PSYPACT- Practicing Over State Lines May 2024.pptx
Jeremiah hammer ammendment appointment of a campaign treasurer by a candidate - jeremiah hammer
1. Texas Ethics Commission P.O. Box 12070 Austin, Texas 78711- 2070 512) 463- 5800 ( TDD 1- 800- 735- 2989)
AMENDMENT: APPOINTMENT OF A FORM ACTA
CAMPAIGN TREASURER BYA CANDIDATE PG 1
I CANDIDATE 2 ACCOUNT# 3 Total pages filed:
NAME
1-
See ACTA Instruction Guide for detailed instructions.
Use this form for changes to existing information only. Do not provide information previously disclosed.
4 CANDIDATE
NEW
I MS/ MRS/ MR FIRST MI
NAME
OFFICE USE ONLY
yv
A h Date Received
NICKNAME LAST ,` SUFFIX
RECEIVED1
5 CANDIDATE
NEW
I ADDRESS/ PO BOX. APT/ SUITE#, CITY; STATE; ZIP CODE
t1AR 0 3 2015
MAILING
C p,
J ®
y
ADDRESS
G"V ' ( 1
mc6 Tx C Tai E FAR I
Date Processed
6 CANDIDATE
NEW
I AREA CODE PHONE NUMBER EXTENSION
PHONE
l
Date Imaged
7 OFFICE HELD NEW I
Of any)
15(
J)
8 OFFICE NEW
I
Jt UC_
SOUGHT
if known)
9 CAMPAIGN
NEW LF MS) MRS/ MR FIRST MI NICKNAME LAST SUFFIX
TREASURER
C—
NAME
In 5* L____
MOM s
10 CAMPAIGN
NEW
I STREET ADDRESS ( NO PO BOX PLEASE); APT/ SUITE#; CITY, STATE; ZIP CODE
TREASURER
9 3 a7) l e.41 L 1
II
7a,/ ?)_ 1 5 aSTREET J t
boo xADDRESS
residence or business)
11 CAMPAIGN
NEW
I AREA CODE PHONE NUMBER EXTENSION
TREASURER
PHONE 3L0) `f3- o L oO
12 CANDIDATE
SIGNATURE I am aware of the Nepotism Law, Chapter 573 of the Texas Government Code.
I am aware of my responsibility to file timely reports as required by title 15 of
the Election Code.
I am away- • i - restrictions in title 15 of the Election Code on contributions
from c• -.•• s and labor organizations.
4 /7- 7/
r.,
A 5
Signature of - -- _----- Date Signed
GO TO PAGE 2
www. ethics. state. tx. us Revised 07/ 14/ 2010
