AD COH-FR-2014-05-20 Texas Ethics Commission P.O.Box 12070 Austin,Texas 78711-2070 (512)463-5800 (TDD 1-800-735-2989)
CANDIDATE / OFFICEHOLDER FORM C/OH
CAMPAIGN FINANCE REPORT COVER SHEET PG 1
1 ACCOUNT# 2 Total pages filed:
The C/OH Instruction Guide explains how to complete this form. (Ethics Commission Filers) q
3 CANDIDATE / MS/MRS/MR FIRST MI
OFFICEHOLDER
OFFICE USE NAME MIL` J►�ST L D E[I 7-B NICKNAME E/"�LAST SUFFIX
Air DuNM MAY 2 0 2014
4 CANDIDATE / ADDRESS/PO BOX; APT/SUITE#; CITY; STATE; ZIP CODE City Secretary
OFFICEHOLDER "he� ��� Hand-delivered City of Coppell
MAILING 764 C Q l CI- I. t , Date Ha d or Postmarked
ADDRESS (( �"���
pi change of address
Receipt# Amount
5 CANDIDATE/ AREA CODE PHONE NUMBER EXTENSION
OFFICEHOLDER �t( Date Processed
PHONE �`, I/K �a
6 CAMPAIGN MS/MRS/MR FIRST MI Date Imaged
TREASURER &tV• Alef q /
NAME , ` • �7I'l l�
NICKNAME LAST SUFFIX
al
7 CAMPAIGN STREET ADDRESS(NO PO BOX PLEASE); APT/SUITE#; CITY; STATE; ZIP CODE
TREASURER
ADDRESS Buz, /�
(residence or business) 816 -JA' 04. t oj7Jic Ty Is-6i
8 CAMPAIGN AREA CODE PHONE NUMBER EXTENSION
TREASURER
PHONE ( Z ) 5e4f 65(1 •
9 REPORT TYPE I I January 15 I I 30th day before election I I Runoff 1 I 15th day after campaign
1 treasurer appointment
(officeholder only)
I I July 15 I I 8th day before election I I Exceeded$500 iNiFinal report(Attach C/OH-FR)
limit
10 PERIOD „, �y Year Month Year
COVERED Dar/Ot / 14 THROUGH J / if /, '
11 ELECTION ELECTION DATE ELECTION TYPE
Mort) Day Year
n PrFnery
I I Runoff I I Ste'
°5—/ 10 / /L(
12 OFFICE OFFICE HELD(if any) 13 OFFICE SOUGHT (if known)
GO TO PAGE 2
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)
CANDIDATE / OFFICEHOLDER REPORT: FORM C/OH
SUPPORT & TOTALS COVER SHEET PG 2
14 C/OH NAME ` 15 ACCOUNT# (Ethics Commission Filers)
Afet4. G,Autv-'
16 NOTICE FROM THIS Box IS FOR NOTICE OF POLITICAL CONTRIBLMONS ACCEPTED OR POLITICAL EXPENDITURES MADE BY POLITICAL COMMITTEES TO SUPPORT THE
POLITICAL CANDIDATE/OFFICEHOLDER. THESE EXPENDITURES MAY HAVE BEEN MADE WITHOUT THE CANDIDATES OR OFFICEHOLDERS KNOWLEDGE OR
COMMITTEE(S) CONSENT. catomATEs AND OFFICEHOLDERS ARE REQUIRED TO REPORT THIS INFORMATION ONLY F THEY RECEIVE NOTICE OF SUCH EXPENDITURES.
COMMITTEE NAME
COMMITTEE TYPE
I I GENERAL
COMMITTEE ADDRESS
I I SPECIFIC
COMMITTEE CAMPAIGN TREASURER NAME
I I additional pages
COMMITTEE CAMPAIGN TREASURER ADDRESS
17 CONTRIBUTION 1. TOTAL POLITICAL CONTRIBUTIONS OF$50 OR LESS(OTHER THAN O go$
TOTALS PLEDGES, LOANS,OR GUARANTEES OF LOANS), UNLESS ITEMIZED
2. TOTAL POLITICAL CONTRIBUTIONS OV
(OTHER THAN PLEDGES,.LOANS,OR GUARANTEES OF LOANS) O•
EXPENDITURE 0 00
TOTALS 3. TOTAL POLITICAL EXPENDITURES OF$100 OR LESS,UNLESS ITEMIZED $
•
4. TOTAL POLITICAL EXPENDITURES $ 4365
CONTRIBUTION 5. TOTAL POLITICAL CONTRIBUTIONS MAINTAINED AS OF THE LAST DAY O W
BALANCE OF REPORTING PERIOD $
OUTSTANDING
LOAN TOTALS 6. TOTAL PRINCIPAL AMOUNT OF ALL OUTSTANDING LOANS AS OF THE $ O
LAST DAY OF THE REPORTING PERIOD
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
0•""a4r me under Title 15 le•-•n =•e.
, CHRISTEL B PETTINOS
*i^, My CMommission ay 102015
Expires
,
Signature of Candidate or Officeholder
AFFIX NOTARY STAMP/SEAL ABOVE T
Sworn to and subscribed before me, by the said 4G�I^o ., J t._..,, a..., , this the
ZO`'1` day of , 20 I4. , to certify which, witness my hand and seal of office.
/WI i I/
ignature of officer-d inistering oath Printed name of officer administering oath Title of officer administering•ath
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)
POLITICAL EXPENDITURES SCHEDULE F
EXPENDITURE CATEGORIES FOR BOX 8(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 In 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 Instruction Guide explains how to complete this form.
1 Total pages Schedule F: 2 FILER AME 3 ACCOUNT#(Ethics Commission Filers)
4 Date
5 Payee name12414.
I
sl z1a( Grr „ 5 it 4tJM--m
6 Amount ($) 7 Payee address; City; State; Zip Code
4 °D 9q6 w, O. toppvcc 75z!ct
8 PURPOSE (a) Category (See categories listed at the top of this schedule) (b) Description (If travel outside of Texas,complete Schedule T)
OF
EXPENDITURE APf 7 r _Wi`_t y
9 Complete ONLY if direct Candidate/Officeholder name /Officcesought _ Office held
expenditure to benefit C/OH
Date Payee name
Amount ($) Payee address; City; State; Zip Code
PURPOSE Category (See categories listed at the top of this schedule) Description (If travel outside of Texas,complete Schedule T)
OF
EXPENDITURE
Complete ONLY if direct Candidate/Officeholder name Office sought Office held .
expenditure to benefit C/OH
Date Payee name
Amount ($) Payee address; City; State; Zip Code
PURPOSE Category (See categories listed at the top of this schedule) Description (If travel outside of Texas,complete Schedule T)
OF
EXPENDITURE
Complete ONLY if direct Candidate/Officeholder name Office sought Office held
expenditure to benefit C/OH
Date Payee name
Amount ($) Payee address; City; State; Zip Code
PURPOSE Category (See categories listed at the top of this schedule) Description (If travel outside of Texas,complete Schedule T)
OF
EXPENDITURE
Complete ONLY if direct Candidate/Officeholder name Office sought Office held
expenditure to benefit C/OH
ATTACH ADDITIONAL COPIES OF THIS SCHEDULE AS NEEDED
www.eth ics.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)
CANDIDATE / OFFICEHOLDER REPORT:
FORM C/OH - FR
DESIGNATION OF FINAL REPORT
The Instruction Guide explains how to complete this form.
•• Complete only if "Report Type" on page 1 is marked "Final Report" --
1 C/OH NAME 2 ACCOUNT# (Ethics Commission Filers)
AFelg. pugori
3 SIGNATURE
I do not expect any further political contributions or political expenditures in connection with my candidacy. I understand that designating a
report asa final report terminates my campaign treasurer appointment. I also understand that I may not accept any campaign contributions
or make any campaign expenditures without a campaign treasurer appointment on file.
• •
ig ature of Candidate/Officeholder
•
4 FILER WHO IS NOT AN OFFICEHOLDER
•• Complete A&B below only if you are not an officeholder. ••
A. CAMPAIGN FUNDS
Check only one:
I do not have unexpended contributions or unexpended interest or income earned from political contributions.
I I I have unexpended contributions or unexpended interest or income earned from political contributions. I understand that I may
not convert unexpended political contributions or unexpended interest or income earned on political contributions to personal
use. I also understand that I must file an annual report of unexpended contributions and that I may not retain unexpended
contributions or unexpended interest or income earned on political contributions longer than six years after filing this final
report. Further,I understand that I must dispose of unexpended political contributions and unexpended interest or income
earned on political contributions in accordance with the requirements of Election Code,§254.204.
B. ASSETS
Check only one:
I do not retain assets purchased with political contributions or interest or other income from political contributions.
I I do retain assets purchased with political contributions or interest or other income from political contributions. I understand that
I may not convert assets purchased with political contributions or interest or other income from political contributions to personal
use. I also understand that I must dispose of assets purchased with political contributions in accordance with the requirements
of Election Code,§254.204.
Signature of Candidate
5 OFFICEHOLDER
•• Complete this section only if you are an officeholder --
I I I am aware that I remain subject to filing requirements applicable to an officeholder who does not have a campaign treasurer on file.
I am also aware that I will be required to file reports of unexpended contributions if,after filing the last required report as an
officeholder,I retain political contributions,interest or other income from political contributions,or assets purchased with political
contributions or interest or other income from political contributions.
Signature of Officeholder
www.ethics.state.tx.us Revised 04/19/2013