CANDIDATE / OFFICEHOLDER FORM C/OH CAMPAIGN FINANCE REPORT Cover Sheet pg 1 The C/OH Instrution Guide explains how to omplete this form. 3. CANDIDATE / OFFICEHOLDER NAME 1. ACCOUNT # (Ethis Commission filers) MS / MRS / MR FIRST MI Mr Sott T 2. Total Pages Filed: 8 OFFICE USE ONLY Reeived NICKNAME LAST SUFFIX Griggs 4. CANDIDATE / OFFICEHOLDER MAILING ADDRESS Change of Address Address/PO BOX; APT / SUITE #; CITY; STATE; ZIP CODE PO Box: 227176 Dallas TX 75222 Hand-delievered or Postmarked 5. CANDIDATE / OFFICEHOLDER PHONE AREA CODE PHONE NUMBER EXTENSION (214) 843 3020 Reeipt # Amount 6. CAMPAIGN TREASURER NAME 7. CAMPAIGN TREASURER ADDRESS (Residene or business) 8. CAMPAIGN TREASURER PHONE MS / MRS / MR FIRST MI Ms Lena NICKNAME LAST SUFFIX Liles Proessed Imaged STREET ADDRESS (NO PO BOX PLEASE); APT / SUITE #; CITY; STATE; ZIP CODE 1125 N. Canterbury Dallas TX 75208 AREA CODE PHONE NUMBER EXTENSION (214) 957 4567 9. REPORT TYPE January 15 10. PERIOD COVERED 11/9/2010 THROUGH 12/31/2010 11. ELECTION ELECTION DATE ELECTION TYPE 5/14/2011 General 12. OFFICE OFFICE HELD (if any) 13. OFFICE SOUGHT (if known) Counil Distrit 3 14. NOTICE OF DIRECT CAMPAIGN BY OTHER INDIVIDUALS ** Diret ampaign expenditures are ampaign expenditures made by others without the andidate's prior onsent or approval Candidates are required to dislose this information only if they reeive notifiation of the diret ampaign expenditure. ** NAME ADDRESS / PO BOX; APT / SUITE #; CITY; STATE; ZIP CODE additional pages GO TO PAGE 2
CANDIDATE / OFFICEHOLDER REPORT: FORM C/OH SUPPORT & TOTALS COVER SHEET PG 2 15 C/OH NAME 16 ACCOUNT #(Ethis Commission filers) 17 NOTICE FROM POLITICAL COMMITTEE(S) ** This box is for notie of politial ontributions aepted or politial expenditures made by politial ommittees to support the andidate/offieholder. These expenditures may have been made without the andidate's or offieholder's knowledge or onsent. Candidates and offieholders are required to report this information only if they reeive notie of suh expenditures.** COMMITTEE TYPE COMMITTEE NAME additional pages GENERAL COMMITTEE ADDRESS SPECIFIC COMMITTEE CAMPAIGN TREASURER NAME COMMITTEE CAMPAIGN TREASURER ADDRESS 18 CONTRIBUTION TOTALS 1. TOTAL POLITICAL CONTRIBUTIONS OF 50 OR LESS (OTHER THAN PLEDGES, LOANS, OR GUARANTEES OF LOANS), UNLESS ITEMIZED 0... TOTALS 2. TOTAL POLITICAL CONTRIBUTIONS (OTHER THAN PLEDGES, LOANS, OR GUARANTEES OF LOANS) 3. TOTAL POLITICAL S OF 50 OR LESS, UNLESS ITEMIZED 4665.00 0 4. TOTAL POLITICAL S 2661.69... CONTRIBUTION BALANCE 5. TOTAL POLITICAL CONTRIBUTIONS MAINTAINED AS OF THE LAST DAY OF REPORTING PERIOD 2003.31... OUTSTANDING LOAN TOTALS 6. TOTAL PRINCIPAL AMOUNT OF ALL OUTSTANDING LOANS AS OF THE LAST DAY OF THE REPORTING PERIOD 8000.00 19 AFFIDAVIT I swear, or affirm, under penalty of perjury, that the aompanying report is true and orret and inludes all information required to be reported by me under Title 15, Eletion ode. AFFIX NOTARY STAMP / SEAL ABOVE ***ELECTRONICALLY CERTIFIED*** Signature of Candidate or Offieholder Sworn to and subsribed before me, by the said, this the 18th day of, January 20, 11 to ertify whih, witness my hand and seal of offie. Signature of offier administering oath Printed name of offier administering oath Title of offier administering oath
POLITICAL CONTRIBUTIONS OTHER THAN PLEDGES OR LOANS SCHEDULE A The Instrution Guide explains how to omplete this form 1 Total pages Shedule A: 1 of 4 3 ACCOUNT # (Ethis Commission filers) 4 5 Mr Charles Snakard 6 7 12/13/2010 100.00 1507 Oak Knoll Street Dallas, TX 75208 8 9 10 Donna Cotter 707 Tenna Loma Dallas, TX 75208 12/13/2010 250.00 Employeer (See Instrutions) Riley Willson 12/13/2010 150.00 1940 Old Orhard Drive Dallas, TX 75208 Van Johnson 12/13/2010 100.00 2306 Lawndale Dallas, TX 75211 Avi Adelman 12/20/2010 20.00 5715 Belmont Dallas, TX 75206 If ontributor is out-of-state PAC, please see instrution guide for additional reporting requirements.
POLITICAL CONTRIBUTIONS OTHER THAN PLEDGES OR LOANS SCHEDULE A The Instrution Guide explains how to omplete this form 1 Total pages Shedule A: 2 of 4 3 ACCOUNT # (Ethis Commission filers) 4 5 Joel Sontag 12/31/2010 50.00 6 1320 Yardley Plae DeSoto, TX 75115 7 8 9 10 Marty & Laura Brown 1811 Marydale Drive Dallas, TX 75208 12/03/2010 500.00 Employeer (See Instrutions) Rihard Davis 12/10/2010 100.00 207 N. Rosemont Dallas, TX 75208 Walter Buhanan 12/10/2010 1000.00 1838 Mayflower Dallas, TX 75208 Margaret B Guy 12/24/2010 25.00 1937 Marydale Dallas, TX 75208 If ontributor is out-of-state PAC, please see instrution guide for additional reporting requirements.
POLITICAL CONTRIBUTIONS OTHER THAN PLEDGES OR LOANS SCHEDULE A The Instrution Guide explains how to omplete this form 1 Total pages Shedule A: 3 of 4 3 ACCOUNT # (Ethis Commission filers) 4 5 Bob Buker 6 7 12/24/2010 100.00 2024 Old Orhard Dallas, TX 75208 8 9 10 Sylvia Camarillo 3 Rihmond Ct Mansfiled, TX 76063 12/24/2010 150.00 Employeer (See Instrutions) Stay Rives 12/24/2010 1000.00 1118 N Zang Blvd Dallas, TX 75203 Craig Shenkel 12/24/2010 1000.00 3105 Stanford Ave Dallas, TX 75225 Amy Cowan 12/24/2010 20.00 821 N Widomere Dallas, TX 75208 If ontributor is out-of-state PAC, please see instrution guide for additional reporting requirements.
POLITICAL CONTRIBUTIONS OTHER THAN PLEDGES OR LOANS SCHEDULE A The Instrution Guide explains how to omplete this form 1 Total pages Shedule A: 4 of 4 3 ACCOUNT # (Ethis Commission filers) 4 5 David & Lee Saba 6 7 12/24/2010 100.00 1808 Marydale Dallas, TX 75208 8 9 10 Employeer (See Instrutions) If ontributor is out-of-state PAC, please see instrution guide for additional reporting requirements.
LOANS SCHEDULE E The Instrution Guide explains how to omplete this form 1 Total pages Shedule E: 1 of 1 3 ACCOUNT # (Ethis Commission filers) 4 TOTAL OF UNITEMIZED LOANS: -> -> -> -> -> -> -> -> 5 of loan 6 Is lender a finanial Institution? Y 12/03/2010 ON 7 Name of lender out-of-state PAC (ID#: ) 9 Loan Amount () 8000.00... 8 Lender address; City; State; Zip Code 1803 Marydale Dallas, TX 75208 12 13 Attorney 10 Interest rate % 11 Maturity date 14 Desription of Collateral X none 15 GUARANTOR INFORMATION 16 Name of guarantor 18 Amount Guaranteed () X not appliable... 17 Guarantor address; City; State; Zip Code 19 Prinipal Oupation 20 Employer of loan Name of lender out-of-state PAC (ID#: ) Loan Amount () Is lender a finanial Institution?... Lender address; City; State; Zip Code Interest rate Y N Maturity date Desription of Collateral none GUARANTOR INFORMATION not appliable Name of guarantor... Guarantor address; City; State; Zip Code Amount Guaranteed () Prinipal Oupation Employer If lender is out-of-state PAC, please see instrution guide for additional reporting requirements.
Texas Ethis Commission P.O. Box 12070 Austin, Texas 78711-2070 (512) 463-5800 1-800-325-8506 POLITICAL S SCHEDULE F 1 Total pages Shedule F: 3 ACCOUNT # (Ethis Commission Filers) 1 of 1 4 Advertising Expense Aounting/Banking Consulting Expense Event Expense Fees 5 Payee name 12/28/2010 Charaters Gift/Awards/Memorials Expense Legal Servies Food/Beverage Expense Polling Expense Printing Expense CATEGORIES FOR BOX 8(a) Salaries/Wages/Contrat Labor Soliitation/Fundraising Expense Travel In Distrit Travel Out Of Distrit Offie Overhead/Rental Expense The Instrution Guide explains how to omplete this form. Loan Repayment/Reimbursement Transportation Equipment & Related Expense Contributions/Donations Made By Candidate/Offieholder/Politial Committee OTHER (enter a ategory not listed above) 6 Amount () 7 Payee address; City; State; Zip Code 4310 Westside Drive Suite B Dallas, TX 75209 1540.72 8 PURPOSE (a) Category (See ategories listed at the top of this shedule) (b) O F Printing Expense Desription Campaign Literature development and prodution 9 Complete ONLY if diret expenditure to benefit C/OH Candidate / Offieholder name Offie sought Offie held Payee name 12/28/2010 Kris Martin Amount () Payee address; City; State; Zip Code 1100.00 2425 S Cesar Chavez Blvd Suite 3 Dallas, TX 75214 PURPOSE O F Category (See ategories listed at the top of this shedule) Consulting Expense Desription media servies and events Complete ONLY if diret expenditure to benefit C/OH Candidate / Offieholder name Offie sought Offie held Payee name 12/31/2010 PayPal Amount () Payee address; City; State; Zip Code 20.97 2211 No First Street San Jose, CA 95131 PURPOSE O F Category (See ategories listed at the top of this shedule) Fees Fees Desription Complete ONLY if diret expenditure to benefit C/OH Candidate / Offieholder name Offie sought Offie held Payee name Amount () Payee address; City; State; Zip Code PURPOSE O F Category (See ategories listed at the top of this shedule) Desription Complete ONLY if diret expenditure to benefit C/OH Candidate / Offieholder name Offie sought Offie held ATTACH ADDITIONAL COPIES OF THIS SCHEDULE AS NEEDED