Appt of CT - Carroll, Don APPOINTMENT OF A CAMPAIGN TREASURER FORM CTA
BY A CANDIDATE PG 1
1 Total pages filed:
See CTA Instruction Guide for detailed instructions. 2
2 CANDIDATE MS/MRS/MR FIRST MI
OFFICE USE ONLY
NAME �w b
Imo' Filer ID#
NICKNAME LAST SUFFIX
Date Received
CA 120LL J �
3 CANDIDATE ADDRESS /PO BOX; APT/SUITE#; CITY; STATE; ZIP CODE \ 6 I (51e)
MAILING _n�A,
ADDRESS G�(2L4 H. 10D � J�OLLd( ) C?
Date Hand-delivered or Postmarked
CC9PP6cc_ -1-x Sal
4 CANDIDATE AREA CODE PHONE NUMBER EXTENSION Receipt# Amount$
PHONE
( 9'7 2) 6c (o — j 2_O 3 Date Processed
5 OFFICE I Date Imaged
HELD CO PPF.LL C ITy C o JcI,- O1-1' C5 3
(if any)
6 OFFICE
SOUGHT CPpELC. C iTy COU/ILJ PLtdrca 3
(if known)
7 CAMPAIGN MS/MRS/MR FIRST MI NICKNAME LAST SUFFIX
TREASURER
NAME iM 6 0o N C Pr2 ROLL A
8 CAMPAIGN STREET ADDRESS; APT/SUITE#; CITY; STATE; ZIP CODE
TREASURER
STREET
ADDRESS
1 0E� C
H D .L '�.i T
(residence or business) C O1�p 5 a I
9 CAMPAIGN AREA CODE f PHONE NUMBER EXTENSION
TREASURER PHONE 5o( -1
Q- 1 2 6 3
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.
i/, 2 3
Signature of Candidate Date igned
GO TO PAGE 2
Forms provided by Texas Ethics Commission www.ethics.state.tx.us Revised 1/1/2023
CANDIDATE MODIFIED FORM CTA
REPORTING DECLARATION PG 2
11 CANDIDATE
NAME
O\ CA- J12.
12 MODIFIED REPORTING COMPLETE THIS SECTION ONLY IF YOU ARE
DECLARATION CHOOSING MODIFIED REPORTING
•• 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.)
•• Candidates for the office of state chair of a political party
may NOT choose modified reporting. ••
I do not intend to accept more than $1,010 in political contributions
or make more than $1,010 in political expenditures (excluding filing
fees) in connection with any future election within the election
cycle. I understand that if either one of those limits is exceeded,
will be required to file pre-election reports and, if necessary, a
runoff report.
2oZ3 / )72 .1,7
Year of election(s)or election cycle to Signature of Candidate
which declaration applies
This appointment is effective on the date it is filed with the appropriate filing authority.
TEC Filers may send this form to the TEC electronically at treasappoint a(�ethics.state.tx.us
or mail to
Texas Ethics Commission
P.O. Box 12070
Austin,TX 78711-2070
Non-TEC Filers must file this form with the local filing authority
DO NOT SEND TO TEC
For more information about where to file go to:
https://www.ethics.state.tx.us/filinginfo/QuickFileAReport.php
Forms provided by Texas Ethics Commission www.ethics.state.tx.us Revised 1/1/2023