exet:s t::uc:s vu r :S:S un!""v CUX.<::UU 1\U:Sllll exet:s 0 1-.<::U U \O.<::J O.>-oouu \ UU 1-0UU-.>0-.<::l:Ol:l) "t CANDDATE FCEHOLDER 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) 01 of 07 3 CANDDATE MS/MRS/MR FRST Ml FCE USE ONLY FCEHOLDER Mr. Maca rio RaDeived f"l fo..) NAME --<.,..._,,.. NCKNAME LAST SUFFX 1""11 {") "~-- Bel montes Jr ~:? - --l..,.., -~,.,... J rrt -~:J co :;:., 4 CANDDATE ADDRESS PO BOX; APT SUTE#; C1Y; STATE; ZP CODE!! \ - ~r-... FCEHOLDER ::: -. ~..,.., MALNG Hand-delil(erficl 0r Pol!fMirked..., ADDRESS J - - ": \,.,,.) Lr.... -. 0 change of address Receipt# --,_ --!AmbUrn.. r:_: 5 CANDDATE/ AREA CODE PHONE NUMBER EXTENSON i. ~, C.J- Processed" FCEHOLDER ; PHONE 6 CAMPAGN MS/MRS/MR FRST Ml maged TREASURER Mr. Estrus }is""14 D2nP 2~3--2ol~ NAME NCKNAME last SUFFX Tucker 7 CAMPAGN STREET ADDRESS (NO PO BOX PLEASE); APT/SUTE#; C1Y; STATE; ZP CODE TREASURER ADDRESS (residence or business) 8 CAMPAGN AREA CODE PHONE NUMBER EXTENSON TREASURER PHONE 9 REPORT TYPE D January 15 30th day before election lxj D Runoff D D July 15 D 8th day before election D Exceeded 500 D limit 15th day after campaign treasurer appointment (officeholder only) Final report (Attach C/OH FR) 10 PEROD Mornh Day Year Mornh Day Year COVERED THROUGH 01 /01 / 2014 01 /23 / 2014 11 ELECTON ELECTON DATE ELECTON 1YPE Monlh Day Year lxj Primary 03/04 / 2014 0 Runoff 0 General 0 Special 12 FCE FCE HELD (if any) 13 FCE SOUGHT (if known) Justice of the Peace, Pet. 5 GOTOPAGE2
Texas Ethics Commission PO Box12070 Austin Texas 78711-2070 (512) 463-5800 (TOO 1-800-735-2989) CANDDATE FCEHOLDER REPORT: FORM C/OH SUPPORT & TOTALS CovER SHEET PG 2 14 C/OH NAME 15 ACCOUNT# (Ethics Commission Filers) Belmontes, Jr., Macario 16 NOTCE FROM THS BOX S FOR NOTCE POUTCAL CONTRBUTONS ACCEPTED OR POUTCAL S MADE BY POUTCAL COMMTTEES TO SUPPORT THE POLTCAL CANDDATE f ACEHOLDER. THESE S MAY HAVE BEEN MADE WTHOUT THE CANDDATES OR FCEHOLDERS KNOWLEDGE OR COMMTTEE(S) CONSENT. CANDDATES AND ACEHOLDERS ARE REQURED TO REPORT THS NFORMATON ONLY F THEY RECBVE NOTCE SUCH S. COMMTTEE TYPE COMMTTEE NAME D additional pages D GENERAL COMMTTEE ADDRESS D SPECFC COMMTTEE CAMPAGN TREASURER NAME ~ ;-,. co, (":::", :"Q rr1 -< r- r~,, -- :;:: f -, - ~h..::.....-( ;:-:u -fj...... ~" i.,_} U>.. " ::- "T!,. - ~~~. " ~- - oe ; l --,.,.i --..,.. ;"n " - --" v. :~ =r.. -. -,.l - ".. COMMTTEE CAMPAGN TREASURER ADDRESS --~ 17 CONTRBUTON 1. TOTAL POLTCAL CONTRBUTONS 50 OR LESS (OTHER THAN l ---,.., CJ 1! - -... -- TOTALS PLEDGES, LOANS, OR GUARANTEES LOANS), UNLESS TEMZED 0.00 < 2. TOTAL POLTCAL CONTRBUTONS (OTHER THAN PLEDGES, LOANS, OR GUARANTEES LOANS) 2,300.00 TOTALS 3. TOTAL POLTCAL S 100 OR LESS, UNLESS TEMZED 0.00 4. TOTAL POLTCAL S 4,059.72 CONTRBUTON 5. TOTAL POLTCAL CONTRBUTONS MANTANED AS THE LAST DAY BALANCE REPORTNG PEROD 19,396.19 OUTSTANDNG LOAN TOTALS 6. TOTAL PRNCPAL AMOUNT ALL OUTSTANDNG LOANS AS THE LAST DAY THE REPORTNG PEROD 5000.00 18 AFFDAVT,,..,,,.:-~~!.!~~~ AMY L. SHRLEY i;(*_,f*~ Notary Public State of relcas 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. ~.~..~~~/ ~~. ~ My Commission Expires 5 Signature of Candidate or Officeholder t1fi!!:... NOVEMBER 15, 2016 AFFX NOTARY STAMP SEAL ABOVE Sworn<"~ and subscribed before me, by the said ~~vl 0 -&_\\M,&>v\\-e_> -sv ld~;t~t~ kx~ ~: c8: ;: w;tness, this the my hand and seal of office. ~c:>-loj V\? v...lo\ \c. ~aturejf offi~inisterindoath Printed n.jne of officer administering oailj Title of officej administering oath www.ethics.state.tx.us Revised 04/19/2013
Texas Ethics Commission PO Box 12070 Austin, Texas 78711-2070 (512) 463-5800 (TDD 1-800-735-2989) 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: 1/1 2 FLER NAME 3 ACCOUNT # (~ics ~missi~ilers):;-1 Belmontes, Jr., Macario C) -"- - > --i ~ " -n :-;D 4 5 Full name of contributor 0 out-of-state PAC(D#: ) 7 Amount of 8 ~.;K*nd Qtributl~ll.. contribution () de~1p~ion <jf appuc~~~) Arriola, Guadalupe -. r l 01/03/14 6 Contributor address; City; State; Zip Code 350.00 5925 Forest Lane, Fort Worth, Texas 76112 ----- --.r ~ ~ { (f travel outside: of TexJ.:;complettfSchedulaT) 9 Principal occupation Job title (See nstructions) 10 Employer (See nstructions) " 1 SeW l Full name of contributor 0 out-of-statepac(d#.:_ --------) Amountof n-kind contribution contribution () description (if applicable) Bodiford, Jerry 01/01/14 Contributor address; City; State; Zip Code 15oo.oo Campaign Office PO Box 471699, Fort Worth, Texas 76147 Principal occupation Job title (See nstructions) 01/14/14 Employer (See nstructions) Self (f travel outside of Texas, comolete Schedule n Full name of contributor 0 out-of-statepac(d#:.,_) Amount of n-kind contribution Texas Democratic Party Contributor address; City; State; Zip Code 4818 EBen White #104, Austin, Texas 78741 Principal occupation Job title (See nstructions) Employer (See nstructions) Full name of contributor 0 out-of-state PAC (10#.:_ --------) Contributor address; City; State; Zip Code Principal occupation Job title (See nstructions) Full name of contributor Contributor address; Principal occupation Job title (See nstructions) contribution () description (if applicable) 450.00 VAN Data (f travel outside of Texas, complete Schedule T) Amountof J contribution () n-kind contribution description (if applicable) (f travel outside of Texas, comolete Schedule Tl Employer (See nstructions) O out-of-state PAC (D#: _) Amount of n-kind contribution -----------1 contribution () description (if applicable) City; State; Zip Code _{_f travel outside of Texas complete Schedule Tl Employer (See nstructions) ATTACH ADDTONAL COPES THS SCHEDULE AS NEEDED f contributor is out-of-state PAC, please see instruction guide foradditional reporting requirements. www.ethics.state.tx. us Revised 04/19/2013
Texas Ethics Commission P.O. Box 12070 Austin Texas 78711-2070 LOANS (512) 463-5800 (TOO 1-800-735-2989) SCHEDULE E The nstruction Guide explains how to complete this form. 1 Total pages Schedule E: Schedule E: 1/1 2 FLER NAME 3 ACCOUNT # (Ethics Commission Filers) Belmontes, Jr., Macario 4 TOTAL UNTEMZED LOANS: 5 of loan 7 Name of lender 0 out-of-state PAC (D#: ) 9 Loan Amount() 9/30/13 Belmontes, Macario 5000.00 6 s lender 8 Lender address; City; State; Zip Code 10 nterest rate a financial nstitution? 848 Big Sky Lane, Saginaw, Texas 76131 11 Maturity date y 0 12 Principal occupation Job title (See nstructions) 13 Employer (See nstructions) 14 Description of Collateral 15 Check if personal funds were deposited into political account [i] none 0 16 GUARANTOR 17 Name of guarantor 19 Amount Guaranteed () NFORMATON Self D not applicable 18 Guarantor address; City; State; Zip Code : rn,..., ~~ 0 -...~:..-..,:,.,~"" --i ;:::;(:..., ~J 20 Principal Occupation (See nstructions) 21 Employer (See nstructions) -< r-.~ of loan Name of lender 0 out-of-state PAC (D#: ) t~~>l:tnarri{jtjnt ()> 1 s lender Lender address; City; State; Zip Code 15\~l"est~ _. ::_". a financial nstitution? -.. -- --....,.,_, -::-.;::- --.,J ;Jlltaturity.cate y N 35 &"" Principal occupation Job title (See nstructions) Employer (See nstructions),.,.... 1-..., "i Description of Collateral 0 none 0 Check if personal funds were deposited into political account GUARANTOR Name of guarantor Amount Guaranteed () NFORMATON 0 not applicable Guarantor address; City; State; Zip Code Principal Occupation (See nstructions) Employer (See nstructions) ATTACH ADDTONAL COPES THS SCHEDULE AS NEEDED f lender is out-of-state PAC, please see instruction guide for additional reporting requirements. www.ethics.state.tx. us Revised 04/19/2013
Texas Ethics Commission P.O. Box 12070 Austin, Texas 78711-2070 (512) 463-5800 (TDD 1-800-735-2989) POLTCAL S SCHEDULE F CATEGORES FOR BOX B(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. 1 Total pages Schedule F: 2 FLER NAME 13 ACCOUNT # (Ethics Commission Filers) 3 Belmontes, Jr., Macario (SEE ATTACHMENT) 4 5 Payee name 6 Amount() 7 Payee address; City; State; Zip Code 8 PURPOSE (a) Category (See categories listed at the top of this schedule) (b) Description (f travel outside of Texas, complete Schedule T) 9 Complete Q!lli.Y if direct Candidate Officeholder name Office sought Office held expenditure to benefit COH ::0.~ " Payee name 0 --., " -L"..,. - ---!?-.,-, -, """",.,_.! ~u; rr1 :o.,..., Amount() Payee address; City; State; Zip Code c)i~c- ::~~: -q )-_,.., \ -.1... C~J-..c- ~ _,~ \ - "")fii - - l ;, "" - -; (,.:) :1> =.. :o PURPOSE Category (See categories listed at the top of this schedule) Description (f travel outside Of Texas, ~oinflete ScJ:J.epule T~,. ~ ~ \ t.~.,._: C> l -n.+:."..,, t -~.or,:,: Complete Q!lli.Y if direct Candidate Officeholder name Office sought! Office held expenditure to benefit C/OH 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) Complete Q!lli.Y if direct Candidate Officeholder name Office sought Office held expenditure to benefit C/OH 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) Complete Q!lli.Y if direct Candidate Officeholder name Office sought Office held expenditure to benefit C/OH ATTACH ADDTONAL COPES THS SCHEDULE AS NEEDED www.ethics.state.tx.us Revised 04/19/2013
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MACario Belm~ntes Ca","~p~ig~. 1/20/14jJabob Bazar Fort Worth ~.. ;..... ~... i 1/20/141Cesar Soto :Fort Worth f~~ " : 1/~QL~~L~~~-~.S.~nchez 1/20/14!1van Oropeza "i72o/i41juan Hernandez ho21 Market Avenue :Fort Worth.. iz~jji4jy\tai-mart _J~36o Lake worth Blv&L:ake worth ;re~~-j[~!~~-jg~[~e o~e-~head 1 1/23/141Tarrant County Dem Partyi2806 Race Street!Texas h6111 iother r - -~ --~,... ~... -~ ~---... ~... ~ -... ~......,... -4 ~~ -~ ~ ~..... ; 1/23/14Target l301 Carroll Street itexas!76107!office Overhead ~"". ~ "~= ~ ~~-== -, ~=- " }/~~[}4:Macario Belmontes Jr --~""o" PO Box 64274 o<y ~-~~"""""i""""""" <""""""-""f=<>""-~-",_,= Fort Worth jtex~~.. J76164!Reimbursement,supplies roata~.. " "" """"" "" " ""1"~"". JSupe!les l Reimbursement -"J«-.-~- Schedule F: 2/2 30! 30, 30, "" -1 " "1 3o1 30 1 """""""""";i 52.241 i 661