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.
MS/ MRS/ MR FIRST MI
2 CANDIDATE
n
OFFICE USE ONLY
NAME
fV { j v' t ( 1/) Acct. #
NICKNAME
f
LAST SUFFIX
CAt1 l Iii
Date Received
RECEIVED
3 CANDIDATE ADDRESS / PO BOX. APT/ SUITE#; CITY. STATE; ZIP CODE
MAILING
I
i FEB 26 2015
ADDRESS l v u br.
J CITY SEC/
444 0/4,, - R. ---76)70
RETARY
4 CANDIDATE AREA CODE PHONE NiAt'
SERl
EXTENSION
Date Hand- delivered or Postmarked
PHONE
VI ? -7) / 0 2---
Date Processed
5 OFFICE
Date Imaged
HELD
Vl
4if any)
6 OFFICE
AS
if known) W I)? I i" C Couo6/ ( 4-b ceet--/—
7 CAMPAIGN
MS/ MRS/ MR IRST MI NICKNAME LAST SUFFIX
TREASURER
NAME
15 . 6;0(4 5 11 O
S
8 CAMPAIGN
STREET ADDRESS ( NO PO BOX PLEASE); APT/ SUITE it CITY; STATE, ZIP CODE
TREASURER
STREET
ADDRESS
2 M/ r 7SC 7 /
residence or business)
etl(ut
v4 L `
9 CAMPAIGN AREA CODE PHONE NUMBER EXTENSION
TREASURER
PHONE
17 ) 3t Y` 1S
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 a d lab• r organizations.
Et/ 41
Si.( ature
off
didate Dat Signed
GO TO PAGE 2
www. ethics. state. tx. us Revised 07/ 14/ 2010