FORMC/OH CAMPAIGN FINANCE REPORT CovER SHEET PG 1. Maca rio. Date Received :,;; : z!;--q NICKNAME LAST SUFFIX ;r-.,_. r':: -- -:.

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1 Texas Ethics Commission PO Box127 Austin Texas (512) (TDD ) CANDDATE OFFCEHOLDER FORMC/OH CAMPAGN FNANCE REPORT CovER SHEET PG 1 The C/OH nstruction Guide explains how to complete this form. 1 ACCOUNT# 2 Total pages filed: (Ethics Commission Filers) 3 CANDDATE MS/MRS/MR FRST Ml OFFCEHOLDER NAME Mr. Maca rio ai of 1rt1 -< r...) C.) l OFUON Date Received :,;;_ _ : z!;--q NCKNAME LAST SUFFX ;r-.,_. r:: -- -:.r- - Bel montes Jr 3. 4 CANDDATE ADDRESS PO BOX; APT/SUTE#; CTY; STATE; ZP CODE -...., Gi ;r;: \).- :::; ( ; ,.. _. \ OFFCEHOLDER :..._,..,... MALNG ADDRESS l J D change of address 5 CANDDATE/ AREA CODE PHONE NUMBER EXTENSON OFFCEHOLDER PHONE Date and-delied or Posked Receipt# Date Processed 6 CAMPAGN MS/MRS/MR FRST Ml Date maged TREASURER NAME Mr. Estrus NCKNAME LAST SUFFX Tucker Amoorn. -., 7 CAMPAGN STREET ADDRESS (NO PO BOX PLEASE); APT SUTE#; CTY; STATE; ZP CODE TREASURER ADDRESS (residence or business) 8 CAMPAGN AREA CODE PHONE NUMBER EXTENSON TREASURER PHONE 9 REPORT TYPE!iJ January 15 D 3oth day before election Runoff 15th day after campaign treasurer appointment (officeholder only) July 15 8th day before election Exceeded $5 Final report (Attach C/OH FR) limit 1 PEROD Month Day Year Month Day Year COVERED 7 / 1 / 213 THROUGH 12 / 31 / ELECTON ELECTON DATE ELECTON TYPE Month Day Year [i] Primary 3/ 4 / 214 DRunoff General D Special 12 OFFCE OFFCE HELD (if any) 13 OFFCE SOUGHT (if known) Justice of the Peace, Pet. 5 GOTOPAGE2 Revised 4/19/213

2 Texas Ethics Commission PO Box 127 Austin Texas (512) (TOO ) CANDDATE OFFCEHOLDER REPORT: FORM C/OH SUPPORT & TOTALS COVER SHEET PG 2 14 C/OH NAME 115 ACCOUNT# (Ethics Commission Filers) Belmontes, Jr., Macario 16 NOTCE FROM THS BOX S FOR NOTCE OF POUllCAL CONTRBUTONS ACCEPTED OR POUllCAL EXPENDTURES MADE BY POUTCAL COMMmEES TO SUPPORT THE POLTCAL CANDDATE/ OFFCEHOLDER. THESE EXPENDTURES MAY HAVE BEEN MADE WTHOUT THE CANDDATES OR OFFCEHOLDERS KNOWLEDGE OR COMMTTEE(S) CONSENT. CANDDATES AND OFFCEHOLDERS ARE REQURED TO REPORT THS NFORMATON ONLY F THEY RECEVE NOTCE OF SUCH EXPENDTURES. D additional pages COMMTTEE NAME.:: f"t COMMTTEE TYPE -<.. r- f:::::;) r"1...,. C) : ; L. :;:J J D GENERAL E ::::J -"-<:" COMMTTEE ADDRESS q :!; c-., -- (.)] D SPECFC ----;.r-- COMMTTEE CAMPAGN TREASURER NAME COMMTTEE CAMPAGN TREASURER ADDRESS,..., --. " ;- r1 --;_) --"" =",._1!"-.) ----., c;:; 17 CONTRBUTON 1. TOTAL POLTCAL CONTRBUTONS OF $5 OR LESS (OTHER THAN TOTALS PLEDGES, LOANS, OR GUARANTEES OF LOANS), UNLESS TEMZED $. 2. TOTAL POLTCAL CONTRBUTONS (OTHER THAN PLEDGES, LOANS, OR GUARANTEES OF LOANS) $ 27,87. EXPENDTURE TOTALS 3. TOTAL POLTCAL EXPENDTURES OF $1 OR LESS, UNLESS TEMZED $. 4. TOTAL POLTCAL EXPENDTURES $ 1,276.7 CONTRBUTON 5. TOTAL POLTCAL CONTRBUTONS MANTANED AS OF THE LAST DAY BALANCE OF REPORTNG PEROD 22, $ OUTSTANDNG LOAN TOTALS 6. TOTAL PRNCPAL AMOUNT OF ALL OUTSTANDNG LOANS AS OF THE LAST DAY OF THE REPORTNG PEROD $ AFFDAVT MARA DEL PLAR CANDA Noi<>Y..-_-o!Ti My commllslon Expires L Morch 21, 217.-f\A{l AFFX NOTARY STAMP SEAL ABOVE 1 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. "l L1J.., J!.J..Ua ,- -..., Signature of Candidate or Officeholder Sworn to and subscribed before me, by the said \A, (lf u () C2 VV\s, this the \ 3 day of jov\ vor:j 2 { "f, to certify which, witness my hand and seal of office. fl) Jj Mo.r\CJ A.,p{ Pi\o-r eo.ryj\, Gf.j ra-n... v\ Sig rurr ring oath Printed name of officer administering oath Title of officerdnistering oath Revised 4/19/213

3 Texas Ethics Commission PO Box 127 Austin Texas (512) (TDD ) POLTCAL CONTRBUTONS OTHER THAN PLEDGES OR LOANS SCHEDULE A The nstruction Guide explains how to complete this form. 1 Total pages Schedule A: Schedule A: 1/4 2 FLER NAME 3 ACCOUNT# (Ethics Commission Filers) Belmontes Jr., Macario CD rn -< 4 Date 5 Full name of contributor out-of-state PAC (D#: ) 7 Amount of T 8 tn-kind CtMitributkm Alameel Family Partners, LTD contribution ($) desgtion gt,:appble) ;; z -":1 -ir 11/27/13 6 Contributor address; City; State; Zip Code -- $25,,. - ()] -- -:r i -;-i 52 Tanbank, Dallas, Texas u ,..: (f travel outside. of Texa; _cj:)mplete..scheduje: n 9 Principal occupation Job title (See nstructions) 1 Employer (See nstructions).. - -i i 1".._) -., Date Full name of contributor out-of-state PAC (D#: ) Amount of : n-kind contribution Arriola, Guadalupe contribution ($) 1/1/13 Contributor address; City; State; Zip Code $ Forest Lane, Fort Worth, Texas Principal occupation Job title (See nstructions) Employer (See nstructions) Self en description (if applicable) _flf travel outside of Texas, complete Schedule n Date Full name of contributor out-of-state PAC (D#: ) Amountof n-kind contribution Arriola, Guadalupe 12/4/13 Contributor address; City; State; Zip Code $ Forest Lane, Fort Worth, Texas Principal occupation Job title (See nstructions) Employer (See nstructions) Self contribution ($) description (if applicable) (f travel outside of Texas, complete Schedule n Date Full name of contributor out-of-state PAC (1#: ) Amountof n-kind contribution Bodiford, Jerry contribution ($) description (if applicable) 11/25/13 Contributor address; City: State; Zip Code $15 Campaign Office PO Box , Fort Worth, Texas Principal occupation Job title (See nstructions) _(f travel outside of Texas complete Schedule n Employer (See nstructions) Self Date Full name of contributor out-of-state PAC (1#: ) Amountof n-kind contribution Chavez, Aracely V.. 1/4/13 Contributor address; City; State; Zip Code $ Wicks Trail, Fort Worth, Texas Principal occupation Job title (See nstructions) Director contribution ($).. description (if applicable) (f travel outside of Texas, complete Schedule T) Employer (See nstructions) Fort Worth lsd -- ATACH ADDTONAL COPES OF THS SCHEDULE AS NEEDED f contributor s out-of-state PAC, please see nstruction guide foraddltlonal reporting requirements. Revised 4/19/213

4 Texas Ethics Commission PO Box127 Austin Texas POLTCAL CONTRBUTONS OTHER THAN PLEDGES OR LOANS (512) (TDD ) SCHEDULE A The nstruction Guide explains how to complete this form. 1 Total pages Schedule A: Schedule A: 2/4 2 FLER NAME 3 ACCOUNT# (Ethics Commission Filers) Belmontes, Jr., Macario Ul,.,., "--> 4 Date 5 Full name of contributor out-of-state PAC(D#: ) 7 Amount of :1 8 -kind C,Wtrib[dn Elizondo, Timothy 12/2/13 6 Contributor address; City; State; Zip Code $ May Street, Fort Worth, Texas 7611 contribution ($) de -iptionj!! app!ble) c. - l ::::,j :;,..: t -= _;=- -11 v: Ul -., ;:, ;. \ -,. v _,_c. - ::J (f travel outside of Texa&;p(>mpleteSchedi;lle T) 9 Principal occupation Job title (See nstructions) 1 Employer (See nstructions)?:... ";. - -l - lr T Services f..),-; Date Full name of contributor out-of-state PAC (1#: ) Amountof J n-kind contribution contribution ($) j description (if applicable) Evans, Maria Pinto 12/2113 Contributor address; City; State; Zip Code $5 978 McFarring Drive, Fort Worth, Texas Principal occupation Job title (See nstructions) Hairstylist (f travel outside of Texas, com_qiete Schedule T) Employer (See nstructions) Date Full name of contributor out-of-state PAC (1#: ) Amountof n-kind contribution Flores, Julian Self contribution ($) description (if applicable) 12/31/13 Contributor address; City; State; Zip Code $1 144 De Ridder Avenue, Fort Worth, Texas 7616 (f travel outside of Texas, complete Schedule T) Principal occupation Job title (See nstructions) Engineer Employer (See nstructions) Ericsson Date Full name of contributor out-of-state PAC (D#: ) Amountof n-kind contribution Garza, Roberto 11/3/13 Contributor address; City; State; Zip Code $1 284 Milam Street, Fort Worth, Texas Principal occupation Job title (See nstructions) Detention Officer contribution ($) description (if applicable) (f travel outside of Texas complete Schedule T) Employer (See nstructions) DFW Airport DPS Date Full name of contributor out-of-statepac(d#: J Amountof n-kind contribution Martinez, Pedro D 1/4/13 Contributor address; City; State; Zip Code $1 16 Samuels Avenue #2, Fort Worth, Texas 7612 Principal occupation Job title (See nstructions) Firefighter contribution ($) description (if applicable) (f travel outside of Texas complete Schedule T) Employer (See nstructions) Arlington Fire Dept ATTACH ADDTONAL COPES OF THS SCHEDULE AS NEEDED f contributor is out-of-state PAC, please see instruction guide foradditional reporting requirements. Revised 4/19/213

5 Texas Ethics Commission PO Box 127 Austin, Texas (512) (TOO ) POLTCAL CONTRBUTONS OTHER THAN PLEDGES OR LOANS SCHEDULE A The nstruction Guide explains how to complete this form. 1 Total pages Schedule A: Schedule A: 3/4 2 FLER NAME 3 ACCOUNT# (Ethics Commission Filers) Belmontes, Jr., Macario 4 Date 5 Full name of contributor Oout-ot-statePAC(D#: ) 7 Amountof b "R<ind ct[ibution contribution ($) ( desfftion (pplile) Puente, Asucena (,, z 12/23/13 6 Contributor address; City; State; Zip Code?J $1 :::::--.::o 344 NW 29th Street, Fort Worth, Texas ,. -: ;: ::., :-:, Ci,,-- (f travel outside of Texasi:.Co.mpletheduiE!.! 9 Principal occupation Job title (See nstructions) Employer (See nstructions) :;: -- -" Teacher FWSD,,"-- -;-. Date Full name of contributor out-of-state PAC (1#:. ---.J Amountof! ltpkind. c :w: ibutioh --- contribution ($) des2r\ption (1 applicable) Rios, Jorge 12/22/13 Contributor address; City; State; Zip Code 8213 Meadowside Drive, Fort Worth, Texas Principal occupation Job title (See nstructions) $4 (f travel outside of Texas comolete Schedule Tl Employer (See nstructions) Date Full name of contributor out-of-statepac(d#:. J.J Amount of n-kind contribution Schattman, Nathan 12/12/13 Contributor address; City; State; Zip Code 6566 Locke Avenue, Fort Worth, Texas Principal occupation Job title (See nstructions) Attorney Employer (See nstructions) Johnston Legal Group, PC contribution ($) description (if applicable) $1 (f travel outside of Texas, complete Schedule n Date Full name of contributor out-of-state PAC(D#:..,) Amountof n-kind contribution contribution ($) description (if applicable) Utt, Michael 1/4/13 Contributor address; City; State; Zip Code 291 6th Avenue, Fort Worth, Texas 7611 Principal occupation Job title (See nstructions) Date 12/2/13 Full name of contributor Utt, Michael $5o (f travel outside of Texas comolete Schedule n Employer (See nstructions) Retired out-of-state PAC (1#: \ Amount of n-kind contribution contribution ($) description (if applicable) Contributor address; City; State; Zip Code $ th Avenue, Fort Worth, Texas 7611 Principal occupation Job title (See nstructions) Jlf travel outside of Texas, comolete Schedule Tl Employer (See nstructions) Retired ATTACH ADDTONAL COPES OF THS SCHEDULE AS NEEDED f contributor is out-of-state PAC, please see instruction guide foradditional reporting requirements. us Revised 4/19/213

6 Texas Ethics Commission PO Box127 Austin, Texas (512) (TDD ) POLTCAL CONTRBUTONS OTHER-THAN PLEDGES OR LOANS SCHEDULE A The nstruction Guide explains how to complete this form. 1 Total pages Schedule A: Schedule A: 4/4 2 FLER NAME 3 ACCOUNT# (Ethics Commission Filers) Belmontes, Jr., Macario 4 Date 5 Full name of contributor out-of-state PAC(D#: ) Villagran, Margarita Garza 1/4/13 6 Contributor address; City; State; Zip Code th Avenue, Fort Worth, Texas Principal occupation Job title (See nstructions) College Advisor Employer (See nstructions) Date Full name of contributor out-of-state PAC (1#: --\ Amount of jl contribution ($) rl Contributor address; City; State; Zip Code Principal occupation Job title (See nstructions) TCU 7 Amount of - "!<kind CCW.tfibution contribution ($).:- destion (pplile) 1 =(r c._ $5 s:: :t :l,;,.. :: :": -ry 1 c: en :i= (f travel outside of TexaS:,:complethedufe "ti:]!f.i:-kind csfi\ributrdn des1!tiption (if applicable) (f travel outside of Texas, comolete Schedule n Employer (See nstructions) Date Full name of contributor out-of-statepac(d#:. --\ Amountof n-kind contribution Contributor address; City; State; Zip Code Principal occupation Job title (See nstructions) Employer (See nstructions) contribution ($) description (if applicable) (f travel outside of Texas, complete Schedule n Date Full name of contributor oul of-statepac(d#:.....jl Amountof n-kind contribution contribution ($) description (if applicable) Contributor address; City; State; Zip Code Principal occupation Job title (See nstructions) (f travel outside of Texas complete Schedule n Employer (See nstructions) Date Full name of contributor out-of-statepac(d#: Jl Amount of n-kind contribution Contributor address; City; State; Zip Code Principal occupation Job title (See nstructions) contribution ($) description (if applicable) (f travel outside of Texas complete Schedule Tl Employer (See nstructions) ATTACH ADDTONAL COPES OF THS SCHEDULE AS NEEDED f contributor is out-of-state PAC, please see instruction guide foradditional reporting requirements. Revised 4/19/213

7 Texas Ethics Commission PO Box 127 Austin, Texas (512) (TDD ) LOANS SCHEDULE E 2 FLER NAME Belmontes, Jr., Macario The nstruction Guide explains how to complete this form. 1 Total pages Schedule E: Schedule E: 1/1 3 ACCOUNT# (Ethics Commission Filers) 4 5 Date of loan 9/3/13 6!slender a financial nstitution? v@ TOTAL OF UNTEMZED LOANS: 7 Name of lender Belmontes, Macario 8 Lender address; City; State; out-of-state PAC (1#: ) 9 Loaunf9!!> Zip Code 848 Big Sky Lane, Saginaw, Texas Principal occupation Job title (See nstructions) 14 Description of Collateral [i} none 16 GUARANTOR NFORMATON 17 Name of guarantor 13 Employer (See nstructions) Self $ 1 lntrate..::-- 15 Check if personal funds were deposited into political account D :::rj :: J -;. ""<, -* - 19 Amount Guaranteed ($) - 1 r-- -> f 11 t ; 18 Guarantor address; City; State; Zip Code not applicable 2 Principal Occupation (See nstructions) 21 Employer (See nstructions) Date of loan Name oflender out-of-state PAC (1#: ) Loan Amount ($) s lender a financial nstitution? y N Lender address; City; State; Zip Code nterest rate Maturity date Principal occupation Job title (See nstructions) Employer (See nstructions) Description of Collateral D none GUARANTOR NFORMATON Name of guarantor Check if personal funds were deposited into political account D Amount Guaranteed ($) not applicable Guarantor address; City; State; Zip Code Principal Occupation (See nstructions) Employer (See nstructions) ATTACH ADDTONAL COPES OF THS SCHEDULE AS NEEDED f lender is out-of-state PAC, please see instruction guide for additional reporting requirements. tx.us Revised 4/19/213

8 Texas Ethics Commission PO Box127 Austin Texas (512) (TOO ) POLTCAL EXPENDTURES SCHEDULE F EXPENDTURE CATEGORES FOR BOX 8(a) Advertising Expense Gift/Awards/Memorials Expense Salaries/Wages/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 Committee Fees Printing Expense Office Overhead/Rental Expense OTHER (enter a category not listed above) The nstruction Guide explains how to complete this form. ACCOUNT # (Ethics Commission Filers) 4 Belmontes, Jr., Macario (SEE ATTACHMENT) 1 Total pages Schedule F: 2 FLER NAME 13 4 Date 5 Payee name :tl rn -< r- 6 Amount($) 7 Payee address; City; State; Zip Code..,.., l:::::> ::-1 (/"}_ <- ;T.) ;o.. ::J..,- ": z... -, i -!:: r-.::... - :,: U!. J 1"-- 8 PURPOSE (a) Category (See categories listed at the top of this schedule) (b) Description (f travel outside oftexas, ce Scle T) -- : (1j OF,._ - -:---,\] - i \.-_ EXPENDTURE : ;_ --,.,. - 9 Complete QNJ.Y if direct Candidate Officeholder name Office sought :.::.1 Office31d _, expenditure to benefit C/OH J \ Date Payee name Amount ($) Payee address; City; State; Zip Code PURPOSE Category (See categories listed at the top of this schedule) Description (f travel outside of Texas, complete Schedule T) OF EXPENDTURE Complete QNJ.Y if direct Candidate Officeholder name Office sought Office held expenditure to benefit C/OH Date Payee name Amount($) Payee address; City; State; Zip Code PURPOSE Category (See categories listed at the top of this schedule) Description (f travel outside oftexas, complete Schedule T) OF EXPENDTURE Complete QNJ.Y if direct Candidate Officeholder name Office sought Office held expenditure to benefit C/OH Date Payee name Amount ($) Payee address; City; State; Zip Code PURPOSE Category (See categories listed at the top of this schedule) Description (f travel outside of Texas, complete Schedule T) OF EXPENDTURE Complete QNJ.Y if direct Candidate Officeholder name Office sought Office held expenditure to benefit C/OH ATACH ADDTONAL COPES OF THS SCHEDULE AS NEEDED us Revised 4/19/213

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11 acario Belmontes Jr PO Box " Reimbursement!Reimbursement "L""""""M- - - """"""" - --""""""""""" :A8 j(l..lij-. ;.... ::: \l t. c: 92 :1 Hd S NVr ti!oz }._! ; ; \ 1 J H tj=r11.::1

FORMC/OH CAMPAIGN FINANCE REPORT CovER SHEET PG 1. OFFICE USE ONLY OFFICEHOLDER Mr. Maca rio Date RaDeived f'"l. Bel montes

FORMC/OH CAMPAIGN FINANCE REPORT CovER SHEET PG 1. OFFICE USE ONLY OFFICEHOLDER Mr. Maca rio Date RaDeived f'l. Bel montes exet:s t::uc:s vu r :S:S un!""v CUX.