CANDIDATE / OFFICEHOLDER form c/qh CAMPAIGN FIN NCE REPORT cover sheet pq 1 The C/OH Instruction Guide explains how to complete this form. 1 Filer ID (Ethics Commission Filers) 2 Total pages filed: 3 CANDIDATE/ OFFICEHOLDER NAME 4 CANDIDATE/ OFFICEHOLDER MAILING ADDRESS Change of Address 5 CANDIDATE/ OFFICEHOLDER PHONE 6 CAMPAIGN TREASURER NAME MS/MRSAMFJ _ FIRST Ml 01A n2i NICKNAME LAST SUFFIX ADDRESS / PO BOX; APT / SUITE-* * CITY; STATE; ZIP CODE 0 3 rw# S VioJo AREA CODE PHONE NUMBER EXTENSION MS / MRS f&r) FIRST 'f r "J fitl/x V NilCKNAME LAST SUFFIX Received OFFICE USE ONLY tf/ /n ft Hand-delivered or Postmarked Receipt # Amount $ Processed./ Imaged 7 CAMPAIGN TREASURER ADDRESS (Residence or Business) STREET ADDRESS (NO PO BOX PLEASE); APT / SUITE #; CITY; STATE; ZIP CODE 1 3 5 p' 8 CAMPAIGN TREASURER PHONE AREA CODE PHONE NUMBER EXTENSION f?l!> ) $'? -13 3 9 REPORT TYPE 1 1 January 15 jj Oth day before election I I Runoff I I 15th day after campaign 1 1 1 1 treasurer appointment (Officeholder Only) July 15 [ ] 8th day before election Q Exceeded $500 limit [ ] Final Report (Attach C/OH - PR) 10 PERIOD COVERED Month Day Year Month Day Year I / i T) THROUGH 1 11 ELECTION ELECTION DATE Month Day Year /6/n 12 OFFICE OFFICE HELD (if any) ) \6f) ELECTION TYPE I I Primary Q Runoff Q Other Des ription Seneral \ j Special 13 OFFICE SOUGHT (if known) GO TO PAGE 2
CANDIDATE / OFFICEHOLDER CAMPAIGN FINANCE REPORT FORM C/OH COVER SHEET PG 2 14 C/OH NAME 15 Filer ID (Ethics Commission Filers) 16 NOTICE FROM POLITICAL COMMITTEE(S) THIS BOX IS FOR NOTICE OF POLITICAL CONTRIBUTIONS ACCEPTED OR POLITICAL S MADE BY POLITICA COMMITTEES TO SUPPORT THE CANDIDATE / OFFICEHOLDER. THESE S MAY AVE BEEN MADE WITHOUT THE CANDIDATE'S OR OFFICEHOLDER'S KNOWLEDGE OR CONSENT. CANDIDATES AND OFFICEHOLDERS ARE REQUIRED TO REPORT THIS INFORMATION ONLY IF THEY RECEIVE NOTICE OF SUCH S. COMMITTEE TYPE COMMITTEE NA E QGENERAL I ISPECIFIC COMMITTEE ADDRESS COM ITTEE CAMPAIGN TREASURER NAME ] Additional Pages COMMITTEE CAMPAIGN TREASURER ADDRESS 17 CONTRIBUTION TOTALS 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) TOTALS TOTAL POLITICAL S OF $100 OR LESS, UNLESS ITEMIZED TOTAL POLITICAL S $5(.6 o ) CONTRIBUTION BALANCE TOTAL POLITICAL CONTRIBUTIONS MAINTAINED AS OF THE LAST D s OF REPORTING PERIOD $ VI. OUTSTANDING LOAN TOTALS TOTAL PRINCIPAL AMOUNT OF ALL OUTSTANDING LOANS AS OF THE LAST DAY OF THE REPORTING PERIOD 18 AFFIDAVIT Sy /-\r 1 SHARON NOWAK Notary Public, State of Texas Comm E pires 09-16-2020 Notary ID 4429489 I swear, or affirrp, undet enalt of perjury, that the accompanying report is true and correct an includes all i formation required to be reported by me under Titl t5 pe, tion Code, Signature of Candidate or Officeholder AFFIX NOTARY STAM P / SEAL ABOVE Sworn to and subscribed before me, by the said I this the L& day of I 20 I / to certify which, witness my hand and seal of office. Shlrw No uctj N i iry P kli - Signature of officer administering oath Printed name of officer administering oath Title of officer administering oath
SUBTOTALS = G/OH FORM C/QH 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 $ 2. SCHEDULE A2: NON-MONETARY (IN-KIND) POLITICAL CONTRIBUTIONS * n d 3. SCHEDULE B: PLEDGED CONTRIBUTIONS $ 4. SCHEDULE E: LOANS $ 5. SCHEDULE FI: POLITICAL S MADE FROM POLITICAL CONTRIBUTIONS 6. SCHEDULE F2: UNPAID INCURRED OBLIGATIONS $ 7. SCHEDULE F3: PURCHASE OF INVEST ENTS ADE FROM POLITICAL CONTRIBUTIONS $ 8. SCHEDULE F4: S MADE BY CREDIT CARD $ 9. 10. 12. SCHEDULE G: POLITICAL S MADE FROM PERSONAL FUNDS $ SCHEDULE H: PAYMENT MADE FROM POLITICAL CONTRIBUTIONS TO A BUSINESS OF C/OH $ SCHEDULE 1: NON-POLITICAL S MADE FROM POLITICAL CONTRIBUTIONS $ SCHEDULE K: INTEREST, CREDITS, GAINS, REFUNDS, AND CONTRIBUTIONS RETURNED TO FILER $
MO ETARY POLITICAL CONTRIBUTIONS schedule A1 2 FILER NAME m ij 1 4 5 Full name of contributor FI out-of-state PAC (ID#: 1 30A lic rfo A 6 1 710 )T T1 do 8 Principal occupation / Job title (See Instructions) \ H n- 9 Full name of contributor FI out-of-state PAC (ID#: ) G-oonMo-Vt\. 0-04 />6 y T7 S3 Principal occupation / Job title (See Instructions) 1 Total pages Schedule A1: 3 Filer ID (Ethics Commission Filers) 7 Amount of contribution ($) te c Amount of contribution ($) loo.e>d Employer (See Instruc n ovitfi ( tjons) -Ur /iv) Full name of contributor FI out-of-state PAC (ID#: ) ua)' A 9 N (yvem oote i Principal occupation / Job title (See Instructions) LlAi e Amount of contribution ($) S Q 0 Full name of contributor fl out-of-state PAC (ID#: 1 Amount of contri ution ($) lo A A la,/ - r ncipal occupation / Job title (See Instructions) Y\(k 1 \f\(2 f ATTACH DDITIONAL COPIES OF THIS SCHEDULE AS NEEDED If contributor is out-of-state PAC, lease see instruction guide for additional reporting requirements. Forms provided by Texas Ethics Com ission www.ethics.state.tx.us Revised 9/8/2015
MO ETARY POLITICAL COLSTRIBUTIOLSS schedule A1 1 Total pages Schedule A1: 2 FILER NAME /l ~' 3 Filer ID (Ethics Commission Filers) 4 'i 2/ (?/? 5 Full na e of contributor FI dut-of-state PAC (ID#: 1 t L r<y 6 l(yo} - S t/ f 775 ' 7 Amount of contribution ($) a? 8 Principal occupation \Job title (See Instructions) 9 Employer (See Instru tions) 1/41 Full name of contributor FI out-of-state PAC (ID#: t f] i c\ 7 oo - X o k Oi- rv\ a Op f)f'» Principal occupation / Jot3 title (See Instructions) l \l r 5/ /o Full name of contributor FI out-of-state PAC (ID#: l /vj's Frftt) Contributor address; City; State Qltf lul p\jaimptyp JJiA Principal occupation / Job title (See Inst uctions) /s-l 17' (y ; Zip Code kpj& i Y 'TJvi > Full name of contributor out-of-state PAC (ID#: ). ty) 9 i H - fxnr Jlrincipal occupation / Job title (See Instructions) Ejjtployer (See Instructions) T L i 0 v,f)j/y a / $e f A ount of contribution ($) Amount of contribution ($) A ount of contribution ($) ATTACH ADDITIONAL COPIES OF THIS SCHEDULE AS NEEDED If contributor is out-of-state PAC, please see instruction guide for additional reporting requirements.
WGN-IVlOiSSETAFiY POLI ICAL CONTRIBUTIOIMS schedule A2 1 Total pages Schedule A2: 2 FILER NAME Di -ii 3 Filer ID (Ethics Commission Filers) 1 4 TOTAL OF UNITEMIZED IN-KIND POLITICAL CONTRIBUTIONS $I1S 5 6 Full name of contributor H out-of-state PAC (ID#: t Y/t? 7 Contributor address; Cit ; State; Zip e s S OX CoiM 8 Amount of 9 in-kind contribution j Gontributiqn. $. description \7S I I Check if travel outside of Texas. Complete Schedule T. 10 Principal occupation / Job title (FOR NON-JUDICIAL) (See Instructions) 11 Employer (FOR NON-JUDICIAL)(See Instructions) 12 Contributor's principal occupation (FOR JUDICIAL) 13 Contributor s job title (FOR JUDICIAL) (See Instructions) 14 Contributor's employer/law firm (FOR JUDICIAL) 15 Law firm of contributor's spouse (if any) (FOR JUDICIAL) 16 If contributor is a child, law firm of parent(s) (if any) (FOR JUDICIAL) Full name of contributor PI out-of-state PAC (ID#: ) Amount of In-kind contribution Contribution $. description I C eck if tra el outside of Texas. Co plete Schedule T. Principal occupation / Job title (FOR NON-JUDICIAL) (See Instructions) Employer (FOR NON-JUDICIAL)(See Instructions) Contributor s principal occupation (FOR JUDICIAL) Contributor s job title (FOR JUDICIAL) (See Instructions) Contributor's e ployer/law firm (FOR JUDICIAL) Law firm of contributor's spouse (if any) (FOR JUDICIAL) If contributor is a child, law firm of parent(s) (if any) (FOR JUDICIAL) ATTACH ADDITIONAL COPIES OF THIS SCHEDULE AS NEEDED If contributor is out-of-state PAC, please see instruction guide for additional eporting requirements.
POLITICAL S MADE FROM POLITICAL CONTRIBUTIONS schedule F1 CATEGORIES FOR BOX 8(a) Advertising Expense E entexpense LoanRepaymenl/Reimbursement Solicitation/Fundraising Expense Accountin /Banking Fees Office O erhead/rental Expense Transportation Equipments Related Expense Consulting Expense Food/Be erage Expense Polling Expense Travel In District Contributions/Donations Made By Gift/Awards/Memorials Expense Printing Expense Travel Out Of District Candidate/Officeholder/Political Co mittee Legal Ser ices SalariesAWages/Contract Labor Other (enter acategory not listed above) CreditCard Payment 1 Total pages Schedule F1: 2 FILER NAME, 1 / It 3 Filer ID (Ethics Commission Filers) fjibc/u 4, i _ h iin 6 Amount ($) Wl 8 PURPOSE OF 5 P vee ngjtu. f\ \i 7 4 So / * (a) Category (See Categories listed at the top of this schedule) (b) Description i 1 CheckiftraveloutsideofTexas. Complete Schedule T. 1 1 Check if Austin, TX, office ol er living expense g Complete ONLY if direct Candidate / Officeholder name Office sought Office held expenditure to benefit C/OH < ijiin Amount ($) Payee name Payee address; Cit ; State; Zip Code PURPOSE OF Category (See Categories listed at the top of this schedule) fv Description 1 1 Check if travel outside of Texas. Co plete Schedule T. 1 1 Check if Austin, TX, officeholder living ex ense Complete ONLY if direct Candidate Officeholder name Office sought Office held expenditure to benefit C/OH S/lS/f?' Amount ($) PURPOSE OF Payee name N R 0 Payee address; City; State; Zip Code fhtzn Category (See Categories listed atihe top of this schedule) Peis n Description 1 1 Check if travel outside of Texas. Complete Schedule T. 1 1 Chec if Austin, TX, officeholder living expense / Comolete ONLY if direct Candidate / Officeholder name Office sought Office held expenditure to benefit C/OH ATTACH ADDITIONAL COPIES OF THIS SCHEDU E AS NEEDED Forms provided by Texas Ethics Com ission www.ethics.state.tx.us Revised 9/8/2015