100816 - Appointment of Campaign Treasurer - John Nichols i
Texas Ethics Commission P.O.Sox 12070 Austin,Texas 78711-2070 (512)463 U= 1-800,325-8
APPOINTMENT OF A CAMPAIGN FORM CTA F
` TREASURER BYA CANDIDATE PG �
Total pages filed:
See CTA Instruction Guide for detailed Instructions. ?J
i MS/MRSfMR FIRST MI '' .'-
�O�x YI OFFICE USE ONLY
{�'CANDIDATE � /
NAME Acct. s
NICKNAME LAST SUFFIX Date Received
!
ADDRESS!PO BOX: APT!SUITE#; CITY; STATE', ZIP CODE BAN
3
CANDIDATE
DELIVERED
d I] AREA CODE PHONE NUMBER EXTENSION HDIPM
� CANDIDATE
PHONE (
Data Processes!
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OFFICE HELD
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(If any) i
61
OFFICE SOUGHT C 01�� , � CQ 6`l4 r4L4-1-GF
(it known) C
7 MS/MRSIMR FIRST MI NICKNAME MST SUFFIX ,I
CAMPAIGN .�
TREASURER S �Q�t� 19
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NAME
STREET ADDRESS(NO PO 13OX PLEASE); APT!SUITE#; CITY; STATE; DP CODE I 1
CAMPAIGN
TREASURER
STREET ��
ADDRESS
(Residence or business)
e I AREA CODE PHONE NUMBER EXTENSION
J CAMPAIGN
TREASURER
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 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 cor orations a ;1abor organizations. -
�r1 2��rG�
Signature of Candidate �Date Signed
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(Revised 011142004)