HomeMy WebLinkAboutChuck KelleyAPPOINTMENT OF A CAMPAIGN TREASURER
BY A CANDIDATE
2 CANDIDATE
NAME
3 CANDIDATE
MAILING
ADDRESS
4 CANDIDATE
PHONE
5 OFFICE
HELD
(if any)
6 OFFICE
SOUGHT
(if known)
7 CAMPAIGN
TREASURER
NAME
8 CAMPAIGN
TREASURER
STREET
ADDRESS
(residence orbusiness)
9 CAMPAIGN
TREASURER
PHONE
70 CANDIDATE
SiGNATURE
See CTq Instruction Guide for petailed lnstructions.
MS/MRS/MR FIRST M�
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NICKNAME � � � ��qST � � � � � � � � � � SUFFI%
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A�DRESS/POBOX; APT/SUITEp; CITY; STATE; ZIPCODE
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AREA CO�E PHONE NUMBER EXTENSION
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MSIMRS/MR FIRST MI NICKNAME
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FORM CTA
PG 'I
1p Total pa9es filetl:
'1
OFFICE USE ONLY
�� 101�
CITY SECRETARY'S OFFICE
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�ate Hand-delivered
Date Processed
Datelmagad
LAST SUFFIX
va �i �v�o''
SIHEETAD�RE55 (NOPOBOXPLEASE); APT/SUITEW; CITY; STATE;
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AREA CODE PHON NUMBER EXTENSION
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ZIP
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 re,strigtions;r�title 15 of the Election Code on contributions
from corporat�onsand IabqY,�organizations.
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S�� atureofCandidate / DateSigned��
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Forms provided by Texas Ethics www.ethics.state.tx.us Revised 70/28/2076
CANDIDATE MODIFIED
REPORTING DECLARATION
y1 CANDIDATE
NAME
12 MODIFIED
REPORTING
DECLARATION
FORM CTA
PG L
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 cycie 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.
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.
Vear of election(s) or election cycle [o
which declaration applies
Signature of Candidate
This appointment is effective orr the date it is filed with the appropriate filing authority.
Forms provided by Texas Ethics www.ethics.state.tx.us neviseo �urzor�u ro