy T urer. Date Signature ampaign reasurer or Deputy Treasurer DS -DE 9 (Rev. 10/10) Rule 1S-2.0001, F.A.C.