Texas Ethics Commission PO Box Austin, Texas ) ( TDD )

Transcription

1 Texas Ethics Commission PO Box Austin, Texas ) ( TDD ) CANDDATE / FCEHOLDER CAMPAGN FNANCE REPORT FORM C/ OH COVER SHEET PG ' The CfOH nstruction Guide explains how to complete this form. 1 ACCOUNT# 2 Total pages filed: ethics ccrnmisrcn Filers) g 3 CANDDATE / MS/ MRSrMR FRST M FCE FCEHOLDER NAME Mr. John D Recalved NCkNAME LAST SUFFX n`' Gorena Jr EVlip 4 CANDDATE / ADDRESS; POBOX. APT, SU7E# ijt STATE, ipcode FCEHOLDER MALNG 417 Creekwood Ln. Hand- delneredorpostmarked ADDRESS change of address Feceipt# Amount 5 CANDDATE/ AREA CODE PHONE NUM EXTENSON FCEHOLDER PHONE 972 ) Processed 6 CAMPAGN MS/ MRS/ MR FRST M maged TREASURER NAME Mrs. Maria G NC, NAME LAST SUFFX Gorena 7 CAMPAGN STF FE- ADDFF55 N.- PC BOX T St TE* CTY STATE. ZPCJCe TREASURER ADDRESS 417 Creekwood Ln. residence or business) 8 CAMPAGN AREA COLE PHONE NUMBER E TENCON TREASURER ( PHONE 972 ) REPORT TYPE January 15 30th day before election Runoff 15th day El treasurer appointment alter campaign ffi. eholderonly) July 15 1 day before election Exceeded$ 500 Final report( Attach GOH- E] FR) limit 10 PEROD Month, ear Morth Day irar COVERED 1 01 / 2013 THROUGH 04 / 30 / ELECTON ELF'_- ondate MorLh Days Tear 111 / 2013 ELECTn,NTV= E Fnmary Runoff O General Special 12 FCE F CE HELD iit any l 13 CrF= ES000HT ;: fknowri Lewisville City Council Place 4 Lewisville City Council Place 4 GO TO PAGE 2 www ethics state. tx us Revised 09/ 28/ 2011

2 Texas Ethics Commission PO Box Austin, Texas ) ( TDD ) CANDDATE / FCEHOLDER REPORT: FORM C/ OH SUPPORT & TOTALS COVER SHEET PG 2 14 C/OH NAME 15 ACCOUNT# ( Ethics Commission Filers) 16 NOTCE FROM THS BOX S FOR NOTCE POLMCAL CONTRBUTONS ACCEPTED OR POLTCAL EXPENDTURES MADE BY POLTCAL COMMTTEES TO SUPPORTTHE POLTCAL CANDDATE/ FCEHOLDER. THESEePEND1rURES Amy HAVE BEEN MADEWrrHOUr THE CANDfOATE3OR FCEHOLDERS KNOWLEDGE OR COMMTTEE( S) CONSENT CANDDATES AND FCEHOLDERS ARE REQURED TO REPORT THS NFORMATON ONLY F THEY RECERE NOTCE SUCH EXPENDTURES. COMMTTEE TYPE E7 GENERAL E7 SPECFC CCMPi TTEE N4WE COMMTTEE_A DC'=" N/A moo COMM TTEECRAFA, NTREASUFER f`aaae additional pages COMMTTEE A1f= 4,, EF 4EES- 17 CONTRBUTON 1 TOTAL POLTCAL CONTRBUTONS $ 50 OR LESS( OTHER THAN Q TOTALS PLEDGES. LOANS. OR GUARANTEES LOANS), UNLESS TEMZED W 0 2. TOTAL POLTCAL CONTRBUTONS OTHER THAN PLEDGES, LOANS OR GUARANTEES LOANS) EXPENDTURE TOTALS 3 TOTAL POLTCAL EXPENDTURES $ 100 OR LESS, UNLESS TEMZED Q $ O 4. TOTAL POLTCAL EXPENDTURES 1, CONTRBUTON BALANCE 5 TOTAL POLTCAL CONTRBUTONS MANTANED AS THE LAST DAY Q REPORTNG PEROD N 1, OUTSTANDNG LOAN TOTALS 6 TOTAL PRNCPAL AMOUNT ALL OUTSTANDNG LOANS AS THE Q LAST DAY THE REPORTNG PEROD 0 18 AFFDAVT swear, or affirm. under penalty of perjury, that the accompanying report is true and correct and includes all information required to be reported by rn under Title 15, Elect n Code Signature of Candidate or Officeholder AFFX NOTARY STAMP/ SEAL ABOVE Sworn to and subscribed before me, by the said this the 7. day of May to certify which, witness my hand and seal of office Signature of officer administering oath a,,,, oath t#y" PO",, JULE K. HENZE Title of officer adm istering oath Notary Public, State of Texas www ethics state tx us rr' y Comm ssion xp res JUy 24, 2016 Revised 09/ 28/ 2011

3 Texas Ethics Commission PO Box Austin Texas ) ( TDD ) POLTCAL CONTRBUTONS OTHER THAN PLEDGES OR LOANS SCHEDULE A The nstruction Guide explains how to complete this form. 1 Total pages Schedule A. 4 2 FLER NAME 3 ACCOUNT# ( Ethics Commission Filers) 4 5 Full name of contributor c ut- nf- tat? P--- UD# 7 Amount of 8 n- kind contribution 03APR2013 Miles Hoelzel , 1400 Bobing Dr. 9 Principal occupation Job title( See nstructions) 10 Employer( See nstructions) Travel Agent Blue Od ssea Travel f travel outside of Texas, ) Full name of contributor J4' of- s`.a' e P4_{ L# Amount of n- kind contribution 05APR2013 Eyad Salloum , 924 Valley View Dr. Principal occupation; Job title( See nstructions) Employer( See nstructions) Realtor/Broker DFW ReMax f travel outside of Texas Full name of contributor x,t- of- tqpac( C#_ Amountof n- kind contribution 05APR2013 Mike & Pam Malone Juniper Ln Lewisville, TX f travel outside of Texas, ) Principal occupation Job title( See nstructions) Employer( See nstructions) nsurance n Malone i Full name of contributor out- Df- star Pa,_ 1Lr4_ Amount of n- kind contribution 08APR2013 Sharon L Boyd , 453 Frankie Ln. Lewisville, TX f travel outside of Texas Principal occupation Job title( See nstructions) Employer( See nstrttctlons) Bookkeeping Self Employed Full name of contributor ut- t stat}: Pk nc# Amount of n- kind contribution 08APR2013 Susan Davis- Duarte ; 256 E. Corporate Dr, Apt Principal occupation Job title( See nstructions) On- Site representative Employer( See nstructions) f travel outside of Texas First American Title ATTACH ADDTONAL COPES THS SCHEDULEAS NEEDED f contributor is out- of-state PAC, please see nstruction guide foradditional reporting requirements. www ethics state tx. us Revised 09128/ 2011

4 Texas Ethics Commission PO Box Austin, Texas ) ( TDD ) POLTCAL CONTRBUTONS OTHER THAN PLEDGES OR LOANS SCHEDULE A The nstruction Guide explains how to complete this form. 1 Total pages Schedule A. _ 2 FLER NAME 3 ACCOUNT# ( Ethics Commission Filers) 4 5 Fill name of contributor out- f- stat? Pa- fdr 7 Amountof 8 n- kind contribution 08APR2013 Donald Murray , 2000 Airfield Ln. Midland, M f travel outside of Texas, ) 9 Principal occupation/ Job title ( See nstructions) 10 Employer( See nstructions) Full name of contributor out- d- tat, PAC( U# Amount of n- kind contribution contribution ($} 08APR2013 Candace Donnelly Reid Farm Rd. Rockford, L f travel outside of Texas Principal occupation/ Job title ( See nstructions) Employer( See nstructions) Full name of contributor out- of-=[atf Psrlr Amountof n- kind contribution 08APR2013 Terry & Marita Broome 25.00, 1122 Wood Heights Dr. f travel outside of Texas, ) Principal occupation/ Job title ( See nstructions) Employer( See nstructions) Retired Full name of contributor, r. t-; r- ea p_ ic Amount of n- kind contribution contribution ($} 09APR2013 James & Barbara Coop Glencairn Ln Principal occupation/ Job title( See nstructions) Employer( See nstructions) Retired f travel outside of Texas Full name of contributor ut- 4stat Fw- C# Amount of n- kind contribution contribution ($} 10APR2013 Douglas Kirksey , 1341 Mustang drive Principal occupation / Job title ( See nstructions) Training Employer( See nstructions) Self Employed f travel outside of Texas. ATTACH ADDTONAL COPES THS SCHEDULEAS NEEDED f contributor is out- of-state PAC, please see nstruction guide foradditlonal reporting requirements. www ethics state tx. us Revised 09/ 28/ 2011

5 Texas Ethics Commission PO Box Austin Texas ) ( TDD ) POLTCAL CONTRBUTONS OTHER THAN PLEDGES OR LOANS SCHEDULE A The nstruction Guide explains how to complete this form. 1 Total pages Schedule A. - 2 FLER NAME 3 ACCOUNT# ( Ethics Commission Filers) 4 5 Full name of contributor u- f- state 7' v=; D= 7 Amountof 8 n- kind contribution 10APR2013 Jerry Nisbett , 511 Beasley Dr Lewisville TX Principal occupation Job title ( See nstructions) 10 Employer( See nstructions) Retired Retired f travel outside of Texas, ) Full name of contributor 11Ut- o1`- stata FAC,, D# Amount of n- kind contribution 10APM013 Steve Hill Camden Dr. Principal occupation Job title ( See nstructions) System Analyst Employer( See nstructions) Blue f travel outside of Texas Full name of contributor out- ofs: a: e PAC; C# Amount of n- kind contribution 11APR2013 DiNino.Barello Brady Plano, TX f f travel outside of Texas, ) Principal occupation / Job title( See nstructions) Retired Employer( See nstructions) Full name of contributor.: r- sa._ PA_ lc'* _ Amount of n- kind contribution contribution ($} 18APR2013 Dan Parrish City; State; Zip Code 1550 Glennhill Lane Lewisville, TX Principal occupation i Job title( See nstructions) Manager Employer( See nstructions) f travel outside of Texas Wolf Environmental Full name of contributor n, t-. f-_. tafr ( ige_ Amount of n- kind contribution contribution ($} 18APR2013 Pam Henricks City- State, Zip Code 1550 Glennhill Lane Lewisville, TX i f travel outside of Texas com late Schedule T Principal occupation Job title ( See nstructions) Employer( See nstructions) Veterinarian Garden Ridge Animal Hospital ATTACH ADDTONAL COPES THS SCHEDULEAS NEEDED f contributor s out- of- state PAC, please see nstruction guide foradditional reporting requirements. www ethics state tx. us Revised 09/ 28/ 2011

6 i i t i Texas Ethics Commission PO Box Austin, Texas ) ( TDD ) POLTCAL CONTRBUTONS OTHER THAN PLEDGES OR LOANS SCHEDULE A The nstruction Guide explains how to complete this form. 1 Total pages Schedule A. _ 2 FLER NAME 3 ACCOUNT# ( Ethics Commission Filers) 4 5 Full name of contributor. ut- f- st< te- H,: ic 7 Amount of $ n- kind contribution contribution {$) 25APR2013 Gregory Andree Valley Oaks Dr 9 Principal occupation/ Job title ( See nstructions) 10 Employer( See nstructions) Manager ATT f travel outside of Texas, ) Full name of contributor oi. t- f- se[ e F4C( D3 Amount of n- kind contribution ' 1 Principal occupation i Job title ( See nstructions) f travel outside f Texas Employer( See nstructions) Full name of contributor r_d- of-_'.atef- C '_# Amount of n- kind contribution f travel outside of Texas, ) Principal occupation ; Job title ( See nstructions) Employer( See nstructions) Full name of contributor ou-- of- State. ar L* Amount of n- kind contribution City' State, Zip Code contribution {$} f travel outside of Texas. Principal occupation / Job title( See nstructions) Employer( See nstructions) Full name of contributor a- stat: F _ ', Ctt Amount of n- kind contribution contribution ($} Principal occupation / Job title ( See nstructions) Employer( See nstructions) f travel outside of Texas co-plate Schedule T ATTACH ADDTONAL COPES THS SCHEDULEAS NEEDED f contributor s out- of- state PAC, please see instruction guide foradditlonal reporting requirements. roww ethics state tx. us Revised 09/ 28/ 2011

7 Texas Ethics Commission PO Box Austin, Texas ) ( TDD ) POLTCAL EXPENDTURES SCHEDULE F EXPENDTURE CATEGORES FOR BOX 8( a) Advertising Expense Gift/ Awards/ Memorials Expense SalariesANages/ Contract Labor Loan Repayment/ Reimbursement Accounting/ Banking Legal Services Solicitation/ Fundraising Expense Transportation Equipment& Related Expense Consulting Expense Food/ Beverage Expense Travel n District Contributions/ Donations Made By Event Expense Palling Expense Travel Out Of District Candidate/ Officeholder/ Political Committee Fees Printing Expense Office Overhead/ Rental Expense OTHER( enter a category not listed above) The nstruction Guide explains how to complete this form. 1 Total pages Schedule F 2 FLER NAME 3 ACCOUNT#( Ethics Commission Filers) Payee name 05APR2013 OfficeMax 6 Amount ( S) 7 Payee address, City State Zip Code S. Stemmons Freeway 9 PURPOSE a) Category =. e. aleaa ies listed at the t, p oftnis s iedile) ( b) Description, ifhavel c,, ts, de, ftec s ) EXPENDTURE Advertising Expense Card Laminate badge covers 9 Complete ONLY if direct Candidate/ Officeholder name Office sought Office held Payee name 05APR2013 Crown Trophy Amount ($) Payee address. City State; Zip Code S South Old Orchard, Suite A PURPOSE Category :- - ateg. n? tvaattnet-.' th_ s- r- aj_ t Description t' trz, outs; deot- eaas completes^ hedule- f) EXPENDTURE Adtisin ver g Expense p Magneticg Badgeg Backings g Complete ONLY if direct Candidate Officehol der name Office sought Office held expenditure to benefit COH 18APR2013 Payee neime Sam' s Club Amount ($) Payee address, City, State; Zip Code Nk. Main St. PURPOSE Category = E. ateacn? s st d e'- t7? t- 1- r this s_ h_ tale; Description i if trevei outside of Texas, ) EXPENDTURE Printing Expense i Envelopes Complete ONLY if direct expenditure to benefit C/OH Candidate/ Officeholder name Office sought Office held 19APR2013 Payee nerve Sam' s Club Amount ( S) Payee address, W. 'Main St. PURPOSE Category +- aeaores isl- t,, tco-, Tthi= to we Description ('* trz, utsidecttew-, a,mplete Schedule T) EXPENDTURE Printing Expense Envelopes Complete ONLY if direct Candidate/ Officeholder name Office sought Office held ATTACH ADDTONAL COPES THS SCHEDULEAS NEEDED www ethics state. tx us Revised 09/ 28/ 2011

8 Texas Ethics Commission FO Box Austin, Texas ) ( TDD ) POLTCAL EXPENDTURES SCHEDULE F EXPENDTURE CATEGORES FOR BOX 8( a) Advertising Expense Gift/AwardstMemorials Expense Sala riesalvag as/ Contract Labor Loan Repayment/ Reimbursement Accounting/ Banking Legal Services Solicitation/ Fundraising Expense Transportation Equipment& Related Expense Consulting Expense Food/ Beverage Expense Travel n District Contributions/ Donations Made By Event Expense Polling Expense Travel Out Of District Candidate/ Officeholder/ Political Committne Fees Printing Expense Office Overhead/ Rental Expense OTHER ( enter a category not listed above) The nstruction Guide explains how to complete this form. 1 Total pages Schedule F 2 FLER NAME 3 ACCOUNT#( Ethics Commission Filers) 4 5 Payee name Jahn D. Gorena 21APR2013 US Post Office 1 6 Amount ( S) 7 Payee address, 1, Civic Cir a) 8 PURPOSE Categcry ';_- rat:+ac i= a lra aj a: d tn, s s: hrduiei ( b) Description, rfrrq r,. tside, ftr s _ omple e Schedule T) EXPENDTURE Advertising Stamps for Letters/ Mailers 9 Complete ONLY if direct Cand,date/ Officeholder name Office sought Office held expenditure to benefit C/ CH Payee name 22APR2013 OfficeMax Amount ($) Payee address City State; Zip Code S. Stemmons Freeway PURPOSE Category _- e; ora_ stroe, iet_ cnthis5d- Jwe Description ('[ ravelrut.ni of- e, es ompm9srhedu1et: EXPENDTURE Advertising Expense Supplies for mailers Complete ONLY if direct Candidate! Officeholder name Office sought Office held 23APR2013 Payee name Sam' s Club Amount ($) Payee adcress City; State; Zip Code ,; 1 W. Main St. PURPOSE Categc, y st datth, b. poft- rss_, ir Description ftra ve,, u tside,, fte. es, cempi- tcschedui) T) Food/ Beverage For Volunteers stuffin g Elo nve es EXPENDTURE g Expense p Complete ONLY if direct Candidate/ Officeholder name Office sought Office held 30APR2013 Payee nerve PavPal Amount ( 5) Payee address: City, State, Zip Code PO Box Omaha, NE PURPOSE Categow aq n st,, li,m, t.,- rth= s- hec i. ei Description lttrave oits,d? oftexas cnmpletr-- eheduiet) EXPENDTURE Fees PayPal Usage Fees for accepting Donations Complete ONLY if direct Candidate/ Officeholder name Office sought Office held ATTACH ADDTONAL COPES THS SCHEDULE AS NEEDED www ethics state. tx us Revised 09/ 28/ 2011