Barrett, Wayne, treasurer's appt. - 8-24-15Texas Ethics Commission
P.O. Box 12070
Austin, Texas 78711 -2070
512)463 -5800
TDD 1- 800 - 735 -2989
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 /MRSQ FIRST MI
6 Re Y A `/
NICKNAME LAST SUFFIX
•Date
P)Wr e_
OFFICE USE ONLY
Acct. #
ceived
1;4
,
\ 6
3
CANDIDATE
MAILING
ADDRESS
ADDRESS / PO BOX; APT / SUITE #; CITY, STATE; ZIP CODE
780 etklins L Ik»A V /fle -TV %734
4
CANDIDATE
PHONE
AREA CODE PHONE NUMBER EXTENSION
(
c3 , 4 `S' /O
� ° , " •-deli ed or P stmarked
�1� �
��
.. ssed �
r "
1 aged 1 -o c`x
5
OFFICE
HELD
(if any)
al
0,
,ija).4
6
OFFICE
SOUGHT
(if known)
AA ik /OV
7
CAMPAIGN
TREASURER
NAME
M�MRS/MR FIRST MI NICKNAME LAST SUFFIX
6ireeNI
8
CAMPAIGN
TREASURER
STREET
ADDRESS
(residence or business)
STREET ADDRESS (NO PO BOX PLEASE); ( APT / SUITE #; I CITY; STATEE, ZIP CODE
/ I Z 1,� >,C lei F"„ -'j 1- 111�.� -8vil I X 77 S 2
�D
9
CAMPAIGN
TREASURER
PHONE
AREA CODE PHONE NUMBER EXTENSION
WS) 1 g53‘:,
10
CANDIDATE
SIGNATURE
I am aware of the Nepotism Law, Chapter 573 of the Texas Government Code.
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 corporations - d labor organizations.
A I .. ek, i/ lir g -a11—/5
• nature of Candidate Date Signed
GO TO PAGE 2
www.ethics.state.tx.us
Revised 07/14/2010