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Paul Kruss - Registration Documents APPOINTMENT OF CAMPAIGN TREASURER CITY OF AVENTURA AND DESIGNATION OF CAMPAIGN 0 t C Office of=theCity Clerk DEPOSITORY FOR CANDIDATES C V (Section 106.021(1), F,S.) FRECEIVED (PLEASE PRINT OR TYPE) NOTE: This form must be on file with the qualifying officer before opening the campaign account. OFFICE USE ONLY 1.CHECK APPROPRIATE BOX(ES): (11 initial Filing of Form Re-filing to Change: C] Treasurer/Deputy Depository Office Q Party 2. Na of Candidate(in th's order: First, Middle, Last) 3. Address(include post q_ffic),e bo)j or street, cit state,zip cod e) 4.Telephone 5 mailtddress No, va- 6. Office sought(include district, circuit, group number) 7. If a candidate for a nonpartisan,office,check if un applicable: 'in TY) C—I'Zi V [-] my intent is to run as a Write-In candidate. & 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. 1 have appointed the following person to act as my Campaign Treasurer Deputy Treasurer 10, Name of PasureA or eputylTVeasurer 11. Mailing Address 12. Telephone 13, city 16 Z' CQde 17. mail dress L County a 1,4—bxk L 18. 1 have designated the following bank as my Primary Depository Q Secondary Depository 19, Name of Ba!tt, 20. Address If 21. City 22. County 23. _State 24. Zip Cod,e L 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 26. Signature Ca didate x 27. Treasurer'q Acceptance of Appointment(fill in the blanks and check the appropriate block) 1, do hereby accept the appointment (Aease Print or Type Name) designated above as: /Campaign Treasurer Deputy T usurer x Dat� Signature of Cam ign Treasurer or Deputy Treasurer IDS-DE 9(Rev. 10/10) Rule 1S-2.0001, F.A.C. OFFICE USE ONLY CANDIDATE STATEMENT OF (section 106.023, F.S.) rOffice of the CityI erk (Please print or type) RECEIVED 1, LIXJ, a candidate for the office of have been provided access to read and understand the requirements of Chapter 106, Florida Statutes. Signature f 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-ICE 84(05111) CITY OF AVENTURA City of RECEIVED A j� �ventura Access to the Candidate Camp-aim Treasurer Handbook and e Election Laws of the State of Florida Candidate: (Print tame) Office_Sought: Mayor Seat L❑ Commissioner Seat 2 ❑ Commissioner Seat 4 Commissioner Seat 6 ❑ I acknowledge that it is my responsibility to read, understand and follow the requirements described in the City of Aventura Municipal Candidate Election resources available on the City of Aventura Website (, __r .ci faventuradco ), including but not limited to: Candidate and Campaign TreasurerHandbook; Compilation of the Election Laws of the State of Florida; City of Aventura Charter and Cade of Ordinances; City of Aventura Political Sign Code;. List of City Vendors; Voter Registration wide; Items for Sale from Miami-Dade County Elections Department; Campaign Financing Forms; Frequently Asked Questions; and Common Reporting Compliance Errors; as well as website links to the Miami-Dade County Elections Department and State of Florida Division of EI tion . Acknowledged y: F Signature of Candidate Gate: Primary Telephone Number: .. Alternate Telephone Number: 9❑ 1 ' ` r E-mail address: - PHONE:: 305-466-8901 * FAX: 305-466-8919 www.cityofavr nturaxorn