FORM C/OH CAMPAIGN FINANCE REPORT COVER SHEET PG 1. 1 Filer ID (Ethics Commission Filers) 2 Total pages filed: rlt~e~ OFACE USE ONLY OFFICEHOLDER
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1 CANDIDATE I FICEHOLDER FORM C/OH 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/ MS/MRS Ml ACE USE ONLY FICEHOLDER rlte NAME Received I"TI NICKNAME LAST SUFFIX co r AtfOv'o -;-:: ril ("") "\ I...,..., <- :: (";o ro;; ;;. > ::: 4 CANDIDATE/ ADDRESS APT I SUITE#; CITY; STATE; ZIP CODE ' -,' ""'" ::z: )>.., -::... FICEHOLDER.. ::> :;j;::. N z- MAILING t::j-o Q) -tl ADDRESS ('")ft! F- > oo Change of Address :X =t) c :;-u(j) :;;.: 5 CANDIDATE/ :;; 9-1 FICEHOLDER t: nd-ded or Dosted PHONE ::: - 6 CAMPAIGN MSIMR Ml Receip # TREASURER f4rhw) NAME Processed NICKNAME SUFFIX Imaged N/b 7 CAMPAIGN.STREET ADDRESS (NO PO BOX PLEASE); APT I SUITE #; CITY; STATE; ZIP CODE TREASURER ADDRESS (Residence or Business) c::::l I Amount 8 CAMPAIGN AREA CODE PHONE NUMBER EXTENSION TREASURER ( ) PHONE 9 REPORT TYPE h day before election D January 15 D Runoff D D July15 D 8th day before election D Exceeded 5 limit D 15th day after campaign treasurer appointment (Officeholder Only) Final Report (Attach C/OH - FR) 1 PERIOD Month Day Year Month Day Year COVERED ol /ol /11& THROUGH o I /2.-1 /2ollt 11 ELECTION ELECTION DATE ELECTION TYPE 12 FICE FICE HELD (if anv) Month Day Year ary D o? /Ol /wt(; - D General Special Runoff Other Description 1;;: (c;.:.\:-r) s f't.uy\vb GO TO PAGE 2 Forms prov1ded by Texas Eth1cs CommiSSion Rev1sed 9/8/215
2 CANDIDATE I FICEHOLDER CAMPAIGN FINANCE REPORT 14 C/OH NAME FORM C/OH COVER SHEET PG 2 15 Filer ld (Ethics Commission Filers) 16 NOTICE FROM POLITICAL COMMITTEE(S) THIS BOX IS FOR NOTICE POLITICAL CONTRIBUTIONS ACCEPTED OR POLITICAL S MADE BY POLITICAL COMMITTEES TO SUPPORT THE CANDIDATE f FICEHOLDER. THESE EXPENDrTURES MAY HAVE BEEN MADE WITHOUT THE CANDIDATE'S OR FICEHOLDER'S KNOWLEDGE OR CONSENT. CANDIDATES AND FICEHOLDERS ARE REQUIRED TO REPORT THIS INFORMATION ONLY IF THEY RECEIVE NOTICE SUCH S. COMMITTEE TYPE COMMITTEE NAME D Additional Pages GENERAL OsPECIFIC COMMITTEE ADDRESS COMMITTEE CAMPAIGN TREASURER NAME COMMITTEE CAMPAIGN TREASURER ADDRESS ro --:-:: r-,..., c:;:) f'fl c:l"\ _,., C- :: ; > ::: -;' ::::-;(:: % l>""t1 ;",-., N --.r co nftl oo ;ciw N -( :;u 17 CONTRIBUTION TOTALS 1. TOTAL POLITICAL CONTRIBUTIONS 5 OR LESS (OTHER THAN PLEDGES, LOANS, OR GUARANTEES LOANS), UNLESS ITEMIZED <) TOTALS CONTRIBUTION BALANCE 2. TOTAL POLITICAL CONTRIBUTIONS (OTHER THAN PLEDGES, LOANS, OR GUARANTEES LOANS) 3. TOTAL POLITICAL S 1 OR LESS, UNLESS ITEMIZED 4. TOTAL POLITICAL S 5. TOTAL POLITICAL CONTRIBUTIONS MAINTAINED AS THE LAST DAY REPORTING PERIOD ' <:['l.e.. f2. tl '2_. S".Pf OUTSTANDING LOAN TOTALS 6. TOTAL PRINCIPAL AMOUNT ALL OUTSTANDING LOANS AS THE LAST DAY THE REPORTING PERIOD Ft&2..._ 18 AFFIDAVIT NIEVES AGUIRRE NOTARY PUBLIC STATE TEXAS My eomm. exp. os 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 1 AFFIX NOTARY STAMP I SEAL ABOVE Sworn to and subscribed before me, by the said CJn \-Po-(LQ ay of j(ailu, llf, to certify which, witness my hand and seal of office. UN 'tjt, this the Forms provided by Texas Ethics Commission Revised 9/8/215
3 SUBTOTALS - C/OH FORM C/OH COVER SHEET PG 3 19 FILER NAME 2 Filer ID (Ethics Commission Filers) 21 SCHEDULE SUBTOTALS SUBTOTAL NAME SCHEDULE AMOUNT 1. D SCHEDULE A 1: MONETARY POLITICAL CONTRIBUTIONS D SCHEDULE A2: NON-MONETARY (IN-KIND) POLITICAL CONTRIBUTIONS 3. D SCHEDULE B: PLEDGED CONTRIBUTIONS 4. D SCHEDULE E: LOANS 118'2 5. D SCHEDULE F1: POLITICAL S MADE PROM POLITICAL CONTRIBUTIONS lt./.4 6. D SCHEDULE F2: UNPAID INCURRED OBLIGATIONS () 7. D SCHEDULE F3: PURCHASE INVESTMENTS MADE FROM POLITICAL CONTRIBUTIONS 8. D SCHEDULE F4: S MADE BY CREDIT CARD 9. D SCHEDULE G: POLITICAL S MADE FROM PERSONAL FUNDS 1. D SCHEDULE H: PAYMENT MADE FROM POLITICAL CONTRIBUTIONS TO A BUSINESS C/OH 11. D SCHEDULE 1: NON-POLITICAL S MADE FROM POLITICAL CONTRIBUTIONS 12. D SCHEDULE K: INTEREST, CREDITS, GAINS, REFUNDS, AND CONTRIBUTIONS RETURNED TO FILER ro r...:» c:> c::::l"'<..., C- ::: z:.r;o > ::: l li.)"> z J>-r, N z- ) -irnfll r= :I> :.'::1 oo VI- ::::lt -i"'' c= ::o(j) 5.. z -i g, -.. Forms provided by Texas Ethics Commission Rev1sed 9/8/215
4 MONETARY POLITICAL CONTRIBUTIONS SCHEDULE A1 1 Total pages Schedule A 1: 2 FILER NAME 3 Filer ID (Ethics Commission Filers) 4 5 Full name of contributor O out-of-state PAC (1#:.,) 7 Amount of contribution () Al>or y 6 Contributor address; City; State; Zip Code 8 Principal occupation I Job title (See Instructions) 9 Full name of contributor out-of-state PAC (1#.. ) Amount of contribution () Contributor address; City; State; Zip Code Principal occupation I Job title (See Instructions} Full name of contributor out-of-state PAC (1#.:_ J Amount of contribution () Contributor address; City; State; Zip Code Principal occupation I Job title (See Instructions} Full name of contributor out-of-state PAC (IO#: J Contributor address; City; State; Zip Code Principal occupation 1 Job title (See Instructions) <.n- -1-o.::.:: ::otn - l>.. 5 ATTACH ADDITIONAL COPIES THIS SCHEDULE AS NEEDED If contributor is out-of-state PAC, please see instruction guide for additional reporting requirements. Forms provided by Texas Ethics Commission Rev1sed 9/8/215
5 NON-MONETARY (IN-KIND) POLITICAL CONTRIBUTIONS SCHEDULE A2 1 Total pages Schedule A2: 2 FILER NAME 3 Filer ID (Ethics Commission Filers) 4 TOTAL UNITEMIZED IN-KIND POLITICAL CONTRIBUTIONS 5 6 Full name of contributor out-of-state PAC (ID#: ) 8 Amount of 9 In-kind contribution Contribution description 7 Contributor address; City; State; Zip Code Check if travel outside of Texas. Complete Schedule T. 1 Principal occupation I Job title (FOR NON-JUDICIAL} (See Instructions) 11 Employer (FOR NON-JUDICIAL)(See Instructions) 12 Contributor's principal occupation (FOR JUDICIAL} 13 Contributor's job title (FOR JUDICIAL) (See Instructions) 14 Contributor's employer/law firm (FOR JUDICIAL} 15 Law firm of contributor's spouse (if any) (FOR JUDICIAL) 16 If contributor is a child, law firm of parent(s} (if any} (FOR JUDICIAL} Full name of contributor out-ol-state PAC (ID#: l Amount of In-kind contribution Contribution description Contributor address; City; State; Zip Code Principal occupation I Job title (FOR NON-JUDICIAL) (See Instructions) Check if travel outside of Texas. Complete Schedule T. Employer (FOR NON-JUDICIAL)(See Instructions) Contributor's principal occupation (FOR JUDICIAL) Contributor's job title (FOR JUDICIAL) (See Instructions) Contributor's employer/law firm (FOR JUDICIAL) Law firm of contributor's spouse (if any) (FOR JUDICIAL) If contributor is a child, law firm of parent(s) (if any) (FOR JUDICIAL) w.:21...,.. - ):> I Cl"' t- ;o I > ::: I z )>. f.;,. N z-rt (X) L! -ir nfl'l?;:= > oo U'J- :r: -1"' c ::tlc.n 6.. z -1 N -< ::: t' ATIACH ADDITIONAL COPIES THIS SCHEDULE AS NEEDED If contributor is out-of-state PAC, please see instruction guide for additional reporting requirements. Forms provided by Texas Ethics Commission Rev1sed 9/8/215
6 PLEDGED CONTRIBUTIONS 2 FILER NAME 1 Total pages Schedule B: SCHEDULE B 3 Filer ID (Ethics Commission Filers) 4 TOTAL UNITEMIZED PLEDGES 5 6 Full name of pledgor 7 Pledgor address; out-of-state PAC (ID#:. ) 8 Amount of Pledge City; State; Zip Code. 9 In-kind contribution description 1 Principal occupation I Job title (See Instructions) Check if travel outside of Texas. Complete Schedule T. Full name of pledgor Pledgor address; out-of-state PAC (ID#: -'l City; State; Zip Code Amount of Pledge In-kind contribution description Principal occupation I Job title (See Instructions) Full name of pledgor Pledgor address; I out-of-state PAC (11/:.,l City; State; Zip Code Check if travel outside of Texas. Complete Schedule T. Amount of Pledge In-kind contribution description Principal occupation I Job title (See Instructions) Full name of pledgor Pledgor address; Principal occupation I Job title (See Instructions) 1 out-of-state PAC (ID#:..Jl City; State; Zip Code Ocheck if travel outside of Texas. Complete Schedule T. Amount of Pledge In-kind contribution description rrl co r- -:: B., --;;o?;):"» 1. (_)Z :Z _)>.,. Check if travel outse of Tom Sc. a:: u... 9 Dfll oo --1 N -<,.f:"' THIS SCHEDULE AS NEEDED ATTACH ADDITIONAL COPIES. "d for additional reporting requirements. PAC please see instruction gul e If contributor is out-of-state ' Revised 9/8/215 Forms provided by Texas Et h tcs Commission
7 LOANS SCHEDULE E 1 Total pages Schedule E: 2 FILER NAME -ta M+2tVl> 4 TOTAL UNITEMIZED LOANS 3 Filer ID (Ethics Commission Filers) 5 of loan 7 Name of lender out-of-state PAC (1#: ) 9 Loan Amount () \'L \ 'Ll)\ \l, -{ MfN/o /l g'l 6 Is lender a financial 8 Lender address; City; State; Zip Code Institution? y 1 Interest rate qo3 <;\-. Wo 1l fo{p 11 Maturity date e WtW 12 Principal occupation I Job title (See Instructions) Description of Collateral 15 Check if personal funds were deposited into political wt (See Instructions) one 16 GUARANTOR 17 Name of guarantor 19 Amount Guaranteed () INFORMATION applicable 18 Guarantor address; City; State; Zip Code 2 Principal Occupation (See Instructions) 21 of loan Name of lender out-of-state PAC (1#: ) Loan Amount {) Is lender Lender address; City; State; Zip Code a financial Institution? y N Interest rate Maturity date Principal occupation I Job title (See Instructions) Description of Collateral Check if personal funds were deposited into political account (See Instructions) ft1 none co r GUARANTOR INFORMATION not applicable Name of guarantor -< Y1 c:::::t... Atunt ;ftee) --.):> > ::::: ;:;, z l>-r; t::;-u (X) _,r,-r :t! ;;r= oft!...::r oo :;g 5.. z -,...; N -.:: Guarantor address; City; State; Zip Code ---' N z- Principal Occupation (See Instructions) -- ATTACH ADDITIONAL COPIES THIS SCHEDULE AS NEEDED If lender is out-of-state PAC, please see instruction guide for additional reporting requirements. Forms provided by Texas Ethics Commission Rev1sed 9/8/215 -
8 POLITICAL S MADE FROM POLITICAL CONTRIBUTIONS SCHEDULE F1 CATEGORIES FOR BOX B(a) Advertising Expense Event Expense Loan Repayment/Reimbursement Solicitation!Fundraising Expense Accounting/Banking Fees Office Overhead/Rental Expense Transportation Equipment & Related Expense Consuning Expense Food/Beverage Expense Polling Expense Travel In District Contributions/Donations Made By Gilt/Awards/Memorials Expense Printing Expense Travel Out Of District Candidate/Officeholder!Polrtical Committee Legal Services SalarieS/Wages/Contract Labor Other (enter a category not listed above) Credit Gard Payment 13 Filer ID (Ethics Commission Filers) 1 Total pages Schedule F1: 2 FILERM Mhvo '"" PayeitfVAvcz l <l 1 D---es ;.e; n( 6 Amount (} 7 Payee address; City; State; tip Code <}22.2( ( 33 A vjh1 S e t+f e t'y\,tv\ {- (&-{. W()t\--k M 1)( 1b{Og 8 (a} Category (See Categories listed at the top of this schedule) (b) Description Check if travel outside oftexas. Complete Schedule T. PURPOSE Check if Austin, TX, officeholder living expense --r-sv:\ ffs 9 Complete ONLY if direct Candidate I Officeholder name Office sought Office held expenditure to benefit CIOH Payee name \. \8. l _±o \A -h fv-kv' Amount (} Payee address; City; State; Zip Code.1 5ctoo s"""',) JZJ. bwjt lcrt- q (2J;l- Category (See Categories listed at the top of this schedule) MC <;i4 Description Check if travel outside of Texas. Complhedule T. PURPOSE Check if Austin, TX, offlceer liv expense H j - );!..., Cl'\ C> ::: c._ ::: :;;;l>?" ::: Complete ONLY if direct Candidate I Officeholder name Office sought - fficld z'"tt expenditure to benefit CIOH,;; co -i r ;:;_;:;; ("""\m \. 1.--\. l <='-' Payee + name (../)- :X stft ' 1-vQ_ -1" :::o(j) (Jr 1 Y\ t-vv"' 9 z --, 6t' Amount (} Payee address; City; State; Zip Code (p.z.o PURPOSE c::i N -< Stt Sr f.--t- f\dl"t' k e1. Glntt Ch q /2!DL Category (See Categories listed at the top of this schedule) \us\ ro(gj'f ot <), #U... Description Check If travel outside of Texas. Complete Schedule T. Check if Austin, TX, officeholder living expense Complete ONLY if direct Candidate I Officeholder name Office sought Office held expenditure to benefit CIOH ATTACH ADDITIONAL COPIES THIS SCHEDULE AS NEEDED Forms provided by Texas Ethics Commission Revised 9/8/215
9 UNPAID INCURRED OBLIGATIONS SCHEDULE F2 CATEGORIES FOR BOX 1(a) Advertising Expense Event Expense Loan Repayment/Reimbursement Solicitation/Fundraising Expense Accounting/Banking Fees Office Overhead/Rental Expense Transportation Equipment & Related Expense Consutting Expense Food/Beverage Expense Polling Expense Travel In District Contributions/Donations Made By Gilt/Awards/Memorials Expense Printing Expense Travel Out Of District Candidate/Officeholder/Pomical Committee Legal Services Salaries/Wages/Contract Labor Other (enter a category notlisted above) 1 Total pages Schedule F2: 2 FILER NAME 3 Filer ID (Ethics Commission Filers) 4 TOTAL UNITEMIZED UNPAID INCURRED OBLIGATIONS 5 6 Payee name 7 Amount () 8 Payee address; City; State; Zip Code 9 TYPE D Political D Non-Political 1 (a) Category (See Categories listed at the top of this schedule) (b) Description PURPOSE D Check H travel outside of Texas. Complete Schedule T. Ocheck if Austin, TXoofficehr living.qinse --1 -:< J> ::-::::; c:,_ 11 Complete ONLY if direct Candidate I Officeholder name Office sought Offid % ):;>o-r'! expenditure to benefit CIDH.,..,.., N... z- ') r \ ; nftl Amount () Payee name.. Payee address; City; State; Zip Code ::.. I :::-'" ;:;:;., :X c:: ;j(j) 6 z l:>; -./ TYPE D Political D Non-Pofitical Category (See Categories listed at the top of this schedule) Description D Check H travel outside of Texas. Complete Schedule T. PURPOSE D Check if Austin, TX, officeholder living expense Complete ONLY if direct Candidate I Officeholder name Office sought Office held expenditure to benefit C/OH ATTACH ADDITIONAL COPIES THIS SCHEDULE AS NEEDED Forms provided by Texas Ethics Comm1ss1on Rev1sed 9/8/215
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