Political Treasurer, Janet Buschert - Mitchell, Jill - 9/1/2017APPOINTMENT AND CERTIFICATION OF POLITICAL TREASURER
FOR CANDIDATES AND COMMITTEES
(Please Print or Type)
Pursuant to Section 67-6603(cl), 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):
c-1
Rev. 1/15
CANDIDATE:
COMMITTEE:
Miscellaneous:
Measure:
Candidate/Measure:
II
II
Il
Name of
Candidate:
ome
Phone:
Phone: C9_40 3 go -?o•1
Office
Sought:
Candidate
Mailing address:
Candidate
email address:
Name of
Committee:
Name of Committee
Chairman:
Home
Phone:
Committee
Mailing address:
Chairman
email address:
Work ^^
�
Phone: C�0A `-10'-D 123
Cell
Phone:(Wg) 3(-0 -io R 1
j'r-kLk@ 000, coo.
Work
Phone:
CERTIFICATION AND APPOINTMENT
Cell
Phone:
1QJ I . do hereby certify and appoint the following individual who is a registered elector of
Name of Candidate or Committee Chairman
the State of Idaho as the political treasurer for the above named candidate or committee:
Submit to:
Eagle City Clerk
660 E. Civic Ln.
Eagle, ID 83616
208-939-6813
e-mail:
cfr@cityofeagle.org
RECEIVED & FILED
CITY OF EAGLE
SEP 01 2017
FiIQ
Route tn.
Name of
Political Treasurer:
Home
Phone:
Treasurer
Mailing address:
Treasurer
Residence address: %v1-__
Jot n 6V3 c/C,Ne'-1-
Work
Phone:
Cell p �1
Phone: c20 )W30 --(0 !�
35 Uvr flo'n -eco` ,r r . -Ga5Le, g`34'/c'
Treasurer
email address:
a►r\e1-- 60s ca m
A
1M�
1, , ra \r\, I, kfmc A 1�%� do
Name of Political fFeasurer
the above named candidate or committee.
Signature of Candidate or Committee Chairman
by accept the appointment as political treasurer for
LSI v �9 ),IVV0)JA)
Signature of P liticeasurer