HomeMy WebLinkAboutPorterfield, Glenn CTA 2012 Texas Ethics Commission P.O.Box 12070 Austin,Texas 78711-2070 512)463-5800 {TDD 1-800-735-2989
APPOINTMENT OF A CAMPAIGN TREASURER FORM CTA
BY A CANDIDATE PG 1
See CTA Instruction Guide for detailed instructions. 1 Total pages filed:
2 CANDIDATE MS/MRS/MR FIRST MI
NAME
enn Acct.q
OFFICE USE ONLY
Gl
NICKNAME . . . . . * . . .LAST * . . . . . . . . . . . . . SUFFIXPC .
Date R7—
ADDRESS
3 CANDIDATE ADDRESS/PO BOX; APT/SUITE p; CITY; STATE; ZIP CODE VMAILING y�� + -�/ y 50(0 1, I to Good r-U�� I /� 16oB a
4 CANDIDATE AREA CODE PHONE NUMBER EXTENSION Date Hand-delivered or Postmarked
PHONE
Date Processed
5 OFFICEt� qqJ'YDate Imaged
HELD
(if any) I C O U� �Oe4- �---t- 6-
6 OFFICE
SOUGHT -
(if known) C 0 U AJ G(k P� �C9
7 CAMPAIGN MS/MRS/MR FIRST MI NICKNAME LAST SUFFIX
TREASURER (
NAME M(L' c5 roomy C RQyltrin
8 CAMPAIGN STREET ADDRESS(NO PO BOX PLEASE); APT/SUITE M. CITY; STATE; ZIP CODE
TSTREET REASURER So
z- C�zk
ADDRESS
o� SS �C `7�ca39
(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 corpo tions and or or aniz tions.
Signature of Candidate Date Signed
GO TOPAGE 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 1-800-735-2989)
CANDIDATE MODIFIED FORM CTA
REPORTING DECLARATION PG 2
11 CANDIDATE
NAME
12 MODIFIED COMPLETE THIS SECTION ONLY IF YOU ARE
REPORTING
DECLARATION CHOOSING MODIFIED REPORTING
•• 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
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.
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.
__.X I-� —_ /Ij4'Vr If
Year of election(s)or election cycle to Signature of Candidate /
which declaration applies /r
This appointment is effective on the date it is filed with the appropriate filing authority.
www.ethics.state.tx.us Revised 07/14/2010