1 Filer ID (Ethics Commission Filers) 2 Total pages filed: ca A*'<- - STREET ADDRESS ( O PO BOX PLEASE); APT / SUITE #; CITY; ST TE; ZIP CODE
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1 CANDIDATE/FICEHOLDER FORM C/GH CAMPAIGN FINANCE REPORT 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/ FICEHOLDER AME MS / MRS / MR FIRST Ml NICKNAME LAST SUFFIX Received FICE USE ONLY 4 CANDIDATE/ FICEHOLDER MAILING ADDRESS Change of Ad ress 5 CANDIDATE/ FICEHOLDER PHONE 6 CAMPAIGN TREASURER NAME ADDRESS / PO BOX; APT / SUITE #; CITY; STATE; ZIP CODE j Id T / /rc OsTy, <n -T'wn> AREA CODE PHONE UMBER EXTENSIO S; RS/ R FJRST Ml A s' NICK A E last SUFFIX ca A*'<- - t and-d ivered or Postmarked Y/lfi/n Receipt # Amount $ Processed. imaged 7 CAMPAIGN TREASURER ADDRESS (Residence or Business) STREET ADDRESS ( O PO BOX PLEASE); APT / SUITE #; CITY; ST TE; ZIP CODE H /1 - V/aFT* CAMPAIGN TREASURER PHONE AREA CODE PHO E NU BER EXTE SION 9 REPORT TYPE o» ; si»,zr (Officeholder Only) July 15 [u j sth day before election Exceeded $500 limit Final Report (Attach C/OH - FR) 10 PERIOD COVERED Month Day Year M " h Year o 1 ~7, f f through a L / / 11 ELECTION ELECTION DATE Month Day Year / 7 12 FICE FICE HELD (if any) ELECTION TYPE R ia y } 1 Runoff 1 1 Other General d] Special 13 FICE SOUGHT (it known) A ft ( <** f?s S' Forms provided by Texas Ethics Commission GO TO PAGE 2 w w.ethics.state.tx.us Revised 9/8/2015
2 ln y CANDIDATE / FICEHOLDER CAMPAIGN FINANCE REPORT FORM C/OH CO ER SHEET PG 2 14 C/OH NAME \J, LIa S1S/ L I rfc 15 Filer ID (Ethics Commission Filers) 16 NOTICE FROM THIS box is for notic of political contributions accepted or political expenditures m de by po itical committees to SUPPORT THE CANDIDATE / FICEHOLDER, THESE S MAY HAVE BEEN MADE WITHOUT THE CANDIDATE'S OR FICEHOLDER S POLITICAL COMMITTEE(S) KNOW EDGE OR CONSENT. CANDIDATES ND FICEHOLDERS ARE REQUIRED TO REPORT THIS INFORM TION ONLY IF THEY RECEIVE NOTICE SUCH S. COMMITTEE TYPE COMMITTEE NAME [GENERAL specific COM ITTEE tpdress COMMITTEE CA PAI N TREASURER NAME ] A ditional Pages COM ITTEE CAMPAIGN TREASURER ADDRESS 17 CONTRIBUTION TOTALS TOTAL POLITICAL CONTRIBUTIONS $50 OR LESS (OTHER THAN PLEDGES, LOANS, OR GUARANTEES LOANS), UNLESS ITEMIZED TOTAL POLITICAL CONTRIBUTIONS (OTHER THAN PLEDGES, LOANS, OR GUARANTEES LOANS) TOTALS TOTAL POLITICAL S $100 OR LESS, UNLESS ITEMIZED TOTAL POLITICAL S CONTRIBUTION BALANCE OUTSTANDING LOAN TOTALS TOTAL POLITICAL CONTRIBUTIONS MAINTAI ED AS THE LAST DAY REPORTING PERIOD TOTAL PRI CIPA AMOUNT ALL OUTSTANDING LOANS AS THE LAST DAY THE REPORTING PERIOD 18 AFFIDAVIT SHARON NOWAK Notary Public, State of Texas Comm. E pires Notary ID swear, or affirm, under penalty of perjury, that t e accompany ng report is true and correct and includes all information required to be reported by me under Title 15, Election G etc' AFFIX NOTARY STAMP/SEAL ABOVE Sworn to gpd subscribed before me, by the said _ Bill, this the 6 20 f~? to certify which, witness my hand and seal of office. Sb&fflr) aoakl Pub I c Signature of officer administering oath Printed name of officer a ministering oath Title of officer administe ing oath Forms provided by Texas Ethics Commission ww.et ics.state.tx,us Revised 9/8/2015
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4 POLITICAL S MADE FROM POLITICAL CONTRIBUTIONS schedule r CATEGORIES FOR BOX 8(a) Ad ertising Expense Event Expense Loan RepaymenVReimbursement Solicitation/Fundraising E ense Accounting/Banking Fees Office O erhead/rental Expense Trans ortation Equipment & Related Expense Consult ng Expense Food/Be erage Expense Polling Expense Travel In District Contributions/Donations Made By Gift/Awards/Memorials Expense Printing E pense Travel Out Of District Candidate/Officeholder/Political Committee Le al Services Salaries/Wages/Contract Labor Other (enter a category not listed above) Credit Card Payment The lnstructjon Guide explains how to complete this form. 1 Total pages Schedule F1: t 2 FILER N ME 3 Filer ID (Ethics Commission Rlers) 4 Da(e.. 5 Pa ee name / 6 7 Payee ad ress; City; Stsftef Zip Code 8 (a) Category (See Categories listed at the top of this schedule) / Jv- S (b) 1 1 Check if travel outside of Texas. Complete Schedule T. f 1 Check it Austin, IX, officeholder li ing expense 9 Complete ONLY if direct Candidate / Officeholder name Office sought Office held expenditure to benefit C/OH Zl * i /1/ m [ f 3 Z- Payee name c ' app r Payee address; City; State; 2?!p Code fa 1 Category (See Categories listed at the top of this schedule) /fao Y i 1 Check if travel outside ot Texas. Complete Schedule I. 1 1 Check if Austin, TX, office older living expense Complete ONLY if direct e enditure to benefit GO /1 t/ n f «/ Candidate / Officeholder name Office sought Ottice eld WiUro# T Payee name l iarp r f tfa t y f LjK Payee add ess; City; State; Zip Code j EXPE DITURE (far / fan- Category (See Categories listed at the top of this schedule) t( 0, Check If travel outside of Texas. Complete Schedule T. 1 1 Chec if Austin, T, officeholder living e pense Complete O LY if direct expenditure to benefit GO Candidate / Officeholder name Office sought Office held H \fa>llm/t ' r fa ATTACH ADDITIONAL COPIES THIS SCHEDULE AS NEEDED Forms provided by Texas Ethics Commission Revised 9/8/2015
5 POLITICAL S MADE FROM POLITICAL CONTRIBUTIONS schedule F1 EXPE DITURE CATEGORIES FOR BOX 8(a) Advertising Expense E ent Expense Loan Repayment/Reimbursement Soiicitation/Fundraising Expense Account!ng/Banking Fees OfficeOverhead/Rental Expense Transportation Equipments Related Expense Consulting Expense Food/Beverage Expense Polling Expense T a el In District Contributions/Do ations Made By Gift Awards/ emorials Expense Printing Expense Travel Out Of District Candidate/Officeholder/Political Committee Legal Ser ices Salaries /Vages/Contract Labor Other (enter a category not listed above) Credit Card Payment «-,,., * The Instruction Guide ex lains how to complete this form. 1 Total pages Schedule F1: 2 FILER NAME. 3 Filer ID (Ethics Commission Rlers) 4 4 / h( < 7 \ J i P 4 w /A<r. 5 Payee name ( 6 Amc/unt ( ) 7 Payeer address; City; State; Zip Code 8 fp Ty/ fp (a) Category (See fategories listed at the top of this schedule) /:U (b) I I Check if tra el outside of Texas. Complete Schedule T. I I Check if Austin, TX, officeholder living expense q cormlete ONLY if direct Candidate / Officeholder name., Office sought Office held expenditure to benefit CTOH / SaT fe* ayee name Payee s(&dress; City; State; Zip Code A-P, Category (Sfee Categories listed at the top of this schedule) A i I I Check if travel outside of Te as. Complete Schedule T. I i Check if Austin, TX, officeholder li ing expense Complete ONLY if direct Candidate Officeholder na e Office sought Office eld expenditure to benefit CVOH M/ - ry Pc / //7 Payee name / // i As (1/ / PPc Payee address; City; State; Zip Code Ar dv Category (See Categories listed at the top of this schedule) AAl/, I I Check if travel outside of Te as. Co plete Schedule T. I I Check if Austin. TX, officehol er living expense Con-nlete O LY if direct Candidate Officeholder name Offic sought Office held expenditure to benefit OOH t / _ / i,, (h //// r fd&t-py ATTACH ADDITIONAL COPIES THIS SCHEDULE AS NEEDED Forms provided by Texas Ethics Commission Revised 9/8/2015
6 if r MONETARY POLITICAL CONTRIBUTIONS schedule A1 The Instruction Guide explains how to complete this form. 1 Total pages Schedule At: 2 FILER NAME 3 Filer ID (Ethics Commission Filers) 4 F> F ll name of contributor n t-nf-state PAC (ID#: ) { i Jer 6 Contributor address; City; State; Zip Co e 7 Amount of contribution ($) 1 8 Principal occupation / Job title (See Instructions) 9 Employer (See Instructions) 3/l»l Full name of contributor out-of-state PAC (ID#: ) Amount of contribution ($) Contributor address; Cit ; State; Zip Code Principal occup tion / Job title (See Instructions) Employer (See Instructions)?/ 1 Full name of contributor out-of-state PAC (ID#: ) / /fa /tlk t hccjj Amount of contribution ($) l - V Principal occupation / Job title (See Instructions) / E ployer (See Instructions) CD Full name of contributor ni -nf-stat pac (in#: ) Amount of contribution ($). o i / a/ T 74 4 Principal occupation / Job title (See Instructions) Employer (See Instructions) ATTACH ADDITIONAL COPIES THIS SCHEDULE AS NEEDED If contributor is out-of-state PAC, please see instruction guide fo additional reporting requi ements. Forms provided by Texas Ethics Commission Revised 9/8/2015
7 MONETARY POLITIC L CONTRIBUTIO S schedule A1 The Instruction Guide explains how to complete this form. 2 FILER NAME W Full name of contributor fl out-of-state PACIID#: ) }/vw- fe dpl -J 6 1 Total pages Schedule At: 3 Filer ID (Ethics Commission Filers) 7 Amount of contribution ($) f 8 Principal occupation / Job title (See Instructions) 9 Employer (See Instructions) Full name of contributor fl out-of-state PAC (ID#: 1 Amount of contribution ($).. Contr butor address; ( Cit : State; Zip Code Principal occupation / Job title (See Instructions) f] E ployer (See Instructions) Full name of contributor H out-of-state PAC (ID#: ) Amount of contribution ($) Principal occupat on Job title (See Instructions) Employer (See Inst uctions) Full name of contributor n out-of-state P C (ID#: ) Amount of contribution ($) Principal occupation / Job title (See Instructions) Employer (See Instructions) ATTACH ADDITIONAL COPIES THIS SCHEDULE AS NEEDED If contributor is out-of-state P G, please see instruction guide for additional reporting requirements. Forms provided by Texas Ethics Commission Revised 9/8/2015
Texas Ethics Commission P.O. Box Austin, Texas (512) (TDD )
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