Political Treasurer Joki RevAPPOINTMENT AND CERTIFICATION OF POLITICALTREASIJ] CEIV . 7
FOR CANDIDATES AND COMMITTEES ofev7
(Please Print or Type)
CITY OFGi,Ce mraN
Pursuant to Section 67-6603(c1), Idaho Code. No contribution shall be received or expend e�yE§015 1411of a
candidate or political committee until he or she appoints a political treasurer and certifies the name an address o he treasurer
to the Secretary of State.
Ce ification is for (check appropriate box below):
Name of ��� �I• ------
CANDIDATE: Candidate:
Home 'l Q//�7`�'')L�}j Work Cell
Phone: U • �32 Phone: �' �1�j� Phone:�g�2
Offce /� �cp+1 I Seat 111
Sought: 1 1—_applicable) -- -------
Candidate l q
Mailing address:
Candidate
—_!o —�-- Ste' �L�•' ' �----
email address: p
❑ COMMITTE
Miscellaneous:
Measure:
Candidate/Measure:
/j,� CERTIFICATION AND APPOINTMENT
I, I F� • `1 Q 17`1 do hereby certify and appoint the following individual who is a registered elector of
Name �f C n/i�ale a GmmittN Chairman
the State of Idaho as the political treasurer for the above named candidate or committee:
Name of _ �1�
Political Treasurer: 9�4rc�
Home Work �JQ ���/1 J� Cell � q p .I���
Phone: Phone: (�l,'��,]"'j" U Phone: �'u�
Treg address: es
/
Mailing
Treasurer
email address:
j J ,tignature c
do hereby t the
Name of Political Treasurer
the above named candidate or committee. \
Signature of
N
political treasurer for
Name of
E:
Committee:
Name of Committee i
Chairman:
—-------
- Work ------- ----Cell ------- ----
Home
Phone: Phone: Phone:
❑
------ ---------------
Committee
Mailing address:
ElChairman
�------�-��—��-----�--
email address:
/j,� CERTIFICATION AND APPOINTMENT
I, I F� • `1 Q 17`1 do hereby certify and appoint the following individual who is a registered elector of
Name �f C n/i�ale a GmmittN Chairman
the State of Idaho as the political treasurer for the above named candidate or committee:
Name of _ �1�
Political Treasurer: 9�4rc�
Home Work �JQ ���/1 J� Cell � q p .I���
Phone: Phone: (�l,'��,]"'j" U Phone: �'u�
Treg address: es
/
Mailing
Treasurer
email address:
j J ,tignature c
do hereby t the
Name of Political Treasurer
the above named candidate or committee. \
Signature of
N
political treasurer for