Treasurer Certification BirdRECEIVED q�
APPOINTMENTAND CERTIFICATION OF POLITICALTREASURAeri 2 d 2,013 Rev. o w
e FOR CANDIDATES AND COMMITTEES
(Please Print or Type) CITY OF CiVBgZ�,�-
C.TFYCLERKS OFFICE
Pursuant to Section 67-6603(cl), Idaho Code. No contribution shall be received or expenJiture 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 ' /
CANDIDATE: Candidate:/ %
Home /D Work Cell y y��
Phone: — Phone: Phone: Q—.!
----------------- --------------- - .._�----- ------------
Office Seat (if
Sought/ l(�
�eR� applicable)
Candidate
Mailing
Marling address: JA !V -/ Al //l 7c %LCL rn, n � . it. l/ /�7 L'% �% �/%
email address: M PR 1 14 4 �o I?Z -fo IV a
Name of
❑ COMMITTEE: Committee:
Name of Committee
Miscellaneous: ❑ Home Work Cell
Phone: Phone: Phone:
Measure:
❑ Committee
CandidatelMeasure: Mailing address:
❑ —---------- -----------------------
Chairman -
email address:
I, L(l ,,// CERTIFICATION AND APPOINTMENT
a /—�tdo hereby certify and appoint the following individual who is a registered elector of
NX
of of Candidate or Co mittee Chairman
the State of Idaho as the political treasurer for the above named candidate or committee:
Nam
Political
Treasurer:
Home Work Cell
Phone: gg��C�' �� - Phone:_ Phone:
Treasurer
Mailing address_
Treasurer
email address: _ate 1_
l Signature of Candidate or Committee Chairman
S MA-- do hereby accept the appointment as political treasurer for
Name of Political Treasurer
the above named candidate or committee.
r! .a
Signature of Political Treasurer