UHFG Insurance Political Action CommitteerJ`z s
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Rev. 12/18
STATE OF IDAHO
OFFICE OF THE SECRETARY OF STATE
LAWERENCE DENNEY
APPOINTMENT AND CERTIFICATION OF POLITICAL TREASURER
FOR COMMITTEES
(Please Print or Type)
Pursuant to Section 67-6603 (c I), 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.
New Filing ■ Update Filing
Nameof
Committee:UHFG Insurance Political Action Committee
Name of Committee Dennis L. Johnson
Chairman:
Party
Affiliation:
Home Work(208)475 -0921 Cell
Phone: Phone. Phone:
Committee
Mailing Address:PO Box 7777, Meridian, ID 83680
Chairman
email address: djohnson@unitedheritage.com
I, Dennis L. Johnson
do hereby certify and appoint the following individual who is a
Name of Committee Chairman
registered elector of the state of Idaho as the political treasurer for the above named candidate or committee:
CERTIFICATION AND APPOINTMENT
Party: 1 Miscellaneous: ❑- Measure:
Name of
Political Treasurer: J effrey D. N e u m eye r
Home
Phone:
Work (208) 475-0919 Cell
Phone: Phone:
Treasurer PO Box 7777
Mailing Address: ,Meridian, ID 83680
Treasurer 2359 N Parkforest Wy, Eagle, ID 83616
Residence Address:
Treasurer
email address: jneumeyer@unitedheritage.com
.tet
Zignature of Chairman
I, Jeffrey D. Neumeyer do hereby accept the ap itme—nt s political treasurer for the above
Name of Political Treasurer
named candidate. , A
-•�_
f1/1 / Signature o ' Political `f , surer
RETURN THIS FORM TO:
Lawerence Denney Secretary of State Elections Division
PO Box 83720 Boise, ID 83720-0080
(208)334-2852 Fax: (208) 334-2282