HomeMy WebLinkAboutTerrye Evans 01152014Texas Ethics Commission POBox 12070 Austin Texas 78711 -2070 (512) 463-5800 (TDD 1-800-735-2989)
AMENDMENT: APPOI TMENTOFA
[)ORIGINAl
FORM ACTA
CAMPAIGN TREASURER BY A CANDIDATE PG 1
1 CANDIDATE 2 ACCOUNT # 3 Total pages filed:
NAME ----.-C V 0.1'1..)JerlV/e-.l
See ACTA Instruction Guide for detailed instructions.
Use this form for changes to existing information only. Do not provide information previously disclosed.
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4 CANDIDATE ~~MRS/MR FIRST MI .••\\ :... _ 1tI~
OF
NAME -re:Y'ry e:~,-: ..
"";0(. ..................~"""~'",
. . ..
Dale R~./...., ...~~ \
NICKNAME LAST SUFFIX !{i/ ~\\~: ;........ r·· ~Vt:l nS \i'\_ ~,/ i
5 CANDIDATE ~ ADDRESS I F'O BOX; APT I SUITE #: CITY; STATE; ZIP CODE ~~ rt ... :P.."', "."MAILING qOLf -rh Y0L.-Lv\!\. olter'\. &+ ~~" ..........~" ............:.~~"~
ADDRESS
Dale ~i1lllWlII, ii\W\\\\
r{\ S_ ~\Y'lV\e~, -r,X ( ~D6e,
7)AIII~1I111
~L.e.-..""':::"
Date Processed
6 CANDIDATE ~ AREA CODE PHONE NUMBER EXTENSION /-) c;--If
PHONE Date Imaged
(tfG1) QL-j (~ qYLl'-f I ~ J~-JL-)
7 OFFICE HELD ~
IJ 1ft(;fany)
8 OFFICE ~
SOUGHT [\ \~ -h''', c.A-C-lrrL(if known)
---.
9 CAMPAIGN ~JMRS I MR FIRST MI NICKNAME LAST SUFFIX
TREASURER
NAME C-'t Y\ ~l~ ~'t-z-5C r-Iel..
10 CAMPAIGN ~ STREET ADDRESS (NO PO BOX PLEASE); APT I SUITE #; CITY; STATE; ZIP CODE
TREASURER C tl(~.Je ~Ll; k 0STREET ;:Lao I C ~ -h--al I
ADDRESS ) .......
(residence or business) .r..
M .~ ~)f\ Y\~I IX ,r:;V /..p 9 I,
L.:r =:z -~
11 CAMPAIGN ~ AREA CODE PHONE NUMBER EXTENSION Ul
TREASURER (17~) r~ iv -1'19/ " ,;TaPHONE :x
12 CANDIDATE ~.
SIGNATURE I am aware ofthe Nepotism Law, Chapter 573 ofthe Texas Govern~tCode. ;Q) . ,
I am aware of my responsibility to file timely reports as required by title 15 of
the Election Code.
I am aware of the restrictions in title 15 of the Election Code on contributions
from corporations and labor organizations. cQ,gj{)~.... f:v~ 1 -L~-11
nature of Candidate Date Signea
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