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
See CTA Instruction Guide for detailed instructions.
1 Total pages filed:
2 CANDIDATE
MS/ MRS/ MR FIRST MI
NAME
e
OFFICE USE ONLY
1 L b , Acct.#
NICKNAME LAST
SUFFIX
Date Received
1 abinsID) REC, EIVFD
3 CANDIDATE ADDRESS/ PO BOX; APT/ SUITE#; CITY; STATE; ZIP CODE
MAILING
t`-'- 1
I (
i 110 CU_D.• FEB 27 2015ADDRESS W
MC n n-e, 1, TX 75D- 11 •
CITY SECRETARY
4 CANDIDATE AREA CODE PHONE NUMBER EXTENSION Date Hand-delivered or Postmarked
PHONE
j y ) ZAs 3 -El 32- Date Processed
5 OFFICE Date Imaged
HELD
if any)
6 OFFICE
y
SOUGHT
u nC i I AT LLL gif known)
l
7 CAMPAIGN MS/ MRS/ MR FIRST MI NICKNAME LAST SUFFIX
TREASURER
NAME
M I J • 01-e-
paG-(11,- t L. o% i 1& D1,-)
8 CAMPAIGN
STREET ADDRESS ( NO PO BOX PLEASE); APT/ SUITE#; CITY; STATE; ZIP CODE
TREASURER
I DL y LU'(l1Du) T?I.Q_ Dr-STREET
ADDRESS
MC t tntnL ( 1 1
residence or business)
9 CAMPAIGN AREA CODE PHONE NUMBER EXTENSION
TREASURER
PHONE
z
7:
1 - C_ I Dj Z-
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 ofthe Election Code.
I am aware o • - - -
II s in title 15 of the Election Code on contributions
from core• rations and labor oral,nizations.
A 2-Z-) 15
r atur-%Candidate Date Signed
GO TO PAGE 2
www. ethics. state. tx. us
Revised 07/ 14/ 2010