Conservation Voters of Idaho (Updated 12-17-19)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 (c1), 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 apolitical treasurer and certifies the name and address of the treasurer to the Secretary of State.
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Name of
Committee: Conservation Voters for Idaho
Action Fund
Name of Committee
Rialin Flores
Party
Chairman:
Affiliation:
Home Work 208-342-1264
Phone: Phone:
Cell 208-371-8183
Phone:
Committee
Box 2802, Boise Idaho
83701
Mailing Address:PO
Chairman
email address:rialin@cvidaho.org
I Rialin Flores 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: Miscellaneous: Measure: ❑
Name of
Political Treasurer:Rialin Flores
Home Work 208-342-1264 Cell 208-371-8183
Phone: Phone: Phone:
Treasurer PO Box 2802
Mailing Address: ,Boise Idaho 83701
Treasurer
Residence Address: 1311 W Dundee, Boise Idaho 83706
Treasurer
email address:rialin@cvidaho.org
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C4- ;-yte' 2�
Signature of Chairman
I, F 1 Pr% -'t J yuoy-t5 do hereby accept the appointment a olitical treasurer for the above
Name of Political Treasurer 4��
named candidate.
Signature of Political Treasurer
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