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Filing Papers - J Casello CITY OF BOYN ON BEACH CITY CLERK'S OFFICE APPOINTMENT OF CAMPAIGN TREASURER AND DESIGNATION OF CAMPAIGN 16 SEP 23 AH 9. 36 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. OFFICE USE ONLY 1. CHECK APPROPRIATE BOX(ES): X❑ Initial Filing of Form Re-filing to Change: J 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 Joe Casello code) 7981 Shaddock Drive 4. Telephone 5. E-mail address Boynton Beach, FL 33436 (561 ) 602-6400 'VoteJoeCasello@gmail.com 6. Office sought(include district, circuit, group number) 7. If a candidate for a nonpartisan office, check if Boynton Beach City Commission, District 4 applicable: fl 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 Q No Party Affiliation Cll Party candidate. 9. I have appointed the following person to act as my ❑X Campaign Treasurer El Deputy Treasurer 10. Name of Treasurer or Deputy Treasurer Kim LeeBove 11. Mailing Address 12. Telephone 6917 Vista Pkwy North, Suite 1 ( 561 ) 689-9787 13. City 14. County 15. State 16. Zip Code 17. E-mail address West Palm Beach Palm Beach Florida 33411 kim.leebove@gmail.com 18. I have designated the following bank as my ❑X Primary Depository p Secondary Depository 19. Name of Bank 20.Address Wells Fargo 5849 Okeechobee Blvd 21. City 22. County 23. State 24. Zip Code West Palm Beach Palm Beach Florida 33417 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 o Ca did X ? \ 27. Treasurer's Acceptance of Appointment(fill in the blanks and check the appropriate block) Kim LeeBove , do hereby accept the appointment (Please Print or Type Name) designated above as: 0 Campaign Treasurer Deputy Treasurer. 1 /(-213//67x - • • .(r. • Date ignature of Campaign Treasurer or Deputy Treasurer DS-DE 9 (Rev. 10/10) Rule 1S-2.0001, F.A.C. CITY OF BOYNTON 'BEACH CITY CLERKS OFFICE APPOINTMENT OF CAMPAIGN TREASURER AND DESIGNATION OF CAMPAIGN 16 SEP 23 AM 9: 36 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. OFFICE USE ONLY 1. CHECK APPROPRIATE BOX(ES): X❑ Initial Filing of Form Re-filing to Change: 1=1 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 Joe Casello code) 7981 Shaddock Drive 4. Telephone 5. E-mail address Boynton Beach, FL 33436 (561 ) 602-6400 VoteJoeCasello@gmail.com 6. Office sought(include district, circuit, group number) 7. If a candidate for a nonpartisan office, check if Boynton Beach City Commission, District 4 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 u Write-In [] No Party Affiliation ED Party candidate. 9. I have appointed the following person to act as my fl Campaign Treasurer X❑ Deputy Treasurer 10. Name of Treasurer or Deputy Treasurer Joe Casello 11. Mailing Address 12. Telephone 7981 Shaddock Drive ( 561 ) 602-6400 13. City 14.'County 15. State 16.Zip Code 17. E-mail address Boynton Beach Palm Beach FL 33436 VoteJoeCasello@gmail.com 18. I have designated the following bank as my ❑X Primary Depository ❑ SecondaryyDepository 19. Name of Bank 20.Address Wells Fargo 5849 Okeechobee Blvd 21. City 22. County 23. State 24.Zip Code West Palm Beach Palm Beach Florida 33417 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. Sig ature of and'date X ' 27. Treasurer's Acceptance of Appointment(fill in the blanks and check the appropriate block) Joe Casello , do hereby accept the appointment (Please Print or Type Name) designated above as: 0 Campaign Treasurer 0 Deputy Treasurer. 31/ X . Date Signa ure of ampaign Treasurer or Deputy Treasurer DS-DE 9(Rev. 10/10) Rule 1S-2.0001, F.A.C. OFFICE USE ONLY STATEMENT OF CANDIDATE (Section 106.023, F.S.) (Please print or type) I, Joe Casello , candidate for the office of Boynton Beach City Commission, District 4 ; have been provided access to read and understand the requirements of Chapter 106, Florida Statutes. 01 Cr) cp rrl CO rn� 1 ,40 ta X �,3 /(0, rnz r signature of Candidate Da e 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)