HomeMy WebLinkAboutTreasurer-02.06.2012-Hammerluntexas Ethics Commission P.O. Box 12070 Austin, Texas 78711-2070 (512) 463-5800 (TDD 1-800-735-2989)
APPOINTMENT OF A CAMPAIG31*4-TREASURER FORM CTA
Y A CANDIDATE PG 1
See GTA Instruction Guide for detailed instructions. 1 Total pages filed:
MS/MRS/MR FIRST MI
2 CANDIDATE OFFICE USE ONLY
NAME
' Acct. #
NICKNAME LAST SUFFIX
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Ij
AMMEKLUt4a 5 �
El
3 CANDIDATE ADDRESS / PO BOX; APT/ SUITE #; CITY: STATE; ZIP CODE B 0 (s 20 2
MAILING
ADDRESS
Ci
SecretarV
4 CANDIDATE AREA CODE PHONE NUMBER EXTENSION Date Hand -delivered or Postmarked
PHONE
Date Processed
5 OFFICE Date Imaged
HELD
(if any)
6 OFFICE
SOUGHT
(if known)
7 CAMPAIGN MS/MRSIMR FIRST MI NICKNAME LAST SUFFIX
TREASURER
NAME HK
8 CAMPAIGN STREET ADDRESS (NO PO BOX PLEASE): APT / SUITE #; CITY; STATE: ZIP CODE
TREASURER
STREET
ADDRESS
(residencebusiness}
9 CAMPAIGN AREA CODE PHONE NUMBER EXTENSION
TREASURER
PHONE
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 aw re of the restrictions in title 15 of the Election Code on contributions
from co tons and labor organizations.
Signature of Candidate Date Signed
G® TO PAGE 2
www. ethics. state.tx.us Revised 07/14/2010
Texas Ethics Commission P.O. Box 12070 Austin, Texas 78711-2070 (512) 463-5800 (TDD 1-Rnn.TVii-79RA1
www. ethics. state. tx.us Revised 07/14/2010
CANDIDATE MODIFIED FORM CTA
REPORTING DECLARATION PC3
11 CANDIDATE
NAME
#
12 MODIFIED
REPORTING REPO
R
COMPLETE THIS SECTIO L IF YOU E
DECLARATION
CHOOSING DIFIED REPORTING
®® This declaration must be filed no later than the 30th day before
the first election to which the declaration applies. ee
ee 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.)
ee Candidates for the office of state chair of a political party
may NOT choose modified reporting. ee
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.
1 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