McCaskill ACT 2015APPOINTMENT OF A CAMPAIGN TREASURER FORM CTA
BY A CANDIDATE PG 1
- .
See CTA Instruction Guide for detailed Instructions.
I Total pages filed:
2 CANDIDATE
NAME
MS /MRS /MR FIRST M
` H A Q•4 rJ 1-A •
NICKNAME LAST SUFFIX
NI c CPS VI LA-
OFFICE USE ONLY
Acct. #
Date Received RECEIVED
JAN 2 8 2015 3
OFFICE OF CITY SECRE
3 CANDIDATE
MAILING
ADDRESS
ADDRESS I PO BOX; APT 1 SUITE #; CITY; STATE; ZIP CODE
(2Q 1 (oT[1 pit I .C. (?U)-CL o U lAtl.E IN
- 7420R a
4 CANDIDATE
PHONE
AREA CODE PHONE NUMBER EXTENSION
(Cb i -1 ) ` 1 I ko - p 1 34
`\ I l
Date Hand - delivered or Postmarked
Date Processed
5 OFFICE
HELD
(if any)
Date Imaged
6 OFFICE
SOUGHT
(if known)
C 11+I OF So NTH Li}V.a C (1 CO IJ.r-1 C 1 L P -, --CE o:
CAMPAIGN
TREASURER
NAME
MS /MRS /MR FIRST MI NICKNAME LAST SUFFIX
,/) �f
-- 14- L-A. A . 1" ' . !J F (CH t O -
NA cC✓4-514-1 C`.
8 CAMPAIGN
TREASURER
STREET
ADDRESS
(residence or business)
STREET ADDRESS (NO PO BOX PLEASE); APT I SUITE #; CITY; STATE; ZIP CODE
1 L 091
!!
6 U 1 Po TO I`/IO -C r n
t_ i, 5" -{ )-1 L14- 1�y_7C,4 --7
9 CAMPAIGN
TREASURER
PHONE
AREA CODE PHONE NUMBER EXTENSION
�
e OL) q q a. - $ ' sm
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.
S A------ Af J r - a g t ao 1 5
Signature of Candidate Date Signed
GO TO PAGE 2
Texas Ethics Commission
www.ethics.state.tx.us
P.O. Box 12070
Austin Texas 78711 -2070
512) 463 -5800
TDD 1- 800 -735 -2
Revised 07/14/2010
ARY
Texas Ethics Commission P.O. Box 12070
CANDIDATE MODIFIED
REPORTING DECLARATION
CANDIDATE
NAME
CANDIDATE
NAM E
12 MODIFIED
REPORTING
DECLARATION
Austin, Texas 78711 -2070 (512) 463 -5800 (TDD 1- 800- 735 -2989)
COMPLETE THIS SECTION ONLY IF YOU ARE
CHOOSING MODIFIED REPORTING
•• This declaration must be filed no later than the 30th day before
the first election to which the declaration applies...
FORM CTA
PG 2
•• 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 party
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 election(s) or election cycle to Signature of Candidate
which declaration applies
This appointment is effective on the date it is filed with the appropriate filing authority.
www.ethics.state.tx.us Revised 07/14/2010