Fillable AND DESIGNATION OF CAMPAIGN DEPOSITORY FOR POLITICAL COMMITTEES (Florida Division of Corporations)

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AND DESIGNATION OF CAMPAIGN DEPOSITORY FOR POLITICAL COMMITTEES (Florida Division of Corporations)

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APPOINTMENT OF CAMPAIGN TREASURER
AND DESIGNATION OF CAMPAIGN
DEPOSITORY FOR
POLITICAL COMMITTEES
(Sections 106.011(2) and 106.021(1), F.S.)
CHECK APPROPRIATE BOX:
Initial Filing for: Primary Treasurer Deputy Treasurer
OFFICE USE ONLY
Re-filing to Change: Primary Treasurer Deputy Treasurer Prim Depository ary/Secondary
1. Committee 2. Telephone
( )
3. Name of Treasurer or Deputy Treasurer 4. Email (optional) 5. Telephone (optional)
( )
6. Mailing Address
7. Street Address
Primary Depository Secondary Depository
8. The following bank has been designated as the
9. Name of Bank 10. Street Address
11. City 12. State 13. Zip Code
14. Signature of Chairman 15. Name of Chairman (Print or Type)
X
Campaign Treasurer’s Acceptance of Appointment
I,
, do hereby accept the appointment as
(Please Print or Type)
treasurer or deputy treasurer for
(Committee)
UNDER PENALTIES OF PERJURY, I DECLARE THAT I HAVE READ THE FOREGOING CAMPAIGN TREASURER’S
ACCEPTANCE OF APPOINTMENT AND THAT THE FACTS STATED ARE TRUE.
X
Date
Signature of Campaign Treasurer or Deputy Treasurer
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AND DESIGNATION OF CAMPAIGN DEPOSITORY FOR POLITICAL COMMITTEES (Florida Division of Corporations)

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Completed 30 July 2020

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