HomeMy WebLinkAboutCampaign Treasurer -03.11.2019- Triggs,MichaelAMENDMENT: APPOINTMENT OF A FORM ACTA
CAMPAIGN TREASURER BYACANDIDATE PG 1
1 CANDIDATE 2 FILERID# 3 Total pages fled -
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See ACTA Instruction Guide for detailed instructions.
Use this form for changes to existing information only. Do not provide information previously disclosed.
4 CANDIDATE
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OFFICE USE ONLY
NAME
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Date f3voenre F
NICKNAME LAST SUFFIX
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5 CANDIDATE
NEW ADDRESS / PO BOX; APT / SUITE #; CITY; STATE; ZIP CODE
MAILING
ADDRESS
If
Date A .tma
633
Receipt# Amount$
Date Processed
6 CANDIDATE
tlE ^.V AREA CODE PHONE NUMBER EXTENSION
Date Imaged
PHONE
7 OFFICE HELD
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(if any)
8 OFFICE
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SOUGHT
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(if known)
9 CAMPAIGN
N!+.^.' MS/M /MR FIRST MI NICKNAME LAST SUFFIX
TREASURER
NAME
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10 CAMPAIGN
NEW STREET ADDRESS (NO PO BOX PLEASE); APT! SUITE #; CITY; STATE; ZIP CODE
TREASURER
STREET
-
or
ADDRESS
(residence or business)
11 CAMPAIGN
Nr -W
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12 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.
A
gig nature a Candidate Date Signed
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Forms provided by Texas Ethics Commission www.ethics,state.tx.us Revised 12/7/2017