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HomeMy WebLinkAboutdwillis_candidate_qualifying_paperwork_20230807CITY OF CAPE CANAVERAL, FLORIDA CANDIDATE PACKET ACKNOWLEDGMENT I Don Willis , would like to announce my candidacy for City Council and do hereby acknowledge receipt of: 1. July 27, 2023 Candidate Qualifying Information Memo 2. 2023 Election Information 3. Qualifying Statement — Domicile Within the City Form + copy of Resolution No. 2023-06 (adopted 5/16/23) 4. Form DS-DE 9 (rev. 07/23), Appointment of Campaign Treasurer and designation of Campaign Depository for Candidates 5. Announcement of Intention to Become a Candidate for Office 6. Form DS-DE 302NP (rev. 2023), Candidate Oath — Nonpartisan Office 7. City Oath of Candidate 8. CE Form 1 (January 1, 2023), Statement of Financial Interests and Instructions 9. Form DS-DE 84 (rev. 05/11), Statement of Candidate 10. Election Laws of the State of Florida as of August 2022 11. Candidate and Campaign Treasurer Handbook as of April 2022 12. 2023 Campaign Treasurer's Report Due Dates for Announced Candidates and general information for filing reports • Reminder: The Final "Terminal Report" (TR) must reflect TOTAL contributions and expenditures being equal. 13. Do's & Don'ts for Campaign Treasurer's Reports 14. Form DS-DE 12 (rev. 11/13), Campaign Treasurer's Report Summary 15. Form DS-DE 13 (rev. 11/13), Campaign Treasurer's Report — Itemized Contributions 16. Form DS-DE 13A (rev. 11/13), Campaign Treasurer's Report— Fund Transfers 17. Form DS-DE 14 (rev. 11/13), Campaign Treasurer's Report — Itemized Expenditures 18. Form DS-DE 14A (rev. 11/13), Campaign Treasurer's Report— Itemized Distributions 19. Form DS-DE 87 (rev. 06/15), Waiver of Report 20. Public Service Request Form 21. Political Sign Regulations I understand to have my name appear on the November 7, 2023 Municipal Election Ballot, I must complete qualifying paperwork and pay qualifying fees during the qualifying period which begins on August 7, 2023 at noon and ends August 18, 2023 at noon. Signature Date: August 7, 2023 OFFICE USE ONLY RECEIVED AUG 0 7 2023 CCO DL Enter Date & Time Received and Initials of Clerk's Office Staff Member CITY OF CAPE CANAVERAL P.O. Box 326.100 Polk Avenue • Cape Canaveral, FL 32920-0326 (321) 868-1220 if www.cityafcapecanaveral.org CITY OF CAPE CANAVERAL, FLORIDA QUALIFYING STATEMENT — DOMICILE WITHIN THE CITY Any registered voter of the City of Cape Canaveral, Florida who desires to qualify as a candidate for the office of mayor and councilmember of the City of Cape Canaveral, Florida ("City Council") is hereby advised: Section 2.02(b) of Article II of the Cape Canaveral City Charter provides: "Each candidate seeking the office of the city council shall be domiciled within the city at least one (1) year immediately prior to the time of qualifying." In addition, "(t)he members of the city council shall be domiciled within the City of Cape Canaveral and shall have and possess the qualifications of registered voters of the City of Cape Canaveral. Any member of the city council who shall cease to have and possess the qualifications imposed on such office shall forfeit his or her office and said office shall immediately become vacant." For purposes of adopting and interpreting the aforementioned City Charter provision, the City Council and citizens of Cape Canaveral relied upon the meaning of the term "domicile" interpreted by Florida Courts as follows: [Domicile] is of more extensive signification and includes, beyond mere physical presence at the particular locality, positive or presumptive proof of an intention to constitute it a permanent abiding place. 'Residence' is of a more temporary character than 'domicile.' 'Residence' simply indicates the place of abode, whether permanent or temporary; 'domicile' denotes a fixed, permanent residence, to which, when absent, one has the intention of returning. 'Residence' has a more limited, precise and local application than 'domicile,' which is used more in reference to personal rights, duties, and obligations. That there is a difference in meaning between 'residence' and 'domicile,' is shown by the fact that a person may have his residence in one place while his domicile is in another. It has also been said that domicile and residence are not synonymous for the reason that a person may have more than one residence at the same time, but only one domicile. Minick v. Minick, 149 So. 483, 488 (Fla. 1933) (quoting 19 Corpus Juris 395). Accord Kevoloh v. Carter, 699 So. 2d 285 (Fla. 5th DCA 1997); In re DeFelice, 172 B.R. 130 (Bankr. S.D. Ha. 1994). City of Cape Canaveral Qualifying Statement — Domicile within the City Page 1 of 2 STATE OF FLORIDA COUNTY OF BREVARD BEFORE ME, the undersigned authority, did personally appear Don Willis (print name), who, upon being duly sworn, did depose and state as follows: 1. My name is Don Willis (print name), I am over the age of eighteen years and I have personal firsthand knowledge of the facts and information set forth herein. 2. I am a candidate for the City Council of Cape Canaveral in the election scheduled to be held on November 7, 2023 ; and I agree to serve on the City Council if I am elected. 3. Before signing this Qualification Statement, I have read and fully understand the aforementioned advisory regarding the qualification requirements to be a candidate to run for the office of City Council of Cape Canaveral, Florida, and if elected, to serve on said City Council. 4. I currently reside at 8984 Puerto Del Rio Dr. , # 301 (print street address), Cape Canaveral, Florida 32920, and represent to the City of Cape Canaveral, other candidates that may be running against me, and the citizens of Cape Canaveral that I am a registered voter of Cape Canaveral, and I am currently, and have been for at least one (1) year immediately preceding my qualifying herein, domiciled within the City of Cape Canaveral at the following address(es): 8984 Puerto Del Rio Dr. , # 301 (print street address(es)) FURTHER YOUR AFFIANT SAYETH NAUGHT. Don Willis (print name) Sworn to and subscribed before me by means of X physical presence OR O online notarization, this 7th day of August , by DON WILLIS whose address is 8984 Puerto Del Rio Dr,. , # 301 Cape Canaveral FL 32920. X Personally Known OR ❑ Produced Identification Type of Identification Produced: NOTARY PUBLIC Daniel L Fewer Notary Public State of Florida Comm# HH014221 Expires 6/24/2024 City of Cape Canaveral Qualifying Statement — Domicile within the City Page 2 of 2 APPOINTMENT 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. RECEIVED AUG 0 7 2023 CCO DL OFFICE USE ONLY 1. CHECK APPROPRIATE BOX(ES): X Initial Filing of Form Re -filing to Change: ❑ Treasurer/Deputy ❑ Depository ❑ Office ❑ Party 2. Name of Candidate (in this order: First, Middle, Last) Donald Andrew Willis 3. Address (include post office box or street, city, state, zip code) 8984 Puerto Del Rio Dr. # 301 CAPE CANAVERAL, FL 32920 4. Telephone (321) 588-1058 5. Candidate's Voter Registration #: 119902557 (Not required for Qualifying Purposes) (Not required for Qualifying Purposes) - Phonetic spelling for audio ballot: Print name phonetically on the line below as you wish it to be pronounced on the audio ballot as may be used by persons with disabilities (see instructions on page 2 of this form): Don Willis 6. Office sought (include district, circuit, group number) City of Cape Canaveral Council 7. If a candidate for a non artisan 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 ❑ Party candidate. 9. I have appointed the following person to act as my V Campaign Treasurer ❑ Deputy Treasurer 10. Name of Treasurer or Deputy Treasurer 11. Telephone Jay Petty (321) 783-4198 12. Mailing Address 8984 Puerto Del Rio Dr., # 401 13. City Cape Canaveral 14. State 15. Zip Code FL. 32920 16. I have designated the following bank as my X Primary Depository ❑ Secondary Depository 17. Name of Bank Sun Rise Bank 18. Address 5604 N. Atlantic Avenue 19. City Cocoa Beach 20. County BREVARD 21. State FL 22. 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. 23. Date August 7, 2023 24. Signature of Candidate X 25. Treasurer's Acceptance of Appointment (fill in the blanks and check the appropriate block) I, Jay Petty , do hereby accept the appointment (Please Print or Type Name) designated above as: X Campaign Treasurer. ❑ Deputy Treasurer. August 7, 2023 Date X Signature of Campaign Treasurer or Deputy Treasure DS-DE 9 (Rev. 07/23) Rule 1S-2.0001, F.A.C. CITY OF CAPE CANAVERAL, FLORIDA ANNOUNCEMENT OF INTENTION TO BECOME A CANDIDATE FOR OFFICE I, Don Willis , hereby notify the City of Cape Canaveral that I have filed Form DS-DE 9, Appointment of Campaign Treasurer and Designation of Campaign Depository for Candidates, with the City's Election Filing Officer, and that I intend to become a Candidate for the Office of City Council Member in the City of Cape Canaveral's Municipal Election on November 7, 2023. I understand it is my responsibility to comply with all applicable election laws and municipal sign codes, and that I must complete and file all required qualifying papers and pay the qualifying and election assessment fees with the City's Election Qualifying Officer during the City's Qualifying Period of Monday, August 7, 2023 at Noon to Friday, August 18, 2023 at Noon, in order to duly qualify as a Candidate for the Office of Council Member during the City of Cape Canaveral's November 7, 2023 Municipal Election. I also understand that within ten (10) days after filing Form DS-DE 9, Appointment of Campaign Treasurer and Designation of Campaign Depository for Candidates, with the City's Election Filing Officer, I must file form DS-DE 84, Statement of Candidate with the City's Election Filing Officer. Signature August 7, 2023 Date OFFICE USE ONLY RECEIVED AUG 0 7 2023 CCO DL Enter Date & Time Received and Initials of Filing Officer or designated Staff Member CANDIDATE OATH NONPARTISAN OFFICE (Do not use this form if a Judicial or School Board Candidate) Check box only if you are seeking to qualify as a write-in candidate: O Write-in-candidate RECEIVED AUG 0 7 2023 CCO DL OFFICE USE ONLY Candidate Oath Name for Ballot: Don / / Willis First Middle Name/Initial/and/or/Nickname Last Name Suffix (See reverse side for Nickname Affidavit.) I swear or affirm that I am a candidate for the nonpartisan office of CAPE CANAVERAL CITY COUNCIL, (Office) (District #) I am a qualified elector of BREVARD County, Florida; (Circuit #) (Group or Seat #) I am a qualified elector under the Constitution and the Laws of Florida to hold the office to which I desire to be nominated or elected; I have qualified for no other public office in the state, the term of which office or any part thereof runs concurrent with the office I seek; and I have resigned from any office from which I am required to resign pursuant to Section 99.012, Florida Statutes; and I will support the Constitution of the United States and the Constitution of the State of Florida. Statement of Outstanding Fines, Fees, or Penalties I owe outstanding fines, fees, or penalties, that cumulatively exceed $250, for ethics or campaign finance violations (s. 99.021(1)(d), F.S.). YES, I Do NO, I Do Not X If you do, you must also specify the amount owed and each entity that levied the same on the reverse side. X (321) 588-1058 don.willis@porter willis.com Signature of Candidate Telephone Number Email Address 8984 Puerto Del Rio Dr # 301, Cape Canaveral FL 32920 Address of Legal Residence City State ZIP Code STATE OF FLORIDA COUNTY OF BREVARD Signature of Notary Public Print, Type, or Stamp Commissioned Name of Notary Public below: Sworn to (or affirmed) and subscribed before me. by means of online notarization ❑ OR physical presence X this 7th day of August , 2023. Personally Known X OR Produced Identification ❑ Type of Identification Produced: Daniel LeFever Notary Public State of Florida Comm# HH014221 Expires 6/24/2024 DS-DE 302NP (Eff._/2023) Rule 1S-2.0001, F.A.C. Statement of Outstanding Fines, Fees, or Penalties Pursuant to Section 99.021(1)(d), F.S., each candidate, whether a party candidate, a candidate with no party affiliation, or a write-in candidate, shall, at the time of subscribing to the oath or affirmation, state in writing whether he or she owes any outstanding fines, fees, or penalties that cumulatively exceed $250 for any violations of s. 8, Art. II of the State Constitution, the Code of Ethics for Public Officers and Employees under part III of chapter 112, any local ethics ordinance governing standards of conduct and disclosure requirements, or chapter 106. Amount Entity Affidavit of Nickname My legal name is Donald Andrew Willis. I am over the age of eighteen (18) and the contents of this affidavit are true and correct. My nickname is Don Willis, I am generally known by this nickname or have used it as part of my legal name. I have not created the nickname to mislead voters. My nickname does not imply I am some other person olitical slogan or othaise associate me with a cause or issue, or that is obscene or profane. • Signature: STATE OF FLORIDA COUNTY OF BREVARD Signature of Notary Public Print, Type, or Stamp Commissioned Name of Notary Public below: Sworn to (or affirmed) and subscribed before me by means of online notarization ❑ ,OR physical presence X this 7th day of August , 2023. Personally Known X OR Produced Identification ❑ Type of Identification Produced: Daniel LeFever Notary Public State of Florida Comm# HH014221 Expires 6/24/2024 DS-DE 302NP (Eff. _/2023) Rule 1S-2.0001, F.A.C. OATH OF CANDIDATE I, Don Willis , do solemnly swear or affirm that I am qualified under the City of Cape Canaveral Charter and Ordinances to hold the Office of Council Member, to which I desire to be elected and I will support the City of Cape Canaveral Charter and Ordinances. Signature of Candidate State of Florida County of Brevard City of Cape Canaveral Sworn to (or affirmed) and subscribed before me by physical presence this 7th day of August, 2023 by Don Willis who is (personally known) or produced Identification. Daniel LeFever Notary Public State of Florida Comm# HH014221 Expires 6/24/2024 Signature of Notary Public Print, type or stamp Commissioned Name of Notary Public FORM 1 STATEMENT OF 2022 FINANCIAL INTERESTS Please print or type your name, mailing address, agency name, and position below: LAST NAME -- FIRST NAME -- MIDDLE NAME : Willis Don MAILING ADDRESS : 8984 Puerto Del Rio Dr. # 301 CITY : ZIP : COUNTY Cape Canaveral 32920 BREVARD NAME OF AGENCY : CAPE CANAVERAL NAME OF OFFICE OR POSITION HELD OR SOUGHT : CITY COUNCIL CHECK ONLY IF [X] CANDIDATE OR ❑ NEW EMPLOYEE OR APPOINTEE FOR OFFICE USE ONLY: RECEVIED AUG 07 2023 CCO DL **** THIS SECTION MUST BE COMPLETED **** DISCLOSURE PERIOD: THIS STATEMENT REFLECTS YOUR FINANCIAL INTERESTS FOR CALENDAR YEAR ENDING DECEMBER 31, 2022. MANNER OF CALCULATING REPORTABLE INTERESTS: FILERS HAVE THE OPTION OF USING REPORTING THRESHOLDS THAT ARE ABSOLUTE DOLLAR VALUES, WHICH REQUIRES FEWER CALCULATIONS, OR USING COMPARATIVE THRESHOLDS, WHICH ARE USUALLY BASED ON PERCENTAGE VALUES (see instructions for further details). CHECK THE ONE YOU ARE USING (must check one): ❑ COMPARATIVE (PERCENTAGE) THRESHOLDS OR X DOLLAR VALUE THRESHOLDS PART A -- PRIMARY SOURCES OF INCOME (If you have nothing to report, write NAME OF SOURCE OF INCOME [Major sources of income to the reporting person - See instructions] "none" or "n/a") SOURCE'S ADDRESS DESCRIPTION OF THE SOURCE'S PRINCIPAL BUSINESS ACTIVITY Charles Schwab 's Inc. Social Security Admin 1958 Summit Park Dr. Orlando 1100 West High Rise, Baltimore MD IRA's & Investments Social Security PART B - SECONDARY SOURCES [Major customers, clients, (If you have nothing to NAME OF BUSINESS ENTITY OF INCOME and other sources of income to businesses report, write "none" or "n/a") NAME OF MAJOR SOURCES OF BUSINESS' INCOME owned by the reporting person - See ADDRESS OF SOURCE instructions] PRINCIPAL BUSINESS ACTIVITY OF SOURCE PART C - REAL PROPERTY [Land, buildings owned by the reporting person - See instructions] (If you have nothing to report, write "none" or "n/a") 8984 Puerto Del Rio Dr. # 301 Cape Canaveral, FL You are not limited to the space on the lines on this form. Attach additional sheets, if necessary. FILING INSTRUCTIONS for when and where to file this form are located at the bottom of page 2. INSTRUCTIONS on who must file this form and how to fill it out begin on page 3. CE FORM 1 - Effective: January 1, 2023 Incorporated by reference in Rule 34-8.202(1), F.A.C. (Continued on reverse side) PART D — INTANGIBLE PERSONAL PROPERTY [Stocks, bonds, certificates of deposit, etc. - See instructions] (If you have nothing to report, write "none" or "n/a") TYPE OF INTANGIBLE BUSINESS ENTITY TO WHICH THE PROPERTY RELATES TRUST FUND WILLIS FAMILY IRREVOCABLE TRUST PART E — LIABILITIES [Major debts - See instructions] (If you have nothing to report, write "none" or "n/a") NAME OF CREDITOR ADDRESS OF CREDITOR ROCKET MORTGAGE 1050 WOODLAND AVE DETROIT MI 48226 PART F — INTERESTS IN SPECIFIED BUSINESSES Ownership or positions in certain types of businesses - See instructions] (If you have nothing to report, write "none" or "n/a") BUSINESS ENTITY # 1 NAME OF BUSINESS ENTITY BUSINESS ENTITY # 2 ADDRESS OF BUSINESS ENTITY PRINCIPAL BUSINESS ACTIVITY POSITION HELD WITH ENTITY I OWN MORE THAN A 5% INTEREST IN THE BUSINESS NATURE OF MY OWNERSHIP INTEREST PART G — TRAINING For elected municipal officers appointed school superintendents, and commissioners of a community redevelopment agency created under Part III, Chapter 163 required to complete annual ethics training pursuant to section 112.3142, F.S. ❑ I CERTIFY THAT I HAVE COMPLETED THE REQUIRED TRAINING. IF ANY OF PARTS A THROUGH G ARE CONTINUED ON A SEPARATE SHEET, PLEASE CHECK HERE ❑ SIGNATURE OF FILER: Signature: Date Signed: AUGUST 7, 2023 CPA or ATTORNEY SIGNATURE ONLY If a certified public accountant licensed under Chapter 473, or attorney in good standing with the Florida Bar prepared this form for you, he or she must complete the following statement: I , prepared the CE Form 1 in accordance with Section 112.3145, Florida Statutes, and the instructions to the form. Upon my reasonable knowledge and belief, the disclosure herein is true and correct. CPA/Attorney Signature: Date Signed: FILING INSTRUCTIONS: If you were mailed the form by the Commission on Ethics or a County Supervisor of Elections for your annual disclosure filing, retum the form to that location. To determine what category your position falls under, see page 3 of instructions. Local officers/employees file with the Supervisor of Elections of the county in which they permanently reside. (If you do not permanently reside in. Florida, file with the Supervisor of the county where your agency has its headquarters.) Form 1 filers who file with the Supervisor of Elections may file by mail or email. Contact your Supervisor of Elections for the mailing address or email address to use. Do not email your form to the Commission on Ethics. it will be returned. State officers or specified state employees who file with the Commission on Ethics may file by mail or email. To file by mail, send the completed form to P.O. Drawer 15709, Tallahassee, FL 32317-5709; physical address: 325 John Knox Rd, Bldg E, Ste 200, Tallahassee, FL 32303. To file with the Commission by email, scan your completed form and any attachments as a pdf (do not use any other format), send it to CEForm1@leg.state.fl.us and retain a copy for your records. Do not file by both mail and email. Choose only one filing method. Form 6s will not be accepted via email. Candidates file this form together with their filing papers. MULTIPLE FILING UNNECESSARY: A candidate who files a Form 1 with a qualifying officer is not required to file with the Commission or Supervisor of Elections. WHEN TO FILE: Initially, each local officer/employee, state officer, and specified state employee must file within 30 days of the date of his or her appointment or of the beginning of employment. Appointees who must be confirmed by the Senate must file prior to confirmation, even if that is less than 30 days from the date of their appointment. Candidates must file at the same time they file their qualifying papers. Thereafter, file by July 1 following each calendar year in which they hold their positions. Finally, file a final disclosure form (Form 1 F) within 60 days of leaving office or employment. Filing a CE Form 1 F (Final Statement of Financial Interests) does not relieve the filer of filing a CE Form 1 if the filer was in his or her position on December 31, 2022. CE FORM 1 - Effective: January 1, 2023. PAGE 2 Incorporated by reference In Rule 34-8.202(1), F.A.C. OFFICE USE ONLY RECEIVED AUG 07 2023 CCO DL STATEMENT OF CANDIDATE (Section 106.023, F.S.) (Please print or type) I, Don Willis candidate for the office of CAPE CANAVERAL CITY COUNCIL ; have been provided access to read and understand the requirements of Chapter 106, Florida Statutes. X AUGUST 7, 2023 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) CITY OF CAPE CANAVERAL 100 POLK AVE. CAPE CANAVERAL, FL 32920 (321) 868-1220 Received Of: DON WILLIS CAMPAIGN ACCOUNT The sum of: $39.00 RECEIPT 08/07/2023 13:02 Number: Cashier: 93680 j.coldiron ELE TAX MISC MISC ELECTION TAX PAYABLE Total $ 24.00 $15.00 $39.00 Remaining Balance: , $0.00 TENDERED: CHECK 91 $39.00 APPOINTMENT 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. RECEIVED SEP 2 5 2023 By: CCO DL OFFICE USE ONLY 1. CHECK APPROPRIATE BOX(ES): ❑ Initial Filing of Form Re -filing to Change: X Treasurer/Deputy ❑ Depository ❑ Office ❑ Party 2. Name of Candidate (in this order: First, Middle, Last) Donald Andrew Willis 3. Address (include post office box or street, city, state, zip code) 8984 Puerto Del Rio Dr., #301 Cape Canaveral, FL 32920 4. Telephone ( 321-588-1058 5. Candidate's Voter Registration #: 119902557 (Not required for Qualifying Purposes). (Not required for Qualifying Purposes) - Phonetic spelling for audio ballot Print name phonetically on the line below as you wish it to be pronounced on the audio ballot as may be used by persons with disabilities (see instructions on page 2 of this form): 6. Office sought (include district, circuit, group number) City of Cape Canaveral City Council 7. If a candidate for a non • artisan office, check if applicable: ❑ My intent is to run as a Write -In candidate. 8. If a candidate for a •artisan office, check block and fill in name of party as applicable: My intent is to run as a ❑ Write -In ❑ No Party Affiliation ❑ Party candidate. 9. I have appointed the following person to act as my ❑ Campaign Treasurer X Deputy Treasurer 10. Name of Treasurer or Deputy Treasurer D'Lana Motta 11. Telephone ((321) 505-9900 12. Mailing Address 8984 Puerto Del Rio Dr., #403 13. City Cape Canaveral 14. State FL 15. Zip Code 32920 16. I have designated the following bank as my X Primary Depository ❑ Secondary Depository 17. Name of Bank Sun Rise Bank 18. Address 5604 N. Atlantic Ave. 19. City Cocoa Beach 20. County Brevard 21. State FL 22. 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. 23. Date September 22, 2023 24. Signature of Candidate X 25. Treasurer's Acceptance of Appointment (fill in the blanks and check the appropriate block) I, D'Lana Motta , do hereby accept the appointment (Please Print or Type Name) designated above as: ❑ Campaign Treasurer X Deputy Treasurer. September 22, 2023 X Date Signature of Campaign Treasurer or Deputy Treasurer DS-DE 9 (Rev. 07/23) Rule 1S-2.0001, F.A.C.