HomeMy WebLinkAboutWirth, Jason_Appointment of Campaign TreasurerAPPOINTMENT OF A CAMPAIGN TREASURER FORM CTA
BY A CANDIDATE PG 1
See CTA Instruction Guide for detailed instructions.
1 Total pages filed:
2 CANDIDATE
MSIMRS/MR FIRST MI
OFFICE USE ONLY
NAME
-37ASa�1
Filer lD#
.. . ............
NICKNAME LAS' . SUFFIX
Dete Racaly
JAN 16 2020
3 CANDIDATE
ADDRESS I PO BOX; APT I SUITE #; CITY; STATE:ZIP CODE
ADDRESS
p
b$ �(�2\2wAy $T Qj�bt.��N 1i, OIoZO
City Secret
Dale Hand-dellvered or Postmarked
4 CANDIDATE
AREA CODE PHONE NUMBER EXTENSION
Recelpl#
Amount$
PHONE
1-0 G7 ., a 5 � �
�5` ��VJ/
Date Processed
5 OFFICE
Date Imaged
HELD
(If any)
8 OFFICE
SOUGHT
'
(If known)
CJ 2-
7 CAMPAIGN
MSIMRS/MR FIRST MI NICKNAME LAST SUFFIX
TREASURER
NAME
`
J CS
8 CAMPAIGN
STREET ADDRESS (NO PO BOX PLEASE); APT ISUITE #; CITY; STATE; ZIP CODE
TREASURER
STREET
ADDRESS
r� '7 Q
(] O is �A 21� sT � OQ�Q0 .3, T� l � to C, V
v V a
(residence or business)
9 CAMPAIGN
AREA CODE PHONE NUMBER EXTENSION
TREASURER
PHONE
J
lJ I
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 ca orations and labor organizations.
- I G - ZC Z0
ure of Candidate Date Signed
GO TO PAGE 2
Forms provided by Texas Ethics Commission www.ethlcs.state.tx.us Revised 12/7/2017
ry
CANDIDATE MODIFIED
REPORTING DECLARATION
11 CANDIDATE
NAME
12 MODIFIED
REPORTING
DECLARATION
FORM CTA
PG 2
COMPLETE THIS SECTION ONLY IF YOU ARE
CHOOSING MODIFIED REPORTING
•• This declaration must be flied no later than the 30th day before
the first election to which the declaration applies. •-
•• 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 political parity
may NOT choose modified reporting. •-
I do not intend to accept more than $500 in political contributions or
make more than $500 in political expenditures (excluding filing fees)
in connection with any future election within the election cycle.
I understand that if either one of those limits is exceeded, I will be
required to file pre -election reports and, if necessary, a runoff
report.
Year of electlon(s) or election cycle to
which declaration applies
Signature of Candidate
This appointment Is effective on the date It is filed with the appropriate filing authority.
TEC Filers may send this form to the TEC electronically at treasa oin ethics.staie.tx.us or
Fax this form to (512) 463-8808 or mail to
Texas Ethics Commission
P.O. Box 12070
Austin, TX 78711-2070
Non-TEC Filers must file this form with the local filing authority
DO NOT SEND TO TEC
For more information about where to file go to:
https://www.ethics.state.tx.0 s/whatsnew/NewF! IersGetting Sta rted. html
Forms provided by Texas Ethics Commission www.ethlcs.state.tx.us Revised 12/7/2017