HomeMy WebLinkAboutCampaign Teasurer -01.25.2017-Kahn,SherwinA—fs- r . 7R711_9n7n 15121463-5800 (TDD 1-800-735-2989)
Texas Ethics commission r.v. ous . c.I v --'- I- -
APPOINTMENT OF A CAMPAIGN TREASURER FORM CTA
BY A CANDIDATE PG 1
1 Total pages fled:
See CTA Instruction Guide for detailed instructions.
2 CANDIDATE
NAME
MS/MRS( FFIRST, `' 1/� RI
OFFICE USE ONLY
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Acct.
. . . . . . . .LAST SUFFIX
N IC
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V
DateReceived
3 CANDIDATE
ADDRESS /PO BOX; APT/SUITE#; CITY; STATE; ZIP CODE
MAILING
ADDRESS
�a- �
4 CANDIDATE
AREA CODE PHONE NUMBER EXTENSION
Date Hand -delivered or Postmarked
PHONE
Date Processed
Date Imaged
5 OFFICE
HELD
1
'N)
(if any)
6 OFFICE
SOUGHT
(if known)
7 CAMPAIGN
TREASURER
LAST SUFFIX
MSIMRSf1 FIRST MI NICKNAME LAST
.{'� I\
NAME
I 11
L/t%�-�Q-�%� �o
CJC
6 CAMPAIGN
STREET ADDRESS (NO PO BOX PLEASE); APT / SUITE #, CITY: STATE; ZIP CODE
TREASURER
'(`--�'
(residence or business)
1/
9 CAMPAIGN
TREASURER
AREA CODE PHONE NUMBER EXTENSION
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 porations 7d labor organizations.
I l GS' �?
65��=
Signature of Candidate Date Signed
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