Dharia, Amit-CTA 2021-02-02APPOINTMENT OF A CAMPAIGN TREASURER FORM CTA
BY A CANDIDATE PG 1
10 CANDIDATE I
SIGNATURE 1 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
Forms provided by Texas Ethics Commission
www.ethics.state.tx.us Revised 12/7/2017
1 Total pages filed:
See CTA Instruction Guide for detailed instructions.
MS / MRS / MR FIRST
MI
OFFICE USE ONLY
CANDIDATE
NAME
Mr. AMITKUMAR
Nirnajan
Filer ID #
NICKNAME * . LAST
SUFFIX
Date R ceived
AMIT DHARIA
2�2�2b21
ADDRESS / PO BOX; APT / SUITE #; CITY;
STATE; ZIP COD
�. Z ,• '�`-' P
3 CANDIDATE
MAILING
ADDRESS
8418 Sterling St, Suite A, Irving, TX 75063
Date Hand -delivered or marked
AREA CODE PHONE NUMBER
EXTENSION
4 CANDIDATE
Receipt# Amount$
PHONE
972 )915 0516 (office)
Date Processed
5 OFFICE
Date Imaged
HELD
N/A
if an
6 OFFICE
Coppell Council Place # 4
SOUGHT
City of
(if known)
MI
NICKNAME
LAST SUFFIX
7 CAMPAIGN
MS/MRS/MR FIRST
TREASURER
NAME
Mr. Amitkumar N Dharia (Amit)
Dharia
STREET ADDRESS (NO PO BOX PLEASE); APT /SUITE #;
CITY; STATE;
ZIP CODE
8 CAMPAIGN
TREASURER
STREET
8418 Sterling Street, Suite A, Irving,
TX 75063 (Office
ADDRESS
(residence or business)
AREA CODE PHONE NUMBER
EXTENSION
9 CAMPAIGN
TREASURER
PHONE
/
10 CANDIDATE I
SIGNATURE 1 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
Forms provided by Texas Ethics Commission
www.ethics.state.tx.us Revised 12/7/2017