Tiffany M GibsonAPPOINTMENT OF A CAMPAIGN TREASURER
BY A CANDIDATE
See CTA Instruction Guide for detailed instructions.
2 CANDIDATE MS/MRS/MR FIRST MI
NAME n�
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NICKNAME LAST SUFFIX
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3 CANDIDATE ADDRESS / PO BOX; APT / SUITE #; CITY; STATE; ZIP CODE
MAILING
ADDRESS
4 CANDIDATE
PHONE
5 OFFICE
HELD
(if any)
6 OFFICE
SOUGHT
(if known)
7 CAMPAIGN
TREASURER
NAME
8 CAMPAIGN
TREASURER
STREET
ADDRESS
(residence or business)
9 CAMPAIGN
TREASURER
PHONE
10 CANDIDATE
SIGNATURE
AREA CODE PHONE NUMBER EXTENSION
(3(9o) 02�bbi2
NA
C "I\t OF S Cyf;✓RT j Cf-f-W C00a t r,
MS/MRS/MR FIRST MI NICKNAME
STREET ADDRESS; APT / SUITE #; CITY;
63 q M Ui 100Pt Sjbh%r� f T-X
AREA CODE PHONE NUMBER EXTENSION
(3�b' ) Mq tot Z
FORM C.TA
PG I
1 Total pages filed:
OFFICE USE ONLY
Filer I D #
Date Received
Date Hand -delivered or Postmarked
Receipt# Amount$
Date Processed
Date Imaged
LAST SUFFIX
STATE; ZIP CODE
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 and labor organizations.
CZ-3
Signature of Candidate Date Signed
GO TOPAGE 2
Forms provided by Texas Ethics Commission
vrww.ethics.state.tx.us
Revised 1/1/2023
CANDIDATE MODIFIED
REPORTING DECLARATION
11 CANDIDATE
NAME
12 MODIFIED
REPORTING
DECLARATION
COMPLETE THIS SECTION ONLY IF YOU ARE
CHOOSING MODIFIED REPORTING
FORM C.TA
PG 2
•- This declaration must be filed no later than the 30th day before
the first election to which the declaration applies. --
The modified reporting option is valid for one election cycle only. -•
(An election cycle includes a primary election, a general election, and any related runoffs.)
•• Candidates for the office of state chair of a political party
may NOT choose modified reporting. •-
I do not intend to accept more than $1,010 in political contributions or
make more than $1,010 in political expenditures (excluding filing fees)
in connection with any future election within the election cycle. I
understand that if either one of those limits is exceeded, I will be
required to file pre -election reports and, if necessary, a runoff
report.
Year of election(s) or election cycle to
which declaration applies
ig ature of Candidate
This appointment is effective on the date it is filed with the appropriate filing authority.
TEC Filers may send this form to the TEC electronically at treasappoint(Q ethics. state.tx.us
or mail to
Texas Ethics Commission
P.O. Box 12070
Austin, TX 78711-2070
Non-TEC Filers must file this form with the local filing authority
DO NOT SEND TO TEC
For more information about where to file go to:
https://www.ethics.state.tx.us/filinginfo/QuickFileAReport.php
Forms provided by Texas Ethics Commission
www.ethics.state.tx.us
Revised 1/1/2023