'' Texas Ethics Commission P.O. Box 12070 Austin, Texas 78711-2070 (512) 463-5800 (TDD 1-800-735-2989) CANDDATE FCEHOLDER FORM C/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 MSMRSMR FRST Ml FCE USE ONLY FCEHOLDER NAME MR0. CA01B L. Date Rec'1ived r--.).. = NCKNAME LAST SUFFX - -=- '1 '- W-fh-\~ c::. 3 r --..,., 4 CANDDATE ADDRESS PO BOX; APT SUTE#; CTY; STATE; ZP CODE.. -.. 100 \Lu-JcxtBLOE.. -<.. Q"\ FCEHOLDER MALNG Date Hand-tleli\l<lred or Postn@'ked.. " ~ ADDRESS l?vrjjst T'f 18U?. ~.---...~..... ; 0 change of address Receipt #r. > :, 5 CANDDATE/ AREA CODE PHONE NUMBER EXTENSON FCEHOLDER PHONE (~1.) l% OloDl 6 CAMPAGN MSMRSMR FRST TREASURER MR., D A1JR1l NAME u. NCKNAME LAST SUFFX \J\L~l lfbr~andel Ml., Date Proce'ssed Date maged 7 CAMPAGN STREET ADDRESS (NO PO BOX PLEASE); APT SUTE#; CTY; STATE; ZPCDDE TREASURER ADDRESS \\0\ 5- c)urtljsj)-1 (residence or business) 9DR\Jt\ \'f ~LQ 8 CAMPAGN AREA CODE PHONE NUMBER EXTENSON TREASURER PHONE <'5{LJ 1% 1-L.S ~~m ;,..} 9 REPORT TYPE D January 15 D 30th day before elect1on D Runoff D rtj July 15 D 8th day before election D Exceeded $500 D lim1t 15th day after campa1gn treasurer appo1ntment (officeholder only) Final report (Attach COH - FR) 10 PEROD Month Day Year Month Day Yaar COVERED THROUGH ~/Q3<SLO~ ao//?:o 20(~ 11 ELECTON ELECTON DATE ELECTON TYPE Month Day Year D Primary D Runofl' D General / / D Spec:al 12 FCE FCE HELD (if any) 13 FCE SOUGHT (1fknown) D\S\<L\ CLE-J<_K GOTOPAGE2
Texas Ethics Commission P.O. Box 12070 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 CfJStc tv.lki3 115 ACCOUNT# (Ethics Commission Filers) 16 NOTCE FROM THS BOX S FOR NOTCE POLTCAL CONTRBUTONS ACCEPTED OR POLTCAL S MADE BY POLTCAL COMMTTEES TO SUPPORT THE POLTCAL CANDDATE f FCEHOLDER. THESE S MAY HAVE BEEN MADE WTHOUT THE CANDDATE'S OR FCEHOLDER'S KNOWLEDGE OR COMMTTEE(S) CONSENT. CANDDATES AND FCEHOLDERS ARE REQURED TO REPORT THS NFORMATON ONLY F THEY RECEVE NOTCE SUCH S. COMMTTEE TYPE COMMTTEE NAME D GENERAL D SPECFC COMMTTEE ADDRESS D additional pages COMMTTEE CAMPAGN TREASURER NAME COMMTTEE CAMPAGN TREASURER ADDRESS 17 CONTRBUTON 1. TOTAL POLTCAL CONTRBUTONS $50 OR LESS (OTHER THAN TOTALS PLEDGES. LOANS. OR GUARANTEES LOANS), UNLESS TEMZED $ 2. TOTAL POLTCAL CONTRBUTONS (OTHER THAN PLEDGES, LOANS, OR GUARANTEES LOANS) J/ $ 45V- DO TOTALS 3. TOTAL POLTCAL S $100 OR LESS, UNLESS TEMZED $ p 4. TOTAL POLTCAL S $ L/50.00 CONTRBUTON BALANCE OUTSTANDNG LOAN TOTALS 18 AFFDAVT 5. TOTAL POLTCAL CONTRBUTONS MANTANED AS THE LAST DAY REPORTNG PEROD $ 6. TOTAL PRNCPAL AMOUNT ALL OUTSTANDNG LOANS AS THE LAST DAY THE REPORTNG PEROD $ rf lr:f,3dv.ou 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. CaocQuJafJt'--bL- Signature of Candidate or Officeholder AFFX NOTARY STAMP SEAL ABOVE Swom to aod '""'c'ibed befom me, by th:a CLAs,e ~Kev, this the / LJ; +/...; day of ~~J, 20, to certify which, witness my hand and seal of office. (~~.~~~ V \ c~ V\\t:\ Smt~ve:{ ~\A_-\-y L'efk Signature of officer adwstering oath Printed name of officer administering oath Title J officer a~istering oath
------------------------- ------------- -- POLTCAL CONTRBUTONS OTHER THAN PLEDGES OR LOANS SCHEDULE A 1 Total pages Schedule A: 2 FLER NAME 3 ACCOUNT# (Ethics Commission Filers) 4 Date 5 Full name of contributor D out-of-state PAC(D#: ) 7 Amount of 8 n-kind contribution ~ftrj 5{ A- Df?L z ] contribution ($) description ':)D. C{) 5TJ(_p./hJaJff)6 13 Jv/ftR.J~)L FAU.--s X 78W9f 9 Principal occupation Job title (See nstructions) 110 Employer (See nstructions) (f travel outside of Texas, complete Schedule T) Date Full name of contributor D out-of-state PAC(D#: ]) Amount of n-kind contribution contribution ($) description CHAD AJf?LSO 0 PkVJt( /DD.oo: B<J QJ..Jt:JT ry 7f!J_p / J (f travel outside lf Texas, complete Schedule T) Cont305rsH/fosve. 6Rove Principal occupation Job title (See nstructions) Employer (See nstructions) Date Full na ~~ cbon~u;;rr 0 g a.u;-o~gc( a:;;;;.=:::::------ j\ Amount of n-kind contribution f\-.-v l-- 1'- }<:_ V JC:: v f"'\..._, contribution ($) description 1 11 o!v1outjt m AJ t :.-vv Principal occupation Job title (See nstructions) J-108 rx 7&Ps 7 Date Full name of contributor D out-of-state PAC(D#:-:-~...-..-r.-----) ~.lf1vf E-:7 Ft-E"T0~ UJJKNOUJtJ Principal occupation Job title (See nstructions) Date Full name of contributor D out-of-state PAC(D#:.,) /00.00 (f travel outside of Texas, complete Schedule T) Employer (See nstructions) Amount of n-kind contribution contribution ($) description ;XXJ.ou 1 (f travel outside of Texas complete Schedule T) Employer (See nstructions) Amount of contribution ($) n-kind contribution description Principal occupation Job title (See nstructions) (f travel outside of Texas, complete Schedule T) Employer (See nstructions) ATTACH ADDTONAL COPES THS SCHEDULE AS NEEDED f contributor is out-of-state PAC, please see instruction guide foradditional reporting requirements.
PLEDGED CONTRBUTONS SCHEDULE 8 1 Total pages Schedule B: 2 FLER NAME 3 ACCOUNT# (Ethics Commission Filers) 4 TOTAL UN TEMZED PLEDGES: 5 Date 6 Full name of pledgor 0 out-of-state PAC(D#: ) 8 Amount of 19 n-kind description 7 Pledgor address; City; State; Zip Code (f travel outside of Texas, complete Schedule T) 10 Principal occupation Job title (See nstructions) 111 Employer (See nstructions) Date Full name of pledgor 0 out-of-state PAC (D#: J Amount of n-kind description Pledgor address; City; State; Zip Code (f travel outside of Texas, complete Schedule T) Principal occupation Job title (See nstructions) Employer (See nstructions) 1$ Date Full name of pledgor 0 out-of-state PAC(D#: ) Amount of n-kind description Pledgor address; City; State; Zip Code (f travel outside of Texas. complete Schedule T) Principal occupation Job title (See nstructions) Employer (See nstructions) Date Full name of pledgor 0 out-of-state PAC(D#: ) Amount of n-kind description Pledgor address; City; State; Zip Code (f travel outside of Texas, complete Schedule T) Principal occupation Job title (See nstructions) Employer (See nstructions) Date Full name of pledgor 0 out-of-state PAC(D#: ) Amount of n-kind description Pledgor address; City; State; Zip Code (f travel outside of Texas. complete Schedule T) Principal occupation Job title (See nstructions) Employer (See nstructions) ATTACH ADDTONAL COPES THS SCHEDULE AS NEEDED f contributor is out-of-state PAC, please see instruction guide for additional reporting requirements.
LOANS SCHEDULE E 1 Total pages Schedule E: 2 FLER NAME 3 ACCOUNT# (Ethics Commission Filers) 4 TOTAL UNTEMZED LOANS: q q $ 5 Date of loan 7 Name of lender 0 out-of-state PAC (D#: ) 9 Loan Amount($) 6 s lender 8 Lender address; City; State; Zip Code 10 nterest rate a financial nstitution? 11 Maturity date y N 12 Principal occupation Job title (See nstructions) 13 Employer (See nstructions) 14 Description of Collateral 15 Check if personal funds were deposited into political account 0 none 0 16 GUARANTOR 17 Name of guarantor 19 Amount Guaranteed($) NFORMATON 0 not applicable 18 Guarantor address; City; State; Zip Code 20 Principal Occupation (See nstructions) 21 Employer (See nstructions) Date of loan Name of lender 0 out-of-state PAC (D#: ) Loan Amount ($) s lender Lender address; City; State; Zip Code nterest rate a financial nstitution? Maturity date y N Principal occupation Job title (See nstructions) Employer (See nstructions) Description of Collateral 0 none 0 Check if personal funds were deposited into political account GUARANTOR Name of guarantor Amount Guaranteed ($) 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.
---------------------------------------------------------------------------- POLTCAL S SCHEDULE F Advertising Expense Accounting/Banking Consulting Expense Event Expense Fees Gift/Awards/Memorials Expense Legal Services CATEGORES FOR BOX 8(a) Salaries/Wages/Contract Labor Solicitation/Fund raising Expense Loan Repayment/Reimbursement Transportation Equipment & Related Expense Food/Beverage Expense Travel n District Contributions/Donations Made By Polling Expense Travel Out Of District Candidate/Officeholder/Political Committee Printing Expense Office Overhead/Rental Expense OTHER (enter a category not listed above) 13 ACCOUNT# (Ethics Commission Filers) 1 Total pages Schedule F: 5 Payee name RJut?R.f;JOE SJVDtDS 6 Amount ($) 7 Payee~ 'L 0; State; Zip Code 8 PURPOSE 9 Complete Qtii.Y: if direct B<JQA)E3( TX 1g~( (a) Category (See categories listed at the top of this schedule) (b) Description (f travel outside of Texas. complete Schedule T) ltdijc:ens 110 0 t?fpw> t;: Candidate Officeholder name Office sought Office held Date Payee name Amount ($) Payee address; City; State; Zip Code PURPOSE Complete ONLY if direct Category (See categories listed at the top of this schedule) Description (f travel outside oftexas. complete Schedule T) Candidate Officeholder name Office sought Office held Date Payee name Amount ($) Payee address; City; State; Zip Code PURPOSE Complete ONLY if direct Date Category (See categories listed at the top of this schedule) Description (f travel outside of Texas, complete Schedule T) Candidate Officeholder name Office sought Office held Payee name Amount($) Payee address; City; State; Zip Code PURPOSE Complete Qtii.Y: if direct Category (See categories listed at the top of this schedule) Description (f travel outs< de oftexas. complete Schedule T) Candidate Officeholder name Office sought Office held ATTACH ADDTONAL COPES THS SCHEDULE AS NEEDED www.ethics.state.tx.us Revised 04/19/2013