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- l-MRS/ MR FIRST MI
OFFICE USE ONLY
NAME
P C-{ c r4
Acct.#
NICKNAME LAST SUFFIX
W
in
Date Received
r
3 CANDIDATE ADDRESS / PO BOX; APT/ SUITE#; CITY; STATE; ZIP CODE FR F ° ~I' E D
MAILING
FEB
DDRESS
d
j O t
h) I n G
r hA
T75 O') E[7 26 2015
CITY SECRETARY
4 CANDIDATE AREA CODE PHONE NUMBER EXTENSION Date Hand-delivered or Postmarked
PHONE
I 7-) ) 51, -2 _ 09 1
Date Processed
5 OFFICE
i
t
A Date Imaged
HELD I- 1 vJk0 r%G j { cs E' '"/ l d I,-0 J" 4
if any) 0 0.o
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6 OFFICE
SOUGHT C) 4 J Cc9U/ 1c
I
1" a ) ` I l (
if known) 1
7 CAMPAIGN
MSMARS/ MR FIRST MI NICKNAME LAST SUFFIX
TREASURER
3 0 Mtn
It
711" L e-kC
NAME fi
8 CAMPAIGN
STREET ADDRESS ( NO PO BOX PLEASE); APT/ SUITE#; CITY; STATE; ZIP CODE
TREASURER
STREET S 11' 7 G tro vu w ov d c. 111' I )
Nisi 7 S<i 7/
ADDRESS J
residence or business)
9 CAMPAIGN AREA CODE PHONE NUMBER EXTENSION
TREASURER
PHONE
0 -
7
5 I 9- 23z
10 CANDIDATE
SIGNATURE
lam 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 Candi ate Date Signed
GO TO PAGE 2
www. ethics. state. tx. us Revised 07/ 14/ 2010