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160601 - Appointment of Campaign Treasurer - Jerome Horace RektorikTexas 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 1 Total pages filed: See CTA Instruction Guide for detailed instructions. 2 CANDIDATE MS/MRS/MR FIRST MI NAME OFFICE USE ONLY MRr 1/6R4ce-- Rom6 Acct.# NICKNAME LAST SUFFIX Date ReceivedREKToILI , 3 CANDIDATE ADDRESS/PO BOX; APT/SUITE#; CITY; STATE; ZIP CODE MAILING ADDRESS 44-3 7 C Ai mo, I) I R 1 ,Ip Cot tit s -a oK', ifx.„ ,figtb 4 CANDIDATE AREA CODE PHONE NUMBER EXTENSION Date Hand-doliveredorPostmarked PHONE y / f { r o ... JJJ q.-/J'\ n Date Processed 1 5 OFFICE Y Date Imaged HELD if any) J6OFFICELall'ejto 5ff fic1 li; Dj c D C/1'/IA cei 2.SOUGHT J f if known) 7 CAMPAIGN MS/MRS/MR FIRST MI NICKNAME LAST SUFFIX TREASURER Mp NAME t I j;/116 cn ,& ) R,00 8 CAMPAIGN STREET ADDRESS (NO PO OX PLEASE); APT/SUITE#;CITY; STATE; ZIP CODE TREASURER 0 Z n U n`STREET I 1`- 1 ADDRESS L' residence or business)C, 11 .e Ja e 1 01 'l ; e,x-A-5 F-7 V i1- 9 CAMPAIGN AREA CODE PHONE NUMBER EXTENSION TREASURER PHONE q ) 2. 2 i 10 CANDIDATE SIGNATURE lam 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. 1{/Pil Atli--/ te,pfj I-4kt Il 20/Zo• 5' nature of Candidate Date Signed GO TO PAGE 2 www.ethics.state.tx.us Revised 07/14/2010