Hedspetch, Mader, treasurer's appt., 8-17-16Texas Ethics Commission
P.O. Box 12070
Austin, Texas 78711 -2070
512 463-5800
(TDD 1- 800 - 735 -2989)
www.ethics.state.tx.us
Revised 07/14/2010
APPOINTMENT OF A CAMPAIGN TREASURER FORM CTA
BY A CANDIDATE PG 1
See CTA Instruction Guide for detailed instructions.
1 Total pages filed:
2
CANDIDATE
NAME
MS /MRS /MR FIRST MI
/VjaJj' ///M, I '
ati
NICKNAME LAST SUFFIX
,/14.5 t d r e�
OFFICE USE ONLY
Acct. #
Dail' eceived
%1 --i
/ n
�`c
3
CANDIDATE
MAILING
ADDRESS
ADDRESS / PO BOX; APT // SUITE #; CITY, STATE; ZIP CODE lip
ll&li �JQ
j�� �p , / Hnvi/I720 ti .7
4
CANDIDATE
PHONE
AREA CODE PHONE NUMBER EXTENSION
(210 838-3q33 4!1'fl
rat =r -n vered rPostmarked
1
)14
a
.4171/4)
5
OFFICE
HELD
(if any)
174
6
OFFICE
SOU GHT
(if known)
y
CitCouncil Alen er / (/5�0%Z '' 3
7
CAMPAIGN
TREASURER
NAME
MS /MRS/MR FIRST MI NICKNAME LAST SUFFIX
/ ( I Mr ' 17j4s�efcJi
8
CAMPAIGN
TREASURER
STREET
ADDRESS
(residence or business)
STREET ADDRESS (NO PO BOX PLEASE); APT / SUITE #; CITY; STATE; ZIP CODE
12 4\761 77320
9
CAMPAIGN
TREASURER
PHONE
AREA CODE PHONE NUMBER EXTENSION.
(,n 1 O) (33g -3 R /
/
10
CANDIDATE
SIGNATURE
I am aware of the Nepotism Law, Chapter 573 of the Texas
I am aware of my responsibility to file timely reports as
the Election Code.
I am aware of the restrictions in title 15 of the Election Code
from corporations and labor organizations.
Government Code.
required by title 15 of
on contributions
pep 7/x /4
i/ / 1 _,✓ -,,G.ff
Signature of Candidate Sig ried
9 �
GO TO PAGE 2
www.ethics.state.tx.us
Revised 07/14/2010