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Lee County Supervisor of Elections Candidate Campaign File Cover S Eet

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Lee County Supervisor of Elections Candidate Campaign File Cover S Eet Leo WE Form 11-200S LEE COUNTY SUPERVISOR OF ELECTIONS CANDIDATE CAMPAIGN FILE COVER S EET Candidate Name Mier Ste-( (as it will appear on ballotl 01 b CAroa ^ 4- ( r 1 v -1° And re__ Residence Address /101-4. ?Cr+ /v1 tet5 339 I M Mailing Address 5 41--. -P (If Different) Telephone Number(s) / i (Daytime) 69/ —711-3 I OR Email Address Wisnit tle.vJantni Ikea . Conn Office Sought Lief GOV A-4Ly cker-ye Area, District, Group Or Seat Number Political Party (If Applicable) (Ze pu to i -c-4-A Date Of Birth Or 02_ i Ci - Voter ID # Ic161 Date o 7 _ s ii _ A_ o oTh Candidate Signature ----7-2--7-dr,49--- Candidates who provide an email address may be contacted by this office, via the email address provided by the candidate, for campaign related communications that pertain exclusively to the candidate's campaign. All other mailings from this office, which pertain to every candidate, will be made via United States Postal Service. SCANNED STATE OF FLORIDA APPOINTMENT OF CAMPAIGN TREASURER AND DESIGNATION OF CAMPAIGN DEPOSITORY FOR CANDIDATES Section 106.021(1) FS CHECK APPROPRIATE BOX *PLEASE TYPE OR PRINT q CORIGINAL APPOINTME qDEPUTY TREASURERqREAPPOINTMENT OF TREASURER SECONDARY DEPOSITORY Name of Candidate (AS YOU WANT IT TO APPEAR ON BALLOT) Address (include P 0 Box, street, city, state, zip code) di 0 C4 r--0(: ,14 ( 6,--;v-e M,' K-co Sit( AA. r---/-, Myers ice_ 339 (----) Telet 00 (Daytn5/ I Party (Partisan Candites Only) Office Sought (IncludeAlstrict, c;zurit or .....grosp number /Le& b I , c4A Lee c......ev - _s ker, t" I have appointed the following person to act as my R.Campaign Treasurer q De uty Treasurer Name of Treasurer or Deputy Treasurer Kr IS -171 SC--Mtif Mailing Address (if P 0 Box or drawer add street address) Telephone (Daytime) qt C4r-c(7-4- e Ur , v e 2-39 - 4. 9 t -'2 ca I Cityn- County State Zip Code 4 .-er5f Lee ic-e_ 33 9 (-) I have designated the following named bank as my IWPrimary Depository q Secondary Depository Name ofDank , Street Address Pr i r(o r-, c(4 6,, e .B.44 c 2_2_4, A) -:\ts ( --Ciree i--- City County State Zip Code ( ri--- /-'1 Yews L-e-e let 3 1 Crti I WILL NOTIFY OU OF ANY ADDITIONS OR CHANGES TO THESE APPOINTMENTS F Signature of Candid t Date Sign 9d Voter ID# or Date of Birth u:r m 2-- A 41 k) 01- _ I °I - t 9 to3 X al 1 CAMPAIGN TREASURER'S ACCEPTANCE OF APPOINTMENT `r.. 1, (ir 1_514 Sc--73 74( . do hereby accept the appointment as (Print or Type) „,--4, ' im' SC-0 rt Campaign Treasurer q Deputy Treasurer for the campaign of (Name of Candidate) who is seeking nomination or election as a k-EPEI 6 1:c4-iv candidate to the office of (fluty) (for Partisan Candidates Only) Gee C-ov et 4- \ S" er-C {e . Asa duly registered voter in Z P f County, (Office 4ught) Florida, I am qualified to accept this appointment. UNDER PENA TIES OF PERJURY, I DECLARE THAT I HAVE READ THE FOREGOING CAMPAIGN TREASURER'S ACC OF APPOINTMENT AND THAT THE FACTS STATED ARE T UE. Pr jos 02 Ai a 7 X _ Signature of Campaign Treasurer or Deputy Treasurer Date Signed DS-DE 9 (08/03) This form has been modified for Lee County only (02/05). SCANNED STATE OF FLORIDA APPOINTMENT OF CAMPAIGN TREASURER AND DESIGNATION OF CAMPAIGN DEPOSITORY FOR CANDIDATES Section 106.021(1) FS CHECK APPROPRIATE BOX *PLEASE TYPE OR PRINT ORIGINAL APPOINTME DEPUTY TREASURE REAPPOINTMENT OF TREASURER qSECONDARY DEPOSITORY Name of Candidate (AS YOU WANT IT TO APPEAR ON BALLOT) Address (include P 0 Box, street, city, state, zip code) cy c C4.3--0(,-"4 ( ri- ,if r4:er S C--CD{ 1 . ,L-, rl yeSS r--c._ 339 tTh nelDaytimel, Party (Pfftisan Candidates Only) Office Sought (include district, circuit qr grouggebu er) Tele2; fi. 743/74 a/ Kep/101(C4-A.ConLiof n-- -1 --C4v-- I have appointed the following person to act as my q Campaign Treasurer eputy Treasurer Name of Treasurer or Deputy Treasu Cr x4.`rty Sc—( Mailing Address (if P 0 Box or rawer add street address) Telephone (Dayt lie0. 7443/ , 90 CA,rot.,4 ( 13 r t v-e City County State Zip Code n /e7L ri iers 4 €e iet_ 339 7 I have designated the following named bank as my g--151-imary Depository NI Secondary Depository !.:-4 Name of Bank Street Address -11 /eye ,- ,,,e4 6 „ 1 ( BA-4 K- I-11 2_,-/-1 (-) - ic74-..s 1 Ere e -(- ,.. City County State Zip Code 339 k rac ,C)L . rtiyeSS. L-et GC_ 0 I WILL NOTIFY YOU OF ANY ADDITIONS OR CHANGES TO THESE APPOINTMENTS — Signature of Candidat Date Signed Voter ID# or Date of Birth 0-) X 2-1(1 -, o-2... _ iq _ i 943 co I c in CI ri CAMPAIGN TREASURER'S ACCEPTANCE OF APPOINTMENT m c. I, t4: Kr 3 CArt4( , do hereby accept the appointment as (Print or Type) Campaign Treasurer A-15eputt' Treasurer for the campaign of • "1/1 fc /gr 3 c_. r( (Name of Candidate) n who is seeking nomination or election as a elopJ to i7c-r candidate to the office of (Partf) (for Partisan Candidates Only) L-et a...4 Sitet-T. #9( . Asa duly registered voter in Z ,.- -Is County, (04Sought) Florida, I am qualified to accept this appointment. UNDER PENALTIES OF PERJU I DECLARE THAT I HAVE READ THE FOREGOING CAMPAIGN TREASURER'S ACC AN APPOINTMENT AND THAT THE FACTS STATED ARE TRUE. X 1- 7,-S-7 Signature of Campaign Treasurer or Deputy Treasurer Date Signed DS-DE 9 (08/03) This form has been modified for Lee County only (02/05St . ANNEL STATEMENT OF CANDIDATE LEE COUNTY - FLORIDA FLORIDA STATUTE CHAPTER 106.023 Each candidate must file a statement of candidate with the qualifying officer within 10 days after he files his Appointment of Campaign Treasurer and Designation of Campaign Depository. Willful failure to file this form is a violation of FS 106.19(1)(c) and FS 106.25(3). STATEMENT OF CANDIDATE PLEASE PRINT /4; ke Sc-c.11 • a candidate for the office of Name of Candidate . have received, read, and Office Sought (include‘Cstrict, circuit, or group number) *understand the requirements of Chapter 106, Florida Statutes. 2— 7, c7/0 Signature of Candidate Date Signed The execution and filing of the statement of candidate does not in and of itself create a presumption that any violation of this chapter or Chapter 104 is a willful violation as defined in s. 106.37. MAIL TO: DELIVER IN PERSON: Qualifying Officer Lee County Constitutional Complex Lee County Elections Office Lee County Elections Office3rd Floor P 0 Box 2545 2480 Thompson Street Fort Myers FL 33902-2545 Fort Myers FL 33901 SHARON L. HARRINGTON Supervisor of Elections Lee County - Florida 239 LEE VOTE 239-533-8683 DS-DE 84 (09-2005) SCANNED OFFICE USE ONLY LOYALTY OATH CANDIDATES WITH PARTY AFFILIATION (Sections 876.05-876.10, Florida Statutes) STATE OF FLORIDA I CC COUNTY : rii Ke see.-43 , First Name Middle Name/Initial Last Name : a citizen of the State of Florida and of the United States of America, ... and a candidate for public office ... do 1/4 hereby solemnly swear or affirm that I will support the Constitution of the United States and of the State of -. Florida. OATH OF CANDIDATE (Section 9.021, Florida Statutes) ft, SCACI (PLEASE PRINT NAME AS YOU WISH IT TO APPEAR 0 THE BALLOT — NAME MAY NOT BE CHANGED AFTER me END OF QUALIFYING) am a candidate for the office of 5 en (office) (district) (circuit) . I am a qualified elector of 2 (6 County, Florida. I am qualified (group) under the Constitution and the Laws of Florida to hold the office to which I desire to be nominated or elected. I have qualified for no other public office in the state, the term of which office or any part thereof runs concurrent with the office I seek; and I have resigned from any office from which I am required to resign pursuant to Section 99.012, Florida Statutes. STATEMENT OF PARTY (Section 99.021, Florida Statutes) I am a member of the ef pv4 I c-cAti. party. I am not a registered member of any other political party and have not been a candidate for nomination for any other political party for a period of 6 months preceding the general electio I • r which I seek to qualify. I have paid the assessment levied against me, if any, as a candidate for said b the executive committee of the political party, of which I am a member. ei:Ke tED “Iewelitlitge WI ) 6Q (-)ta I , C0". Signature of Candidate Daytime Telephone Number Email Address ci 0 C4ror4 4 ( ar . n aarlyers CC vqg Address City State ZIP Code Sworn to (or affirmed) and subscribed before me this El day of urte. , 200%. Personally Known: DC' or _. A A — CSai "• 1 .4t .a_.. Produced Identification: Signs ure of Notary Public – State of Florida Print, Type or Stamp Commissioned Name of Notary Public Type of Identification Produced: DENISE IC MCKENNA St: tri .r. MY COMMISSION* DD70084Re ANNED .......--4-,1 .. December', 2011 I d CI aal 303 2,,s' NM{ 11104D IHRU TROY FAIN INS DS-DE 24 (Rev.
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