Texas Ethics Commission P.O. Box 12070 Austin, Texas 78711-2070 (512) 463-5800 (TDD 1-800-735-2989) FORM COR-C/OH CORRECTION/AMENDMENT AFFIDAVIT FOR CANDIDATE/ 1. ACCOUNT # 2. Total pages filed: 3 OFFICE USE ONLY 3. CANDIDATE/ NAME MS / MRS / MR FIRST MI Kevin..................................................................... NICKNAME LAST SUFFIX Date Received Felder 4. ORIGINAL REPORT TYPE cx January 15 c July 15 c Runoff c Exceeded 500 limit c Other (specify) Date Hand-delievered or Date Postmarked c 30th day before election c 8th day before election c 15th day after treasurer appointment (officeholder only) c Final report Receipt # Amount 5. ORIGINAL PERIOD COVERED Month Day Year Month Day Year 11/1/2016 THROUGH 12/31/2016 Date Processed Date Imaged 6. EXPLANATION OF CORRECTION I forgot to add outstanding loan of 3250 from previous campaign. 7. AFFIDAVIT I swear, or affirm, under penalty of perjury, that this corrected report is true and correct. Check ONLY if applicable: c cx Seminannual reports:this report is an amendment/correction to a semiannual report due on or after September 1, 2011. If amendment/correction is filed on or after the eighth day after the original. report was filed, 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 Other reports (excluding semiannual reports due on or after September 1, 2011): 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 * * * Signature of Candidate or Officeholder AFFIX NOTARY STAMP / SEAL ABOVE Sworn to and subscribed before me, by the said, this the day 7th of, February 20, 17 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 www.ethics.state.us Revised 09/01/2011
CANDIDATE / CAMPAIGN FINANCE REPORT FORM C/OH 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 NAME Kevin NICKNAME LAST SUFFIX Felder Date Received OFFICE USE ONLY 4 CANDIDATE / ADDRESS / PO BOX; APT / SUITE #; CITY; STATE; ZIP CODE MAILING ADDRESS 8404 Capriola Change of Address Dallas TX 75228 5 CANDIDATE/ PHONE AREA CODE PHONE NUMBER EXTENSION ( ) 214 559 6999 Date Hand-delivered or Date Postmarked 6 CAMPAIGN TREASURER NAME MS / MRS / MR FIRST MI Mr Howard NICKNAME LAST SUFFIX Johnson Receipt # Amount Date Processed Date Imaged 7 CAMPAIGN TREASURER ADDRESS (Residence or Business) STREET ADDRESS (NO PO BOX PLEASE); APT / SUITE #; CITY; STATE; ZIP CODE 7153 Rolling Fork Dallas TX 75227 8 CAMPAIGN TREASURER PHONE AREA CODE PHONE NUMBER EXTENSION 214 559 6999 ( ) 9 REPORT TYPE X January 15 30th day before election Runoff 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 11 01 2016 THROUGH 12 31 2016 11 ELECTION ELECTION DATE ELECTION TYPE Month Day Year 05 06 2017 X Primary General Runoff Special Other Description 12 OFFICE OFFICE HELD (if any) 13 OFFICE SOUGHT (if known) N/A Council District 7 GO TO PAGE 2
CANDIDATE / CAMPAIGN FINANCE REPORT FORM C/OH COVER SHEET PG 2 14 C/OH NAME 15 Filer ID 16 NOTICE FROM POLITICAL COMMITTEE(S) (Ethics Commission Filers) THIS BOX IS FOR NOTICE OF POLITICAL CONTRIBUTIONS ACCEPTED OR POLITICAL EXPENDITURES MADE BY POLITICAL COMMITTEES TO SUPPORT THE CANDIDATE /. THESE EXPENDITURES 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 EXPENDITURES. COMMITTEE TYPE COMMITTEE NAME GENERAL SPECIFIC COMMITTEE ADDRESS COMMITTEE CAMPAIGN TREASURER NAME Additional Pages COMMITTEE CAMPAIGN TREASURER 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) 610 EXPENDITURE TOTALS 3. TOTAL POLITICAL EXPENDITURES OF 100 OR LESS, UNLESS ITEMIZED 4. TOTAL POLITICAL EXPENDITURES 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 325 18 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 AFFIX NOTARY STAMP / SEAL ABOVE Sworn to and subscribed before me, by the said, this the 7th day of, February 20, 17 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
SUBTOTALS - C/OH FORM C/OH COVER SHEET PG 3 19 FILER NAME 20 Filer ID (Ethics Commission Filers) 21 SCHEDULE SUBTOTALS NAME OF SCHEDULE SUBTOTAL AMOUNT 1. SCHEDULE A1: MONETARY POLITICAL CONTRIBUTIONS 6,10 2. SCHEDULE A2: NON-MONETARY (IN-KIND) POLITICAL CONTRIBUTIONS 3. SCHEDULE B: PLEDGED CONTRIBUTIONS 4. SCHEDULE E: LOANS 5. SCHEDULE F1: POLITICAL EXPENDITURES MADE FROM POLITICAL CONTRIBUTIONS 6. SCHEDULE F2: UNPAID INCURRED OBLIGATIONS 7. SCHEDULE F3: PURCHASE OF INVESTMENTS MADE FROM POLITICAL CONTRIBUTIONS 8. SCHEDULE F4: EXPENDITURES MADE BY CREDIT CARD 9. SCHEDULE G: POLITICAL EXPENDITURES MADE FROM PERSONAL FUNDS 10. SCHEDULE H: PAYMENT MADE FROM POLITICAL CONTRIBUTIONS TO A BUSINESS OF C/OH 11. SCHEDULE I: NON-POLITICAL EXPENDITURES MADE FROM POLITICAL CONTRIBUTIONS 12. SCHEDULE K: INTEREST, CREDITS, GAINS, REFUNDS, AND CONTRIBUTIONS RETURNED TO FILER
MONETARY POLITICAL CONTRIBUTIONS SCHEDULE A1 2 FILER NAME The Instruction Guide explains how to complete this form. 1 Total pages Schedule A1: 1 of 2 3 Filer ID (Ethics Commission Filers) 4 Date 5 Full name of contributor out-of-state PAC (ID#: ) 7 Amount of contribution () 12/16/2016 Mr Wesley Pool 100 6 P.O. Box 887 Dallas, TX 75106 8 9 Broker Self Date Full name of contributor out-of-state PAC (ID#: ) Amount of contribution () 12/17/2016 Ms Ellen Pool 100 2020 Marydale Dallas, TX 75208 Date Full name of contributor out-of-state PAC (ID#: ) Amount of contribution () Ms Barbara Pool 12/29/2016 100 49 Crown Place Richardson, TX 75080 Date Full name of contributor out-of-state PAC (ID#: ) Amount of contribution () Mr Richard Pool 12/29/2016 100 49 Crown Dallas, TX 75080 ATTACH ADDITIONAL COPIES OF THIS SCHEDULE AS NEEDED If contributor is out-of-state PAC, please see instruction guide for additional reporting requirements.
MONETARY POLITICAL CONTRIBUTIONS SCHEDULE A1 2 FILER NAME The Instruction Guide explains how to complete this form. 1 Total pages Schedule A1: 2 of 2 3 Filer ID (Ethics Commission Filers) 4 Date 5 Full name of contributor out-of-state PAC (ID#: ) 7 Amount of contribution () 12/30/2016 Mr John Ellis 10 6 3301 Mockingbird Lane Highland Park, TX 75205 8 9 Date Full name of contributor out-of-state PAC (ID#: ) Amount of contribution () 12/29/2016 J. McDonald & Ellen Williams 100 5646 Milton Street Dallas, TX 75206 Date Full name of contributor out-of-state PAC (ID#: ) Amount of contribution () Mr PHILLIP POOL 12/19/2016 100 3438 RANKIN STREET Dallas, TX 75205 Date Full name of contributor out-of-state PAC (ID#: ) Amount of contribution () ATTACH ADDITIONAL COPIES OF THIS SCHEDULE AS NEEDED If contributor is out-of-state PAC, please see instruction guide for additional reporting requirements.