Allison HeywardAPPOINTMENT OF A CAMPAIGN TREASURER FORM CTA
BY A CANDIDATE PG 1
See CTA Instruction Guide for detailed instructions.
1 Total pages filed:
2 CANDIDATE
MS Hs y MR FIRST MI
OFFICE USE ONLY
NAME
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Filer ID #
. . ICK . NA . ME . . . . . . . . . . LAST . . . . . . . . . . . . . . . . . SUFFIX . . . . . .
N
Dale Received
,L,A e 1,10 Q. (-� -
6
3 CANDIDATE
ADDRESS / PO BOX, APT / SUITE #, CITY; STATE; ZIP CODE
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MAILING
ADDRESS
2 L-
C� VI =% � I 1( � �
Date Hand-delivered or Postmarked
4 CANDIDATE
AREA CODE PHONE NUMBER EXTENSION
Receipt#
Amount$
PHONE
Date Processed
5 OFFICE
Date Imaged
HELD
(if any)
g OFFICE
SOUGHT
^
Ll
(if known)
1 00 II r
7 CAMPAIGN
MS /I f�k MR FIRST MI NICKNAME LAST SUFFIX
TREASURER
NAME
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L e— VA-
8 CAMPAIGN
STREET ADDRESS (NO PO BOX PLEASE); APT / SUITE tk, CITY; STATE; ZIP CODE
TREASURER
2 Z
STREET
ADDRESS
C —�
(residence or business)
9 CAMPAIGN
AREA CODE PHONE NUMBER EXTENSION
TREASURER
PHONE
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.
am aware of the restrictions in title 15 of the Election Code on contributions
from corporations and labor organizations.
v-
.4i nature of C ndidate Date Signed
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Forms provided by Texas Ethics Commission www.ethics.state . tx.us Revised 12/7/2017