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Declaration of Treasurer - Reynolds, James - 9/8/2017
APPOINTMENT AND CERTIFICATION OF POLITICAL TREASURER FOR CANDIDATES AND COMMITTEES (Please Print or Type) o> ods' 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. 08/07 r CANDIDATE: COMMITTEE: Miscellaneous: Measure: Candidate/Measure: Name of Candidate: c_� i e3 /4)10 Home Home Work Cell Phoma -Q — S'ag 3 Phone: Az - U V a Phone: OfficeSeat (if Sought: Co (JA.,f L 5ea4-- applicable) Candidate Mailing address: Candidate :email address: Name of Committee: 1 I t q 11. 5 Aecei Fcrce, Jl44Qc9vta1( caw • Name of Committee Chairman: Home Phone: Committee Mailing address: Chairman email address: Work Phone: &a , f D 8 O Cell Phone: CERTIFICATION AND APPOINTMENT I, Ja,v s . K& o !els do hereby certify and appoint the following individual who is a registered elector of Name of Candidate or Comm ee Chai man the State of Idaho as the political treasurer for the above named candidate or committee: ................................ rY � Ph L� s 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 of Political Treasurer: Home /� c� Phone( TL -I f0. a 2'T (j O l Treasurer f( Mailing address: t 1 Treasurer email address: Y I C ka wt, e_ da Y isel p Ccs © Work Phone: Pholne`L6D 110` s ct re,s z cf re l- / �h Signature of Candidatb.ordmmittee Chairman I, JO_ l4(e5-0 • /'� ..0 {cis , do hereby accept the appointment as political treasurer for Name of Politica` Treasurer the above named candidate or committee. ms/0/-, Signature of Political Treasurer