FORM C/OH CAMPAIG N FINANCE REPORT COV ER SHEET P G 1. 1 Filer ID (Ethics Commission Fliers) 2 Tolal pages tiled: 5],l ~A-rJ,vl

Transcription

1 CANIATE I FICEHOLER CAMPAIG N FINANCE REPORT COV ER SHEET P G 1 T he C/OH Instruction Guide expl ain s h o w to c omp l ete t h is form. 1 Filer I (Ethics Commission Fliers) 2 Tolal pages tiled: 3 C A N IATE / MS I MRS I MA FIRST Ml O FFICEHOLER 5],l A-rJ,vl N A ME NICKNA ME LAST SUFFIX G>Ofr 4 C A NIATE / ARESS I PO BOX; APT I SUITE #; CITY; STATE ; ZIP COE O FFICEHOL E R I O FFIC E U SE ONLY RECEIVE APR B /5 A-SH-0:::(,rJG Cr Legal epartment M A ILING ARESS Cha nge of Address MY, -ry 77 ' :3o 5 CANIATE/ ARE A COE PHONE NUMBER EXTENS ION FICEHOLER PHONE ( 7 /"?:> ) 2-if B--( '?Ob 6 C A M PAIGN MS I MRS I MR FIRST Ml Receipt # TR E A S URER - G if.n _ S.' N AM E.... a te Pro cessed NICKNAM E LAST SUFFIX al e Imaged Geoff- 7 C A M PAIG N STREET ARESS (NO PO BOX PLEASE); APT I SU ITE #: CITY; STATE ; ZIP COE TREASURER A RESS q;j,f It> Pf21 Cr. (Residence or Business) /! JX '77Lf9f 8 C A MPAIGN AREA COE PHONE NUMBER EXTENSION T R E A S U R E R P H ONE ( 1 t 3 ) gjlf.-lf-16l) ato Hand-delivered 0 1 alo Postmarked I Amount S 9 REPORT TYPE January 15 30th day be fore election Runoll July 15 8th day before election Exceeded 500 limit 151h day alter campaign treasurer appointment (Olficeholdcr Only) Final Repon (Atlach C/OH FA) tf / i / 20/8 'f / 2 t.j /?,:o/8 10 P E R IO Month ay Year Month ay Year COVERE THROUGH 11 E L E CTIO N ELECTION ATE ELECTION TYPE Month ay Year Primary / s- / 2o/8 General RunoH Other escnptwn Special 12 FIC E FICE HEL (ii any) 13 FICE SOUGHT I known) GO TO PAGE 2 Form s p rovid ed by Texas Ethics Com mission R evised 9/8/201 5

2 CANIATE I FICEHOLER CAMPAIGN FINANCE REPORT COVER SHEET PG 2 14 C /OH NAME Sl{s fl1. GE.fc;pF 115 Filer I (Ethics Commission Fi lers) 16 NOTICE FROM TH IS BOX IS FOR NOTICE POLITICAL CONTRIB UTIONS ACCEPTE OR POLITICAL EXPENITURES MAE BY POLITICAL COMMITTEES TO P O LITIC A L SU PPORT THE CANIATE f FICEHOLER. THESE EXPENITURES MAY HAVE BEEN MAE WITHOUT THE CANIATE'S OR FICEHOLER'S COMMITTEE(S) KNOWLEGE OR CONSENT. CANIATES AN FICEH OLERS ARE REQU IRE TO REPORT THIS INFORMATION ONLY IF THEV RECE IVE NOTl CE SUCH EXPENITURES. COMM ITTEE TYPE COMM ITTEE NAME 0 GE NERA L OsPECIFIC COMM ITTEE ARESS COMM ITTEE CAMPAIGN TRE ASU RER NAME Additional Pages COMM ITTEE CAMPA IGN TREASURER ARESS 17 CONTRIBUTION 1. TOTAL POLITICAL CONTR IBUT IONS 50 OR LESS (OTHER THAN TOTALS PLEGES, LOANS, OR GUARANTEES LOANS), UNLESS ITEM IZE 2. TOTAL POLITICAL CONTRIBUTIONS (OTH ER THAN PLEGES, LOANS, OR GUARANTEES LOANS) EXPENIT U RE TOTALS 3. TOTAL PO LITICA L EXPEN ITURES 100 OR LESS, UNLESS ITEM IZE 4. TOTAL POLITICAL EXPENITURES 5)o7 CONTRIBUTION BALANCE 5. TO TA L POLITICA L CONTR IBUT IONS MA INTAINE AS THE LAST AY REPORTING PER IO OUTSTANING 6. TO TAL PR INC IPAL AMOUNT ALL OU TSTAN ING LOANS AS THE LOAN TOTAL S LAST AY THE REPORTING PER IO 18 A F FIAVIT s-ttl'-:. SHARON NOWAK [f(,ji_ i Nota ry Public, State of Texas ''{... :/f/ Comm. Expires "',%m,,,,," Notary I I 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 under Title 15, Election Code. S ignatu re of Candidate or Officeholder AFFIX NOTA RY STAMP I SEAL ABOVE Sworn to a nd subscribed before m e, by the said Su.sa.n G-esoff, this the U) day of r::lori l, 20 / S, to certify whic h, witness my h a nd and seal of office. -m.a./2_ ShafoY\ NowQ No-f-aN Public... S ignature of o fficer administering oath Printed name o f o fficer administering oath Title of otficej administeri ng oath Forms provided by Texas Ethics Commission Revised 9/8/2015

3 SUBTOTALS - C/OH COVER SHEET PG 3 19 FILER NAME ht,en &>off- 120 Filer I (Ethics Commission Fi lers) 21 SCHEULE SUBTOTALS SUBTOTAL NAME SCH EULE AMOUNT SCHEULE A 1: MONETARY POLITICAL CONTRIBUTIONS SCH EULE A2: NON-MONETARY (IN-KIN) POLITICAL CONTRIBUTIONS SCHEULE B: PLEGE CONTR IBUTIONS 4. SCHEULE E: LOANS 5. SCHEULE F1: POLIT ICAL EXPENITURES MAE FROM POLITICAL CONTRIBUTIONS SCH EULE F2: UNPAI INCURRE OBLIGATIONS SCHEULE F3: PURCHASE INVESTMENTS MAE FROM POLITICAL CONTRIBUTIONS SCHEULE F4: EXPENITURES MAE BY CREIT CAR SCHEULE G: POLITICAL EXPEN ITURES MAE FROM PERSONAL FUNS 2B)p7 SCHEULE H PAYMENT MAE FROM POLITICAL CONTRIBUTIONS TO A BUSINESS C/OH SCH EULE I: N O N-POLITICAL EXPEN ITURES MAE FROM POLITICAL CONTRIBUTIONS 12. SCHEULE K: INTEREST, CREITS, GAINS, REFUN S, AN CONTRIBUTIONS RETURNE TO FILER Forms provided by Texas Ethics Commission Revised 9/8/20 15

4 POLITICAL EXPENITURES MAE FROM PERSONAL FUNS SCHEULE G Advertising Expense Accounting/Banking Consulting Expense Contributions/onatio ns Made By Candidate/Otticeho lder/po l1tical Com mittee Credit Card Payment EXPENITURE CATEGORIES FOR BOX 8{a) Event Expense Fees Food/Beverage Expense G itt/awards/mem orials Expense Legal Services Loan RepaymenL'A eimbursement Office Overhead/Re ntal Expense Po lling Exp ense Printing Exp ense Salaries/Wages/Contract Labor Th e Instruction Guide explains how to complete this form. Sol1citation/Fundraising Expense Transporta tion Equipment & Rela ted Expense Trave l In istrict Travel O ut O f istrict Othe r (cnlc r a ec tcgory not listed above} Total pages Schedule G: 2 FILER N AM E 3 File r I (Ethics Commission Filers) 4 5 Payee na m e 6 ) 8!15J, b7 political con tributions EXPENITURE!tvC, 7 Payee add ress ; City ; State; Zip Code Sou-rff /VlaJ!ZoAP 77 5'o (a) C a tegory (Sec Catcgor cs listed at the lop of this schedule) (b) e sc riptio n Check if travel ou tside of Texas. Complete Schedule T. Check ii Austin, TX, officeholder living expense 9 Complete ONLY if direct Candidate I Officeholder na m e Office held expe nditu re to benefit C/OH.s:'u.>',i,J G:e>off=..,.. Payee na m e Amount () f hroo political contributions EXPENITURE Payee ad dress; City; State; L IP C od e UL/fu fm!d/3 /ZL Cf/-Mf}tv. Category See Categories listed at the top of this schedule) Com plete ON LY if direct expenditure to benefit C/OH<;u,tAr./ 6 st>rf,,.. (b) escription Check if travel outside or Texas. Complete Schedule T. O Check if Austin, TX, officeholder living expense Office held ate 'f ;?, znr B A4;;) politica l contributions EXPENITURE Complete ON LY if direct expenditure to benefit C/OHS Payee name F/K::EBct>f L Payee address; City ; State ; Zip Code Category {See Categories listed at th e top of this schedule) C andida te I Officeholder nam e {I_ m,,jge>eff- (b) escrip ti o n Check ii travel oulside of Texas. Complete Schedule T. Check ii Austin, TX, officeholder living expense Office held ATIACH AITIONAL COPIES THIS SCHEULE AS NEEE Forms provided by Texas Ethics Commission ate.tx. us Revised 9/8/2015

5 POLITICAL EXPENITURES MAE FROM PERSONAL FUNS SCHEULE G EXPENITURE CATEGORIES FOR BOX 8(a) Advertising Expense Event Expense Loan Repayment/Reimbursement Solicitation/Fundraising Expense Accounting/Banking Fees Office Overhead/Rental Expense Transportation Equipment& Related Expense Consulting Expense Food/Beverage Expense Polling Expense Travel In istrict ContributlonS1onations Made By Gift/Awards/Memorials Expense Printing Expense Travel Out Of istrict Candidate/Officeholder/Political Committee Legal Services SalariesN.lages/Contract Labor Other (enter a category not listed above) Credit Card Payment Th e Instruction Guide explains how to complete this form. 1 Total pages Schedule G: 2 FILER NAME I 3 File r I (Ethics Commission Fi lers) 4 '?-- /to/7_,[j/9, 1 '?o 6 Arfiountf () O political contributions 5 Payee name G /C l,f?"n,j 6-es.oFF 7 Payee ad d ress; City; State; Z ip Code 8 (a) Category (See Categories listed at the top of this schedule) (b) escription Check it travel outside of Texas. Complete Schedule T. EXPENITURE Check if Austin, TX, officeholder living expense IJWerm S!!'iG ft'ffea[ - 9 Complete ONLY if direct Candidate I Officeholder name Office sought Office held expenditure to benefit C/OH S'Lt >M G&> tjff- klh1 /)> /3,olr(l)) t'os mo-j h ate Payee na m e Amount () Payee address; City; State; Zip Code political contri butions Category (See Categories listed at the top of this schedule) (bl escription Check ii travel outside of Texas. Complete Schedule T. EXPENITURE Check it Austin, TX, officeholder living expense Complete ONLY if direct Candidate I Officeholder name Office sought Office held expenditure to benefit C/OH ate Payee name Amount () Payee address; City; State; Z ip Code political contributions Category (See Categories listed at the lop of this schedule) (b) escription Check if travel outside of Texas. Complete Schedule T. EXPENITURE Check ii Austin, TX, officeholder li ving expense Complete ONLY if direct Candidate I Officeholder name Office sought Office held expenditure to benelit C/OH ATTACH AITIONAL COPIES THIS SCHEULE AS NEEE Forms provided by Texas Ethics Commission Revised 9/8/2015