Certification of Treasurer - Koellisch, Robert - 8/23/2017RECEIVED & FILED
CITY OF EAGLE
seA „ APPOINTMENT AND CERTIFICATION OF POLITICAL TREASJRERAUG 2 3 20 15
�v. 1
T.c FOR CANDIDATES AND COMMITTEES Fila•
fa .;i:r. �, (Please Print or Type) Route to:
'Ai Pursuant 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:
❑ COMMITTEE:
Miscellaneous: ri
Measure:
Candidate/Measure:
Name of
Candidate: TO 3r: i J
Home/ (/ \ Work
Phone: (7o ZSl v3'7 zz,0 Z Phone:
OSoght: Ci4&Lr✓- Ct i"( COU ,v C. 1(,
Candidate
Mailing address:
Candidate
email address:
Name of
Committee:
l
Cell rr
Phone: (2,0d�3L - 0 3i4"
/4f ,L/ LAI rQPMCi SCv.,.) 7›e_i 016 -LE, /1,) 136/6
iCoeLL r c)L(6044Ar` .CdAl
Name of Committee
Chairman:
Home Work Cell
Phone: Phone: Phone:
Committee
Mailing address:
Chairman
email address:
CERTIFICATION AND APPOINTMENT
1, Kb g?Rr J. rot. 1{l((, do hereby certify and appoint the following individual who is a registered elector of
Name of Candidate ormmittee Chairman
the State of Idaho as the political treasurer for the above named candidate or committee:
Name of
Political Treasurer: 1.
C.
Submit to:
Eagle City Clerk
660 E. Civic Ln.
Eagle, ID 83616
208-939-6813
e-mail:
cfr@cityofeagle.org
Home/...7Work
Phone: . '9 j — 2'o Phone:
Treasurer
Mailing address:
Phone: (I04) g3 t% - 6,000
11-1-3(4 rwA4c Ls c Die cA 6 c 67, 0,36./6
Residenceaddress: 1 U 3L{ dei' C t S CA/3 1? / 0 .C36 f6.
Treemailasurer
7,>06L.L1 se I F 6M ( ,
address: Kdd
signature of Candidate or Committee Chairman
I, f
Cotrift,L j<O 1) iTSe , do hereby accept the appointment as political treasurer for
Name of Political Treasurer /— 7
the above named candidate or committee.
nature o Political Treasurer