STATEMENT OF
SOLICITATION
(Section 106.0701, Florida Statutes)
Office Use Only
Tracking: _____________________________
Account: _____________________________
PART A
Office Holder: Candidate: (Choose One)
Name Telephone
Mailing Address Email Address
City State Zip Code
Name of Organization
PART B
Relationship Between Office Holder or Candidate and Organization
(in whole or in part): (Choose One)
Organization Type:
(Choose One)
PART C
Web Address as Required by Section 106.0701(3), F.S. (if website has not been created, put “To be
determined”)
PART D
Date
Signature of Office Holder or Candidate
INSTRUCTIONS FOR COMPLETING AND FILING FORM DS-DE 102
STATEMENT OF SOLICITATION
Introductory Information
As this form utilizes drop-down menus, you must enter the information directly on the form prior to printing. After printing,
sign the document. Fax
or mail PAGE 1 of the form to the Division of Elections, Bureau of Election Records, R. A. Gray
Building, Room 316, 500 South Bronough Street, Tallahassee, Florida 32399-0250; Fax Number 850-245-6259.
Who Must File Form DS-DE 102
The Governor, Lieutenant Governor, members of the Cabinet, state legislators, or candidates for such offices who directly or
indirectly solicit, cause to be solicited, or accept any contribution on behalf of an organization that is exempt from taxation under
s. 527 or s. 501(c)(4) of the Internal Revenue Code, which such individuals, in whole or in part, establish, maintain, or control,
must file Form DS-DE 102.
Form DS-DE 102 (Created 07/06) PAGE 1
(continued on PAGE 2
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