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.
0
CHECK APPROPRIATE BOX(ES):
Initial Filing of Form Re -filing to Change: [] Treasurer/Deputy Depository (] Office Party
2. Name of Candidate (in this order: First, Middle, Last)
Shaniqua Rose
3. Address (include post office box or street, city, state, zip
code)
3239 Old Winter Garden Rd
Orlando, FL 32805
4. Telephone
(407 ) 8013489
5. E-mail address
vote4shan@gmail.com
6. Office sought (include district, circuit, group number)
City Commissioner
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 partisan, office, check block and fill in name of party as applicable: My intent is to run as a
Write -In No Party Affiliation
•i
Party candidate.
9. I have appointed the following person to act as my )gjj Campaign Treasurer Deputy Treasurer
10. Name of Treasurer or Deputy Treasurer
Jennifer Jones
11. Mailing Address
755 Lake Monroe Rd # 471116
12. Telephone
( )
13. City
Lake Monroe
14. County
Seminole
15. State
FL
16. Zip Code
32747
17. E-ma'I address
vote4shan@gmail.com
18. I have designated the following bank as my
0
Primary Depository Secondary Depository
19. Name of Bank
Axiom
20. Address
715 S Goldwyn Ave
21. City
Orlando
22. County
Orange
23. State
FL
24. Zip Code
32805
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
05/10/2021
26, Signature of Candidate
X
27. Treasurer's Acceptance of Appointment (fill in the blanks an check the appropriate block)
Jennifer L Jones , do hereby accept the appointment
(Please
designated above as:
/1/')(/ 11' �'
0
Print or Type Name)
Campaign Treasurer - (—j Deputy Treasurer.
X '1
L
�,.,
bi ) ' r�� ftiam n -Treasurer or Deputy Treasurer
Date _Ig atu e`e p�a+g p y
DS -DE 9 (Rev. 10/10)
Rule 1S-2.0001, F.A.C.