Treasurer Certification MoberlyD i
AT.e tom APPOINTMENTAND CERTIFICATION OF POLITICAL TREASLIkEM16UG1 VICLEV. o
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FOR CANDIDATES AND COMMITTEES $lafOtaot5 w 1
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Pursuant to Section 67-6603(cl), 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.
Certification is for (check appropriate box below):
Name of
CANDIDATE: Candidata:
Home Work Cell
Phone: I -r\ - �2��'�- Phone: Phone:
Office Seal (if
Sought:
-._..._ZA CdT�PPlicable)
Candidate
Mailing address:
Candidate
email address:
i Qrs�t_fiS�r\ _
❑ COMMITTEE:
Miscellaneous:
Measure: F]
Candidate/Measure: 11
Chairman
email address
CERTIFICATION AND APPOINTMENT
I.
Qg.: & e is �� , do hereby certify and appoint the following individual who is a registered elector of
Name of Candidate or ommiflee irman
the State of Idaho as the political treasurer for the above named candidate or committee:
RETURN THIS
FORM TO:
Jaycee Holman
City Clerk
City of Meridian
33 E. Broadway Ave.
Meridian ID 83642
(208) 888-4433
Fax: (208) 888-4218
Name of
Political Treasurer:
Home Work Cell
Phone:��-7J _ Phone: Phone:_ map
Treasurer
Mailing address ;�US
Treasurer
email address:
------- Ej9.,.1e.Q+^�'?F`o--1ys��S�t�Ct11..._Cs_zy�.—=--�-------- -- —
or Committee Chairman
I,�r�a� , do hereby accept Ke appointment as political treasurer for
Name u Political Treasurer
the above named candidate or committee.
J
Signatufe of Polili Treasurer