HomeMy WebLinkAboutTreasurer Certification Palmer4tiATs o APPOINTMENT AND CERTIFICATION OF POLITICAL TREASUREECEIR�To -1
FOR CANDIDATES AND COMMITTEES 1Ul
(Please Print or Type) JUL 0 9 2013
r�rg a oc' Pursuant to Section 67-6603(cl), Idaho Code. No contribution shall be received or expenditure pP"ftr I oNF a
candidate or political committee until he or she appoints a political treasurer and certifies the name I��`�� e t er
to the Secretary of State. OFFICE
Certification is for (check appropriate box below):
Name o ----------------- ------ l
❑ CANDIDATE: Candidafte:
C
T COMMITTEE:
Miscellaneous: Q
Measure:
Candidate/Measure:
Work Cell
Phone: Phone:
Office Seat (if
Sought: applicable)
Mailing address:
,..-----_ .-------------_--.
Candidate
email address:
Name of
Committee:
Name of Committee
Chairman:
Home
Work
Phone:
Phone:
tee
address:
address:
Cell
Phone:
_ CERTIFICATION AND APPOINTMENT
Name o Candidattee or Committee Chairman
I, � of �rN12� , do hereby certify and appoint the following individual who is a registered elector of
the State of Idaho as the political treasurer for the above named candidate or committee:
RETURN THIS
FORM TO:
Jaycee Holman
City Clerk
City of Meridian
33 E. Broadway Ave.
Meridian ID 83642
(208) 8884433
Fax: (208) 8884218
jholman@merldiancity.org
Name of
Political Treasurer:
Home Work Cell—_ -
Phone: Phone: Phone:Z&-$10—Z 17y
Treasurer `
Mailing address�?jq �j S /'2 �i OQ `�', j(�o
Aa—
[email address
.� Signktpebof Can ' e or Committee Chairman
I, 1 L�UT� v rlHnl 1��, do ointment as political treasurer for
Name of Political Treasurer
the above named candidate or committee.
Signature of Political Treasurer