APPOINTMENT AND CERTIFICATION OF POLITICAL TREASURER
FOR CANDIDATES AND COMMITTEES
(Please Print or Type)
Pursuant to Section 67-6603(c1), 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 certifi es the name and address of the treasurer
to the Secretary of State.
C-1
Rev. 1/15
Certifi cation is for (check appropriate box below):
CANDIDATE:
Name of
Candidate:
Home
Phone:
Work
Phone:
Cell
Phone:
Offi ce
Sought:
District
Number: Party:
Candidate
Mailing address:
Candidate
email address:
Signature of Political Treasurer
Signature of Candidate or Committee Chairman
RETURN THIS
FORM TO:
Lawerence Denney
Secretary of State
Elections Division
PO Box 83720
Boise, ID 83720-0080
(208) 334-2852
Fax: (208) 334-2282
I, _______________________________, do hereby accept the appointment as political treasurer for
the above named candidate or committee.
Name of
Political Treasurer:
Home
Phone:
Work
Phone:
Cell
Phone:
Treasurer
Residence address:
Treasurer
email address:
COMMITTEE:
Name of
Committee:
Home
Phone:
Work
Phone:
Cell
Phone:
Name of Committee
Chairman:
Party
Affi liation (if any):
Committee
Mailing address:
Chairman
email address:
Party:
Miscellaneous:
Measure:
Candidate/Measure:
CERTIFICATION AND APPOINTMENT
I, _______________________________, do hereby certify and appoint the following individual who is a registered elector of
the State of Idaho as the political treasurer for the above named candidate or committee:
Name of Candidate or Committee Chairman
Name of Political Treasurer
Treasurer
Mailing address:
City Clerk Contact Info
Kuna City Clerk Chris Engels
751 W 4th Street
Kuna, ID 83634
Phone: 208.387.7726
Email: CityClerk@KunaID.gov
