Loading...
Defranc, Kevie 03-29-24- Notice of Intent to Run THE CITY OF BOYNTON BEACH 2025 CANDIDATE NOTICE OF INT_E_NT TO RUN [Candidate's Name: Ke-\� e ayor []District 1 district 3 [Appointment of Campaign Treasurer and Designation of Campaign Depository for Candidates (DS-DE 9) Ensure Candidate signs Block 26 FILED Ensure Campaign Treasurer or Deputy Treasurer signs acceptance �e Ensure form is completely filled out Note: Only one primary and one secondary depository can be designated CITYC LERKRS OFFICE Appointment of Campaign Treasurer and Designation of Campaign Depository for Candidates (DS-DE 9) Ensure Candidate signs Block 26 Ensure Campaign Treasurer or Deputy Treasurer signs acceptance Ensure form is completely filled out Note: Only one primary and one secondary depository can be designated [Statement of Candidate (DS-DE 84) I, Ve,v , , acknowledge receipt of printed copies of the following: Qualifying Information 2023-2025 Calendar of Reporting Dates �/'/Florida Election Code Candidate & Campaign Treasurer Handbook Date: Signature Comments: Checked: f Reviewed: Date: OFFICE USE ONLY STATEMENT OF CANDIDATE FILED (Section 106.023, F.S.) 4t `°; 9 2024 (Please print or type) CITY CLERK'S OFFICE 1, IN;� candidate for the office of LID have been provided access to read and understand the requirements of Chapter 106, Florida Statutes. X ,l (. rQl -- Sigi ature of Candidate ate 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) APPOINTMENT OF CAMPAIGN TREASURER ,. AND DESIGNATION OF CAMPAIGN DEPOSITORY FOR CANDIDATES ` $" 9, (Section 106.021(1), F.S.) (PLEASE PRINT OR TYPE) NOTE: This form must be on file with the filing officer before opening the campaign account. OFFICE USE ONLY 1.CHECK APPROPRIATE BOX(ES): - ❑f 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 PO Box or Street, City, State, Zip Code): (Please Print or Type Name) 31.a �)iE_ u�, cj,, 4bv t Q, beFrqVxC, Bp 0&j., , f::,.L :2-:!)q3S 4. Telephone: 5. Candidate's Voter Registration#: 6. Email Address: ( 1 ) 311- ! '(not required for qualifying purposes) �' 7. Office Sought(include district, circuit, group, or seat#): 8. If a candidate for a nonpartisan office, check the box if applicable: UEAMVV�( ,GL 1 intend to run as a Write-In Candidate. 9. If a candidate for Rartisan office, check the box and fill in the name of the party as applicable: I intend to run as a ❑ Write-In Candidate. o Party Affiliation Candidate. ❑ Party candidate. 10. 1 have appointed the following person to act as my: aCampaign Treasurer ❑ Deputy Treasurer 11. Name of Treasurer or Deputy Treasurer: 12. Telephone: 13. Email Address: ( I ) 317 -7 774, AbL, 14. Mailing Address: 15. City: 16. State: 11-lip Code: 3La( 5E ,( I 13E r_1_1 1 18. 1 have designated the following bank as my (check appropriate box): UPrilmary Depository ❑ Secondary Depository 19. Name of Bank: 20. Address: G-1 � -7 1-�bl �j AVE 21. City: 22. County: 23. State: 24. Zip Code: - -�3 UNDER PENALTIES OF PERJURY,I DECLARE THAT I HAVE READ THE FOREGOING FORM FOR THE APPOINTMENT OF THE CAMPAIGN TREASURER AND DESIGNATION OF THE CAMPAIGN DEPOSITORY AND THAT THE FACTS STATED IN IT ARE TRUE. 26. Signature of Candidate: 25. Date: La I L 27. Treasurer's Acceptance of Appointment(fill in the blanks and check he appropriate box) I, _ do hereby accept the appointment designated above as: (Please Print or Type Name) 5,6`ampaign Treasurer. ❑ Deputy Treasurer. 29. Signature of Campaign Treasurer of Deputy Treasurer 28. Date: DS-DE 9(Eff.10/23) Rule 1S-2.001,F.A.C.