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HomeMy Public PortalAboutStatement of CandidateOFFICE USE ONLY STATEMENT OF CANDIDATE (Section 106.023, F.S.) (Please print or type) 1, co r�r °Y-e-1 O ' candidate for the office of ORLCITYCL SEPI2'lS f%'s1i','c q CoiNt,vt,'s's,'oaa er- have been provided access to read and understand the requirements of Chapter 106, Florida Statutes. X ©q/o9 Sign re of Candidate Date 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 (05/11) ERKDO M1:35