Certification of Treasurer - Gold, Miranda - 9/5/2017a t
ti;..;.:, Rev. 1/15
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,•? o • 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):
Name of
CANDIDATE: Candidate: M► c a,h� k 1 t7 lel
Home Work
Phone: Phone:
OfficSought:
C s J n C'( 1
Sought:
Candidate
I
Mailing address: lL V ^o0 �0d ect
Candidate ,^
email address: U �� - F 1) 1 &k 10 e On 1 . (%19 YY 1
APPOINTMENT AND CERTIFICATION OF POLITICAL TREASURER
FOR CANDIDATES AND COMMITTEES
(Please Print or Type)
C-1
PhoCell ne: (5i Z)
Of , &rete , ► O Salol L
Name of
COMMITTEE: Committee:
Miscellaneous:
Measure: n
Candidate/Measure:
Name of Committee
Chairman:
Home Work Cell
Phone: Phone: Phone:
Committee
Mailing address:
Chairman
email address:
CERTIFICATION AND APPOINTMENT
I, (\ .iar 4((Q . n _ , do hereby certify and appoint the following individual who is a registered elector of
Name off Candidate or Committee Chairman
the State of Idaho as the political treasurer for the above named candidate or committee:
Pomc
Politicall '1be Treasurer:
Submit to:
Eagle City Clerk Home C ' g (307, Work Cell
660 E. Civic Ln. 0
Phone: Phone: Phone: 2,0 $b 7 a-1 8
Eagle, ID 83616 Treasurer 13,5' 1 1J /14a.,,�s L e a ��
Mailing address: �t ,Y31,2 / b
208-939-6813
e-mail: Treasurer
Residence address: 5
cfr@cityofeagle.org
Treasurer
email address:
plums I ®c ►-ruts
Signature of n date or ommittee Chairman
I, E (, -z 6 eft\ (115 , do hereby accept the appointment as political treasurer for
Name of Political reasurer —�
the above named candidate or committee.
Signature of Poli fcal Treasurer