STATEMENT OF CANDIDATE. X^^^ July 1, Florida Statutes. candidate for the office of city Commissioner District 5 Orlando, FL
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1 STATEMENT OF CANDIDATE (Section , F.S.) (Please Type) OFFICE USE ONLY 1, Ezell Harris candidate for the office of city Commissioner District 5 Orlando, FL have received, read and understand the requirements of Chapter 106, Florida Statutes. X^^^ July 1, 2009 ignature 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 (1)(c), (1), Florida Statutes). DS-DE 84 (Rev. 03/08)
2 STATE OF FLORIDA OFFICE USE ONLY APPOINTMENT OF CAMPAIGN TREASURER AND DESIGNATION OF CAMPAIGN DEPOSITORY FOR CANDIDATES (Section (1 ), F.S.) (PLEASE TYPE) CHECK APPROPRIATE BOX: Original Appointment q Deputy Treasurer q Reappointment of Treasurer Name of Candidate Ezell Harris 1. Address (include post office box or street, city, state, zip code) 804 West Concord Street Orlando, FL Telephone (optional) 2. Part y ( Partisan candidates only) 3. Office (add district, circuit, group number) (407) City Commissioner District 5 I have appointed the following person to act as my Campaign Treasurer 4. Name of Treasurer or Deputy Treasurer Alexander Heard q Deputy Treasurer 5. Mailing Address (If post office box or drawer add street address) 6. Telephone 3333 West South Street 1 (407) City 8. County 9. State 10. Zip Code Orlando Orange Florida I have designated the following named bank as my Primary Depository q Secondary Depository 11. Name of Bank 12. Street Address Bank Of America 390 North Orange Avenue Suite City 14. County 15. State 16. Zip Code Orlando Orange Florida Signature of Candidate _ Date ) Le July 1, 2009 Campaign Treasurer 's Acceptance of Appointment Alexander Heard, do hereby accept the appointment as (Please Print or Type) Campaign Treasurer 11 Deputy Treasurer for the campaign of Ezell Harris who is seeking nomination or election as a Non-Partisan candidate to the office of City Commissioner District 5. UNDER PENALTIES OF PERJURY, I DECLARE THAT I HAVE READ THE FOREGOING CAMPAIGN TREASURER'S ACCEPTANCE OF APPOINTMENT AND THAT THE FACTS STATED ARE TRUE. (Party) July 1, 2009 X lam( ^Wrj Date Signature of Campaign Treasurer or Deputy Treasurer DS-DE 9 (Rev. 01/08)
3 STATE OF FLORIDA APPOINTMENT OF CAMPAIGN TREASURER AND DESIGNATION OF CAMPAIGN DEPOSITORY FOR CANDIDATES (Section (1 ), F.S.) OFFICE USE ONLY (PLEASE TYPE) CHECK APPROPRIATE BOX: Original Appointment q Deputy Treasurer q Reappointment of Treasurer Name of Candidate Ezell Harris 1. Address (include post office box or street, city, state, zip code) 804 West Concord Street Orlando, FL Telephone (optional) 2. Party ( Partisan candidates only) 3. Office (add district, circuit, group number) 407) City Commissioner District 5 I have appointed the following person to act as my q Campaign Treasurer Deputy Treasurer 4. Name of Treasurer or Deputy Treasurer Ezell Harris 5. Mailing Address (If post office box or drawer add street address) 6. Telephone 804 West Concord Street City 8. County 9. State 10. Zip Code Orlando Orange Florida I have designated the following named bank as my El Primary Depository q Secondary Depository 11. Name of Bank 12. Street Address Bank Of America 390 North Orange Avenue Suite City 14. County 15. State 16. Zip Code Orlando 17. Si nature of Candidate Date July 1, 2009 Campaign Treasurer 's Acceptance of Appointment I, Ezell Harris, do hereby accept the appointment as (Please Print or Type) q Campaign Treasurer Deputy Treasurer for the campaign of Ezell Harris who is seeking nomination or election as a Non-Partisan candidate to the office of City Commissioner District.5 UNDER PENALTIES OF PERJURY, I DECLARE THAT I HAVE READ THE FOREGOING CAMPAIGN TREASURER'S ACCEPTANCE OF APPOINTMENT AND THAT THE FACTS STATED ARE TRUE. (Party) J u l y 1, 2009 X Date Si ture of Campaign Treasurer or Deputy Treasurer DS-DE 9 (Rev. 01/08)
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