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
f/1 R'u Acct #
NICKNAME LAST SUFFIX
Date Received
wco-
RECEIVED
3 CANDIDATE ADDRESS / PO BOX; APT/ SUITE#, CITY; STATE; ZIP CODE
MAILING
p 30/ 660 BR. Ks utE` 1 /
4/
6-
KtN6Jeyi- rxi ps)7d
FEB ' 6 2015ADDRESS
M
CITY SECRETARY
4 CANDIDATE AREA CODE PHONE NUMBER EXTENSION
Date Hand- delivered or Postmarked
PHONE
Date Processed
5 OFFICE
7 / j a d
Date Imaged
HELD
if any)
6 OFFICE
SOUGHT
j S' l2 i c.71- " j C%4y. Co Rep 21,5 4-1( e
if known)
7 CAMPAIGN
MS/ MRS/ MR FIRST MI NICKNAME LAST SUFFIX
TREASURER
LNAME
f`/2 D AVID J
8 CAMPAIGN
STREET ADDRESS ( NO PO BOX PLEASE); APT/ SUITE#; CITY; STATE, ZIP CODE
STREET
TREASURER `
e 3 G / C D r¢/ L g2LA-rls vy 4.,. i /'/ 1„
erg
T , `?S d S76G
ADDRESS
residence or business)
9 CAMPAIGN AREA CODE PHONE NUMBER EXTENSION
TREASURER
PHONE
7/ 1 cI7 J 9/1J— /+
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.
Signature of Candidate Date Signed
GO TO PAGE 2
www. ethics. state. tx. us Revised 07/ 14/ 2010