Robbins, Randy CTAAPPOINTMENT OF A CAMPAIGN TREASURER
FORMCTA
BY A CANDIDATE
PG 1
See CTA Instruction Guide for detailed instructions.
I Total pages filed:
2 CANDIDATE
MSiMRS/MR FIRST MI
OFFICE USE ONLY
NAME
ftl /4��
Filer ID #
ADDRESS I PO BOX: APT I SUITE #; -�',ITY: STATE� ZIP CODE
C-or^ _�wfl-jt,L, -t -T� 0 64
[OFFICE 10HITY SECRETARY,l
3 CANDIDATE
ADDRESS
AREA CODE PHONE NUMBER EXTENSION
Irlivered or Postmarked
Receipt # Amount S
4 CANDIDATE
PHONE
C)
Date Processed
Date Imaged
5 OFFICE
HELD
6 OFFICE
SOUGHT
7 CAMPAIGN
MS/MRSIMR FIRST MI NICKNAME
LAST SUFFIX
TREASURER
(A
NAME
8 CAMPAIGN
STREET ADDRESS; APT SUITE CITY;
STATE: ZIP CODE
TREASURER
(residence or business)
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 th r strictions in title 15 ofthe Election Code on contributions
771,
11
Signat�e of Candidate
bate Signed
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Forms provided byTexas Ethics Commission www.*micm.stava,m.ua Revised 1/112024