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Appointment Of A Campaign Treasurer By A Specific-Purpose Committee STA - Texas
| Appointment Of A Campaign Treasurer By A Specific-Purpose Committee Form. This is a Texas form and can be used in Ethics Commission Statewide . |
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Texas Ethics Commission P.O. Box 12070 Austin, Texas 78711-2070 (512) 463-5800 (TDD 1-800-735-2989) APPOINTMENT OF A CAMPAIGN TREASURER BY A SPECIFIC-PURPOSE COMMITTEE See STA Instruction Guide for detailed instructions. 2 COMMITTEE NAME Acct. # FORM STA PG 1 1 Total pages filed: OFFICE USE ONLY 3 COMMITTEE ADDRESS ADDRESS / PO BOX; APT / SUITE #; CITY; STATE; ZIP CODE Date Received 4 CAMPAIGN TREASURER NAME MS / MRS / MR FIRST MI HD/PM Date Processed NICKNAME LAST SUFFIX Date Imaged 5 CAMPAIGN TREASURER STREET ADDRESS (residence or business) STREET ADDRESS (NO PO BOX PLEASE); APT / SUITE #; CITY; STATE; ZIP CODE 6 MAILING ADDRESS same as above ADDRESS / PO BOX; APT / SUITE #; CITY; STATE; ZIP CODE 7 CAMPAIGN TREASURER PHONE 8 PERSON APPOINTING TREASURER 9 SIGNATURE AREA CODE PHONE NUMBER EXTENSION ( FIRST ) MI LAST SUFFIX I understand that I have been appointed as the campaign treasurer for this specific-purpose committee and that I am responsible for filing all required reports and that I may be subject to fines for failure to do so. I am aware of the restrictions in title 15 of the Election Code on contributions from corporations and labor organizations. Signature of Campaign Treasurer 10 ASSISTANT CAMPAIGN TREASURER (see instructions) FIRST MI LAST SUFFIX 11 ASSISTANT CAMPAIGN TREASURER ADDRESS 12 ASSISTANT CAMPAIGN TREASURER PHONE ADDRESS / PO BOX; APT / SUITE #; CITY; STATE; ZIP CODE AREA CODE PHONE NUMBER EXTENSION ( ) CONTINUE ON PAGE 2 This appointment is effective on the date it is filed with the commission. www.ethics.state.tx.us Revised 09/01/2003 American LegalNet, Inc. www.FormsWorkFlow.com Texas Ethics Commission P.O. Box 12070 Austin, Texas 78711-2070 (512) 463-5800 (TDD 1-800-735-2989) SPECIFIC-PURPOSE COMMITTEE: PURPOSE AND MODIFIED REPORTING DECLARATION 13 COMMITTEE NAME FORM STA PG 2 14 COMMITTEE PURPOSE SUPPORT CANDIDATE CANDIDATE / OFFICEHOLDER NAME OPPOSE CANDIDATE OFFICE SOUGHT (candidate) / OFFICE HELD (officeholder) ASSIST OFFICEHOLDER BALLOT IDENTIFICATION OF MEASURE / # Month SUPPORT MEASURE DESCRIPTION ELECTION DATE Day Year OPPOSE MEASURE 15 MODIFIED REPORTING DECLARATION COMPLETE THIS SECTION ONLY IF YOU ARE CHOOSING MODIFIED REPORTING. ··This declaration must be filed no later than the 30th day before the first election to which the declaration applies. ·· ··The modified reporting declaration is valid for one election cycle only. ·· (An election cycle includes a primary election, a general election, and any related runoffs.) The committee does not intend to accept more than $500 in political contributions or make more than $500 in political expenditures (excluding filing fees) in connection with any future election within the election cycle. The committee understands that if either one of those limits is exceeded, the committee's campaign treasurer 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 Signature of Campaign Treasurer ATTACH ADDITIONAL COPIES OF THIS FORM AS NEEDED www.ethics.state.tx.us Revised 09/01/2003 American LegalNet, Inc. www.FormsWorkFlow.com
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