HomeMy WebLinkAboutCFR_02.19.2016_BoydstunAPPOINTMENT OF A CAMPAIGN TREASURER FORM CTA
BY A CANDIDATE
PG 1
See CTA Instruction Guide for detailed instructions.
I Total pages filed:
2 CANDIDATE
MS/MRS/MR FIRST
MI OFFICE USE ONLY
NAME
he�, 0.
Acct. #
LAST LAST
SUFFIX
ADDRESS I PO BOX; APT I SUITE #; CITY; STATE;
Date Received
ZIP CODE
3 CANDIDATE
MAILING
ADDRESS
L'4'
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4 CANDIDATE
AREA CODE PHONE NUMBER EXTENSION
DatisHand-deliv!re
,A Postmarked
PHONE
(
Date Processed
5 OFFICE
Date Imaged
I
HELD
(if any)
6 OFFICE
SOUGHT
C'e> tA IN C! ]Mpm�, eD1;4rid
(if known)
7 CAMPAIGN
MS/MRS/MR FIRST MI NICKNAME
LAST SUFFIX
TREASURER
A
ENVY) C
goyd5*Q'I
NAME
8 CAMPAIGN
STREET ADDRESS (NO PO BOX PLEASE): APT I SUITE CITY;
STATE; ZIP CODE
TREASURER
, Ge0-r!vej`-w- 7 -78 4 -
STREET
ADDRESS
(residence or business)
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.
Date Signed
Signature of (:!Sndidate
GO TO PAGE 2
www.ethics.state.tx.us Revised 07/14/2010
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CANDIDATE MODIFIED FORM CTA
REPORTING DECLARATION PG 2
11 CANDIDATE
NAME
12 MODIFIED
REPORTING COMPLETE THIS SECTION ONLY IF YOU ARE
DECLARATION CHOOSINGMODIFIED REPORTING
The modified reporting option is valid for one election cycle only.
(An election cycle includes a primary election, a general election, and any related runoffs)
Candidates for the office of state chair of a pocal party
may NOT choose moded reporting. --
0 001
mww"1001111 W-11 -11' 111 -1
I u1noersianT inalf IT liner one or Muse ArTIN5 Is excEM-17-5k 0
required to file pre-election reports and, if necessary, a runoff
report.
Year of election(s) or election cycle to Signature of Candidate
which declaration applies
www. ethics. state. tx. us Revised 07/14/2010