FORM C/OH CAMPAIGN FINANCE REPORT COVER SHEET PG 1. Date Received NICKNAME LAST SUFFIX r--:! (T,..all ~ 'r_i"';t TX - (J. N :t: ADDRESS.
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1 CANDDATE / OFFCEHOLDER FORM C/OH CAMPAGN FNANCE REPORT COVER SHEET PG 1 1 Filer D (Ethics Commission Filers) 2 Total pages filed: The e/oh nstruction Guide explains how to complete this form. - 3 CANDDATE/ MS/MRS~ FRST M OFFCE USE ONLY OFFCEHOLDER NAME BV(K.~ Date Received NCKNAME LAST SUFFX r--:! c:.':) ~""- o' c.; ~ a' 4 CANDDATE/ ADDRESS / PO BOX; APT / SUTE #; CTY; STATE; ZP CODE -- :tj OFFCEHOLDER (T,..all ~ 'r_i"';t TX - (J MALNG 1.-"2..9 (,-oe.,..+t ~r-. N :t: ADDRESS :tt~ í~o~ :r,::if:l (i O Change of Address ::!Jl':.- C d~ 5 CANDDATE/ AREA CODE PHONE NUMBER EXTENSON 00 C') OFFCEHOLDER Hand-delivered or Date<EJl)tmarked PHONE O (2/4 ) 505- ~~,~ Date 6 CAMPAGN MS / MRS / MR FRST M Receipt # TREASURER (~~~(l... NAME Date Processed NCKNAME LAST SUFFX Date maged [c\a \e.fy\otj 7 CAMPAGN STREET ADDRESS (NO PO BOX PLEASE); APT / SUTE #; CTY, STATE; ZP CODE TREASURER ADDRESS \34'2. l (Residence or Business) AS~b("O~ L~ <;C"q... ~ ~ ("'q ~ r-\.t 'LX 150~l_ e: Amount ""'" e=: 8 CAMPAGN AREA CODE PHONE NUMBER EXTENSON TREASURER PHONE (4l'1 ) 43~'- 0//9 9 REPORT TYPE D January 15 30th day before election D Runoff D D ~UY15 D 8th day before election D Exceeded 500 limit D 15th day after campaign treasurer appointment (Officeholder Only) Final Report (Attach C/OH - FR) 10 PEROD Month Day Year Month Day Year COVERED 'f /l~ / ( {, /3 / 16 THROUGH 11 ELECTON ELECTON DATE ELECTON TYPE Month Day Year O Primary O Runoff O Other Description 5 /1 / 1(; ~General O Special 12 OFFCE OFFCE HELD (if any) 13 OFFCE SOUGHT (if known) Sc:_hOO\ ~oo~ P\ac(._ Qt,qr~t GO TO PAGE 2
2 CANDDATE / OFFCEHOLDER CAMPAGN FNANCE REPORT FORM C/OH COVER SHEET PG 2 14 C/OH NAME 16 NOTCE FROM POLTCAL COMMTTEE(S) u r \(e.. 15 Filer D (Ethics Commission Filers) THS BOX S FOR NOTCE OF POLTCAL CONTRBUTONS ACCEPTED OR POLTCAL S MADE BY POLTCAL COMMTTEES TO SUPPORT THE CANDDATE / OFFCEHOLDER. THESE S MAY HAVE BEEN MADE WTHOUT THE CANDDATE'S OR OFRCEHOLDER'S KNOWLEDGE OR CONSENT. CANDDATES AND OFFCEHOLDERS ARE REQURED TO REPORT THS NFORMATON ONLY F THEY RECEVE NOTCE OF SUCH S. COMMTTEE TYPE COMMTTEE NAME DGENERAL DSPECFC COMMTTEE ADDRESS COMMTTEE CAMPAGN TREASURER NAME o Additional Pages COMMTTEE CAMPAGN TREASURER ADDRESS 17 CONTRBUTON 1. TOTAL POLTCAL CONTRBUTONS OF 50 OR LESS (OTHER THAN TOTALS PLEDGES, LOANS, OR GUARANTEES OF LOANS), UNLESS TEMZED TOTAL POLTCAL CONTRBUTONS (OTHER THAN PLEDGES, LOANS, OR GUARANTEES OF LOANS) TOTAL POLTCAL S OF 100 OR LESS, TOTALS UNLESS TEMZED TOTAL POLTCAL S 35, CONTRBUTON 5. TOTAL POLTCAL CONTRBUTONS MANTANED AS OF THE LAST DAY BALANCE OUTSTANDNG 6. TOTAL PRNCPAL AMOUNT OF ALL OUTSTANDNG LOANS AS OF THE LOAN TOTALS LAST DAY OF THE REPORTNG PEROD OF REPORTNG PEROD AFFDAVT PATTY C. BUSBY Notary PubliC, State of Texas My Commission Expires March 05, 2018 swear, or affirm, under penalty of perjury, that the accompanying report is ""d"thoo~ true and correct and includes all information required to be reported by me íi#' Signature 01 Candidate or Officeholder AFFX NOTARY STAMP SEALABOVE icer administering oath
3 SUBTOTALS - e/oh FORM e/oh COVER SHEET PG 3 19 FLER NAME ~ ur-k~ \-t ~\, 20 Filer D (Ethics Commission Filers) 21 SCHEDULE SUBTOTALS SUBTOTAL NAME OF SCHEDULE AMOUNT - 1. O SCHEDULEA1: MONETARY POLTCAL CONTRBUTONS 25' O SCHEDULEA2: NON-MONETARY (N-KND) POLTCAL CONTRBUTONS ~OO - 3. O SCHEDULE B: PLEDGED CONTRBUTONS Z 4. SCHEDULE E: LOANS O e: - 5. O SCHEDULE F1: POLTCAL S MADE FROM POLTCAL CONTRBUTONS *5 6. O e: SCHEDULE F2: UNPAD NCURRED OBLGATONS 7. O SCHEDULE F3: PURCHASE OF NVESTMENTS MADE FROM POLTCAL CONTRBUTONS f3' 8. O ro SCHEDULE F4: S MADE BY CREDT CARD 9. O SCHEDULE G: POLTCAL S MADE FROM PERSONAL FUNDS XY ~._. 10. O SCHEDULE H: PAYMENT MADE FROM POLTCAL CONTRBUTONS TO A BUSNESS OF C/OH y 11. O SCHEDULE : NON-POLTCAL S MADE FROM POLTCAL CONTRBUTONS J2) 12. O SCHEDULE K: NTEREST, CREDTS, GANS, REFUNDS, AND CONTRBUTONS RETURNED TO FLER _f2f
4 L\JJtb. MONETARY POLTCAL CONTRBUTONS SCHEDULE A1 f ====-==-::::. =.=- =========~=====..-=--=======-===;==-===--::======..-._ Th, '"~""'tlo" ""'d..--+ "p'''"' how to,omp'''' th', totm. _~_. 1 to,"' "",; Schedule " 3,ALEA NAME f)" rt t \~ a F,',,' D (ell""" Oo,"m;;;;" C',,,, 4 Date s Full name of contributor O out-of-state PAC 110#... m m. '. m.... Amount of contribution () QrQ.fr c;.04fla~ B\q:,r' 5~~DfO~LL~ l lb 6 Contributor addr~ss;.. -- ""OCit~; St~t~;' Zi'P C~d:, t S O O e ~----L.S-+t..Lr!)( ~:~~~l:-:~:~::=ljctions).. _l~ ~mpoyer (See nstrllct~ons) 1/ / '1' Da{te {" ~: ;;~~;:"bo~ l.l-.~ '"~'::;:{" ""' RÚA u S ~ Contributor address; City: State; Zip Code 15 O O - -,, AmOllnt of contribution () 1--P-n-'n-c-iP-a-l-o-cc-"u-p'-a-ti-o-n--/-J-o-b--t-itl~(see-nsíructio~-S) E~ployer (See nstr~;~-) _ _._ _ _ Date 'o" name 0"0011""''' D out state ""'''' J Amount of contribution () ' Contributor address; City: State: _Zi_P C.O_d_e 111_. _ _. _. Principal occupation i Job title (S-e-e--n s-t -r-u--c-ti-o-n-s)------=--=r=- =::lstructl:~:) o._ :::-=D=a=te====~==F=-L==r=la=m=e=o=f =co=r='t=ri=ij=ut=or::::" ===D=o=u=t.=Of=-S:::-~AC:~... _..~T-~llOL;~-t-~;co:~~::~~~~~ ! i Contributor' address; City; State; Zip Code --- ;;: -nc-ip-a-l-o~-cu-l"~;-j-o-b-ti -tl-e-( s--e-e---ns-.t-rl- C-ti-o-n-S) ' -E-m-p-lo -y-e-r-(s-e-e-n-s-tr-l ~on~ ~==-=.==================::::::::::::::::::::::::============================================================================---- ATTACH ADDTONAL COPES OFTHS SCHEDULE AS NEEDED f contributor s out-ot-stats PAC, please see nstruction guide for additional reporting requirements.
5 NON-MONETARY (N-KND) POLTCAL CONTRBUTONS SCHEDULE A2 The nstruction Guide explains how to complete this form. 1 Total pages Schedule A2: 2 FLER NAME ~U,..tl \~Q' \ 3 Filer D (Ethics Commission Filers) 4 TOTAL OF UN TEMZED N-KND POLTCAL CONTRBUTONS ~ t500- PhOtJt. e,a"'\<"" 5 Date 6 Full name of contributor O out-of-state PAC (10#: \ 8 Amount of 9 n-kind contribution Contribution description. (O r~.q.t.j. A_.~~~,:~ a..+.tf. 7 Contributor address; City; State; Zip Code DClleck if travel outside oftexas. Complete Schedule T. 10 Principal occupation / Job title (FOR NON-JUDCAL) (See nstructions) 11 Employer (FOR NON-JUDCAL)(See nstructions) (.\r(.."-~",,('d... f.. 12 Contributor's principal occupation (FOR JUDCAL) 13 Contributor's job title (FOR JUDCAL) (See nstructions) 14 Contributor's employer/law firm (FOR JUDCAL) 15 Law firm of contributor's spouse (if any) (FOR JUDCAL) 16 f contributor is a child, law firm of parentis) (if any) (FOR JUDCAL) Date Full name of contributor O out-ot-state PAC (10#:._..._.._ \ Amount of n-kind contribution Contribution description Contributor address; City; State; Zip Code DCheck if travel outside of Texas. Complete Schedule T..- Principal occupation / Job title (FOR NON-JUDCAL) (See nstructions) Employer (FOR NON-JUDCAL)(See nstructions) Contributor's principal occupation (FOR JUDCAL) Contributor's job title (FOR JUDCAL) (See nstructions) Contributor's employer/law firm (FOR JUDCAL) Law firm of contributor's spouse (if any) (FOR JUDCAL) f contributor is a child, law firm of parentis) (if any) (FOR JUDCAL) ATACH ADDTONAL COPES OF THS SCHEDULE AS NEEDED f contributor s cut-of-state PAC, please see nstruction guide for additional reporting requirements. Forms provided by Texas Ethics COmmission Revised 9/8/2015
6 POLTCAL S MADE FROM POLTCAL CONTRBUTONS SCHEDULE F1 CATEGORES FOR BOX Sea) Advertising Expense Event Expense Loan Repayment/Reimbursement Solicitation/Fundraising Expense Accounting/Banking Fees Oflice Overhead/Rental Expense Transportation Equipment & Related Expense Consulting Expense Food/Beverage Expense Polling Expense Travel n District Contributions/Donations Made By GiHlAwards/Memorials Expense Printing Expense Travel Out Of District Candidate/Officeholder/Political Committee Legal Services Salaries/Wages/Contract Labor Other (enter a category not listed above) Credit Card Payment The nstruction Guide explains how to complete this form. 1 Total pages Schedule Ft: 2 FLER NA~ 13 Filer D (Ethics Commission Filers) \-~\ 4 Da~ /30/" Ur~L 5 Payee name ~oo~,.. t',..,d\j~~ (" \ e.5 6 Amour;t () 7 Payee address; City; State; Zip Code 3s'70. \'-' D4114 r "ÍX S (a) Category (See Categories listed at the top of this schedule) (b) Description D Check if travel outside ot exas. Complete Schedule T PURPOSE ~t,~~ e, OF D Check it Austin, TX, officeholder living expense r r \ t-ñ\tj~ 9 Complete ONLY if direct Candidate / Officeholder name Office sought Office held expenditure to benefit C/OH ~. - Ds/~/" Payee name A uc:;ti ""' L Qc..t,~ Amount () Payee address; City; State; Zip Codl;, Category (See Categories listed at the top of this schedule) Description PURPOSE D Check if travel outside oftexas. Complete Schedule T OF ~ c\ V e. c-t\ S ;JJ) D Check if Austin, TX, ohiceholder living expense EX(] ljj51.. Complete ONLY if direct Candidate / Officeholder name Office sought Office held expenditure to benefit C/OH Date Payee name Amount () Payee address; City; State; Zip Code Category (See Categories listed at the top of this schedule) Description PURPOSE D Check if travel outside of Texas. Complete Schedule T. OF D Checl< if Austin, TX, otticeholder living expense Complete ONLY if direct Candidate / Officeholder name Office sought Office held expenditure to benefit C/OH ATTACH ADDTONAL COPES OFTHS SCHEDULE AS NEEDED Forms provided by Texas Ethics Commission Revised 9/8/2015
u. NICKNAME LAST SUFFIX
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