HomeMy WebLinkAboutDesignation of Campaign Teasurer-11.18.2021-Wilson-Kirby, JaquitaAPPOINTMENT OF A CAMPAIGN TREASURER FORM CTA
BY A CANDIDATE PG 1
See CTA Instruction Guide for detailed instructions.
1 Total pages filed:
2 CANDIDATE
MS/MRS/MR FIRST MI
OFFICE USE ONLY
NAME
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Filer ID #
V �
NICKNAME LAST SUFFIX
Date R.K4�:CEIVEU
3 CANDIDATE
ADDRESS / PO BOX; APT / SUITE #; CI ; STATE; ZIP CODE
MAILING
ADDRESS
�A
M G ITT. SVC S
�-�
Date Hand -delivered or Postmarked
7 , i
L.
4 CANDIDATE
AREA CODE PHONE NUMBER EXTENSION
Receipt#
Amount$
PHONE
Date Processed
5 OFFICE
Date Imaged
HELD
(if any)
6 OFFICE
SOUGHT
known)
(if
7 CAMPAIGN
MS/MRS/MR FIRST MI NICKNAME LAST SUFFIX
TREASURER
NAME
V h Lti N;0� l
8 CAMPAIGN
STREET ADDRESS; APT / SUITE #; CITY; STATE; ZIP CODE
TREASURER
STREET
ADDRESS�
� � 1
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.
Si re f Candidate Date S ned
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Forms provided by Texas Ethics Commission www.ethics.state.tx.us Revised 4/2/2021