Rodriquez, Joe, treas. appt., 7-25-17Texas Ethics Commission
P.O. Box 12070
Austin. Texas 78711-2070
512) 463-5800
DD 1-800-735-2989
APPOINTMENT OF A CAMPAIGN TREASURER FORM CTA
BY A CANDIDATE PG 1
See CTA Instruction Guide for detailed instructions.
11 Total pages filed:
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2
CANDIDATE
NAME
MS/MRS A FIRST MI
J os /9
NICKNAME LAST SUFFIX
nDate
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OFFICE USE ONLY
Acct.
Received
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n
3
3
CANDIDATE
MAILING
ADDRESS
ADDRESS / PO BOX; APT / SUITE #; CITY; STATE; ZIP CODEI
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4
CANDIDATE
PHONE
AREA CODE PHONE NUMBER EXTENSION
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OFFICE
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OFFICE
SOUGHT
(if known)
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CAMPAIGN
TREASURER
NAME
M R R FIRST MI NICKNAME LAST SUFFIX
,
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8
CAMPAIGN
TREASURER
STREET
ADDRESS
(residence or business)
STREET ADDRESS (NO PO BOX PLEASE); APT / SUITE #; CITY; STATE; ZIP CODE
''ff I
X103 TNi.tic247J. bi• t4iNTS ✓i /(a/ Tx %73i O
9
CAMPAIGN
TREASURER
PHONE
AREA CODE PHONE NUMBER EXTENSION
( 93 6) 9-- /
if
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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.
ii_ l Z
Government Code.
required by title 15 of
on contributions
=.0,7
---- 7-2S
Signature of C. Nate Date Signed
GO TO PAGE 2
www.ethics.state.tx.us
Revised 07/14/2010