APPOINTIVIENTOF CAMPAIGN TREASURER RECEIVED

AND DESIGNATIONOF CAMPAIGN

DEPOSITORYFORCANDIDATES SEP 0 2 2021
(Section 106. 021(1), F.S.) ^^ ^p ^p^gg
(PLEASEPRINTORTYPE) C(TYCLERK
NOTE: This form must be on file with the qualifying
officer before opening the campaign account. OFFICE USE ONLY
1. CHECK APPROPRIATE BOX(ES):
Initial Filing of Form Re-filing to Change: Q Treasurer/Deputy Q Depository Q Office [-j Party
2. Name of Candidate (in this order: First, Middle, Last) 3. Address (include post office box or street, city, state, zip
code)
John Dugan
451 BayfrontPlace#5511
4. Telephone 5. E-mail address Naples, FL 34102
(239 ) 248-3193 john. dugan. us@gmail. com
6. Office sought (include district, circuit, group number) 7. If a candidatefor a non artisan office, check if
Council Me-.wvb^^ applicable:
Q Myintent isto run asa Write-ln candidate.
8. If a candidatefor a partisan office, check block and fill in name of party as applicable: My intent is to run as a
Write-ln L| No PartyAffiliation Party candidate.
9. 1 have appointed the following person to act as my Campaign Treasurer Q Deputy Treasurer
10. Name of Treasurer or Deputy Treasurer
Mike Stang
11. Mailing Address 12. Telephone
6416 Autumn Woods Boulevard ( 239 ) 398-5654
13. City 14. County 15. State 16. Zip Code 17. E-mail address
Naples Collier FL 34109 mbstang@comcast. net
18. 1 have designated the following bank as my PrimaryDepository Q SecondaryDepository
19. Name of Bank 20. Address
First Integrity Bank 895 5th Ave S
21. City 22. County 23. State 24. Zip Code
Naples Collier FL 34102
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. Signal r of aridi ate

September 2, 2021 ^ u"

27 Treasurer's Acceptance of Appointment (fill in the bla s and check he a propriate block)
^

1. , do herebyaccepttheappointment
(Pl ase Print or Type N me)
designated above as: Campaign Treasurer Deputy Treasurer

September 2, 2021 x
Date gnat re of C mp gn urerorDe uty Treasurer
DS-DE9 (Rev. 10/10) Rule1S-2.0001, F.A.C.