Political Treasurer WarrenQATeE,< APPOINTMENT AND CERTIFICATION OF POLITICAL TREASURRECEIVE-T)
FOR CANDIDATES AND COMMITTEES JUL 15 2013/0
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Pursuant to Section 67-6603(cl), Idaho Code. No contribution shall be received or expenditure mil QY —
candidate or political committee until he or she appoints apolitical treasurer and certifies the name d o e s
to the Secretary of State.
Certification is for (check appropriate box below):
® CANDIDATE: I
Name ofCandidate: !ke
Work Cell
%(%aj 027 Phone: Phone: 7,0g 7o j 027
Seat (if
OV t? e_4 ,L,_____-- applicable)
Candidate
Mailing address 51
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address:
❑ COMMITTEE: "me
ofCommittee:
Name of Committee
Chairman:
Miscellaneous: F]
Home
Phone:
Measure: F1
Committee
Mailing address:
Candidate/Measure:
Chairman
email address:
Work
Phone:
Cell
Phone:
CERTIFICATION AND APPOINTMENT
I, `5d -e �keh Id%I rren do hereby certify and appoint the following individual who is a registered elector of
Name of Candidate or Committee Chairman
the State of Idaho as the political treasurer for the above named candidate or c_o_m_mitte_e:
FName of
Political Treasurer: Rot,)lai Cpm r --
RETURN
RETURN THIS
FORM T0:
Jaycee Holman
City Clerk
City of Meridian
33 E. Broadway Ave.
Meridian If 83642
(208) 888-4433
Fax: (208) 888-4218
jholman@meridiancity.org
Home Work Cell
Phone:
Phone: Phone•o1C1�•6X61• D,I Phone:%YDg.��
Treasurer
Mailing address—1\—\�.- 1.�11WYY"�p �kxvpP,"us_. �c6(
Treasurer
email address: (br-10
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DD Si nature of Candidate or Commitlee rmai rC�a n
I, Y�tJ P— C�rn'Ndl o hereby accept the appointment as political treasurer for
Name of Political Treasurer
the above named candidate or committee.
Signature of Political Treasurer