HomeMy WebLinkAbout191024 - Appointment of Campaign Treasurer - Concerned Citizens of Bryan/College Station Political Action CommitteeAMENDMENT: APPOINTMENT OF A CAMPAIGN FORM ASTA
TREASURER BY A SPECIFIC-PURPOSE COMMITTEE PG 1
See ASTA Instruction Guide for detailed instructions. 1 Total pages filed :
If you are involved in a School District Bond El ection, you must file Form OFFICE USE ONLY
ASTA with the local filing authority BEFORE sending a file-stamped 1 page
copy to the Texas Ethics Commission. Date Received
2 COMMITTEE NAME Concerned Citizens of Bryan/College 3 FILER ID# [RECEIVED
Political Action Committee N/A
4 COMMITTEE I NEw I Concerned Citizens of Bryan/College Station
OCT 2 ,1 /019
NAME Political Action Committee I BY ~ .. :.~-~-~~ .... i ....
5 COMMITTEE ~ ADDRESS I PO BOX: APT I SUITE #; CITY ; STATE; ZIP CODE
ADDRESS
Date Hand-delivered or Postmarked
6 CAMPAIGN ~ MS/MRS/MR FIRST Ml Receipt# I Amount$
TREASURER
NAME Date Pr ocessed
.. . . . . . .. . . . ..
NICKNAME LAST SUFFIX
Date Imaged
7 CAMPAIGN ~ STREET ADDRESS (NO PO BO X PLEASE); APT I SUITE #; CIT Y; STATE ; ZIP CODE
TREASURER
STREET
ADDRESS
(residence or business)
8 CAMPAIGN ~ ADDRESS I PO BOX; APT I SUITE #; CITY; STATE ; ZIP CODE
TREASURER
MAILING
ADDRESS
D same as above
9 CAMPAIGN ~ AREA CODE PHONE NUMBER EXTENSION
TREASURER ( ) PHONE
10 PERSON FIRST Ml LAST SUFFIX
APPOINTING
TREASURER
11 SIGNATURE I understand that I have been appointed as the campaign treasurer for this specific-purpose
committee and that I am responsible for filing all required reports and that I may be subject to
fines for failure to do so . I am aware of the restrictions i title 15 of the Election Code on
con trib utions from corporations and labor organiz Z::"~ _ /
~ A .-
. ~ -,
/ Signature of Campaign Treasurer
12 ASSISTANT I NEW I FIRST Ml LAST SUFFIX
CAMPAIGN
TREASURER
(see instructions)
13 ASSISTANT ~ ADDRESS I PO BOX; APT I SUITE#; CITY ; STATE; ZIP CODE
CAMPAIGN
TREASURER
ADDRESS
14 ASSISTANT ~ AREA CODE PHONE NUMBER EXTENSION
CAMPAIGN
TREASURER ( )
PHONE
GOTO PAGE 2
Forms provided by Texas Ethics Com mis sion www.ethics.state .tx .us Rev ised 10/ 14/2019