HomeMy WebLinkAboutCampaign Treasurer - Ross - 07.11.2013Texas Ethics Commission P.O. Box 12070 Austin, Texas 78711-2070 (512) 463-5800 (TDD 1-800-735-2989)
APPOINTMENT OF A► CAMPAIGN TREASURER FORM CTAT,
BY A CANDIDATE
PG 'I
See CTA Instruction Guide for detailed instructions.
1 Total pages filed:
2
CANDIDATE
MsIMRS /MR FIRST MI
OFFICE USE ONLY
NAME----
Mr. Loyd D.
Acct. #
..........................
NICKNAME LAST SUFFIX
Dale RossEICM
a.
ADDRESS / PO BOX; APT / SUITE #; CITY; STATE, ZIP CODE
JUL 112013
3 CANDIDATE
MAILING
Georgetown TX 78626
ADDRESS
4
CANDIDATE
AREA CODE PHONE NUMBER EXTENSION
IF
ate an -
PHONE
Date Processed
5
OFFICE
Date Imaged
HELD
Georgetown City Council - District 6
(if any)
6
OFFICE
SOUGHT
Mayor - City of Georgetown
(if known)
7
CAMPAIGN
MS/MRS/MR FIRST MI NICKNAME
LAST SUFFIX
TREASURER
NAME
Ms. Mary B Mickie
Ross
8
CAMPAIGN
STREET ADDRESS (NO PO BOX PLEASE); APT / SUITE #; CITY; STATE;
ZIP CODE
TREASURER
Georgetown TX
78626
STREET
ADDRESS
(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 the restrictions in title 15 of the Election Code on contributions
from corp tions andjqbor organizations.
0 7
Signature of Candidate
Date Signed
GO TO PAGE 2
www. ethics. state. tx.us Revised 07/14/2010
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