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APPOINTMENT AND CERTIFICATION OF POLITICAL TREASURER FOR CANDIDATES AND COMMITTEES (Please Print or Type) 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 certifi es the name and address of the treasurer to the Secretary of State. C-1 Rev. 1/15 Certifi cation is for (check appropriate box below): CANDIDATE: Name of Candidate: Home Phone: Work Phone: Cell Phone: Offi ce Sought: District Number: Party: Candidate Mailing address: Candidate email address: Signature of Political Treasurer Signature of Candidate or Committee Chairman RETURN THIS FORM TO: Lawerence Denney Secretary of State Elections Division PO Box 83720 Boise, ID 83720-0080 (208) 334-2852 Fax: (208) 334-2282 I, do hereby accept the appointment as political treasurer for the above named candidate or committee. Name of Political Treasurer: Home Phone: Work Phone: Cell Phone: Treasurer Residence address: Treasurer email address: COMMITTEE: Name of Committee: Home Phone: Work Phone: Cell Phone: Name of Committee Chairman: Party Affi liation (if any): Committee Mailing address: Chairman email address: Party: Miscellaneous: Measure: Candidate/Measure: CERTIFICATION AND APPOINTMENT I, do hereby certify and appoint the following individual who is a registered elector of the State of Idaho as the political treasurer for the above named candidate or committee: Name of Candidate or Committee Chairman Name of Political Treasurer Treasurer Mailing address: Submit to: Eagle City Clerk 660 E. Civic Ln. Eagle, ID 83616 [PHONE REDACTED] e-mail: [EMAIL REDACTED]