DSDE9 Appointment of Campaign Treasurer- MeltzAPPOINTMENT OF CAMPAIGN- TREASURER-
AND DESIGNATION OF CAMPAIGN
DEPOSITORY FOR CANDIDATES
(Section 106.021(1), F.S.)
(PLEASE PRINT OR TYPE)
J
NOTE: This form must be on file with the qualifying
02-12-19 1 4 : 5 8 R C V D {`
officer before oeening the campaign account.
OFFIC USE ONLY
1. CHECK APPROPRIATE BOX(ES):
0 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
Jonathan Meltz
code)
157 NE 104 Street, Miami Shores, FL 33138
4. Telephone
5. E -mail address
(305 ) 757 -9677
Jmeltz @meltzlaw.com
6. Office sought (include district, circuit, group number)
7. If a candidate for a nonpartisan office, check if
Miami Shores Village Council
applicable:
❑ My intent is to run as a Write -In candidate.
8. If a candidate for a ap rtisan 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 0 Campaign Treasurer Deputy Treasurer
10. Name of Treasurer or Deputy Treasurer
Jonathan Meltz
11. Mailing Address
12. Telephone
157 NE 104 Street
( 305 ) 757 -9677
13. City
14. County
15. State
16. Zip Code
17. E -mail address
Miami Shores
Miami -Dade
FL
33138
Jmeltz @meltzlaw.com
18. 1 have designated the following bank as my ❑X Primary Depository Secondary Depository
19. Name of Bank 20. Address
Bank of America- 94-99 -NE 2nd-Avenue
21. City
22. County
23. State
24. Zip Code
Miami Shores
Miami -Dade
FL
33138
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 -
2/7/19
X k(ec '*
27. Treasurer's Acceptance of Appointment (fill in the blanks and check the appropriate block)
I Jonathan Meltz do hereby accept the appointment
(Please_ Printor. Tye Name)
.
designated above as: X❑ Campaign Treasurer Deputy Treasurer
k4
2/7/19 X
Date Signature of Campaign Treasurer or Deputy Treasurer
DS -DE 9 -(Rev. 11)110)- Rule -1.S- 2.0.0-0-1,_ F.A_C�