HomeMy WebLinkAbout191219 -- Appointment of Campaign Treasurer - David FujimotoAPPOINTMENT OF A CAMPAIGN TREASURER FORM CTA
BY A CANDIDATE PG 1
See CTA Ins truction Guide for detailed instructions.
1 Total pages filed :
1..
2 CAND I DATE MS/MRS ~ FIRST Ml OFFICE US E ONLY
NAME Da.~1~ w. ff\r. Fil er ID #
...
NICKNAME LAST SUFF IX
11 Dater eceived " Fu:~ i (ti D ~ -:-~E· "ED f'u.~·,
3 CANDIDATE ADDRESS I PO BOX ; APT I SU ITE #; CIT Y: STATE ; ZIP CODE IJCC 1 9 .. . .
MA I LING l'3Dt C~\-h.t_,.-e
VT: .J: •;pf.?.~ .. 4?.. ADDRESS La.ne...
( o 11 ej e Stet ti()"' TX --.
J Date Hand-delivered or Pos tmarked
71~14'5"
4 CAND IDATE AREA CODE PHONE NUMBER EXTENSION Receipt# I Amount$
PHONE
( 703 ) 4-34-~o91 Date Processed
5 OFF I CE Date Im aged
HELD
(if a n y)
6 OFFICE c 0 lll'5e_ St-a.-\-il) n c ;-\"( Lol-lr' c i \ P\a!'.e_ -& Lt SOUGHT
(if known)
7 CAMPAIGN MS/MRS/MR FIRST Ml NICKNAME LAST SUFFIX
TREASURER
NAME Mr. c_ "°''"' i s-1-~\ie(" D. Lr or.
8 CAMPA I GN STREET ADDRESS (NO PO BOX PLEASE); APT I SU ITE #; CITY; STATE ; ZIP CODE
TREAS U RER 27oi ? i ne ~u. rs-\-c r:
STREET
ADDRESS 8'(10..'0 ) \X ) 11 <&00>
(residence o r business)
9 C AMPA IGN AREA CODE PHONE NUMBER EX TENS ION
TREASURER
PHONE ( i7i ) ~20 -3bl0
10 CANDI DATE
SIGNATURE I am aware of the Nepotism Law, Chapter 573 of the Texas Government Code .
I am aware of m y responsibi l ity to fi le time ly reports as requ i red b y t it le 15 of
the Election Code.
I am aware of the restrictions in title 15 of the E lection Code on contributions
from ~j and labor organizati ons .
~) ~
/z /;'3 h1 .. ~~ ~ -
• I\ ......-""-'
S ignature of Ca ~idate D a te Signed
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Forms provided by Texas Ethics Co mmi ssio n www.ethics.state .tx.u s Rev ised 12/7/2017