David McKinneyAPPOINTMENT AND CERTIFICATION OF POLITICAL TREAS�M-, -,:, § C-1
Rev. 1/15
FOR CANDIDATES AND COMMITTEES A
(Please Print or Type) SEP on 8
Pursuant to Section 67-6603(cl), Idaho Code. No contribution shall be received or experkiftarpr cl i.y.or on behalf of a
candidate or political committee until he or she appoints a political treasurer and certifies thd,'baq a
�r,treasurer
to the Secretary of State.
.-
Certification is for (check appropriate box below):
,,e of
El COMMITTEE:
Committee:
Name of Committee
Chairman:
Miscellaneous: Home
Phone:
Measure:
'Committee
Mailing address:
Candidate/Measure:❑
lChairman
email address:
Work
Phone:
CERTIFICATION AND APPOINTMENT
Cell
Phone:
I, do hereby certify and appoint the following individual who is a registered elector of
Name of Candidate or Committee h irm
the State of Idaho as the political treasurer for the above named candidate or committee:
Name of
Political Treasurer: V1
Home Work
Phone: 2 V ttC Phone:
- - - — — -------
Treasurer
Mailing address:
Treasurer
Residence address: 1 2 -7 -5 -
Please remit to:
City Clerk's Office
City of Meridian
33 E. Broadway Ave.
Suite 104
Meridian, ID 83642
(208) 8884433
clerk@merldiancity.org
Treasurer
email address:
Cell
Phone:
&3 6q lo
gnatur'e of Candidate or CAmittee Chairman
do hereby accept the appointment as political treasurer for
Na mb of Political Treasurer
the above named candidate or committee,
V Sig6ture of Politi (1'r easurer