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.