Loading...
WM COH-2015-07-15 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) 3 CANDIDATE / MS/MRS/MR FIRST MI OFFICEHOLDER • M OFFICE USE ONLY NAME M A ys k) 5Ley • _ Date Received NICKNAME LAST SUFFIX 11.0ES /WA Ys 11 i �1 r< S- 4 CANDIDATE / ADDRESS/PO BOX; APT/SUITE#; CITY; STATE; ZIP CODE OFFICEHOLDER MAILING �- ADDRESS 142, Jo r1 • .e,r Ckt Chi I )47So Date Hand-delivered or Postmarked n change of address Receipt# Amount 5 CANDIDATE/ AREA CODE PHONE NUMBER EXTENSION OFFICEHOLDER Q Date Processed PHONE ( -1?2) 74S— iq9 2- 6 6 CAMPAIGN M 40 MR FIRST MI Date Imaged TREASURER n NAME . .G 2cEAIE CF+R s r/ NICKNAME LAST SUFFIX 7 CAMPAIGN STREET ADDRESS(NO PO BOX PLEASE); APT/SUITE#; CITY; STATE; ZIP CODE TREASURER ADDRESS (residence or business) 2, ( 1 J a l FT 1,,)pp0 ex?paz 1 X 756/9 8 CAMPAIGN AREA CODE PHONE NUMBER EXTENSION PHONE TREASURER (172 ` 304 - 30 (4 04 - 30 ( t 9 REPORT TYPE I I January 15 ( I 30th day before election I I Runoff 15th day after campaign treasurer appointment (officeholder only) X July 15 I I 8th day before election I Exceeded $500 I Final report(Attach C/OH-FR) limit 10 PERIOD Month Day Year Month Day Year COVERED1 / /5/ is THROUGH 7 /15 /5 11 ELECTION ELECTION DATE ELECTION TYPE Month Day Year Primary I Runoff X General Special 5/ /0/zo14 12 OFFICE OFFICE HELD(if any) 13 OFFICE SOUGHT (if known) C t'rY Courvctc. Pt 3 C,TY op Co p Pea, GO TO PAGE 2 www.ethiCs.state.tx.us Revised 09/28/2011 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) l&eSLE•( M M •(.._% 3 SIGNATURE I do not expect any further political contributions or political expenditures in connection with my candidacy. I understand that designating a report as a final report terminates my campaign treasurer appointment. I also understand that I may not acce t any campaign contributions or make any campaign expenditures without a campaign treasurer appointment on file. (A)12 a • ✓g. kA0-0 Signature of ndidate/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 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 I do not retain assets purchased with political contributions or interest or other income from political contributions. I 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 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. rA1 Signat a of Officeholder www.ethics.state.tx.us Revised 09/28/2011 Texas Ethics Commission P.O.Box 12070 Austin,Texas 78711-2070 (512)463-5800 (TDD 1-800-735-2989) POLITICAL EXPENDITURES SCHEDULE G MADE FROM PERSONAL FUNDS 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 G: 2 FILER NAME 3 ACCOUNT# (Ethics Commission Filers) WAS (\ \ (5 4 Date 5 Payee name _ 3 S GRRVCNS Got.F P )Ato _ F'►12,ST "J I TE THor:4ST C-ItvRc_t4 6 Amount ($) 7 Payee address; City; State; Zip Code polimbtical contri Reiursementbutions from 420 S. 14 EA Irr f 1 Co P PEI L 7--X 75 0(9 intended 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 IDo11 AcTt On) 1%'\A < SC%4(LAr SN(P F()IQ b F Flee IP*C) z `^ fl Check ifAustin,TX,officeholder living expense Date Payee name Amount ($) Payee address; City; State; Zip Code Reimbursement from political contributions intended PURPOSE Category (See categories listed at the top of this schedule) Description (If travel outside of Texas,complete Schedule T) OF EXPENDITURE • Check if Austin,TX,officeholder living expense Date Payee name Amount ($) Payee address; City; State; Zip Code Reimbursement from political contributions intended PURPOSE Category (See categories listed at the top of this schedule) Description (If travel outside of Texas,complete Schedule T) OF EXPENDITURE • Check ifAustin,TX,officeholder living expense Date Payee name Amount ($) Payee address; City; State; Zip Code 1-1 Reimbursement from political contributions intended PURPOSE Category (See categories listed at the top of this schedule) Description (If travel outside of Texas,complete Schedule T) OF EXPENDITURE ❑ Check ifAustin,TX,officeholder living expense ATTACH ADDITIONAL COPIES OF THIS SCHEDULE AS NEEDED www.ethics.state.tx.us Revised 07/28/2014 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) W€,5 IfY)it) YS 16 NOTICE FROM THIS BOX IS FOR NOTICE OF POL MCAL CONTRIBUTIONS ACCEPTED OR POLITICAL EXPENDITURES MADE BY POUTICAL COMMITTEES TO SUPPORT THE POLITICAL CANDIDATE/OFFICEHOLDER. THESE EXPENDITURES MAY HAVE BEEN MADE WITHOUT THE CANDIDATES OR OFRCEHOLDER S KNOWLEDGE OR COMMITTEE(S) CONSENT. CANDIDATES AND OFFICEHOLDERS ARE REQUIRED TO REPORT THIS INFORMATION ONLY IF THEY RECEIVE NOTICE OF SUCH EXPENDITURES. COMMITTEE NAME COMMITTEE TYPE GENERAL COMMITTEE ADDRESS I I SPECIFIC COMMITTEE CAMPAIGN TREASURER NAME additional pages COMMITTEE CAMPAIGN TREASURER ADDRESS 17 CONTRIBUTION 1. TOTAL POLITICAL CONTRIBUTIONS OF$50 OR LESS(OTHER THAN TOTALS PLEDGES, LOANS, OR GUARANTEES OF LOANS), UNLESS ITEMIZED 2. TOTAL POLITICAL CONTRIBUTIONS (OTHER THAN PLEDGES, LOANS,OR GUARANTEES OF LOANS) (JS EXPENDITURE l`� TOTALS 3. TOTAL POLITICAL EXPENDITURES OF$100 OR LESS, UNLESS ITEMIZED $ 0 4. TOTAL POLITICAL EXPENDITURES $ 24 I. 86 CONTRIBUTION 5. TOTAL POLITICAL CONTRIBUTIONS MAINTAINED AS OF THE LAST DAY BALANCE OF REPORTING PERIOD OUTSTANDING • 6. TOTAL PRINCIPAL AMOUNT OF ALL OUTSTANDING LOANS AS OF THE LOAN TOTALS LAST DAY OF THE REPORTING PERIOD `p 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 MINIM S PITMI101 me under Title 15, Election Code. /' � my Commission W Mht 10.201! 'I Sig ture of Candidate or Officeholder AFFIX NOTARY STAMP/SEAL ABOVE \ `� Sworn to and subscribed before me, by the said `^ 03t \. N,U $ , this the day of tel%&. , 20 \S , to certify which, witness my hand and seal of office. 414101411 , 1. .•.,, / 0 ti-se-KM-1. PE-rsem.-rte ffs Signature of or administerin•oath Printed name of officer administering oath Title of officer administering oath www.ethics.state.tx.us Revised 09/28/2011