Texas Ethics Commission P.O. Box Austin, Texas (512) (TOO ) FORMC/OH FINANCE REPORT CovER SHEET PG 1
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1 ' {-~,, CAMPAGN TREASURER Texas Ethics Commission P.O. Box Austin, Texas (512) (TOO ) CANDDATE FCEHOLDER FORMC/OH FNANCE REPORT CovER SHEET PG 1 1 ACCOUNT# 2 Total pages filed: (Ethics Commission Filers) The C/OH nstruction Guide explains how to complete this form.... & 3 CANDDATE (_~RS/MR FRST Ml FCE USE ONLY FCEHOLDER NAME Date Received..... n P>.H~84w.r>n~. NCKNAME LAST SUFFX -< r ") k'~j)ey r1... ~Bu. "" (._ ~ t ~'1"A ~;._;; ~""J -..- ;''1 ~"""" i 4 CANDDATE ADDRESS /POBOX; APT SUTE#; CTY: STATE: ZP CODE - '<.! - FCEHOLDER - - MALNG - ""- Date Hand-deli\'!lred or Postmarked ADDRESS. _,., D change of address 5 CANDDATE/ AREA CODE PHONE NUMBER EXTENSON FCEHOLDER PHONE MS~MH ifocl~'dirst 6 CAMPAGN Ml TREASURER. NAME NCKNAME SUFFX &ow~ Rec,ipt #.. Daterrocesse~ 7 CAMPAGN STREET ADDRESS (NO PO BOX PLEASE): APT SUTE#: CTY; STATE: ZP CODE ADDRESS (residence or business) 8 CAMPAGN AREA CODE PHONE NUMBER EXTENSON TREASURER PHONE ' n A:~rn \\;~:A~K \,..\l)~1ot~ l,, ' 9 REPORT TYPE ~anuary 15 D 30th day before election D Runoff D D July 15 D 8th day before election D Exceeded 500 D limit 15th day after campaign treasurer appointment (officeholder only) Final report (Attach C/OH - FR) 10 PEROD Month Day Year Month Day Year. COVERED THROUGH /vq /2DJ3 01 //6//:loif 11 ELECTON ELECTON DATE ~NTYPE Month Day Year Prtmary 0 Runoff 0 General O Special 03/Di /2D'f GOTOPAGE2 12 FCE FCE HELD (if any) 13 FCE SOUGHT (if known) ~0~ Comm;6~~,o~R J?r. 2_. (
2 SUPPORT Texas Ethics Commission PO Box12070 Austin Texas (512) (TDD ) CANDDATE FCEHOLDER REPORT: & TOTALS C~E~SH~T P-9 2 C: '.. ~ ''l C/OH NAME -'15 FORM C/OH ACCOUNT# ~.@lues Ci5fiimissi0ti1'i!.~@) t.n~., - ~.'~,... 'l { : ~,.. r -- ;,, NOTCE FROM - lliis BOX S FOR NOTCE POLTCAL CONlRlBUTONS ACCEPTED OR POLTCAL S MADE BY POLTCAL CO&'iltTEES TO SUPPORr'THE; POLTCAL CANDDATE f FCEHOLDER. THESE S MAY HAVE BEEN MADE WTHOUT THE CANDDATE'S OR FCESOL1JER'S ~EDGE of!:: COMMTTEE(S) CONSENT. CANDDATES AND FCEHOLDERS ARE REQURED TO REPORT lliis NFORMATON ONLY F lliey RECBVE NOTCE 9F:SUCH ~DTURES. COMMTTEE TYPE COMMTTEE NAME --. ',~" ";\) ~- ' <,;.) D GENERAL D SPECFC COMMTTEE ADDRESS COMMTTEE CAMPAGN TREASURER NAME 0 additional pages COMMTTEE CAMPAGN TREASURER ADDRESS 17 CONTRBUTON 1. TOTAL POLTCAL CONTRBUTONS 50 OR LESS (OTHER THAN TOTALS PLEDGES, LOANS, OR GUARANTEES LOANS), UNLESS TEMZED -o- 2. TOTAL POLTCAL CONTRBUTONS (OTHER THAN PLEDGES, LOANS, OR GUARANTEES LOANS) TOTALS 3. TOTAL POLTCAL S 100 OR LESS, UNLESS TEMZED 4. TOTAL POLTCAL S 175.L~f :1 1 D81!J.:2f CONTRBUTON BALANCE OUTSTANDNG LOAN TOTALS 5. TOTAL POLTCAL CONTRBUTONS MANTANED AS THE LAST DAY REPORTNG PEROD 6. TOTAL PRNCPAL AMOUNT ALL OUTSTANDNG LOANS AS THE LAST DAY THE REPORTNG PEROD.2_., DO. tj0 18 AFFDAVT swear, or affirm, under penalty of perjury, that the accompanying report is true and correct and includes all information required to be reported by me ;&~:;:::~oa~ ~~""'"M ot~odl.o,. oct; ho"e' AFFX NOTARY STAMP SEAL ABOVE Swo;;-Jt-and subscribe&efore me, by the said!l ~'">f2'~ t~ t day of 1A-u.. t,v-t.-, 20 my hand, this the Lt/, to certi({ which, witness " and seal of office. l~(u(/ ' firevt.~hjc ''\. ;(/c-{av'y ~nature ifr administering oath Printed name of officer administering oath Title of 6'tticer administering oath
3 Texas Ethics Commission PO Box12070 Austin, Texas (512) (TDD ) POLTCAL CONTRBUTONS OTHER THAN PLEDGES OR LOANS 2 FLER NAME H 4 Date 'LJ,, J.. ~zonn0 The nstruction Guide explains how to complete this form. 1 Total pages Schedule A: SCHEDULE A 3/~ 3 ACCOUNT # (Ethics Commission Filers) 9 Employer (See nstructions) Date Full name of contributor 0 out-of-state PAC (id#:,\ Amount of 1-\ ~~~kind corfttibution Employer (See nstructions) contribution () ', descrtption (if applicable) (f travel outside of Texas, complete Schedule T) Date Full name of contributor 0 out-of-state PAC(D#: ) Amount of n-kind contribution Employer (See nstructions) contribution () description (if applicable) (f travel outside of Texas, complete Schedule T) Date Full name of contributor 0 out-of-state PAC(D#.:_ ') Amountof n-kind contribution contribution () description (if applicable) (f travel outside ~~Texas, comolete Schedule Tl Employer (See nstructions) Date Full name of contributor 0 out-of-state PAC (D#:.,l Amountof n-kind contribution contribution () description (if applicable) (f travel outside of Texas, comolete Schedule Tl Employer (See nstructions) ATACH ADDTONAL COPES THS SCHEDULE AS NEEDED f contributor is out-of-state PAC, please see instruction guide foradditional reporting requirements.
4 Texas Ethics Commission PO Box12070 Austin Texas (512) (TDD ) LOANS The nstruction Guide explains how to complete this form. SCHEDULE E rn 4/& 3 ACCOUNT# ff.1~k;s Ccirliffiission; ~ile'f~) ~-.. ~ 4 TOTAL UNTEMZED LOANS{ 6 slander a financial nstitution? vq 12 /eaclre 14 Description of Collateral 'j{j none 10 nterest rate NA 11 Maturity date Ml). 13 Employer (See nstructions) ltlflh 15 Check if personal funds were deposited into political account 0 16 GUARANTOR NFORMATON 17 Nameofguarantor 19 Amount Guaranteed() 0 not applicable 18 Guarantor address: City; State; Zip Code 20 Principal Occupation (See nstructions) 21 Employer (See nstructions) Date of loan Name of lender 0 out-of-state PAC (D#: ) Loan Amount() s lender a financial nstitution? y N Lender address; City; State; Zip Code nterest rate Maturity date! Employer (See nstructions) Description of Collateral O none GUARANTOR NFORMATON Name of guarantor Check if personal funds were deposited into political account 0 Amount Guaranteed () Guarantor address; City; State; Zip Code 0 not applicable Principal Occupation (See nstructions) Employer (See nstructions) ATTACH ADDTONAL COPES THS SCHEDULE AS NEEDED f lender s out-of-state PAC, please see nstruction guide for additional reporting requirements.
5 Texas Ethics Commission PO Box Austin, Texas (512) (TOO ) POLTCAL S Advertising Expense Accounting/Banking Consulting Expense Event Expense Fees 1 Total pages Schedule F: 4 Date d-t 1 J -oq ~ J 3 6 Amount() CATEGORES FOR BOX 8(a) o<:" ;;-;: :::: 1 Gift/Awards/Memorials Expense Salaries/Wages/Contract Labor Loan Repayment/~~fiiburs~nt ~ -,- 1 Legal Services Solicitation/Fundraising Expense Transportation Equ~ment &~lated El<p~se Food/Beverage Expense Travel n District Contributions/DonattQns Made13y '- _ Polling Expense Travel Out Of District Candidate/OfficeNilder/Political C<imrhittee Printing Expense Office Overhead/Rental Expense '.- J,:::,;'"lllt "!. OTHER (enter a cat!f!)'ory n~jisted at:i6ve) The nstruction Guide explains how to complete this form. ~- : _-! AQCOUN-411 (Ethics~mmission Filers) 2 FLER H~{wnne_; ~ J(eu i ~~ GJ. 8 (a) Category (See categories listed at the top of this schedule) (b) Description (f travel outside of Texas, complete Schedule T) 9 Complete ONLY if direct F/1 /nq Fe-e,. Candidate Officeholder name Date Payee name Amount () Complete QMJ.Y if direct Category (See categories listed at the top of this schedule) Description (f travel outside of Texas, complete Schedule T) Candidate Officeholder name Date Payee name Amount () Complete ONLY if direct Date Category (See categories nsted at the top of this schedule) Description (f travel outside oftexas, complete Schedul& T) Candidate Officeholder name Payee name Amount() Complete QHJ.Y if direct Category (See categories listed at the top of this schedule) Description (f travel outside of Texas, complete Schedule T) Candidate Officeholder name ATTACH ADDTONAL COPES THS SCHEDULE AS NEEDED tx. us Revised 04/19/2013
6 Texas Ethics Commission PO Box12070 Austin Texas (512) (TDD ) POLTCAL S Advertising Expense Accounting/Banking Consulting Expense Event Expense Fees 1 Total pages Schedule F: d- SCHEDULE F CATEGORES FOR BOX 8(a) Gift/Awards/Memorials Expense Salaries/Wages/Contract Labor Loan Repayment/Reimbursement {pj(j Legal Services Solicitation/Fund raising Expense Transportation Equipment & Related Expense Food/Beverage Expense Travel n D1'str.ct ' Contributions/J:!bnatiom~ Made By Polling Expense Travel Out Of District Candidatef!!!tfficeh~er/Poli~ Com!!!~ttee Pnntmg Expense.. Office. Overhead/Rental Expense OTHER (enter a cate~ry not fijf&d abd\te) The nstruction Gutde explams how to complete this form.,.-..,,. c_ ;,)..,:-; ' ~l!lr r..,.., ACCOUNT # ii6ttiics COrllmissioil i'i!ef!l ~-~ ~ -- 4 Date 5 Payeename ;'i ll -11-(~ 6 Amount () rftjo, b:q UnPS 7 }CL~cw-;1} %ot~ 8 (a) Category (See categories listed at the top of this schedule) J i 9 Complete Q!::J.X if direct Candidate Officeholder name Amount () fltej. :?j:, Category (See categories listed at the top of this schedule).f'dd-me:l outside of Texas, complete Schedule T) Complete Q!::1J.X if direct Candidate Officeholder name Category (See categories listed at the top ofthis schedule) ,~ - ~- Complete Q!::J.X if direct expenditure to benefit COH Candidate Officeholder name Amount () Complete Q1i1.Y if direct Category (See categories listed at the top of this schedule) Candidate Officeholder name Description (f travel outside of Texas, complete Schedule T) +1J~ ~ordo ATTACH ADDTONAL COPES THS SCHEDULE AS NEEDED
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