HomeMy WebLinkAboutCampaign Treasurer-01.30.2017-Romero, LawrenceTema Fthir f.nrnnniccinn Pr) Rnx'1i070 Altctin TaxaS 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 (led:
See CTA Instruction Guide for detailed instructions.
2 CANDIDATE MSIMR$ MR FIRST MI
OFFICE USE ONLY
NAME
NICKNAME LAST $UFFEX
Data Received
el it n
RECEIVED
3 CANDIDATE
ADDRESS I PO BOX; APT! SUITE#; CITY; STATE; ZIP CODE
MAILING
JAN 3 0 2017
ADDRESS
4 CANDIDATE
AREA CODE PHONE NUMBER EXTENSION
Date Fland-delivered or Postmarked
PHONE
Data Processed
5 OFFICE
Date Imaged
HELD
(if any)
6 OFFICE
SOUGHT
67/A/Q
(it known)
"f+r//!Li err
7 CAMPAIGN
MSIMRIR> FIRST MI NICKNAME LAST SUFFIX
TREASURER
NAME
A
8 CAMPAIGN
STREET ADDRESS (NO PO BOX PLEASE}; APTISUITE#: CITY; STATE; ZIPCODE
TREASURER
STREET
ADDRESS
(residence or business)
AREA CODE FfI61NE NUMBER Jr EXTENSION
9 CAMPAIGN
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.
Signature of Candidate Dat Signed
GO TOPAGE 2
www.ethics.state.U.us Revised 07/14/2010