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
n
I
OFFICE USE ONLY
ills
J
a_c S Acct.#
NICKNAME LAST SUFFIX
Date Received
81f-do
RECEIVED
3 CANDIDATE ADDRESS/ PO BOX; / APT/ SUITE#; CITY; STATE; ZIP CODE
MAILING
ADDRESS 0 4007 J/ L 7 7JV70-zc- FEB 13 2015
C1
CITY SECRETARY
4 CANDIDATE AREA CODE PHONE NUMBER EXTENSION Date Hand- delivered or Postmarked
PHONE
q7?-) G
L
if ly - '56 e, Date Processed
5 OFFICE
is
Date Imaged
HELD
if any)
6 OFFICE
t n ' qSOUGHT
b-t e
M L L i /, J/ pdif known) i/
7 CAMPAIGN
MS/ MRS/ MR ( FIRST / MI NICKNAME LASTLAST//
J
SUFFIX
NAME
TREASURER
f . j0,6ir'V 1' aF /( C l D//1/ V(
8 CAMPAIGN
STREET ADDRESS ( NO PO BOX
ASSEE);
APT/ SUITE#; CITY; STATE; ZIP CODE
y
TREASURERRER
VC lYe. 75o / D
STREET p? D
ADDRESS
residence or business)
9 CAMPAIGN AREA CODE PHONE NUMBER EXTENSION
TREASURER
PHONE 91d) gj 3'y - 5.06 3
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 core. - tions and labo organizations.
L;[_// iA A_
9 9//
fir
fig of Candidate Date Signed
GO TO PAGE 2
www. ethics. state. tx. us Revised 07/ 14/ 2010