Williamson ACT 2020r
APPOINTMENT OF A CAMPAIGN TREASURER FORM CTA
BY A CANDIDATE PG 1
See CTA Instruction Guide for detailed instructions.
3 Total pages fled:
2 CANDIDATE
NAME
MS IMRS/MR FIRST MI
OFFICE USE ONLY
r
RECEIVED
Date Received
NICKNAME-ASTl J%
9
SUFFIX
C\ lM 1f
JAN 1 6 2020
3 CANDIDATE
MAILING
ADDRESS //PO BOX; APT/SUITE #; CITY; STATE; ZIP CODE
Va IADDRESS
cw t f Iw IVO 7( v0 "
OFFICE OF CITY SECRETAR
a stmad/ce
1tl
J1
4 CANDIDATE AREA CODE PHONE NUMBER EXTENSION Receipt# Amcuni$
PHONE
Date Processed
5 OFFICE
Date Imaged
HELD
if any)
8 OFFICE
SOUGHT UAI w
if known)
UU
7 CAMPAIGN
TREASURER
MS/MRS/MR FIRST MI NICKNAME
Any
LAST SUFFIX
NAME urf.
8 CAMPAIGN
STREET ADDRESS (NO PO BOX PLEASE); APT SUITE#; CITY; STATE; ZIP CODE
TREASURER n /..1 4GDG
STREET
ADDRESS
VV (
i j_ _ L
residence or business)
9 CAMPAIGN AREA CODE PHONE NUMBER EXTENSION
TREASURER
PHONE
D/
to 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.
lit
Signature of Candidate Date Signed
GO TO PAGE 2
Forms provided by Texas Ethics Commission www. ethics. state.tx. us Revised 12/6/2019