Yvonne ty t. lake - appointment of a campaign treasurer by a candidate - yvonne _ty_ t. lake
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
69MR FIRST
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OFFICE USE ONLY
NAME V
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LAST SUFFIX
1 i ., 1`An Date Received
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CITY; STATE; ZIP CODE
MAILING
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4 CANDIDATE AREA CODE PHONE NUMBER EXTENSION Date Hand- delivered or Postmarked
PHONE
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5 OFFICE
Date Imaged
HELD
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6 OFFICE
SOUGHT
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4
7 CAMPAIGN
MS RS R FIRST MI NICKNAME LAST SUFFIX
TREASURER
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NAME
8 CAMPAIGN
STREET ADDRESS ( NO PO BOX PLEASE); APT/ UITE#;; . CITY; STATE; ZIP CODE
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STREET
ADDRESS Inn j / 1/(
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9 CAMPAIGN AREA CODE PHONE NUMBER EXTENSION
TREASURER
PHONE
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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.
r
Signat = . f Candidate Date Signed
GO TO PAGE 2
www. ethics. state. tx. us Revised 07/ 14/ 2010
