Amendment-Appointment Of A Campaign Treasurer By A General-Purpose Committee {AGTA}

Revised //201 Forms provided by Texas Ethics Commission www.ethics.state.tx.us ACRONYM COMMITTEEADDRESSCAMPAIGNTREASURERNAME CAMPAIGNTREASURERPHONE() () 1614 same as aboveCAMPAIGNTREASURERMAILINGADDRESS 56913FORM AGTAPG 1 4COMMITTEENAME AMENDMENT: APPOINTMENT OF A CAMPAIGNTREASURER BY A GENERAL-PURPOSE COMMITTEE2NEW 13Total pages filed:FILER ID #COMMITTEE NAMESee AGTA Instruction Guide for detailed instructions.ADDRESS / PO BOX;APT / SUITE #;CITY;STATE;ZIP CODEMS / MRS / MRFIRSTMINICKNAMELASTSUFFIXAREA CODEPHONE NUMBEREXTENSION ADDRESS / PO BOX;APT / SUITE #;CITY;STATE;ZIP CODEFIRSTMILASTSUFFIXFIRSTMILASTSUFFIXAREA CODEPHONE NUMBEREXTENSIONADDRESS / PO BOX;APT / SUITE #;CITY;STATE;ZIP CODESTREET ADDRESS (NO PO BOX PLEASE);APT / SUITE #;CITY;STATE;ZIP CODE REGULAR MONTHLY7810111215ASSISTANTCAMPAIGNTREASURERPHONEASSISTANTCAMPAIGNTREASURERADDRESSASSISTANTCAMPAIGNTREASURERSIGNATUREPERSONAPPOINTINGTREASURERCAMPAIGNTREASURERSTREETADDRESS(residence or business)REPORTINGTYPEThis appointment is effective on the date it is filed with the commission.CONTINUE ON PAGE 2NEW NEW NEW NEW NEW NEW NEW NEW NEW NEW I understand that I have been appointed as the campaign treasurer for this general-purposecommittee and that I am responsible for filing all required reports and that I may be subject tofines for failure to do so. I am aware of the restrictions in title 15 of the Election Code on contributionsfrom corporations and labor organizations.Signature of Campaign Treasurer OFFICE USE ONLY Date Received Receipt #Date Hand-delivered or PostmarkedDate ProcessedAmount $ Date Imaged American LegalNet, Inc. www.FormsWorkFlow.com Revised //201 Forms provided by Texas Ethics Commission www.ethics.state.tx.us 000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000 000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000 00000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000019CONTROLLINGENTITYINFORMATION 000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000 ATTACH ADDITIONAL COPIES OF THIS FORM AS NEEDED2021FORM AGTAPG 2AMENDMENT: GENERAL-PURPOSE COMMITTEECONTROLLING ENTITY INFORMATION17COMMITTEE NAMEFULL NAME OF CONTROLLING ENTITYACRONYMFULL NAME OF CONTROLLING ENTITYACRONYMFULL NAME OF CONTROLLING ENTITYACRONYMFULL NAME OF CONTROLLING ENTITYACRONYM adddeleteadddeleteadddeleteadddeleteadddeleteadddeleteadddeleteadddeleteadddeleteadddeleteadddeleteadddeleteadddelete 18FILER ID #FirstMILastSuffixFirstMILastSuffixFirstMILastSuffixFirstMILastSuffixFirstMILastSuffixFirstMILastSuffixFirstMILastSuffixFirstMILastSuffixFirstMILastSuffixFirstMILastSuffixadddeleteCONTRIBUTIONDECISIONMAKERSEXPENDITUREDECISIONMAKERS American LegalNet, Inc. www.FormsWorkFlow.com Revised //201 Forms provided by Texas Ethics Commission www.ethics.state.tx.us 24COMMITTEE NAME000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000 RECIPIENTGENERALPURPOSECOMMITTEES FORM AGTAPG 3Committee nameCommittee address;City;State;Zip Code000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000 Committee name000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000 Committee name000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000 Committee nameATTACH ADDITIONAL COPIES OF THIS FORM AS NEEDED2223FILER ID # ADD ADD ADD ADDAMENDMENT: GENERAL-PURPOSE COMMITTEERECIPIENT COMMITTEESCommittee address;City;State;Zip CodeCommittee address;City;State;Zip CodeCommittee address;City;State;Zip Code Filers may send this form to the TEC electronically at treasappoint@ethics.state.tx.us or mail to Texas Ethics CommissionP.O. Box 12070Austin, TX 78711-2070For more information about where to file go to: 000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000 Committee name ADDCommittee address;City;State;Zip Code American LegalNet, Inc. www.FormsWorkFlow.com