FORM CIOH CAMPAIGN FINANCE REPORT COVER SHEET PG 1. 1 Filer ID 2 Total pages filed: NICKNAME LAST SUFFIX 1.\ MAILING Receipt# Amount ADDRESS
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1 CANDIDATE / FICEHOLDER FORM CIOH CAMPAIGN FINANCE REPORT COVER SHEET PG 1 The C/ OH Instruction Guide explains how to complete this form. 1 Filer ID 2 Total pages filed: 6 3 CANDIDATE/ MS/ MRS/ MR FIRST MI FICEHOLDER Brandon NAME FICE USE ONLY Received NICKNAME LAST SUFFIX 1.\ Jones 1% 4 CANDIDATE/ ADDRESS/ PO BOX; APT/ SUITE#; CITY; ZIP CODE Hand- delivered or Po martgetf.` FICEHOLDER 936 Old Orchard Lane MAILING Receipt# Amount ADDRESS Change of Address Lewisville, TX 7567 Processed Imaged 5 CAMPAIGN MS/ MRS/ MR FIRST MI TREASURER NAME NICKNAME LAST SUFFIX 6 CAMPAIGN STREET ADDRESS( NO PO BOX PLEASE); APT/ SUITE#; CITY; STATE; ZIP CODE TREASURER ADDRESS Residence or Business) 7 CAMPAIGN AREA CODE PHONE NUMBER EXTENSION TREASURER PHONE 8 REPORT TYPE January 15 3th day before election July 15 8th day before election Runoff 15th day after campaign treasurer appointment( officeholder only) El Exceeded$ 5 limit Ei Final Report( Attach C/OH- FR) 9 PERIOD Month Day Year Month Day Year COVERED 7/ 1/ 216 THROUGH 12/ 31/216 1 ELECTION ELECTION DATE ELECTION TYPE Month Day Year Primary Runoff Other I General Special 11 FICE FICE HELD( if any) 12 FICE SOUGHT( if known) Lewisville City Council Place 4 Place 4 GO TO PAGE 2 Forms provided by Texas Ethics Commission us Version V
2 CANDIDATE I FICEHOLDER REPORT: SUPPORT & TOTALS FORM C/ OH COVER SHEET PG 2 2 of 6 13 C/ OH NAME 14 Filer ID 15 NOTICE This box is for notice of political contributions accepted or political expenditures made by political committees to support the FROM candidate/ officeholder. These expenditures may have been made without the candidate' s or officeholder's knowledge or POLITICAL consent. Candidates and officeholders are required to report this information only if they receive notice of such expenditures. COMMITTEE( S) Additional Pages COMMITTEE TYPE COMMITTEE NAME GENERAL Ej SPECIFIC COMMITTEE ADDRESS COMMITTEE CAMPAIGN TREASURER NAME COMMITTEE CAMPAIGN TREASURER ADDRESS 16 CONTRIBUTION 1. TOTAL POLITICAL CONTRIBUTIONS $ 5 OR LESS( OTHER THAN PLEDGES, TOTALS LOANS, OR GUARANTEES LOANS), UNLESS ITEMIZED 2. TOTAL POLITICAL CONTRIBUTIONS OTHER THAN PLEDGES, LOANS, OR GUARANTEES LOANS) 3. TOTAL POLITICAL S $ 1 OR LESS, UNLESS ITEMIZED TOTALS 4. TOTAL POLITICAL S CONTRIBUTION 5. TOTAL POLITICAL CONTRIBUTIONS MAINTAINED AS THE LAST DAY THE $ BALANCE REPORTING PERIOD OUTSTANDING 6. TOTAL PRINCIPAL AMOUNT ALL OUTSTANDING LOANS AS THE LAST DAY $ LOAN TOTALS THE REPORTING PERIOD AFFADAVIT 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. i Signature Can.. ate or Officeholder AFFIX NOTARY STAMP/ SEAL ABOVE Swor to and subscribed before^m e, by the said C \ v ocni.z, this the day of`^', 2 l 1, to certify which, witness my hand and seal of office. VArreiL. Signa re of officer administering Printed name of officer administering Title of officer a ministering oath orms provl. e.. y Texas Et ics ommission www. et ics.sta s ILIE HEINZE dor./ t= Notary Public State of T6X68 Comm. Expires Nofory ID Version V
3 SUBTOTALS - CIOH FORM C/ OH COVER SHEET PG 3 3 of 6 18 FILER NAME 19 Filer ID 2 SCHEDULE SUBTOTALS NAME SCHEDULE SUBTOTAL AMOUNT 1. SCHEDULE Al: MONETARY POLITICAL CONTRIBUTIONS 2. SCHEDULE A2: NON- MONETARY( IN- KIND) POLITICAL CONTRIBUTIONS 3. SCHEDULE B: PLEDGED CONTRIBUTIONS 4. SCHEDULE E: LOANS 5. X SCHEDULE Fl: POLITICAL S FROM POLITICAL CONTRIBUTIONS SCHEDULE F2: UNPAID INCURRED OBLIGATIONS 7. SCHEDULE F3: PURCHASE INVESTMENTS FROM POLITICAL CONTRIBUTIONS 8. SCHEDULE F4: S MADE BY CREDIT CARD 9. SCHEDULE G: POLITICAL S FROM PERSONAL FUNDS 1. SCHEDULE H: PAYMENT FROM POLITICAL CONTRIBUTIONS TO A BUSINESS C/ OH 11. SCHEDULE I: NON- POLITICAL S FROM POLITICAL CONTRIBUTIONS 12. SCHEDULE K: INTEREST, CREDITS, GAINS, REFUNDS, AND CONTRIBUTIONS RETURNED TO FILER Forms provided by Texas Ethics Commission state. tx. us Version V
4 POLITICAL S FROM POLITICAL CONTRIBUTIONS SCHEDULE Fl CATEGORIES FOR BOX 8( a) Advertising Expense Event Expense Loan Repayment/ Reimbursement Solicitation/ Fundraising Expense Fees Office Overhead/Rental Expense Transportation Equipment& Related Expense Consulting Expense Food/ Beverage Expense Polling Expense Travel in District Contributions/ Donations Made By- Gift/ Awards/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 Instruction Guide explains how to complete this form. 1 Total pages Schedule Fl: 2 FILER NAME 3 Filer ID Sch: 1/ 3 Rpt: 4/ / 29/ 216 Frost Bank 6 Amount($) 7 Payee address; City; State; Zip Code W Main St 8 PURPOSE a) Category ( See Categories listed at the top of this schedule) ( b) Description - El Check if travel outside of Texas. Complete Schedule T. 9 8/ 3/ 216 Frost Bank W Main St PURPOSE a) Category ( See Categories listed at the top of this schedule) ( b) Description ElCheck if travel outside of Texas. Complete Schedule T. 9/ 3/ 216 Frost Bank W Main St PURPOSE a) Category ( See Categories listed at the top of this b) Description schedule) ( Check if travel outside of Texas. Complete Schedule T, porms provided by Texas Ethics Commission state. tx. us Version V
5 POLITICAL S FROM POLITICAL CONTRIBUTIONS SCHEDULE Fl CATEGORIES FOR BOX 8( a) Advertising Expense Event Expense Loan Repayment/ Reimbursement Solicitation/ Fundraising Expense Fees Office Overhead/ Rental Expense Transportation Equipment& Related Expense Consulting Expense Food/ Beverage Expense Polling Expense Travel in District Contributions/ Donations Made By- Gift/Awards/ Memorials Expense Printing Expense Travel Out of District Candidate/ Officeholder/ Political Committee Legal Services Salaries/Wages/ Contract Labor OTHER( enter a category not listed above) Credit Card Payment The Instruction Guide explains how to complete this form. 1 Total pages Schedule Fl: 2 FILER NAME 3 Filer ID Sch: 2/ 3 Rpt: 5/ / 31/216 Frost Bank 6 Amount($) 7 Payee address; City; State; Zip Code W Main St 8 PURPOSE a) category ( See Categories listed at the top of this schedule) ( b) Description El Check if travel outside of Texas. Complete Schedule T. 9 Complete ONLY if direct Candidate/Officeholder name Office sought Office held 11/ 3/ 216 Frost Bank W Main St PURPOSE a) Category ( See Categories listed at the top of this schedule) ( b) Description Check if travel outside of Texas. Complete Schedule T. 12/ 31/ 216 Frost Bank W Main St PURPOSE a) Category ( See Categories listed at the top of this schedule) ( b) Description Check if travel outside of Texas. Complete Schedule T. corms provided by Texas Ethics Commission www. ethics.state. tx. us Version V
6 POLITICAL S FROM POLITICAL CONTRIBUTIONS SCHEDULE Fl CATEGORIES FOR BOX 8( a) Advertising Expense Event Expense Loan Repayment/ Reimbursement Solicitation/ Fundraising Expense Fees Office Overhead/Rental Expense Transportation Equipment& Related Expense Consulting Expense Food/ Beverage Expense Polling Expense Travel in District Contributions/ Donations Made By- Gift/Awards/ 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 Instruction Guide explains how to complete this form. 1 Total pages Schedule Fl: 2 FILER NAME 3 Filer ID Sch: 3/ 3 Rpt: 6/ / 1/ 216 Frost Bank 6 Amount($) 7 Payee address; City; State; Zip Code W Main St 8 PURPOSE a) category ( See Categories listed at the top of this schedule) ( b) Description U Check if travel outside of Texas. Complete Schedule T. 9 corms provided by Texas Ethics Commission tx.us Version V
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