HomeMy Public PortalAboutStatement of CandidateSTATEMENT OF
CANDIDATE
(Section 106.023, F.S.)
(Please print or type)
NOV2' 1O pM3:53
ORLCIT VCLERKDO
. IDennC4
candidate for the office of .) C\ andl.) C_; MCIpC e c r- j ;
have been provided access to read and understand the requirements of
Chapter 106, Florida Statutes.
X ,sAot.r
/U/,3///,3
Signature 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)