Clifford B. Ain - Registration Documents RECEIVED
OFFICE OF THE CITY CLERK
APPOINTMENT OF CAMPAIGN TREASURER
AND DESIGNATION OF CAMPAIGN
DEPOSITORY FOR CANDIDATES 0CT 3 0 2023
(Section 106.021(1), F.S.)
(PLEASE PRINT OR TYPE) CITY OF "ENTURA
NOTE: This form must be on file with the qualifying
officer before opening the campaign account. OFFICE USE ONLY
1. CHECK APPROPRIATE BOX(ES):
,M Initial Filing of Form Re-filing to Change: ❑ Treasurer/Deputy Depository Office Party
2. Name of Candidate (in this order: First, Middle, Last) 3. Address (include post office box or street, city, state, zip
C C( P F 0ju )�I d code) Z a� ZT C 67a xZ- V-'-D
4. Telephone 5. E-mail address". A3
6. Office sought(include district, circuit, group number) 7. If a candidate for a nonpartisan office, check if
applicable:
C'J jT/ 3 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. 1 have appointed the following person to act as my Campaign Treasurer Deputy Treasurer
10. Name of Treasurer or Deputy Treasurer
CLIFF-aRll) 'B I 49 !
11. Mailing Address 12.Telephone
SL v__,� 1 /J3 (3(J-1- ) 1,Y4 -- v?DI/
13. City 14. County 15. State 16. Zip Code 17. E-mail address
AV rwvylr fXW41- Apr Pt 331Co (�5910 a HC ' I
18. 1 have designated the following bank as my Primary Depository Secondary Depository
19. Name of Bank 0 20. AddressLo gT-D ,$1i-�c&gq F
21. City 22. County 23. State 24. Zip Code
PV CgTV0 rt 1641I.-, _�bopF, Ft 1 3340
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 of Candidate
(D vF /vo il-3 X 7 , Q ,
27. Treasurer's Acceptance of Appointment (fill in the blanks and check the appropriate block)
I, C C ( F-F03 1,J 7. A 7 j , do hereby accept the appointment
(Please Print or Type Name)
designated above as: Campaign Treasurer Deputy Treasurer.
Date Sign a of Campaign Treasurer or Deputy Treasurer
DS-DE 9 (Rev. 10/10) Rule 1S-2.0001, F.A.C.
OFFICE USE ONLY
S TAT E M E N T OF RECEIVED
CANDIDATE OFFICE OF THE CITY CLERK
(Section 106.023, F.S.)
0 CT 3 0 2023
(Please print or type)
CITY OF "ENTURA
candidate for the office of _f F01- 3 ;
have been provided access to read and understand the requirements of
Chapter 106, Florida Statutes.
x " 3 . <:z - 1614113
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 RECEIVED
n OFFICE OF THE CITY CLERK
e A ura
2024 Municipal Election OCT 3 0 2023
CITY OF AVENTURA
Access to the Candidate and Campaign Treasurer
Handbook
and
The Election Laws of the State of Florida
Candidate: !911i
(Print Name)
Office Sought:
Commissioner Seat 1 ❑
Commissioner Seat 3 9
Commissioner Seat 5 ❑
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 (www cityofaventura com),
including but not limited to:
Candidate and Campaign Treasurer Handbook; Compilation of the Election Laws of the State of
Florida; City of Aventura Charter and Code of Ordinances; City of Aventura Political Sign Code;
List of City Vendors; Voter Registration Guide; 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 Elections.
Acknowledged by: R
Sign re of Candidate
Date: I o 11VS 43
Primary Telephone Number: 3 _v J
Alternate Telephone Number: ? - IN — )33
E-mail address:
PHONE: 305-466-8901 FAX: 305-466-8919
www.cityofaventura.com