Briggs Campaign Treasurer Amendment - 12/10/2019 AMENDMENT: APPOINTMENT OFA FORM ACTA
CAMPAIGN TREASURER BYA CANDIDATE PG 1
1 CANDIDAT 2 FILER ID# 3 Total pages filed::
NAME
-a(y G -Pr M S 1
See ACTA Instruction Guide for detailed instructions.
Use this form for changes to existing information only. Do not provide Information previously disclosed. - '
4 CANDIDATE NEW I MS/MRS/MR FIRST MI
NAME /L ^ (/ OFFICE USE ONLY
' ' I r3 v i I 1 1 b e5 'Date Received
NICKNAME y LAST V SUFFIX RECEIVED
nEC 1 0 7019
5 CANDIDATE NEW I ADDRESSAD /PO B1OX; APT j/SUITE#; CITY; .. STATE; ZIP CODE
MAILING
ADDRESS %' 0 h�"RQht �/ 1 fD .
D ` L�S S I Date Hague 'S ke J^
be.r \`'v-n `�-1-1./ -1 o Receipt# Amounts
�. ^'1`.V Date Processed
6 CANDIDATE NEW AREA CODE PHONE NUMBER EXTENSION
PHONE Date Imaged
(gy() ) Fav -133q
7 OFFICE HELD NEW I I //�,, r/� 1 j��) —II-I, I} .�(�LT�) �1(—
(deny) cA-ki 1 3R l l C I I "�I S 1 1 1 c \ a G+\/ C- l 4_/.C.11 IV>7
8 OFFICE NEW I V' ///'''111
SOUGHT l� / / O r AI I r
OP I r '_)L y\,'NY�
(if known) I" U` "T"/ .r
9 CAMPAIGN NEW I MS/MRS/MR FIRST MI NICKNAME LAST SUFFIX
TREASURER
NAME PA r. V 1 S k( 1 a J(fin s
ES
10 CAMPAIGN NEW I STREET ADDRESS(NO PO BOX PLEASE); APT/SUIT #; CITY; STATE; ZIP CODE
TSTRREETRER 3 ` 0% g 1 O )6-e.-4n. '�) c+
ADDRESS l
(residence or business) 0.e,VI.. >1 Tx- -7(ia-v R " .
d1 CAMPAIGN NEW I AREA CODE PHONE NUMBER EXTENSION
EA8URER • /U 1-� ) /L\ 5 — 2 OD
PHONE � \ •�. vJ
12 CANDIDATE - -
SIGNATURE I am aware of the Nepotism Law, Chapter 573 of the Texas Government Code; .
I am-aware of my responsibility to file timely reports as required by title 15 of
the Election Code.
I am awa a of the restrictions in title 15 of the Election Code on contributions
from bor orations and aboro nizations.
p i - i — ii - ) 9
Si at re of Candidate - Date Signed
GO TO PAGE 2
Forms provided by Texas Ethics Commission www.ethics.state.tx.us Revised 12/5/2019