Appointment of Treasurer, Shelby Phillips - Curry, Shane - 9/1/2015¢SASS o APPOINTMENT AND CERTIFICATION OF POLITICAL TREASURER c -'
Rev. 08107
FOR CANDIDATES AND COMMITTEES
Q (Please Print or Type)
Pursuant to Section 67- 6603(c1), Idaho Code. No contribution shall be received or expenditure made by or on behalf of a
candidate or political committee until he or she appoints a political treasurer and certifies the name and address of the treasurer
to the Secretary of State.
Certification is for (check appropriate box below):
❑ Name of 4mt �wyrq CANDIDATE: Candidate:
Home Work Cell (� l V D) U �� _ L9
Phone: Phone: Phone.
Office (� � � (1 jy t i► � ` Seat (if
Sought: >I �� 1 applicable)
Candiate
Mailing 29 Q r � iJk v-\ n P1,-
Candidate ��; "� i �^ 1„, _ • �� /� j—.�,�
email address: V ` t"V`'�J- r � �V` � jV► V �
CERTIFICATION AND APPOINTMENT
do hereby certify and appoint the following individual who is a registered elector of
Name of Candidate or Committee Chairm n
the State of Idaho as the political treasurer for the above named candidate or committee:
RETURN THIS
FORM TO:
Sharon Bergmann
Clerk- Treasurer
City of Eagle
PO Box 1520
Eagle ID 83616
(208) 939 -6813
Fax: (208) 939 -6827
sharon @cityofeagle.org
Name of
Political Treasurer:
Home Work Cell 2_419
Phone: Phone: �D& 4D_1 -
Phone: ` -1 ¢
Treasurer
Mailing address b dD—1 W ' ?0 p A.CC X ` " � } KSA - Uk
Treasurer, 1 i innn �C? �
email address: 1 � � J r' `,'{ `
Signature of Candidate or Committee Chairman
l�A VMV do hereby ccept the app 'ntment as political treasurer for
Name o litical Treasurer
the above named candidate or committee.
Signaturl olitical re r
Name of
❑ COMMITTEE:
Committee:
Name of Committee
Chairman:
Miscellaneous: ❑
Home Work Cell
Phone: Phone: Phone:
Measure: ❑
Committee
Mailing address:
Candidate/Measure: E]
Chairman
email address:
CERTIFICATION AND APPOINTMENT
do hereby certify and appoint the following individual who is a registered elector of
Name of Candidate or Committee Chairm n
the State of Idaho as the political treasurer for the above named candidate or committee:
RETURN THIS
FORM TO:
Sharon Bergmann
Clerk- Treasurer
City of Eagle
PO Box 1520
Eagle ID 83616
(208) 939 -6813
Fax: (208) 939 -6827
sharon @cityofeagle.org
Name of
Political Treasurer:
Home Work Cell 2_419
Phone: Phone: �D& 4D_1 -
Phone: ` -1 ¢
Treasurer
Mailing address b dD—1 W ' ?0 p A.CC X ` " � } KSA - Uk
Treasurer, 1 i innn �C? �
email address: 1 � � J r' `,'{ `
Signature of Candidate or Committee Chairman
l�A VMV do hereby ccept the app 'ntment as political treasurer for
Name o litical Treasurer
the above named candidate or committee.
Signaturl olitical re r