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HomeMy WebLinkAboutAppointment of Campaign Treasurer RR - Refiled 08-12-2016APPOINTMENT 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 RECEIVED AUG 12 29156 MG 12:10 PM 1. CHECK APPROPRIATE BOX(ES): O Initial Filing of Form Re -filing to Change: X- Treasurer/Deputy X-Depository ❑ Office ❑ Party 2. Name of Candidate (in this order:First, Middle, Last) Rocky Randels 3. Address (include post office box or street, city, state, zip code) 308 East Central Blvd P.O. Box 308 Cape Canaveral, FL 32920-0308 4. Telephone (321) 784-5694 5. E-mail address RockyRandels1@gmail.com 6. Office sought (include district, circuit, group number) City Council, Cape Canaveral 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 D No Party Affiliation ® Party candidate. 9. I have appointed the following person to act as my X- Campaign Treasurer ❑ Deputy Treasurer 10. Name of Treasurer or Deputy Treasurer Rocky Randels 11. Mailing Address P. O. Box 308 12. Telephone (321) 784-5694 13. City Cape Canaveral 14. County Brevard 15. State FL 16. Zip Code 32920 17. E-mail address RockyRandels1@gmail.com 18. I have designated the following bank as my X- Primary Depository Secondary Depository 19. Name of Bank Sunrise Bank 20. Address 5604 N. Atlantic AVe Cocoa Beach, FL 32931 21. City Cocoa Bch, 22. County Brevard 23. State FL 24. Zip Code 32931 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 12 Aug 2016 26. Signature of Candidate X Rocky Randels 27. Treasurer's Acceptance of Appointment (fill in the blanks and check the appropriate block) I, Rocky Randels , do hereby accept the appointment (Please Print or Type Name) designated above as: X- Campaign Treasurer O Deputy Treasurer. 12 Aug 2016 X Rocky Randels Date Signature of Campaign Treasurer or Deputy Treasurer DS -DE 9 (Rev. 10/10) Rule 1S-2.0001, F.A.C.