HomeMy WebLinkAboutDesignations of Campaign Treasurer-Campaign Finance Reports & Filings-Jim Berk -3/9/2006
Texas Ethics Commission
P.O. Box 12070
Austin, Texas 78711-2070
(512) 463-5800
1-800-325-8500
APPOINTMENT OF A CAMPAIGN
TREASURER BY A CANDIDATE
FORM CTA
PG 1
W Total pages filed:
See eTA Instruction Guide for detailed instructions.
W CANDIDATE MS , MRS I MR FIRST t>E19 J~ MI OFFICE USE ONLY
JJ9 m e-.5? e-
NAME Ace!. #
. . . .
NICKNAME LAST SUFFIX o ~ (~ ~n\Yr[] ~
f:j In) CEIC (~ {YJ 12 .
2.J CANDIDATE ADDRESS ,po BOX; APT I SUITE #; CITY: STATE; ZIP CODE
730/ THfirlles rfU:J., J.. ~Q/..~i!.~ vl)le. MAR - 9 2006
MAILING
ADDRESS 7'1. J
7/tJ3tf CITY SECRETARY'S
OFFIr.E
~ CANDIDATE AREA CODE PHONE NUMBER EXTENSION HD 'PM
PHONE (tJ7) i-rS'j ;;)/7b
Date Processed
~ OFFICE HELD NIA Date Imaged
(if any)
W OFFICE SOUGHT I
~ r/Y t OUNc....IL
(if known)
~ CAMPAIGN MS/MRS/MR FIRST MI NICKNAME LAST SUFFIX
rL It vy2 ee I(} ,L S EIZ K. (Y1 (l.5 .
TREASURER
NAME
JJ CAMPAIGN STREET ADDRESS (NO PO BOX PLEASE); APT I SUITE #; CITY; STATE: ZIP CODE
730/ If! f}m e..s Ttlll-/J ~(JtJ..6Y Ul / It 7)t
TREASURER
STREET 7/O,ly(
ADDRESS
(Residence or business)
~ CAMPAIGN AREA CODE PHONE NUMBER EXTENSION
b
TREASURER (C!lJ7) c.ul 217
PHONE
~ I am aware of the Nepotism Law, Chapter 573 of the Texas Government Code.
CANDIDATE
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
tromv::a:SCd la~s ~ )011 J (J"
/ Signature of Candidate D~e Sir/ned
GO TO PAGE 2
r!__ Printed on recycled paper
(Revised 01/14/2004)
Texas Ethics Commission
P.O. Box 12070
Austin, Texas 78711-2070
(512)463-5800
1-800325-8503
CANDIDATE MODIFIED
REPORTING DECLARATION
FORM CTA
PG 2
~
CANDIDATE NAME
~
MODIFIED
REPORTING
DECLARATION
COMPLETE THIS SECTION ONLY IF YOU ARE 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 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.
r~~ Printed on recycled paper
(Revised 01/14/2004)