Treasurer Appointments

1. Texas Ethics Commission P.O. Box 12070 Austin, Texas 78711- 2070 512) 463-5800 ( TDD 1- 800- 735-2989)
APPOINTMENT OF A CAMPAIGN TREASURER FORM CTA
BY A CANDIDATE PG 1
1 Total pages filed:
See CTA Instruction Guide for detailed instructions.
2 CANDIDATE
MS/ MRS/ MR FIRST MI
OFFICE USE ONLY
NAME
ATI Acct. #
NICKNAME LAST SUFFIX
Date Received
L7J
RECEIVED
3 CANDIDATE ADDRESS / PPO BOX;
APTT//
SUITE#; CITY; STATE; ZIP CODE
MAILING
ADDRESS S L!/
2 f
1 Ff It" 4 , m f` z
0 2014
Mc X—) y 1
6 CITY SECRETARY
4 CANDIDATE AREA CODE PHONE NUMBER EXTENSION
Date Hand- delivered or Postmarked
PHONE
6 Ij
U ) /_ o D Date Processed
5 OFFICE
4J
Date Imaged
HELD
if any)
6 OFFICE
C i- rySOUGHT
r [[
S
TO
IC Zif known) C(/ l ,- C-- / 1 I `-'
7 CAMPAIGN
MS/ MRS/ MR FIRST MI NICKNAME LAST SUFFIX
TREASURER
NAME
DObSo `
8 CAMPAIGN
STREET ADDRESS ( NO PO BOX PLEASE); APT/ SUITE#; CITY; STATE; ZIP CODE
TREASURER
STREET
ADDRESS
io o f
4// L/ Mot,vo .cy 7 -23 6 7
residence or business)
9 CAMPAIGN AREA CODE PHONE NUMBER EXTENSION
TREASURER
PHONE
Lr72 ) s'gz - Limb
10 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 aware of the restrictions in title 15 of the Election Code on contributions
from corporations and labor organizations.
ft.VA
CUIrtr"-
t
3h )y
Signature of Candidate Date Signed
GO TO PAGE 2
www. ethics. state. tx. us Revised 07/ 14/ 2010