HomeMy WebLinkAboutMitchell, Ross CTA 2004 Texas Ethics Commission P.O.Box 12070 Austin,Texas 78711-207D (512)463-5800 1-800-325-8506
APPOINTMENT OF A CAMPAIGN FORM CTA
TREASURER BY A CANDIDATE PG 1
i Total pages filed:
See CTA Instruction Guide for detailed instructions. '17
MS/MRS MR FIRST MI OFFICE USE ONLY
2
CANDIDATE ��S 5 Li Acct #
NAME
NICKNAME LAST SUFFIX Date Received
M-TTe-'#Fn L
3 ADDRESS/PO BOX; APT/SUITE t, CRY; STATE, ZIPCODECAN
MAILING �c� $ LGC �`� ✓GESS X �'''�
ADDRESS /
AREA CODE PHONE NUMBER EXTENSION HD/PM
4
CANDIDATE
PHONE \y i7 Z c�' 3 Date Processed
Date Imaged
5
OFFICE HELD
(If any)
6
OFFICE SOUGHT
(if known)
MS/MRS`id � FIRST MI NICKNAME LAST SUFFIX
7
CAMPAIGN
TREASURER r� q
NAME 'S' I1f- 1 � yD �
STREET ADDRESS(NO PO BOX PLEASE), APT/SUITE#; CITY; STATE; ZIP CODE
8
CAMPAIGN
TREASURER
STREET
ADDRESS
(Residence or business)
AREA CODE PHONE NUMBER EXTENSION
9
CAMPAIGN
TREASURER ( I'lye, ) i.E s ? 1
PHONE \
10
CANDIDATE I am aware of the Nepotism Law, Chapter 573 of the Texas Government Code.
SIGNATURE
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 co orations and labor organizations. -
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Signature of Candidate Date Signed
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(Revised 011142004)
7�p� Printed on recycled paper
Texas Ethics Comrnission P.O.Box 12070 Austin,Texas 78711-2070 (512)463-5800 1-800 25-8506
CANDIDATE MODIFIED FORM CTA
REPORTING DECLARATION PG 2
11
CANDIDATE NAME I I
& 1 A 2 E QTcHc--LL
12MODIFIED COMPLETE THIS SECTION ONLY IF YOU ARE CHOOSING MODIFIED
REPORTING REPORTING.
DECLARATION
-• This declaration must be filed no later than the 30th day before the
first election to which the declaration applies. --
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 and candidates for
county 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.
Z 0o S_
Year of elections)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.
��e Pnnted on recycled paper (Redsed01/14/2004)