HomeMy WebLinkAboutGipson_Campaign Treasurer_09.24.2014Tavnc Pthirc (.r)mmkzzinn PC) Rr)y 19n70 Austin. Texas 78711-2070 (512) 463-5800 (TDD 1-800-735-2989)
APPOINTMENT OF A CAMPAIGN TREASURER FORM CTA
BY A CANDIDATE PG
1 Total pages filed:
See CTA Instruction Guide for detailed instructions.
2 CANDIDATE
MS/MRSIMR FIRST MI OFFICE USE ONLY
NAMEP_
1,4 "'t T/ Acct. #
NICKNAME . . . . . . LAST. . . . . . . . . . . . . . . SUFFIX
7y' N now
ADDRESS / PO BOX; APT I SUITE CITY; STATE; ZIP CODE 111111111t
3 CANDIDATE
MAILING
ADDRESS
7-
4 CANDIDATE
AREA CODE PHONE NUMBER EXTENSION Date Hand -delivered or Postmarked
PHONE
Date Processed
5 OFFICE
Date Imaged
HELD
(if any)
6 OFFICE
SOUGHT
known)
CLNJAJC-
(if
7 CAMPAIGN
MS/MRS1MR FIRST MI NICKNAME LAST SUFFIX
TREASURER
NAMEmte
MA. Jo-S#vA co cre-
8 CAMPAIGN
STREET ADDRESS (NO PO BOX PLEASE); APT / SUITE iP, CITY; STATE; ZIP CODE
TREASURER
STREETIt/
ADDRESS
( 719
(residence or business)
17
7
9 CAMPAIGN
AREA CODE PHONE NUMBER EXTENSION
TREASURER
PHONE
(.
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.
DatignWd
Signature of Candidate
GO TO PAGE 2
www. ethics.state. tx. us Revised 07/1412010