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HomeMy Public PortalAboutAppointment of Campaign Treasurer (2)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. CHECK APPROPRIATE BOX(ES): ❑X Initial Filing of Form Re -filing to Change: Treasurer/Deputy 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 Avenue 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 nonpartisan office, check if applicable: [] My intent is to run as a Write -In candidate. 8. If a candidate for a . artisan 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 Q Campaign Treasurer Ei Deputy Treasurer 10. Name of Treasurer or Deputy Treasurer Latashia N. Washington 11. Mailing Address 1521 Crooms Avenue 12. Telephone ( 407 ) 283-5183 13. City Orlando 14. County Orange 15. State FL 16. Zip Code 32805 17. E-mail address LWashington1977@yahoo.com 18. I have designated the following bank as my X Primary Depository 0 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 (0— O—i_ 26. Signature of Candidate X 27. Treasurer's Acceptance of Appointment (fill in the blanks and ck the appropriate block) l Latashia N. Washington , do hereby accept the appointment (Please designated above as: (:)-10-1S X Print or Type Name) X Campaign Treasurer . Deput T er. Date ature of paign Treasurer or Deputy Treasurer DS -DE 9 (Rev. 10/10) Rule 1S-2.0001, F.A.C.