Appointment of Treasurer, Jeff Laughlin - Reynolds, James - 9/3/2015AT s APPOINTMENT AND CERTIFICATION OF POLITICAL TREASURER c -'
Rev. 08/07
., C FOR CANDIDATES AND COMMITTEES
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(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):
CANDIDATE:
Name of I
Candidate: -Ja wl L°S
Home Work �[ Cell /�
Phone: —q5q - e0 ` 3 Phone: OU -- ` 4 9?LIO Phone:; O , 861-q 7 4 9
Office Seat (if
Sought: m�jo r l�f� 1,� applicable)
v""� /'�
Candidate V
Place, l Mailing address: + l 1 9 Q r l` h e _ ly l e /f'o
Candidate
email address: r 144 o R co
❑ COMMITTEE:
Name of
Committee:
Name of Committee
Chairman:
Miscellaneous: ❑
Home Work Cell
Phone: Phone: Phone:
Measure: ❑
Committee
Candidate/Measure: El
Mailing address:
Chairman
email address:
CERTIFICATION AND APPOINTMENT
do hereby certify and appoint the following individual who is a registered elector of
Name of Candidate or Co mittee Chairman
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 �Q U to
Political l Treasurer: �J
Home Work Cell
Phone: M -q3g_ 33615 Phone. Phone:a6i- FU - 179
T
reasurer oo
Mailing address: 17) 936
alp
Treasurer n
email address: �1` 14 uz�k 41 to �VtQ (I ce>
Signature of Candhke or Committee Chairman
Name of Political ti re Treasurer , do hereby accept the appointme olitical treasurer for
the above named candidate or committee.
gnature of Political Treasurer