CORRECTION/AMENDMENT AFFIDAVIT FOR CANDIDATE/OFFICEHOLDER

Transcription

1 CORRECTION/AMENDMENT AFFIDAVIT FOR CANDIDATE/ FORM COR-C/OH 1 Filer ID (Ethics Commission Filers) 2 Total pages filed: 4 OFFICE USE ONLY 3 CANDIDATE / MS / MRS / MR FIRST MI Tennell NICK LAST SUFFI Atkins Date Received 4 ORIGINAL REPORT January 15 TYPE July 15 Exceeded 500 limit (specify) 30th day before election 15th day after treasurer appointment (officeholder only) Date Hand-delivered or Date Postmarked 8th day before election Final report Receipt # Amount 5 ORIGINAL PERIOD COVERED Month Day Year Month Day Year THROUGH Date Processed Date Imaged 6 EPLANATION OF CORRECTION Returned both 5/17/17 1,000 contributions (each...totaling 2,000)to John Hamilon and Sarah Hamilton on 3/25/19 7 AFFIDAVIT I swear, or affirm, under penalty of perjury, that this corrected report is true and correct. Check ONLY if applicable: Semiannual reports: I swear, or affirm, that the original report was made in good faith and without an intent to mislead or to misrepresent the information contained in the report. reports: I swear, or affirm, that I am filing this corrected report not later than the 14th business day after the date I learned that the report as originally filed is inaccurate or incomplete. I swear, or affirm, that any error or omission in the report as originally filed was made in good faith. * * * Electronically Certified * * * AFFI NOTARY STAMP / SEAL ABOVE Signature of Candidate or Officeholder 5th April Sworn to and subscribed before me, by the said, this the day of, 20, 19 to certify which, witness my hand and seal of office. Signature of officer administering oath Printed name of officer administering oath Title of officer administering oath Remember To Attach Any Part Of The Campaign Finance Report Form Needed To Report And Explain Corrections Forms provided by Texas Ethics Commission Revised 04/27/2015

2 CANDIDATE / 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: 4 3 CANDIDATE / MS / MRS / MR FIRST MI Tennell NICK LAST SUFFI Atkins Date Received OFFICE USE ONLY 4 CANDIDATE / ADDRESS / PO BO; APT / SUITE #; CITY; STATE; ZIP CODE MAILING ADDRESS 2717 Meadow stone lane Dallas T Change of Address 5 CANDIDATE/ PHONE AREA CODE PHONE NUMBER ETENSION ( ) Date Hand-delivered or Date Postmarked 6 CAMPAIGN MS / MRS / MR FIRST MI Mrs Velma NICK LAST SUFFI Milliner Receipt # Amount Date Processed Date Imaged 7 CAMPAIGN ADDRESS (Residence or Business) STREET ADDRESS (NO PO BO PLEASE); APT / SUITE #; CITY; STATE; ZIP CODE 1407 Laura Lane Dallas T CAMPAIGN PHONE AREA CODE PHONE NUMBER ETENSION ( ) 9 REPORT TYPE January 15 30th day before election 15th day after campaign treasurer appointment (Officeholder Only) July 15 8th day before election Exceeded 500 limit Final Report (Attach C/OH - FR) 10 PERIOD COVERED Month Day Year Month Day Year THROUGH ELECTION ELECTION DATE ELECTION TYPE Month Day Year Primary General Special 12 OFFICE OFFICE HELD (if any) 13 OFFICE SOUGHT (if known) District 8 Council District 8 GO TO PAGE 2

3 CANDIDATE / CAMPAIGN FINANCE REPORT COVER SHEET PG 2 14 C/OH 15 Filer ID 16 NOTICE FROM POLITICAL COMMITTEE(S) (Ethics Commission Filers) THIS BO IS FOR NOTICE OF POLITICAL CONTRIBUTIONS ACCEPTED OR POLITICAL EPENDITURES MADE BY POLITICAL COMMITTEES TO SUPPORT THE CANDIDATE /. THESE EPENDITURES MAY HAVE BEEN MADE WITHOUT THE CANDIDATE'S OR 'S KNOWLEDGE OR CONSENT. CANDIDATES AND S ARE REQUIRED TO REPORT THIS INFORMATION ONLY IF THEY RECEIVE NOTICE OF SUCH EPENDITURES. COMMITTEE TYPE COMMITTEE GENERAL SPECIFIC COMMITTEE ADDRESS COMMITTEE CAMPAIGN Additional Pages COMMITTEE CAMPAIGN ADDRESS 17 CONTRIBUTION TOTALS 1. TOTAL POLITICAL CONTRIBUTIONS OF 50 OR LESS (OTHER THAN PLEDGES, LOANS, OR GUARANTEES OF LOANS), UNLESS ITEMIZED 2. TOTAL POLITICAL CONTRIBUTIONS (OTHER THAN PLEDGES, LOANS, OR GUARANTEES OF LOANS) 4604 EPENDITURE TOTALS 3. TOTAL POLITICAL EPENDITURES OF 100 OR LESS, UNLESS ITEMIZED 4. TOTAL POLITICAL EPENDITURES CONTRIBUTION BALANCE 5. TOTAL POLITICAL CONTRIBUTIONS MAINTAINED AS OF THE LAST DAY OF REPORTING PERIOD OUTSTANDING LOAN TOTALS 6. TOTAL PRINCIPAL AMOUNT OF ALL OUTSTANDING LOANS AS OF THE LAST DAY OF THE REPORTING PERIOD AFFIDAVIT 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. ***ELECTRONICALLY CERTIFIED*** Signature of Candidate or Officeholder AFFI NOTARY STAMP / SEAL ABOVE Sworn to and subscribed before me, by the said, this the 5th day of, April 20, 19 to certify which, witness my hand and seal of office. Signature of officer administering oath Printed name of officer administering oath Title of officer administering oath

4 SUBTOTALS - C/OH COVER SHEET PG 3 19 FILER 20 Filer ID (Ethics Commission Filers) 21 SCHEDULE SUBTOTALS OF SCHEDULE SUBTOTAL AMOUNT \/ 1. SCHEDULE A1: MONETARY POLITICAL CONTRIBUTIONS 2. SCHEDULE A2: NON-MONETARY (IN-KIND) POLITICAL CONTRIBUTIONS 46,04 3. SCHEDULE B: PLEDGED CONTRIBUTIONS 4. SCHEDULE E: LOANS 5. \/ SCHEDULE F1: POLITICAL EPENDITURES MADE FROM POLITICAL CONTRIBUTIONS 60, SCHEDULE F2: UNPAID INCURRED OBLIGATIONS 7. SCHEDULE F3: PURCHASE OF INVESTMENTS MADE FROM POLITICAL CONTRIBUTIONS 8. SCHEDULE F4: EPENDITURES MADE BY CREDIT CARD 9. SCHEDULE G: POLITICAL EPENDITURES MADE FROM PERSONAL FUNDS 10. SCHEDULE H: PAYMENT MADE FROM POLITICAL CONTRIBUTIONS TO A BUSINESS OF C/OH 11. SCHEDULE I: NON-POLITICAL EPENDITURES MADE FROM POLITICAL CONTRIBUTIONS 12. SCHEDULE K: INTEREST, CREDITS, GAINS, REFUNDS, AND CONTRIBUTIONS RETURNED TILER

5 POLITICAL EPENDITURES MADE FROM POLITICAL CONTRIBUTIONS SCHEDULE F1 Advertising Expense Accounting/Banking Consulting Expense Contributions/Donations Made By Candidate/Officeholder/Political Committee Credit Card Payment EPENDITURE CATEGORIES FOR BO 8(a) Event Expense Fees Food/Beverage Expense Gift/Awards/Memorials Expense Legal Services Loan Repayment/Reimbursement Office Overhead/Rental Expense Polling Expense Printing Expense Salaries/Wages/Contract Labor The Instruction Guide explains how to complete this form. Solicitation/Fundraising Expense Transportation Equipment & Related Expense Travel In District Travel Out Of District (enter a category not listed above) 1 Total pages Schedule F1: 2 FILER 3 1 of 1 4 Date 5 Payee name 03/25/2019 John Hamilton Filer ID (Ethics Commission Filers) 6 Amount () 7 Payee address; City; State; Zip Code N. St Paul Suite 3350Dallas, T EPENDITURE (a) Category (See Categories listed at the top of this schedule) (b) Check if Austin, T, officeholder living expense Returned 1,000 contribution 9 Complete ONLY if direct Candidate / Officeholder name Office sought Office held Date Payee name 03/25/2019 Sarah Hamilton Amount () Payee address; City; State; Zip Code N. St. Paul Suite 3350Dallas, T EPENDITURE Category (See Categories listed at the top of this schedule) Check if Austin, T, officeholder living expense Returned 1,000 contribution Complete ONLY if direct Candidate / Officeholder name Office sought Office held Date Payee name Amount () Payee address; City; State; Zip Code EPENDITURE Category (See Categories listed at the top of this schedule) Check if Austin, T, officeholder living expense Complete ONLY if direct Candidate / Officeholder name Office sought Office held ATTACH ADDITIONAL COPIES OF THIS SCHEDULE AS NEEDED