Donna LusignanRECETv'-
AUG 2 6 2019
APPOINTMENTAND CERTIFICATION OF POLITIC6a� SURER C-1
ti aor L°
Rev. 1/15
01 FOR CANDIDATES AND COMMITTEES
(Please Print or Type)
rs o Pursuant to Section 67-6603(cl), Idaho Code. No contribution shall be received or expenditure made by or on behalf of a
candidate or political committee until he or she appoints a political treasurer and certifies the name and address of the treasurer
to the Secretary of State.
Certification is for (check appropriate box below):
Name of _
[�'ANDIDATE: Candidate:�jj��(//4
HomeWork Cell
Phone: / 9 9`��� �S� Phone: Phone:
Office \ J
Sought:
Candidate T
Mailing address: /03-3 Zt�7- )I-Crk-e�6
Candidate
email address: d6r)V)' k�l c'
Name of
❑ COMMITTEE: Committee:
li Name of Committee
Chairman:
Miscellaneous: El I Home Work Cell
Phone: Phone: Phone:
Measure: ❑ I Committee
Candidate/Measure: ❑ '' Mailing address: -
Chairman
email address:
CERTIFICATION AND APPOINTMENT
I,! ❑: 119I C— dam, do hereby certify and appoint the following individual who is a registered elector of
ame of Candidate or Committee Chairman
the State of Idaho as the political treasurer for the above named candidate or committee:
1 Name of
Political Treasurer:
Home Work Cell
Phone:'a(jg'`�ID'3 -• O p S<(p Phone: Phone: `Zb
1 Treasurer
Please deliver to:
Chris Johnson
City Clerk
City of Meridian
33 E. Broadway Ave.
Suite 104
Meridian, ID 83642
cityclerk@meridiancity.
org
jMailing address: 1
Treasurer ` C
Residence address:.] 23 \-u.\�e c>` w o o c,
Treasurer
email address: ��h� Z�j a IN
ig Can idate o ommittee C airman
I, % -ay ; c-\- , e C.\ -,�x P-- do hereby accept the appointment as political treasurer for
Name of Political Treasurer
the above named candidate or committee. U 0 c
S nature of Political Treasurer