Texas Ethics Commission P.O. Box Austin, Texas (512) ACCOUNT # (Ethics Commission filers)
|
|
- Meryl Chambers
- 8 years ago
- Views:
Transcription
1 Texas Ethics Commission P.O. Box Austin, Texas (512) GENERAL-PURPOSE COMMITTEE CAMPAIGN FINANCE REPORT GPAC FORM COVER SHEET PG 1 The GPAC INSTRUCTION GUIDE explains how to complete this form. 1 ACCOUNT # (Ethics Commission filers) 2 PAGE # 1/5 3 COMMITTEE NAME OFFICE USE ONLY Texas Speech Language Hearing Association PAC Received 4 COMMITTEE ADDRESS Change of Address ADDRESS / PO BOX; APT / SUITE #; CITY; STATE; ZIP CODE Hand-delivered or Postmarked 5 CAMPAIGN TREASURER NAME MS / MRS / MR FIRST MI Mr. Don R NICKNAME LAST SUFFIX McCullough Receipt # Processed Imaged Amount 6 CAMPAIGN TREASURER'S STREET ADDRESS (Residence or business) 7 CAMPAIGN TREASURER'S MAILING ADDRESS Change of Address STREET ADDRESS (NO PO BOX PLEASE); APT / SUITE #; CITY; STATE; ZIP CODE STREET OR PO BOX; APT/SUITE#; CITY; STATE; ZIP CODE 8 CAMPAIGN TREASURER PHONE AREA CODE PHONE NUMBER EXTENSION ( 512 ) REPORT TYPE January 15 30th day before election Dissolution (attach PAC-DR) 10 PERIOD COVERED X 8th day before election July 15 Runoff 10th day after campaign treasurer termination THROUGH 01/01/ /30/ ELECTION ELECTION DATE ELECTION TYPE Primary Runoff General Special GO TO PAGE 2
2 GENERAL-PURPOSE COMMITTEE REPORT: F ORM GPAC COVER SHEET PG PURPOSE AND TOTALS 2 12 COMMITTEE NAME 13 COMMITTEE ACTIVITY (Attach lists on plain paper to complete this report if necessary.) Texas Speech Language Hearing Association PAC 1. Candidates (identify by name or, if applicable, classify by party) 2. Measures (describe by date and location of election and nature of issue) 3. Officeholders Assisted (identify by name or, if applicable, classify by party) A. Supported B. Opposed A. Supported B. Opposed ACCOUNT # 14 CONTRIBUTION TOTALS 1. TOTAL OF $50 OR LESS (OTHER THAN PLEDGES, LOANS, OR GUARANTEES OF LOANS), UNLESS ITEMIZED $ EXPENDITURE TOTALS 2. TOTAL (OTHER THAN PLEDGES, LOANS, OR GUARANTEES OF LOANS) $ 3. TOTAL POLITICAL EXPENDITURES OF $50 OR LESS, UNLESS ITEMIZED $ CONTRIBUTION BALANCE OUTSTANDING LOAN TOTALS 4. TOTAL POLITICAL EXPENDITURES 5. TOTAL MAINTAINED AS OF THE LAST DAY OF THE REPORTING PERIOD $ 6. TOTAL PRINCIPAL AMOUNT OF ALL OUTSTANDING LOANS AS OF THE LAST DAY OF THE REPORTING PERIOD $ $ AFFIDAVIT I swear, or affirm, under penalty of prejury, that the accompanying report is true and correct and includes all information required to be reported by me under Title 15, Election Code. DON R. MCCULLOUGH Signature of Campaign Treasurer AFFIX NOTARY STAMP / SEAL ABOVE Sworn to and subscribed before me, by the said, this the day of,20, to certify which, witness my hand and seal of office. Signature of officer administering oath Printed name of officer administering oath Title of officer administering oath Revised 09/01/2003
3 3/5 4 5 PANHANDLE REGIONAL SPEECH & HEARING ASSOCIATION AMARILLO TX LOCAL ASSOCIATION 10 HOUSTON ASSOCIATION FOR COMMUNICATON DISORDERS 25 HOUSTON TX Mrs. TERI TRAVIS 7 SPRING TX Ms. RAHCELL HARRIS SULPHUR SPRINGS TX SPEECH THREAPY Mrs. RONDA WEST HOUSTON TX 77079
4 4/5 4 5 Ms. KRISTEN POSEY ROUND ROCK TX Ms. DENEEIS WATSON POLLOCK TX Ms. DEBORAH KOELLIKER MT VERNON TX Ms. JENNY CLARK 10 AMARILLO TX Mrs. APRIL SMITH-KOEBEL SAN ANTONIO TX 78230
5 5/5 4 5 Mr. MERIDITH MOORE Principal occupation PLANO / Job TX title (See Instructions) 10
Texas Ethics Commission P.O. Box 12070 Austin, Texas 78711-2070 (512)463-5800 1-800-325-8506 ADDRESS / PO BOX; APT / SUITE #; CITY; STATE; ZIP CODE
Texas Ethics Commission P.O. Box 1200 Austin, Texas 811-200 (512)463-5800 1-800-325-8506 GENERAL-PURPOSE COMMITTEE CAMPAIGN FINANCE REPORT GPAC FORM COVER SHEET PG 1 The GPAC INSTRUCTION GUIDE explains
More informationTexas Ethics Commission P.O. Box 12070 Austin, Texas 78711-2070 (512)463-5800 TDD 1-800-735-2989
Texas Ethics Commission P.O. Box 12070 Austin, Texas 78711-2070 (512)463-5800 TDD 1-800-735-2989 GENERAL-PURPOSE COMMITTEE CAMPAIGN FINANCE REPORT GPAC FORM COVER SHEET PG 1 The GPAC INSTRUCTION GUIDE
More informationTexas Ethics Commission P.O. Box 12070 Austin, Texas 78711-2070 (512)463-5800 1-800-325-8506. 1 ACCOUNT # (Ethics Commission filers) 00015670
Texas Ethics Commission P.O. Box 12070 Austin, Texas 78711-2070 (512)463-5800 1-800-325-8506 GENERAL-PURPOSE COMMITTEE CAMPAIGN FINANCE REPORT GPAC FORM COVER SHEET PG 1 The GPAC INSTRUCTION GUIDE explains
More informationElection capture Requirements and Procedure - Texas
Texas Ethics Commission P.O. Box 12070 Austin, Texas 78711-2070 (512)463-5800 1-800-325-8506 GENERAL-PURPOSE COMMITTEE CAMPAIGN FINANCE REPORT GPAC FORM COVER SHEET PG 1 The GPAC INSTRUCTION GUIDE explains
More informationTexas Ethics Commission P.O.Box 12070 Austin, Texas 78711-2070 (512)463-5800 TDD 1-800-735-2989 ADDRESS / PO BOX; APT/SUITE #; CITY; STATE ZIP CODE
MONTHLY FILING GENERAL-PURPOSE COMMITTEE CAMPAIGN FINANCE REPORT F ORM MPAC COVER SHEET PG 1 The MPAC INSTRUCTION GUIDE explains how to complete this form. 3 COMMITTEE 1 ACCOUNT # (Ethics Commission filers)
More informationTexas Ethics Commission P.O.Box 12070 Austin, Texas 78711-2070 (512)463-5800 TDD 1-800-735-2989 ADDRESS / PO BOX; APT/SUITE #; CITY; STATE ZIP CODE
MONTHLY FILING GENERAL-PURPOSE COMMITTEE CAMPAIGN FINANCE REPORT F ORM MPAC COVER SHEET PG 1 The MPAC INSTRUCTION GUIDE explains how to complete this form. 3 COMMITTEE NAME Texas Apartment Association
More informationTexas Ethics Commission P.O. Box 12070 Austin, Texas 78711-2070 (512)463-5800 1-800-325-8506. 1 ACCOUNT # (Ethics Commission filers) 00016096
Texas Ethics Commission P.O. Box 12070 Austin, Texas 78711-2070 (512)463-5800 1-800-325-8506 GENERAL-PURPOSE COMMITTEE CAMPAIGN FINANCE REPORT GPAC FORM COVER SHEET PG 1 The GPAC INSTRUCTION GUIDE explains
More informationSPECIFIC-PURPOSE COMMITTEE CAMPAIGN FINANCE REPORT
SPECIFIC-PURPOSE COMMITTEE CAMPAIGN FINANCE REPORT F ORM SPAC C OVER SHEET PG 1 The SPAC INSTRUCTION GUIDE explains how to complete this form. 3 COMMITTEE NAME Texas Association of Reverse Mortgage Lenders
More informationTexas Ethics Commission P.O. Box 12070 Austin, Texas 78711-2070 (512)463-5800 TDD 1-800-735-2989
Texas Ethics Commission P.O. Box 12070 Austin, Texas 78711-2070 (512)463-5800 TDD 1-800-735-2989 GENERAL- COMMITTEE CAMPAIGN FINANCE REPORT GPAC FORM COVER SHEET PG 1 The GPAC INSTRUCTION GUIDE explains
More informationTexas Ethics Commission P.O. Box 12070 Austin, Texas 78711-2070 (512)463-5800 1-800-325-8506. 1 ACCOUNT # (Ethics Commission filers) 00016096
Texas Ethics Commission P.O. Box 12070 Austin, Texas 78711-2070 (512)463-5800 1-800-325-8506 GENERAL-PURPOSE COMMITTEE CAMPAIGN FINANCE REPORT GPAC FORM COVER SHEET PG 1 The GPAC INSTRUCTION GUIDE explains
More informationTexas Ethics Commission P.O. Box 12070 Austin, Texas 78711-2070 (512)463-5800 1-800-325-8506 MS / MRS / MR FIRST MI. ... NICKNAME LAST SUFFIX Andy
JUDICIAL CANDIDATE / OFFICEHOLDER CAMPAIGN FINANCE REPORT JC/OH FORM COVER SHEET PG 1 The JC/OH INSTRUCTION GUIDE explains how to complete this form. 3 CANDIDATE / OFFICEHOLDER NAME 1 ACCOUNT # (Ethics
More informationTexas Ethics Commission P.O.Box 12070 Austin, Texas 78711-2070 (512)463-5800 TDD 1-800-735-2989 ADDRESS / PO BOX; APT/SUITE #; CITY; STATE ZIP CODE
MONTHLY FILING GENERAL-PURPOSE COMMITTEE CAMPAIGN FINANCE REPORT F ORM MPAC COVER SHEET PG 1 The MPAC INSTRUCTION GUIDE explains how to complete this form. 3 COMMITTEE 1 ACCOUNT # (Ethics Commission filers)
More informationTexas Ethics Commission P.O.Box 12070 Austin, Texas 78711-2070 (512)463-5800 1-800-325-8506. A. Supported. B. Opposed. A. Supported. B.
Texas Ethics Commission P.O. Box 12070 Austin, Texas 78711-2070 (512)463-5800 1-800-325-8506 GENERAL- COMMITTEE CAMPAIGN FINANCE REPORT GPAC FORM COVER SHEET PG 1 The GPAC INSTRUCTION GUIDE explains how
More informationCORRECTION AFFIDAVIT FOR POLITICAL COMMITTEE
CORRECTION AFFIDAVIT FOR POLITICAL COMMITTEE FORM COR-PAC 1 ACCOUNT # 2 PAGE # 1 of 10 3 COMMITTEE NAME 4 TREASURER NAME Texas Pest Control Association FIRST MI LAST Myers, Ken (Mr.) Date Received OFFICE
More informationJUDICIAL SPECIFIC-PURPOSE COMMITTEE CAMPAIGN FINANCE REPORT
JUDICIAL SPECIFIC-PURPOSE COMMITTEE CAMPAIGN FINANCE REPORT F ORM JSPAC C OVER SHEET PG 1 The JSPAC INSTRUCTION GUIDE explains how to complete this form. 3 COMMITTEE NAME JUDICIAL ROUNDUP PAC 1 ACCOUNT
More informationTexas Ethics Commission P.O.Box 12070 Austin, Texas 78711-2070 (512)463-5800 1-800-325-8506 ADDRESS / PO BOX; APT/SUITE #; CITY; STATE ZIP CODE
MONTHLY FILING GENERAL- COMMITTEE CAMPAIGN FINANCE REPORT F ORM MPAC COVER SHEET PG 1 The MPAC INSTRUCTION GUIDE explains how to complete this form. 3 COMMITTEE NAME Northwest Democrats of Bexar County
More informationTexas Ethics Commission P.O. Box 12070 Austin, Texas 78711-2070 (512)463-5800 1-800-325-8506 ADDRESS / PO BOX; APT / SUITE #; CITY; STATE; ZIP CODE
Texas Ethics Commission P.O. Box 12070 Austin, Texas 78711-2070 (512)463-5800 1-800-325-8506 GENERAL-PURPOSE COMMITTEE CAMPAIGN FINANCE REPORT GPAC FORM COVER SHEET PG 1 The GPAC INSTRUCTION GUIDE explains
More informationTexas Ethics Commission P.O. Box 12070 Austin, Texas 78711-2070 (512)463-5800 TDD 1-800-735-2989
Texas Ethics Commission P.O. Box 12070 Austin, Texas 78711-2070 (512)463-5800 TDD 1-800-735-2989 GENERAL- CAMPAIGN FINANCE REPORT GPAC FORM COVER SHEET PG 1 The GPAC INSTRUCTION GUIDE explains how to form.
More informationTexas Ethics Commission P.O. Box 12070 Austin, Texas 78711-2070 (512)463-5800 1-800-325-8506 ADDRESS / PO BOX; APT / SUITE #; CITY; STATE; ZIP CODE
Texas Ethics Commission P.O. Box 1200 Austin, Texas 811-200 (512)463-5800 1-800-325-8506 COUNTY EXECUTIVE COMMITTEE CAMPAIGN FINANCE REPORT CEC FORM COVER SHEET PG 1 The CEC INSTRUCTION GUIDE explains
More informationTexas Ethics Commission P.O. Box 12070 Austin, Texas 78711-2070 (512)463-5800 1-800-325-8506 MS / MRS / MR FIRST MI. ... NICKNAME LAST SUFFIX Noll
JUDICIAL CANDIDATE / OFFICEHOLDER CAMPAIGN FINANCE REPORT JC/OH FORM COVER SHEET PG 1 The JC/OH INSTRUCTION GUIDE explains how to complete this form. 3 CANDIDATE / OFFICEHOLDER NAME 1 ACCOUNT # (Ethics
More informationTexas Ethics Commission P.O. Box 12070 Austin, Texas 78711-2070 (512)463-5800 TDD 1-800-735-2989. 2 PAGE # 1 of 13 3 COMMITTEE NAME OFFICE USE ONLY
Texas Ethics Commission P.O. Box 12070 Austin, Texas 78711-2070 (512)463-5800 TDD 1-800-735-28 GENERAL- COMMITTEE CAMPAIGN FINANCE REPORT GPAC FORM COVER SHEET PG 1 The GPAC INSTRUCTION GUIDE explains
More informationCANDIDATE / OFFICEHOLDER CAMPAIGN FINANCE REPORT
CANDIDATE / OFFICEHOLDER CAMPAIGN FINANCE REPORT FORM C/OH COVER SHEET PG 1 The C/OH Instruction Guide explains how to complete this form. 1 Filer ID (Ethics Commission Filers) 2 Total pages filed: 3 CANDIDATE
More informationLEGISLATIVE CAUCUS REPORT OF CONTRIBUTIONS & EXPENDITURES
LEGISLATIVE CAUCUS REPORT OF CONTRIBUTIONS & EXPENDITURES FORM LEG COVER PAGE The Form LEG I NSTRUCTION GUIDE explains how to complete this form. 3 CAUCUS NAME House Democratic Caucus 1 2 PAGE # 1 of 10
More informationTexas Ethics Commission P.O. Box 12070 Austin, Texas 78711-2070 (512)463-5800 TDD 1-800-735-2989 MS / MRS / MR FIRST MI
JUDICIAL CANDIDATE / FICEHOLDER CAMPAIGN FINANCE REPORT JC/OH FORM COVER SHEET PG 1 The JC/OH INSTRUCTION GUIDE explains how to complete this form. 3 CANDIDATE / FICEHOLDER NAME 1 ACCOUNT # (Ethics Commission
More informationTexas Ethics Commission P.O. Box 12070 Austin, Texas 78711-2070 (512)463-5800 1-800-325-8506. MS / MRS / MR FIRST MI Maria Teresa
JUDICIAL CANDIDATE / OFFICEHOLDER CAMPAIGN FINANCE REPORT JC/OH FORM COVER SHEET PG 1 The JC/OH INSTRUCTION GUIDE explains how to complete this form. 3 CANDIDATE / OFFICEHOLDER NAME 1 ACCOUNT # (Ethics
More informationTexas Ethics Commission P.O. Box 12070 Austin, Texas 78711-2070 (512)463-5800 TDD 1-800-735-2989. MS / MRS / MR FIRST MI Michael D.
JUDICIAL CANDIDATE / FICEHOLDER CAMPAIGN FINANCE REPORT JC/OH FORM COVER SHEET PG 1 The JC/OH INSTRUCTION GUIDE explains how to complete this form. 3 CANDIDATE / FICEHOLDER NAME 1 ACCOUNT # (Ethics Commission
More informationTexas Ethics Commission P.O. Box 12070 Austin, Texas 78711-2070 (512)463-5800 1-800-325-8506 MS / MRS / MR FIRST MI. ... NICKNAME LAST SUFFIX Peden
JUDICIAL CANDIDATE / OFFICEHOLDER CAMPAIGN FINANCE REPORT JC/OH FORM COVER SHEET PG 1 The JC/OH INSTRUCTION GUIDE explains how to complete this form. 3 CANDIDATE / OFFICEHOLDER NAME 1 ACCOUNT # (Ethics
More informationTexas Ethics Commission P.O. Box 12070 Austin, Texas 78711-2070 (512)463-5800 1-800-325-8506 COMMITTEE CAMPAIGN TREASURER ADDRESS
JUDICIAL CANDIDATE / OFFICEHOLDER CAMPAIGN FINANCE REPORT JC/OH FORM COVER SHEET PG 1 The JC/OH INSTRUCTION GUIDE explains how to complete this form. 3 CANDIDATE / OFFICEHOLDER NAME 1 ACCOUNT # (Ethics
More informationTexas Ethics Commission P.O. Box 12070 Austin, Texas 78711-2070 (512)463-5800 1-800-325-8506 MS / MRS / MR FIRST MI. ... NICKNAME LAST SUFFIX Harris
JUDICIAL CANDIDATE / OFFICEHOLDER CAMPAIGN FINANCE REPORT JC/OH FORM COVER SHEET PG 1 The JC/OH INSTRUCTION GUIDE explains how to complete this form. 3 CANDIDATE / OFFICEHOLDER NAME 1 ACCOUNT # (Ethics
More informationTexas Ethics Commission P.O. Box 12070 Austin, Texas 78711-2070 (512)463-5800 TDD 1-800-735-2989. MS / MRS / MR FIRST MI Maria T.
JUDICIAL CANDIDATE / FICEHOLDER CAMPAIGN FINANCE REPORT JC/OH FORM COVER SHEET PG 1 The JC/OH INSTRUCTION GUIDE explains how to complete this form. 3 CANDIDATE / FICEHOLDER NAME 1 ACCOUNT # (Ethics Commission
More informationTexas Ethics Commission P.O. Box 12070 Austin, Texas 78711-2070 (512)463-5800 1-800-325-8506. MS / MRS / MR FIRST MI Leora T.
JUDICIAL CANDIDATE / OFFICEHOLDER CAMPAIGN FINANCE REPORT JC/OH FORM COVER SHEET PG 1 The JC/OH INSTRUCTION GUIDE explains how to complete this form. 3 CANDIDATE / OFFICEHOLDER NAME 1 ACCOUNT # (Ethics
More informationTexas Ethics Commission P.O. Box 12070 Austin, Texas 78711-2070 (512)463-5800 1-800-325-8506 MS / MRS / MR FIRST MI. ... NICKNAME LAST SUFFIX Hecht
Texas Ethics Commission P.O. Box 1200 Austin, Texas 811-200 (512)463-5800 1-800-325-8506 JUDICIAL CANDIDATE / OFFICEHOLDER CAMPAIGN FINANCE REPORT JC/OH FORM COVER SHEET PG 1 The JC/OH INSTRUCTION GUIDE
More informationSPECIFIC-PURPOSE COMMITTEE SPECIAL SESSION REPORT
SPECIFIC-PURPOSE COMMITTEE SPECIAL SESSION REPORT F ORM SPAC-SS C OVER SHEET PG 1 1 ACCOUNT # (Ethics Commission filers) 2 PAGE # 1/12 3 COMMITTEE NAME Texans for Rick Perry Received OFFICE USE ONLY 4
More informationTexas Ethics Commission P.O. Box 12070 Austin, Texas 78711-2070 (512)463-5800 1-800-325-8506 MS / MRS / MR FIRST MI. ... NICKNAME LAST SUFFIX Brister
Texas Ethics Commission P.O. Box 1200 Austin, Texas 811-200 (512)463-5800 1-800-325-8506 JUDICIAL CANDIDATE / OFFICEHOLDER CAMPAIGN FINANCE REPORT JC/OH FORM COVER SHEET PG 1 The JC/OH INSTRUCTION GUIDE
More informationTexas Ethics Commission P.O. Box 12070 Austin, Texas 78711-2070 (512)463-5800 1-800-325-8506 TITLE FIRST MI. Lori... NICKNAME LAST SUFFIX.
JUDICIAL CANDIDATE / OFFICEHOLDER CAMPAIGN FINANCE REPORT JC/OH FORM COVER SHEET PG 1 The JC/OH INSTRUCTION GUIDE explains how to complete this form. 3 CANDIDATE / OFFICEHOLDER NAME 1 ACCOUNT # (Ethics
More informationEstate Planning - How to File a Service Spending
CANATE FCEHOLER CAMPAGN FNANCE REPORT FORM C/OH COVER SHEET PG 1 The C/OH nstruction Guide explains how to complete this form. 1 Filer 2 Total pages filed: 6 3 CANATE FCEHOLER NAME MS/MRS/MR Mr. FRST Julian
More informationTEXAS ETHICS COMMISSION
TEXAS ETHICS COMMISSION CANDIDATE/OFFICEHOLDER CAMPAIGN FINANCE REPORT FORM C/OH INSTRUCTION GUIDE Revised April 29, 2015 Texas Ethics Commission, P.O. Box 12070, Austin, Texas 78711 (512) 463-5800 FAX
More informationJUDICIAL SPECIFIC-PURPOSE COMMITTEE CAMPAIGN FINANCE REPORT
Texas Ethics Commission P.O.Box 070 Austin, Texas 78711-2070 (5)43-5800 1-800-325-850 JUDICIAL SPECIFIC-PURPOSE COMMITTEE CAMPAIGN FINANCE REPORT F ORM JSPAC C OVER SHEET PG 1 The JSPAC INSTRUCTION complete
More informationTEXAS ETHICS COMMISSION
TEXAS ETHICS COMMISSION CAMPAIGN FINANCE GUIDE FOR POLITICAL COMMITTEES Revised September 15, 2015 Texas Ethics Commission, P.O. Box 12070, Austin, Texas 78711 (512) 463-5800 FAX (512) 463-5777 TDD 1-800-735-2989
More informationTEXAS ETHICS COMMISSION
TEXAS ETHICS COMMISSION CAMPAIGN FINANCE GUIDE FOR CANDIDATES AND OFFICEHOLDERS WHO FILE WITH LOCAL FILING AUTHORITIES This guide is for candidates for and officeholders in the following positions: county
More informationTEXAS ETHICS COMMISSION
IN THE MATTER OF BEFORE THE ELAINE H. PALMER, TEXAS ETHICS COMMISSION RESPONDENT ORDER and AGREED RESOLUTION I. Recitals The Texas Ethics Commission (the commission) met on March 27, 2013, to consider
More informationCANDIDATE AFFIDAVIT [Art. XXVIII, Sec. 2(2) & 1-45-110(1), C.R.S.]
Space Below For Office Use Only Municipal Candidates file with the Municipal Clerk CANDIDATE AFFIDAVIT [Art. XXVIII, Sec. 2(2) & 1-45-110(1), C.R.S.] This affidavit shall certify that I,, am a candidate
More informationPOLITICAL ACTION COMMITTEE (PAC) QUARTERLY REPORTING FORM
POLITICAL ACTION COMMITTEE (PAC) QUARTERLY REPORTING FORM For assistance in completing To be filed with: Calendar year 2014 this form contact: Mark Martin, Secretary of State Arkansas Ethics Commission
More information2. Present residence address no. street town state zip code. Mailing address, only if mail delivery is not available to residence address
Form # A-1 (Rev. 11/12/09) Notary Public Unit Office of the Secretary of the State State of Connecticut PO Box 150470 Hartford, CT 06115-0470 FOR OFFICE USE ONLY Trans. # Acct. # Date of Appt. APPLICATION
More informationHARRIS COUNTY SHERIFF'S DEPARTMENT ATTORNEY'S BAIL BOND APPLICATION 1. NAME OF APPLICANT: BAR CARD # DATE OF BIRTH: DL#
DATE APPLICATION PREPARED: HARRIS COUNTY SHERIFF'S DEPARTMENT ATTORNEY'S BAIL BOND APPLICATION 1. NAME OF APPLICANT: BAR CARD # DATE OF BIRTH: DL# 2. BUSINESS ADDRESS: PHONE # ( ) CITY: ZIP: EMAIL: HOME
More informationTexas Ethics Commission P.O. Box 12070 Austin, Texas 78711-2070 (512)463-5800 1-800-325-8506. 1 ACCOUNT # (Ethics Commission filers) 00016482
Texas Ethics Commission P.O. Box 12070 Austin, Texas 78711-2070 (512)463-5800 1-800-325-8506 GENERAL-PURPOSE COMMITTEE CAMPAIGN FINANCE REPORT GPAC FORM COVER SHEET PG 1 The GPAC INSTRUCTION GUIDE explains
More informationNew Application for Business Occupational Tax Certificate
New Application for Business Occupational Tax Certificate YEAR Business Name: Business Telephone Number: Fax Number: Business Address (physical location): Suite or Apt No.: City, State, Zip: E-mail: Type
More informationSmall Business Enterprises (SBE) Certification Application
Small Business Enterprises (SBE) SBE Certification Program Information and Application Mission Statement: The Office of Business Opportunity is committed to creating a competitive and diverse Business
More informationDRAFT. When & Where to File the Form 460. A. General Information
When & Where to File the Form 460 This chapter reviews when and where committees file the Recipient Committee Campaign Statement (Form 460). All reports and statements filed under the Political Reform
More informationINSTRUCTIONS FOR COMPLETING DBPR ABT 6021 DIVISION OF ALCOHOLIC BEVERAGES AND TOBACCO APPLICATION FOR PASSENGER VESSEL PERMIT
INSTRUCTIONS FOR COMPLETING DBPR ABT 6021 DIVISION OF ALCOHOLIC BEVERAGES AND TOBACCO APPLICATION FOR PASSENGER VESSEL PERMIT If you have any questions or need assistance in completing this application,
More informationProper Procedures to Make Business Permit Changes
Proper Procedures to Make Business Permit Changes Board approval to make changes to a business permit depends upon: A properly completed Application to Make Business Permit Changes accompanied by the appropriate
More informationSEAL. Acknowledgment. Sample Acknowledgment Form: State of Maine County of. The foregoing instrument was acknowledged before me this day of
Acknowledgment An acknowledgment is a formal admission made in person before a proper official by someone who has executed an instrument. The signer must personally appear before the Notary Public, the
More information3. Required Questions (for each debtor), write your answer to each question. Did you meet with your attorney in person before you signed the form?
341 Meeting of Case Number Date 1. Introductory Statement My name is, I represent the Chapter 13 Trustee assigned to your case. Today you will be answering questions about your bankruptcy petition under
More informationState of Maine Office of the Secretary of State
State of Maine Office of the Secretary of State Application for a Notary Public Commission This section is for office use only. Notary Public #: Commission issued: for a Maine Resident Please read these
More informationApplication for Paralegal Certification Exam on October 10, 2015
G. Gray Wilson, Chair Wilson & Coffey 110 Oakwood Drive Suite 400 Winston-Salem, NC 27103 (336) 631-8866 Lisa M. Robinson, Vice-Chair Central Carolina Community College 1105 Kelly Drive Sanford, NC 27330
More informationCampaign Finance Report (NOTE: This report must be clear and legible. It may be typed or printed in blue or black ink.)
PAGE 1 Commonwealth of Pennsylvania Campaign Finance Report (NOTE: This report must be clear and legible. It may be typed or printed in blue or black ink.) Filer Identification Number : 9700012 Report
More informationLast (Surname) First (Given) Middle Initial. Street Address
1 ESSEX COUNTY COLLEGE APPLICATION FOR A CERTIFICATE OF ELIGIBILITY FOR NONIMMIGRANT (F-1) STUDENT STATUS (FORM I-20) MAIN CAMPUS VISIT OUR WEBSITE WEST ESSEX CAMPUS OFFICE OF RECRUITMENT AND MARKETING
More informationCORRECTION/AMENDMENT AFFIDAVIT FOR CANDIDATE/OFFICEHOLDER. 12 Total pages filed: OFFICE USE ONLY. t(~(\e1t\. D D WC ELECTIONS TYPE
Texas Ethics Commission PO Box 12070 Austin Texas 78711-2070 (512) 463-5800 (TOO 1-800-735-2989) FORM COR-C/OH CORRECTON/AMENMENT AFFAVT FOR CANATE/FCEHOLER 1 ACCOUNT# 12 Total pages filed: FCE USE ONLY
More informationIMPORTANT LEGAL NOTICE
IMPORTANT LEGAL NOTICE MAIL THE COMPLETED AND SIGNED FORM AND ALL OF YOUR DOCUMENTATION TO: SAN ANTONIO INDEMNITY COMPANY IN RECEIVERSHIP MILFORD CONSULTING, LLC, SPECIAL DEPUTY RECEIVER P.O. Box 279,
More informationWASHINGTON CONSUMER LOAN COMPANY LICENSE
WA Surrender Checklist Jurisdiction-Specific Requirements WASHINGTON CONSUMER LOAN COMPANY LICENSE Instructions 1. Surrender request must be filed in NMLS within 20 days of the event. 2. Confirm the Records
More informationNOTE: List only Minnesota activity on the following pages:
STATE OF MINNESOTA ANNUAL REPORT OF CONSUMER FINANCE COMPANIES REGULATED LOAN COMPANY TO THE COMMISSIONER OF COMMERCE AS OF DECEMBER 31, NOTE: List only Minnesota activity on the following pages: Licensee:
More informationPART A. I,, in my capacity as Corporate Secretary or LLC Manager Name of Corporate Secretary or LLC Manager
COLORADO DEPARTMENT OF LABOR AND EMPLOYMENT DIVISION OF WORKERS COMPENSATION REJECTION OF COVERAGE BY CORPORATE OFFICERS OR MEMBERS OF A LIMITED LIABILITY COMPANY (LLC) PART A 1. Type of Entity Corporation
More informationMassHealth Commonwealth of Massachusetts EOHHS www.mass.gov/masshealth. MassHealth Buy-In for people who are eligible for Medicare
MassHealth Commonwealth of Massachusetts EOHHS www.mass.gov/masshealth MassHealth Buy-In for people who are eligible for Medicare IF your monthly income before taxes and deductions is below AND your assets
More informationBefore you fill out this paperwork, there may be a faster way to resolve the issue you are currently having with an attorney.
OFFICE OF THE CHIEF DISCIPLINARY COUNSEL STATE BAR OF TEXAS GRIEVANCE FORM ONLINE FILING AVAILABLE AT http://cdc.texasbar.com. I. GENERAL INFORMATION Before you fill out this paperwork, there may be a
More informationFAMILY COURT SERVICES 501 WEST ADAMS STREET, ROOM 2150 JACKSONVILLE, FL 32202 (904) 255-1060 MAIN CHECKLIST FOR: MOTION TO LIFT BANK LEVY
FAMILY COURT SERVICES 501 WEST ADAMS STREET ROOM 2150 JACKSONVILLE FL 32202 (904) 255-1060 MAIN CHECKLIST FOR: MOTION TO LIFT BANK LEVY Use this form if your bank accounts have been frozen by the Department
More informationUI Appeal Hearing Opening
Persons on the telephone in the Appeal Hearing: Williamson Employer Primary Representative, Alice Williamson Brown TWC Hearing Officer Mitchell UI Claimant, Debbie Mitchell Johnson Employer Representative,
More informationTexas. DeVry Impact. Summary Statistics. Earnings by Education Level. Total Wage Growth Over Studied Period. 65% Growth $44,262. 42% Growth $39,478
Texas DeVry Inc. s eight Texas locations 1 produced $82.7 million in economic impact in FY2010. As part of this economic impact, DeVry Inc. schools supported 809 jobs. Wage Impact annually, while the degree
More informationHow To File A Civil Suit In Texas
Effective 09/01/2013 JUDGE ERIN H. GARCIA JUSTICE OF THE PEACE 2-2 974 E HARRISON ST BROWNSVILLE, TEXAS 78520 (956) 544-0858 / FAX: (956) 550-1467 INFORMATION ON CIVIL SUITS The Rules of Judicial Ethics
More informationLicensure as a Pharmacy Technician
*** Submit this page with application *** ***FOR OFFICE USE ONLY*** Receipt # ID # Issue Date License # State of Rhode Island Board of Pharmacy Room 205 3 Capitol Hill Providence, RI 02908-5097 Instructions
More informationForm 309 General Information (Application for Registration of an Out-of-State Financial Institution) Commentary
Form 309 General Information (Application for Registration of an Out-of-State Financial Institution) The attached form is drafted to meet minimal statutory filing requirements pursuant to the relevant
More informationForm 312 General Information (Application for Registration of a Foreign Business Trust, Real Estate Investment Trust or Other Foreign Filing Entity)
Form 312 General Information (Application for Registration of a Foreign Business Trust, Real Estate Investment Trust or Other Foreign Filing Entity) The attached form is drafted to meet minimal statutory
More informationJEFFERSON COUNTY BAIL BOND BOARD APPLICATION FOR SURETY LICENSE
JEFFERSON COUNTY BAIL BOND BOARD APPLICATION FOR SURETY LICENSE NOTICE: Pursuant to Occupations Code Chapter 1704.162 Section (2) (b) and the Jefferson County Bail Bond Board local rules, failure to submit
More informationSAMPLE ARTICLES OF INCORPORATION XYZ BOOSTER CLUB, INC. ARTICLE I. The name of the corporation is XYZ BOOSTER CLUB, INC. ARTICLE II ARTICLE III
SAMPLE ARTICLES OF INCORPORATION XYZ BOOSTER CLUB, INC. ARTICLE I The name of the corporation is XYZ BOOSTER CLUB, INC. The corporation is a non-profit corporation. The period of its duration is perpetual.
More informationTRANSFER OF HOSTING ACCOUNT AND/OR DOMAIN NAME RE: UNAVAILABILITY OF CURRENT REGISTRANT
TRANSFER OF HOSTING ACCOUNT AND/OR DOMAIN NAME RE: UNAVAILABILITY OF CURRENT REGISTRANT If the Current Registrant refuses to sign the REGISTRANT/CUSTOMER TRANSFER AGREEMENT then your Domain Name or Hosting
More informationApplication Checklist of Requirements for Interior Design Certification (N.J.S.A. 45:3-38)
New Jersey Office of the Attorney General Division of Consumer Affairs New Jersey State Board of Architects Interior Design Examination and Evaluation Committee 124 Halsey Street, 3rd Floor, P.O. Box 45001
More informationProfessional Land Surveyor Application
Attach a clear, full-face passportstyle photograph (2 x 2 ) of your head and shoulders, taken within the past six months. A photo is required with each application. Do not use a paper clip to attach the
More informationWhen should this form be used?
INSTRUCTIONS FOR FLORIDA SUPREME COURT APPROVED FAMILY LAW FORM 12.980(j), MOTION FOR MODIFICATION OF INJUNCTION FOR PROTECTION AGAINST DOMESTIC VIOLENCE, REPEAT VIOLENCE, DATING VIOLENCE, OR SEXUAL VIOLENCE
More information2015-2016 FINANCIAL AID STUDENT INFORMATION SHEET
2015-2016 FINANCIAL AID STUDENT INFORMATION SHEET Group 5 Packet Phone: (662) 720-7205 Fax: (662) 720-7232 Please answer all questions carefully. Do not leave any blank. PERSONAL INFORMATION Name Last
More informationAn affidavit is a document containing a statement that the deponent swears to be true to the best of their knowledge.
Affidavit An affidavit is a document containing a statement that the deponent swears to be true to the best of their knowledge. The commissioner then signs as confirmation that the oath or affirmation
More information2016-2017 Liquor License Application Applicant Name:
Cook County Liquor Control Commission 118 N. Clark Street, Room 1160 Chicago, Illinois 60602 (312) 603-3727 (312) 603-5771 (fax) Toni Preckwinkle President Cook County Board of Commissioners Zahra Ali
More informationForm 304 General Information (Application for Registration of a Foreign Limited Liability Company) Commentary
Form 304 General Information (Application for Registration of a Foreign Limited Liability Company) The attached form is drafted to meet minimal statutory filing requirements pursuant to the relevant code
More informationForm 201 General Information (Certificate of Formation For-Profit Corporation) Commentary
Form 201 General Information (Certificate of Formation For-Profit Corporation) The attached form is drafted to meet minimal statutory filing requirements pursuant to the relevant code provisions. This
More informationAUSTIN CPA CHAPTER/CPE FOUNDATION Becker Review Course Scholarship GUIDELINES AND INSTRUCTIONS
AUSTIN CPA CHAPTER/CPE FOUNDATION Becker Review Course Scholarship GUIDELINES AND INSTRUCTIONS The Becker Review Course Scholarship offered by the Austin CPA Chapter/CPE Foundation covers 2 sections of
More informationSTATE OF NEVADA OFFICE OF THE SECRETARY OF STATE
STATE OF NEVADA ROSS MILLER SCOTT W. ANDERSON Deputy Secretary for Commercial Recordings Commercial Recordings Division 202 N. Carson Street Carson City, NV 89701-4069 Telephone (775) 684-5708 Fax (775)
More informationInstructions Application for a Business License
New Jersey Office of the Attorney General Division of Consumer Affairs Fire Alarm, Burglar Alarm and Locksmith Advisory Committee 124 Halsey Street, 6th Floor, Newark, NJ 07102 http://www.njconsumeraffairs.gov/fbl/
More informationCertificate of Employment for Health Care Risk Managers
Certificate of Employment for Health Care Risk Managers PART I (1) or (2): TO BE COMPLETED BY THE APPLICANT FOR HEALTH CARE RISK MANAGER LICENSURE, IF USING EXPERIENCE TO QUALIFY. (1) I hereby certify
More informationM E M O R A N D U M. TO: All Interior Designer Candidates. FROM: Jean Williams, Executive Director Oklahoma Board of Architecture
M E M O R A N D U M TO: All Interior Designer Candidates FROM: Jean Williams, Executive Director Oklahoma Board of Architecture RE: Registration and Testing Application Process This application is for
More informationMississippi State Board of Nursing Home Administrators 1755 Lelia Drive, Ste. 305, Jackson, MS 39216 (601) 362-6914 www.msnha.ms.
1755 Lelia Drive, Ste. 305, Jackson, MS 39216 (601) 362-6914 www.msnha.ms.gov Application Information Sheet Administrator-in-Training Program (AIT) It is reasonable for you to expect a time frame of nine
More informationREPORT OF CONTRIBUTIONS AND EXPENDITURES
FORM R-1 REPORT OF CONTRIBUTIONS AND EXPENDITURES NEW JERSEY ELECTION LAW ENFORCEMENT COMMISSION P.O. Box 185, Trenton, NJ 08625-0185 (609) 292-8700 or Toll Free Within NJ 1-888-313-ELEC (3532) www.elec.state.nj.us
More informationForm 203 General Information (Certificate of Formation Professional Corporation) Commentary
Form 203 General Information (Certificate of Formation Professional Corporation) The attached form is drafted to meet minimal statutory filing requirements pursuant to the relevant code provisions. This
More informationRisk Management GUIDE GUIDE. for PHYSICIAN. Austin, TX 78716 800-580-8658 512-425-5800. www.tmlt.org
More information
When should this form be used?
INSTRUCTIONS FOR FLORIDA SUPREME COURT APPROVED FAMILY LAW FORM 12.980(i), MOTION FOR EXTENSION OF INJUNCTION FOR PROTECTION AGAINST DOMESTIC VIOLENCE, REPEAT VIOLENCE, DATING VIOLENCE, OR SEXUAL VIOLENCE
More informationSTATEMENT OF FINANCIAL INTEREST
STATEMENT OF FINANCIAL INTEREST For assistance in completing State/District officials file with: Calendar year covered this form contact: Mark Martin, Secretary of State (Note: Filing covers the previous
More informationCITY OF JACKSON, MISSISSIPPI MINORITY/WOMEN BUSINESS ENTERPRISE DISCLOSURE AFFIDAVIT
CITY OF JACKSON, MISSISSIPPI MINORITY/WOMEN BUSINESS ENTERPRISE DISCLOSURE AFFIDAVIT In order to evaluate the legitimacy of each MBE/FBE applicant, certain relevant information must be provided initially,
More informationDEBT SETTLEMENT PLAN (Only Committees that are terminating are eligible to file this form.) (See reverse side for instructions)
FOR OCF USE ONLY GOVERNMENT OF DISTRICT OF COLUMBIA OFFICE OF CAMPAIGN FINANCE WASHINGTON, D.C. 20009 ID# NAME OF DEBT SETTLEMENT PLAN (Only Committees that are terminating are eligible to file this form.)
More information1 Account. SIMPLE IRA Distribution Form. Owner information. distribution For transfer incident to divorce see Sections 3 and 6.
1 Account Owner information 2 Request Please type or print carefully. If your address is different from what is currently shown on your account, your signature must be guaranteed in Section 13. for distribution
More informationApplication for Tax Abatement for Rehabilitation of Property in a Local Historic District
Application for Tax Abatement for Rehabilitation of Property in a Local Historic District Historic Preservation Office Austin, Texas 512-974-2727 Adopted December 2012 To encourage preservation and maintenance
More informationINFORMATION ABOUT THE RECOVERY FUND PROCESS
TEXAS DEPARTMENT OF SAVINGS & MORTGAGE LENDING Douglas B. Foster Commissioner INFORMATION ABOUT THE RECOVERY FUND PROCESS The Texas Department of Savings and Mortgage Lending accepts signed, written claims
More informationAthletic Trainer License Application Methods
Athletic Trainer License Application Methods Please read carefully to determine the application method for which you are qualified Indicate the appropriate method on the application and submit the required
More informationRETURN TO ALCOHOLIC BEVERAGE CONTROL PERMIT DEPARTMENT P.O. BOX 540 MADISON, MS 39130-0540
APPLICATION, CHANGE IN LOCATION OF ABC PERMITTED BUSINESS RETURN TO ALCOHOLIC BEVERAGE CONTROL PERMIT DEPARTMENT P.O. BOX 540 MADISON, MS 39130-0540 APPLICATION INSTRUCTIONS Please read these instructions
More information