Eric Beam ACTA FormTexas 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
AMEND NT: APPOINTMENT OFA / FOR CTA
1
CAMPAIGN TREASURED BYA CANDIDATE PG 1
1 CANDIDATE
Erl NAME
2 ACCOUNT #
3 Total pages filed:
See ACTH Instruction Guide for detailed instructions.
Use this form for changes to existing information on /y. Do not provide information previously disclosed.
4 CANDIDATE
NEW I MS/MRS ) FIRST MI
OFFICE USE ONLY
NAME
A
Date Received
°r� L
. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
. . . .
NICKNAME SUFFIX
LAST
5 CANDIDATE
NEW ADDRESS /PO BOX; APT / SUITE #; CITY; STATE; ZIP CODE
MAILING
S �Z y �,N! I °%
fA +",�f��U'r� c` -( i0j)
ADDRESS
Dale Hand - delivered or Postmarked
�J
Date Processed
6 CANDIDATE
NEW AREA CODE PHONE NUMBER EXTENSION
PHONE
Date Imaged
7 OFFICE HELD
NEW
(if any)
8 OFFICE
NEW
SOUGHT
(if known)
C) 7
9 CAMPAIGN
NEW MS M MR FIRST MI NICKNAME LAST SUFFIX
TREASURER
NAME
,�y�
// t0 ����, � �•Ire, Jam,
10 CAMPAIGN
NEW STREET ADDRESS (NO PO BOX PLEASE); APT / SUITE #; CITY; STATE; ZIP CODE
TREASURER
STREET
} J �j
S70 c,✓`^e(jcct, C / dJse,k 1`ht z IoVA
ADDRESS
J
(residence or business)
11 CAMPAIGN
NEW AREA CODE PHONE NUMBER EXTENSION
TREASURER
PHONE
l ll 3,p6- � 9 i
12 CANDIDATE
SIGNATURE
I am aware of the Nepotism Law, Chapter 573 of the Texas Government Code.
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 and labor organizations.
/ter /�_ - -2
Signature of Candidate Date Signed
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www.ethics.state.tx.us Revised 07/14/2010