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Fletcher, Eliot-CTA 2021-02-02 (PL 4)APPOINTMENT OF A CAMPAIGN TREASURER FORM CTA BY A CANDIDATE 1 PG See CTA Instruction Guide for detailed instructions. 1 Total pages filed: 2 CANDIDATE MS/MRS/MR FIRST MI OFFICE USE ONLY NAME Filer ID # Dr. Eliot S ..................................... NICKNAME LAST SUFFIX Date Iiv qd 2 2 2b 2 Fletcher 3 CANDIDATE ADDRESS / PO BOX; APT / SUITE #; CITY; STATE; ZIP CODE MAILING 517 Harris St Coppell Texas 75019 ADDRESS Date Hand deliver ostmarked 4 CANDIDATE AREA CODE PHONE NUMBER EXTENSION Receipt# Amount$ PHONE 617 ) 869-6816 Date Processed 6 OFFICE Date Imaged HELD NA (if any) 6 OFFICE SOUGHT City Council Position 4 (if known) 7 CAMPAIGN MS/MRS/MR FIRST MI NICKNAME LAST SUFFIX TREASURER NAME Dr. Eliot S. Fletcher 8 CAMPAIGN STREET ADDRESS (NO PO BOX PLEASE); APT / SUITE #; CITY; STATE; ZIP CODE TREASURER 517 Harris St Coppell Texas 75019 STREET ADDRESS (residence or business) 9 CAMPAIGN AREA CODE PHONE NUMBER EXTENSION TREASURER PHONE 617 ) 869-6816 10 CANDIDATE SIGNATURE I am aware of the Nepotism Law, Chapter 573 of the Texas Government Code. 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. Signature of Candidate Date Signed GO TO PAGE 2 Forms provided by Texas Ethics Commission Reset Form Revised 1/1/2021