Fillable Form 142011: /-I~'w4e.d 1b't04 ~~1e1o,Tj. 3BIS Z. .- (Tom Green County)

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Form 142011: /-I~'w4e.d 1b't04 ~~1e1o,Tj. 3BIS Z. .- (Tom Green County)

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Texas Ethics
Commission
..
PO
Box
12070
A
us
t
In,
1i
exas
78711.2070
(512)463-5800
(TOO
1-800-735-2989)
APPOINTMENT
OF
A
CAMPAIGN
FORM
JCTA
TREASURER
BY
A
JUDICIAL
CANDIDATE
PG
1
1 Total pages filed:
See
JCTA
Instruction
Guide
for
detailed
instructions.
MSIMRSIMR
2
JUDICIAL
OFFICE
USE
ONLY
CANDIDATE
fr1/1..
MI
""'---'
.,
NAME
~~'~{~J
Z.
Acet. #
NICKNAME
SUFFIX
Date ReceIved
/-I~'w4e.d
NOV
142011
ADDRESS I PO BOX;
APT I SUITE #;
CITY;
STATE;
ZIP CODE
3
JUDICIAL
CANDIDATE
MAILING
3BIS
D~-h,etc\.
~~
ADDRESS
....
_
..
.-
•
~~1e1o,Tj.
1b't04
Date Hand-delivered or Postmarked
AREA
CODE
PHONE NUMBER
EXTENSION
4
JUDICIAL
CANDIDATE
Date Processed
PHONE
(32S)
qJ./tf-
/ZEf(5
Date
Imaged
5
OFFICE
HELD
(if
any)
:Ju.~ict!
of:~
dw
e
MI/'--11lCf
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6
OFFICE
SOUGHT
(if
Known)
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Joi!l~
fOt-t#!-
MSIMRSiMR
MI
SUFFIX
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FIRST
NICKNAME
7
CAMPAIGN
!ia:D;ld
TREASURER
NAME
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f}1a~lj
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STREET ADDRESS (NO
PO
BOX
PLEASE); APT I SUITE #; CITY;
STATE;
ZIP CODE
8
CAMPAIGN
TREASURER
STREET
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ADDRESS
(Residence
or
business)
S"tUA
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AREA CODE PHONE NUMBER EXTENSION
9
CAMPAIGN
TREASURER
PHONE
(52.S)
q4U.-~
10
CANDIDATE
SIGNATURE
I
am
aware
of
the
Nepotism
Law,
Chapter
573
of
the
Texas
Government
Code.
t
am
aware
of
my
responsibility
to
file
timely
reports
as
required
by
Title
15
of
the
Election
Code.
t
am
aware
of
the
restrictions
in
title
15
of
the
Election
Code
on
contributions
frS1E:nsr;;:::;:;;J0ns
II
/14/Zo/7
Signature
of
Candidate
1
Date
~igned
GO
TO
PAGE
2
www.elhics.slale.lx.us
Revised
09/01/2003
INFORMATION NOT DISPLAYED
INFORMATION NOT DISPLAYED
INFORMATION NOT DISPLAYED
INFORMATION NOT DISPLAYED
Texas Ethics Commission
P.O.
Box 12070
Austin, Texas 78711-2070
(512) 463-5800
(TOO 1-800-735-2989)
JUDICIAL
DECLARATION
OF
INTENT
FORM
JCTA
REGARDING
EXPENDITURE
LIMITS
PG
2
11
JUDICIAL
CANDIDATE
NAME
12
JUDICIAL
DECLARATION
OF
INTENT
REGARDING
EXPENDITURE
LIMITS
STATEMENT
OF
JUDICIAL
CANDIDATE'S
INTENT
TO
COMPLY
OR
NOT
COMPLY
WITH
THE
EXPENDITURE
LIMITS
PRESCRIBED
BY
THE
JUDICIAL
CAMPAIGN
FAIRNESS
ACT.
••
This
declaration
must
be
filed
before
a Judicial
candidate
may
accept
campaign
contributions
or
make
campaign
expenditures.
Elec.
Code
§
263.164
.••
Please check the appropriate box.
I swear
or
affirm that I
will
voluntarily comply with the limits
on
expenditures prescribed by the Judicial Campaign Fairness Act.
D
I hereby affirm that I do not intend to comply with the limits
on
expenditures prescribed by the Judicial Campaign Fairness Act.
~/~
Signature
of
Candidate
AFFI">OOlAAY
STAMP/SEALABOVE .
Sworn to and subscribed before me by
W~
l1oc-~rcY
-<
this the / A
..
P---
.
day
,20
I 2 ,
to
certify which, witness my hand and seal of office.
Signature
of
officer administering oath Print name
of
officer administering oath Title
of
officer administering oath
www.ethics.state.lx.us ReVised 09101/2003
Texas Ethics Commission
P.O. Box 12070
Austin, Texas 78711-2070
(512) 463-5800
(TOO 1-800-735-2989)
JUDICIAL
CANDIDATE
MODIFIED
REPORTING
DECLARATION
FORM
JCTA
PG
3
13
JUDICIAL
CANDIDATE
NAME
14
MODIFIED
REPORTING
DECLARATION
COMPLETE
THIS
SECTION
ONLY
IF
YOU
ARE
CHOOSING
MODIFIED
REPORTING.
PLEASE
READ
THE
EXPLANATION
OF
MODIFIED
REPORTING
IN
THE
INSTRUCTIONS
TO
THIS
FORM
.
••
This
declaration
must
be
filed
no
later
than
the
30th
day
before
the
first
election
to
which
the
declaration
applies.
• •
..
The
modified
reporting
option
is
valid
for
one
election
cycle
only.
(An election cycle includes a primary election, a
general
election,
and
any
related runoffs,)
I
do
not
intend
to
accept
more
than
$500
in
political
contributions
or
make
more
than
$500
in
political
expenditures
(excluding
filing
fees)
in
connection
with
any
future
election
within
the
election
cycle.
1
understand
that
if
either
one
of
those
limits
is
exceeded,
I
will
be
required
to
file
pre-election
reports
and,
if
necessary,
a
runoff
report.
I
understand
that
I
am
required
to
file
semiannual
reports,
telegram
reports,
and
special-session
reports,
if
applicable,
regardless
of
the
amount
of
the
contributions
I
accept
or
the
expenditures
I
make.
ZhL,W
Signature
of
Candidate
Year
o{
electiol".(s)
or
election
cycle
to
which
declaration
applies
-
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Form 142011: -I'w4e.d 1b't04 1e1o,Tj. 3BIS Z. .- (Tom Green County)

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Completed 9 August 2020

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