Gordon, Golene 10-21-24- Amendment to Notice of Intent to Run APPOINTMENT OF CAMPAIGN TREASURER
AND DESIGNATION OF CAMPAIGN FILED
DEPOSITORY FOR CANDIDATES
(Section 106.021(1), F.S.)
OCT 21 2024
(PLEASE PRINT OR TYPE)
CITY CLERK'S OFFICE
NOTE: This form must be on file with the filing officer before
opening the campaign account. OFFICE USE ONLY
1. CHECK APPROPRIATE BOX(ES):
❑■ Initial Filing of Form i 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) 1500 GATEWAY BLVD. STE 220
GOLENE GORDON BOYNTON BEACH, FL, 33426
4. Telephone: 5. Candidate's Voter Registration #: 6. Email Address:
(561 ) 853-5959 109786189
E l e ctG g o rd o n@ G m a i I.C O M
(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
Commissioner District 1 if I intend
table:
❑ to run as a Write-In Candidate.
9. If a candidate for=bun office, check the box and fill in the name of the party as applicable: I intend to run as a
Write-In Candidate. ■
❑ ❑ No Party Affiliation Candidate. ❑ Party candidate.
10. I have appointed the following person to act as my: CI Campaign Treasurer ❑ Deputy Treasurer
11. Name of Treasurer or Deputy Treasurer: 12. Telephone: 13. Email Address:
Golene Golene (561 )853-5959 ELECTGGORDON@GMAIL.COM
14. Mailing Address: 15. City: 16. State: 17. Zip Code:
1500 Gateway Blvd Ste 220 Boynton Beach FL 33426
18. I have designated the following bank as my (check appropriate box): ❑■ Primary Depository ❑ Secondary Depository
19. Name of Bank: 20. Address:
Wells Fargo 200 N Congress AVE
21. City: 22. County: 23. State: 24. Zip Code:
Boynton Beach Palm Beach FL 33426
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:
M/2/!?
2/ A? v (
27. Treasurer' Acceptance of Appointment (fill in the blanks and check the appropriate box)
GOLENE GORDON do hereby accept the appointment designated above as:
(Please Print or Type Name)
❑■ Campaign Treasurer. ❑ Deputy Treasurer.
29. Signature of Campaign reasurer or Deputy Treasurer
28. Date: /1/4//d--,/ v
DS-DE 9 (Rev.09/23) /` Rule 1S-2.0001, F.A.C.
OFFICE USE ONLY
STATEMENT OF
CANDIDATE FILED
(Section 106.023, F.S.) OCT 21
2u24
(Please print or type)
CITY CLERK'S OFFICE
1, GOLENE GORDON
candidate for the office of CITY COMMISIONER DISTRICT 1 ;
have been provided access to read and understand the requirements of
Chapter 106, Florida Statutes.
X ( r lD g/ a
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)
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