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HomeMy WebLinkAboutDesignations of Campaign Treasurer-Campaign Finance Reports & Filings-Tom Hart -2/6/2012Texas Ethics Commission P.O. Box 12070 Austin. Texas 78711-2070 (512) 463-5800 (TDD 1-800-735-2989) APPOINTMENT OF A CAMPAIGN TREASURER FoRnn CTA BY A CANDIDATE PG 1 See CTA Instruction Guide for detailed instructions. 1 Total pages filed: 2 CANDIDATE MS/MRS/MR FIRST Mi ~ Yh OFFICEUSEONLY NAME ,y /~ ~ . ~ //~~ Acct # . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . NICKNAME LAST SUFFIX . ~ ~ ~ Date`F~e ~'~ ~~ ~ ~ 4 ~~"~ ~ sil~~ ~ ~~ 3 CAN D I DAT E ADDRESS / PO BOX; APT / SUITE #; CITY; STATE; ZIP CODE ~~ ~~'~ '~ t~~ %~ ~ ~~ ~~ ~ ~ ~ ~~ ~~ ~ ~ MAILING ADDRESS i ~ ~~ ~~nl~j~I ,~ ~ 6 t ~ ~~~~ s~~,~~~r~~~~s c~F~~~ ` ~, ~~ ~ c~ C~//-~/ ~ ~~ ~ ~ ~~..~~~~ ~~~- . 4 CANDIDATE AREA CODE PHONE NUMBER EXTENSION ~ Date Hand-delivered or Postmarked PHONE /"1~~~' `C'-- ^ /~~ %~ \ l_.l ~~~ ~ ~ ~ / ~ I l .~ Date Processed 5 OFFICE HELD ~ ~~ ~~" Datelmaged if an ~~~~ "" ~ ~ ~ A~C' r ~ J Y) ( -.~ T g OFFICE SOUGHT ~ ,~ /' ~ ~ (if known) / ~ ~ c' / ~ ~~~ 7 CAMPAIGN TREASURER MSIMRS/MR FIRST MI NICKNAME ~~ LAST SUFFIX NAME ~ ~ ~ /~ 8 CAMPAIGN STREETADDRESS (NOPOBOXPLEASE); APTlSUITE#; CITY; STATE; ZIPCODE TREASURER ADDRESS ~ ~ J 7 / ~ ~~~'~~~ ~ ~/ ~ ~ ~~ ` ~ (residence or business) 7 /, ~~ ~ cL-CJ 9 CAMPAIGN AREA CODE PHONE NUMBER EXTENSION TREASURER PHONE ! ~~ ( 7 \ C~~~ ~ ~ ~ / ~ ~~ / ~ 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 r strictions in titie 15 of the Election Code on contributions from corporations nd la or organizations. ~ /~ S'gnature of C didate ate Si ned GO TO PAGE 2 www.ethics.state.tx.us Revised 07/14/2010 T..~~ Gthi.•~ r~mmiccinn Pn Rrn ~~mn Austin Texas 78711-2070 (512)463-5800 (fDD 1-800-735-2989) CANDIDATE MODIFIED FoRnn CTA REPORTING DECLARATION PG 2 11 CANDIDATE NAME ~2 MODIFIED COMPLETE THIS SECTION ONLY IF YOU ARE REPORTING DECLARATION CHOOSING MODIFIED REPORTING •• This deciaration 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 c.yGe inGudes a primary election, a general election, and a~y 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. 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. Year of election(s) 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. www.ethics.state.tx.us Revised 07/14/2010 Texas Etflics Commission P.O. Box 12070 Austin, Texas 78711-2070 (512) 465800 1-800325-5506 APPOINTMENT OF A CAMPAIGN TREASURER BY A CANDIDATE FORM CTA PG 1 ,~ Total pages filed: S ee CTA Instruction Guide for detailed instructions. 2 Ms r M r MR / FIRST 'nl OFFICE USE ONLY CANDIDATE ~/~ ~~.~y/,~ ' acct # NAME ~- / (~/' ' ! . NICKNAME LAST SUFFIX Date Received 3 CANDIDATE MAILING ADDRESS ! PO BOX, a.PT /SUITE #: CITY: STATE: ZIP CCDE / '~/ 7 ~~~ ~ "~- ~` EB ~ ZO(l L DDRESS A . ITY ECRETARY'S FI 4 AREA CODE PHONE NUMBER EXTENSION HD/PM CANDIDATE /~~ PHONE /~-f ~~ ~~~ ~ ~ ~ ~ \i Date Processed 5 OFFICE HELD ~ ~ / ~ ` ~ Date Ima ed e (if any) ~ ~C~ !7 ~ 6 OFFICE SOUGHT ~ ~ (if known) ~~ ,(~~'(~~ {, 7 CAMPAIGN TREASURER MS/MRS/M- FIRST MI NICKNAME / ~t~ ~ / // ~ LAST SUFFIX NAME G' / I ~ ; (/` s`~ ------"jj $ STREET F,DDRESS (NO PO BOX PLEASE): ,/7),PT 1 SUITE #: CI?Y. STATE ( / /~ ZIP CODE CAMPAIGN TREASURER 1 / ~ ~ ~ ~' ~~~~ ~ ~~.- STREET ADDRESS .--~"""~ ~~~ (j~ ~~ ~ ~ •;~ ~ ~ ~~ (Residence or business) S ~ ~/ 9 PHONE NUMBER EXTENSION AREA COD E CAEASURER R ~ /^r / ~ ( ~ /1 7 ~J ,_ 3 fir, ~ ~ 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 a s required by title 15 of the Election Code. I am aware of the res rictions in title 15 of the Election Code on contributions from corporations a d labor rganizations. ~_..~.. ~ ~~~ Signature of Candidate Date Signed GO TO PAGE 2 ~;• Printed on recycled paper (Revised Oi/14~20047 Texas Ethics Commission P.O.Box12070 Austin, Texas 78711-2070 (512)46& 1-800-325~Sa06 APPOINTMENT OF A CAMPAIGN FoRnn CTA TREASURER BYA CANDIDATE PG 1 1 Total pages filed: S ee CTA Instruction Guide for detailed instructions. y MS /MRS ! MR FIRST MI OFFICE USE ONLY CANDIDATE /~-/t /~^ / n"L # NAME ~ v,r, ...... . . .... ... .............. ....... . NICKNAME LAST SUFFIX __ pat t ._ ,,,,~a~~T,-~I 1~_~ 'ti.. ~~ 4 ~~ n ~ ..,•, ,.... ._ 3 CANDIDATE ADDRESS / PO BOX; APT /SUITE #; CITY; STATE; ZIP CODE ~ ~ ~ ~ ~~ ~~ ~ ~ _ p FED ~ ~ 2~~b MAILING • ~, ~~ ADDRESS ~/~~~/ //r ,~- ~~~ ,. / ~ / LL^ A 4 AREA CODE PHONE NUMBER EXTENSION HD/PM CANDIDATE PHONE (~/ ~~ ~/ /~ ~/ ~ / 7 Date Processed 5 OFFICE HELD (if an ) //' //~ / Datelmaged y ~ ~-~C/-~/~l[t / / s OFFICE SOUGHT /~ _ //1^/1 / (if known) / ~ {/ / ^< < / VVV 7 MS/MRS/MR FI RST MI NICKNAME / LAST SUFFIX ~ TREASURER ^ ~~' O~Z~j'~~ ~,~y I~ NAME 8 STREET ADDRESS (NO PO BOX PLEASE); APT /SUITE #; CITY; STATE; ZIP CODE CAMPAIGN TREASURER // ~ ~~ /D_ ~/~% / T STREET ADDRESS (Residence or business) n / ' _ I~CG/r1 /~ 8 AREA CODE PHONE NUMBER EXTENSION CAMPAIGN TREASURER PHONE ($/~ ~ ~ ~ 5"~~ O ~ ~ ~~ 10 CANDIDATE I am aware of the Nepotism Law, Chapter 573 of the Texas Government Code. SIGNATURE 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 a d labor organizations. ~~ ~ Signature of Candidate Date Signed GO TO PAGE 2 ~!~ i~~s Printed on recycled paper ~~. (Revised 01/14/2004) Texas Ethics Commission P.O. Box 12070 Austin, Texas 78711-2070 (512)463-5800 100-325-8.506 CANDIDATE MODIFIED REPORTING DECLARATION FORM CTA PG 2 11 CANDIDATE NAME 12 MODIFIED 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. Year of election(s) 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. Cji Printed on recycled paper (Revised 01!14/2004) Texas Ethics Commission P.O. Box 12070 Austin, Texas 78711-2070 (512)463-5800 1 ~06~325-8~`i0G APPOINTMENT OF A CAMPAIGN TREASURER BY A CANDIDATE FORM CTA PG 1 1 Total pages filed: S ee CTA Instruction Guide for detailed instructions. 2 MS /MRS / MR FIRST MI OFFICE USE ONLY '- CANDIDATE NAME ` p ~ ~i~C . / ~TY) . NICKNAME LAST SUFFIX a e ed ! ~~~ s ADDRESS / PO BOX; APT I SUITE #; CITY; STATE; ZIP CODE ,f MAR - 3 2004 CANDIDATE MAILING ~ 7 ~ 7 J~(fC!^/~~ >!~ ADDRESS CITY SECRETARY'S ~~~~~~ ~~~ ~~ ~~ Q OFFICE 4 AREA CODE PHONE NUMBER EXTENSION HDIPM CANDIDATE PHONE ' ' /~ ~ /' ~ / ( b ~ ~ ~ ~/ J Y ( (/ Date Processed 5 OFFICE HELD if /'~ ~ Date Imaged ( any) 6 OFFICE SOUGHT (if known) / /'~ ~~~' ~~ / 'p ~ ~~ /// i' 7 MS/MRS/MR MI NICKNAME LAST SUFFIX FIRST CAMPAIGN ^ ///s' /,~~~~~ ~~ 6y~~ ~~~"`~~~ TREASURER NAME 8 STREET ADDRESS (NO PO BOX PLEASE ); APT I SUITE #; CITY; STATE; ZIP CODE ff ~~ !O~ ~ ~~ ~ TREASURER ` STREET ADDRESS (Residence or business) ~ / ~y ~/-Q / x ~~ 9 AREA CODE PHONE NUMBER EXTENSION CAMPAIGN TREASURER (~ ~ 7) 3 S S'- Q -- PHONE ~ ( J (~ 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 re trictions in title 15 of the Election Code on contributions from corporations a d labor organizations. '~ ©' Signa re of Candidate ate igned GO TO PAGE 2 Printed on recycled paper (Revised 01/1412004) Texas Ethics Commission P.O. Box 12070 Austin, Texas 78711-2070 (512)463-5800 1-SOC>-3~ S.R~ CANDIDATE MODIFIED REPORTING DECLARATION FORM CTA PG Z CANDIDATE NAME 112 MODIFIED 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. Year of election(s) or election cycle to which declaration applies Signature of Candidate This appointment is effective on the date it is filed with the appropriate filing authority. yI~ Nnnted on recycled paper (Revised 01/14/2004)