GPAC 2014-01-15 (2)Texas Ethics Commission P.O. Box 12070 Austin, Texas 7871 1-2070 (51 2) 463-5800 (TDD 1-800-735-2989)
GENERAL-PURPOSE COMMITTEE FORM GPAC
CAMPAIGN FINANCE REPORT COVER SHEET PG 1
3 COMMITTEE NAME
1
The GPAC Instruction Guide explains how to complete thls form.
4 COMMITTEE 1 ADDRESS
1 ACCOUNT#
(Ethics Commission Filers)
1 ADDRESS I PO BOX; APT I SUITE #: CITY; STATE: ZIP CODE
a Change of Address
PO BOA 1%
2 Total pages filed:
I JAN 1 5 2014
City Secretary
HD 1 PM
5 CAMPAIGN
TREASURER
NAME
Receipt #
MS 1 MRS 1 MR
......
NICKNAME
Arnounl
FIRST
. . .
LAST
MI
. .
SUFFIX
I Date Processed
6 CAMPAIGN
TREASURER'S
STREET ADDRESS
(residence or business)
ZIPCODE STREET ADDRESS (NO PO BOX PLEASE); APT ISUITE t; CITY; STATE;
1 El
Change of Address
7 CAMPAIGN
TREASURER'S
MAILING ADDRESS
APTlSUlTE t; CITY; STATE; ZIP CODE STREET OR PO BOX:
8 CAMPAIGN
TREASURER
PHONE
AREA CODE PHONE NUMBER EXTENSION
30th day before election
Blh day before election
Dissolution (attach PACDR)
lOUIday aflercarnpaign lreasurertermination
THROUGH
10 PERIOD COVERED Month Day Year I Month Day Year
/O /Ag /Lor8j
Primary Runoff General ~peual I
11 ELECTION
GO TO PAGE 2
www.ethics.state.tx.us Revised 04/19/2013
ELECTION DATE
Monlh Day Year
ELECTION TYPE
Texas Ethics Commission P.O. BOX 12070 Austin. Texas 78711-2070 (51 2) 463-5800 CTDD 1-800-735-2989)
13 COMMITTEE
ACTIVITY
(attach lists on plain
paper to complete this
report if necessary.)
GENERAL-PLIRPOSE COMMITTEE REPORT: FORM GPAC
PURPOSE AND TOTALS COVER SHEET PG 2
1. Candidates
12 COMMITTEE NAME
(identify by name
or, if applicable.
classify by party)
ACCOUNT # (Ethics Commission Files)
A. Supported
8. Opposed
I A. Supported
(describe by date
and location of
3. Officeholders
Assisted
election and
nature of issue) B. Opposed
C' C,PPGC ,/-
14 CONTRIBUTION
TOTALS
..........
CONTRIBUTION
BALANCE
'(identify by name
or, if applicable,
classify by party)
1. TOTAL UNITEMIZED POLITICAL CONTRIBUTIONS (OTHER THAN
PLEDGES, LOANS, OR GUARANTEES OF LOANS), UNLESS ITEMIZED
check here if this report qualifies for the higher itemization threshold
.............
EXPENDITURE
TOTALS
............
OUTSTANDING
LOAN TOTALS
4. TOTAL POLITICAL EXPENDITURES
2. TOTAL POLITICAL CONTRIBUTIONS
(OTHER THAN PLEDGES, LOANS, OR GUARANTEES OF LOANS)
3. TOTAL POLITICAL EXPENDITURES OF $100 OR LESS, UNLESS ITEMIZED
5. TOTAL POLITICAL CONTRIBUTIONS MAINTAINED AS OF THE LAST DAY
OF THE REPORTING PERIOD
$
$ -
6. TOTAL PRINCIPAL AMOUNT OF ALL OUTSTANDING LOANS AS OF THE
LAST DAY OF THE REPORTING PERIOD
15 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.
..+ ..-/ .. . e- .
CHRISTEL 6 PETTINOS .,'
. .
My Commission Expires
l;2LL,f-. +:&.> ..;? ".* ,5w-L \
sigdGure of Campaign Treasurer
AFFIX NOTARY STAMP I SEAL ABOVE
, to certify which, witness my hand and seal of office.
www.ethics.state.tw.us Revised 0411 912013