Appointment of Treasurer, Stan Bastian - Bastian, Stanley J. - 9/4/2015SAT SE.gl
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APPOINTMENT AND CERTIFICATION OF POLITICAL TREASURER
FOR CANDIDATES AND COMMITTEES
(Please Print or Type)
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Rev. 08/07
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):
j CANDIDATE: Name of
Cand'd t • (G�
i a e. r�lS�i/
Home �31 Work Y`I V''C'�
Phone: Phone:
Office
Sought: Seat (if
applicable)
Candidate 16,6 ,� �e �ele�
Mailing address:
Candidate ��
email address: 5Qi1
El COMMITTEE
Name of
Committee:
Name of Committee
Chairman:
Miscellaneous: ❑
Home
Work
Phone:
Measure: ❑
Phone:
Committee
Candidate /Measure: ❑
Mailing address:
Chairman
email address:
Cell��
Phone:
Cell
Phone.
CERTIFICATION AND APPOINTMENT
J kC i r'?�''
Name of Candidate or Committee Chairman do hereby certify and appoint the following individual who is a registered elector of
the State of Idaho as the political treasurer for the above named candidate or committee:
Name of
Political Treasurer: (_ n
I 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
Home Work Phone: d /3 — Cell Phone: ( Z� p lO
Phone:
Treasurer
Mailing address: L,-Ul?
Treasurer
email address:
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Signature of Candidate or Committee Chairman
��r , do hereby acce e a o'
Name of Political Treasurer pp Intment as political treasurer for
the above named candidate or committee. '
Signature of Political Treasurer