Bernstein, Davin-COH 2018-04-06CANDIDATE / OFFICEHOLDER
FOR; C/OH
CAMPAIGNCOVER
SHEET PG 1
1 Filer ID (Ethics Commission Filers)
2 Total pages filed:
The C/01-1Instruction Guide explains how to complete this form.
3 CANDIDATE/
MS / MRS /`R FIRST MI
OFFICEHOLDER
OFFICE USE ONLY
NAME
. . . . . . . . . . . . . . . . . . .
Date Received
NICKNAME LAST SUFFIX
ADDRESS / PO BOX; APT / SUITE #; CITY; STATE; ZIP CODE
2� /40( -Cow 003> Dom'
¢ CANDIDATE /
OFFICEHMAILING OLDER
ADDRESS
❑ Change of Address
��
G O PIPE < e—i • !'�' SO 1 g
AREA CODE PHONE NUMBER EXTENSION
5 CANDIDATE/
OFFICEHOLDER
PHONE
(Z 7 /7-/s.5'%
Date Hand -delivered or Date Postmarked
6 CAMPAIGN
MS / MRS / MR FIRST MI
Receipt # Amount $
TREASURER
Z 7,-W
NAME
, , . , , , . , , , , , , , , , , , , . .
Date Processed
NICKNAME LAST SUFFIX
/v / / G O v
Date Imaged
7 CAMPAIGN
STREET ADDRESS (NO PO BOX PLEASE); APT /`SUITE #; CITY; STATE;
ZIP CODE
TREASURER
ADDRESS
910 M A L (, a,e Jt> D Je
(Residence or Business)
co)0RCe-( T)6 -75'01-9
8 CAMPAIGN
AREA CODE PHONE NUMBER EXTENSION
TREASURER
> �� �P J
(47Z Q
PHONE
9 REPORT TYPE
January 15 30th day before Runoff
15th day
election F�
after campaign
F-�
treasurer appointment
(Officeholder Only)
July 15 E-1 8th day before election Exceeded$5001imit
Final Report (Attach C/OH - FR)
10 PERIOD
Month Day Year Month
Day Year
COVERED
2 / /6 �%
/ /Q THROUGH / / Z/
11 ELECTION
ELECTION DATE
ELECTION TYPE
Month Day Year
❑ Primary ❑ Runoff ❑ Other
��'+
rl / s /f OQ '
` v
Description
General ❑ Special
12 OFFICE
OFFICE HELD (If any)
13 OFFICE SOUGHT (If known)
Q�
GO TO PAGE 2
rorms provtaea ny f exas ttnics uommission www.ethics.state.tx.us Revised 9/8/2015
CANDIDATE / OFFICEHOLDER
FORM C/OH
CAMPAIGN1 COVER SHEET PG 2
14 C/OH NAME15
�N s =/'0.r, Dav (N
Filer ID (Ethics Commission Filers)
16 NOTICE FROM
THIS BOX IS FOR NOTICE OF POLITICAL CONTRIBUTIONS ACCEPTED OR POLITICAL EXPENDITURES MADE BY POLITICAL COMMITTEES TO
POLITICAL
SUPPORT THE CANDIDATE / OFFICEHOLDER. THESE EXPENDITURES MAY HAVE BEEN MADE WITHOUT THE CANDIDATES OR OFFICEHOLDERS
COMM ITTEE(S)
KNOWLEDGE OR CONSENT. CANDIDATES AND OFFICEHOLDERS ARE REQUIRED TO REPORT THIS INFORMATION ONLY IF THEY RECEIVE NOTICE
OF SUCH EXPENDITURES.
COMMITTEE TYPE
COMMITTEE NAME
GENERAL
COMMITTEE ADDRESS
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
QOO'.-
(OTHER THAN PLEDGES, LOANS, OR GUARANTEES OF LOANS)
(�
EXPENDITURE
3. TOTAL POLITICAL EXPENDITURES OF $100 OR LESS,
$ % R
�• �`�
TOTALS
UNLESS ITEMIZED
Li
4. TOTAL POLITICAL EXPENDITURES
$ -300--
CONTRIBUTION
5. TOTAL POLITICAL CONTRIBUTIONS MAINTAINED AS OF THE LAST DAY
$ q•
OF REPORTING PERIOD
/
OUTSTANDING
6. TOTAL PRINCIPAL AMOUNT OF ALL OUTSTANDING LOANS AS OF THE
$
LOAN TOTALS
LAST DAY OF THE REPORTING PERIOD
IS 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
e under Title 15, Election Code.
JEAN DWINNELL —_
Notary ID #4576603
My Commission Expires
June 20, 2021
nature of Can f ceholder
AFFIX NOTARY STAMP / SEALABOVE
(� �j
Sworn to jand subscribed before me, by the said _ 1/ i this the (�
of , 20 P ertify hich, witness my hand and seal of office.
-
(" 1� 4 t, I J ', 79,// � 11 � I , 0 n pa
FIgnature of officer administering oath Printed name of officer administering oath Title o officer administering oath
Forms provided by Texas Ethics Commission www.ethics.state.tx.us H@VISed 9/8/2015
Forms provided by Iexas Ethics Commission www. ethics. state.tx.us Revised 9/8/2015
SUBTOTALS d C/OH FOR C/OW
COVER SWEET PG 3
19
FILER NAME
D A+V ! N �RN 57Z�'/N
20 Filer ID (Ethics Commission Filers)
21
SCHEDULE SUBTOTALS
NAME OF SCHEDULE
SUBTOTAL
AMOUNT
1.
X
SCHEDULEAI: MONETARY POLITICAL CONTRIBUTIONS
$ '900,60
2.
El
SCHEDULE A2: NON -MONETARY (IN-KIND) POLITICAL CONTRIBUTIONS
$
3.
❑
SCHEDULE B: PLEDGED CONTRIBUTIONS
$
4.
El
SCHEDULE E: LOANS
$
5.
�
SCHEDULE F1: POLITICAL EXPENDITURES MADE FROM POLITICAL CONTRIBUTIONS
$ �2S 3Q
6.�(
SCHEDULE F2: UNPAID INCURRED OBLIGATIONS
$1000.00
7.
El
SCHEDULE F3: PURCHASE OF INVESTMENTS MADE FROM POLITICAL CONTRIBUTIONS
$
a.
El
SCHEDULE F4: EXPENDITURES MADE BY CREDIT CARD
$
9.
El
SCHEDULE G: POLITICAL EXPENDITURES MADE FROM PERSONAL FUNDS
$
10.
El
SCHEDULE H: PAYMENT MADE FROM POLITICAL CONTRIBUTIONS TO A BUSINESS OF C/OH
$
11.
SCHEDULE I: NON-POLITICAL EXPENDITURES MADE FROM POLITICAL CONTRIBUTIONS
$
12.
SCHEDULE K: INTEREST, CREDITS, GAINS, REFUNDS, AND CONTRIBUTIONS
RETURNED TO FILER
$
Forms provided by Iexas Ethics Commission www. ethics. state.tx.us Revised 9/8/2015
MONETARY POLITICAL CONTRIBUTIONS SCHEDULE Al
The instruction Guide explains how to complete this form.
1 Total pages Schedule Al:
2 FILER NAME
3 Flier ID (Ethics Commission Filers)
4 Date
5 Full name of contributor n out-of-slate PAC (ID#: )
7 Amount of contribution ($)
DAV 114
6 Contributor. address; City; State; . Zip ....... Code
6
2 2.49 W.Pacq tooat, �,e,�aooEe c.,7X* Oro/
8 Principal occupation / Job title (See Instructions)
Fou/VDER/ENi��1q&r �
g Employer (See Instructions)
C Igff4e GL C.
Date
Full name of contributor ❑ out-of-state PAC (IDN:
Amount of contribution ($)
...
Contributor address; City; State; Zip Code
Jk 10 V
5&Z V ICLA060D Aitv�,CaPPEt�
Principal occupation / Job title (See Instructions)
$p-'eaeE
Employer (See Instructions)
S E'G F
Date
Full name of contributor ❑ out-of-state PAC (ID#: t
Amount of contribution ($)
SK,�'2. ow S...............
4
Contributor
)00,—
address; City; State; Zip Code
3 8 6091VN FA 66, c 47*0Mc c, 7X 7s4/9
Principal occupation / Job title (See Instructions)
Employer (See Instructions)
Date
Full name of contributor [] out-of-state PAC (IDN: 1
Amount of contribution ($)
.......................I....I.........
Contributor address; City; State; Zip Code
Principal occupation / Job title (See Instructions)
Employer (See Instructions)
ATTACH ADDITIONAL COPIES OF THIS SCHEDULE AS NEEDED
If contributor Is out-of-state PAC, please see Instruction guide for additional reporting requirements.
Forms provided by Texas Ethics Commission www.ethics.state.tx.us Revised 9/8/2015
POLITICAL IT
FROM POLITICAL 1 I SCHEDULE F1
EXPENDITURE CATEGORIES FOR BOX 8(a)
Advertising Expense Event Expense Loan Repayment/Reimbursement Sollaltation/FundratsingExpense
Accounting/Banking Fees Office Overhead/Rental Expense Transportation Equipment & Related Expense
Consulting Expense Food/Beverage Expense Polling Expense Travel In District
Contributlorhs/Donations Made By Gfft/Awards/Memorfals Expense Printing Expense Travel Out Of District
Candidate/Officeholder/Political Committee Legal Services Salaties/Wages/Contract Labor Other (enter a category not listed above)
Credit Card Payment
The Instruction Guide explains how to complete this form.
1 Total pages Schedule F1:
2 FILER NAME V l N Ste' il2'N S i�7N
Z� �°►
3 Filer ID (Ethics Commission Filers)
4 Date
3 2 8-18
5 Payee nam
es
,e (- O G A L- MC -DI -4
6 Amount ($)
7 Payee address; City; State; Zip Code
'3DU,
61q 1lRdNiii, D&.
PL ANo , 7-).( '7154--�
$
(a) Category (See Categories listed at the top of this schedule)
(b) Description
PURPOSE
❑ Check It travel outside of Texas. Complete Schedule T.
OF
EXPENDITURE
/�
AD�EI�� S I NYp�iNs
❑ Check if Austin, TX, officeholder living expense
'pbG �'n c� >Q►D �E� n �S �/V G
9 Complete ONLY if direct Candidate / Officeholder name Office sought Office held
expenditure to benefit C/OH
Date
Payee name
?,5-27- /8IS1?
i`I.rc P4- A c G
Amount ($)
Payee address; City; State; Zip Code
Z $• 3 8
166 AvE 11 EAs r
A RL I A)G TvAj , P>G 760 1)
Category (See Categories listed at the top of this schedule)
Description
PURPOSE
❑ Check it travel outside ofTexas. Complete Schedule T.
OFP�.N
EXPENDITURE
s ��
PC INTI Ai
❑ Check if Austin, TX, officeholder living expense
at'S /N esf c Aril P S
Complete ONLY if direct Candidate / Officeholder name Office sought Office held
expenditure to benefit C/OH
Date
Payee name
Amount ($)
Payee address; City; State; Zip Code
Category (See Categories listed at the top of this schedule)
Description
PURPOSE
❑ Check if travel outside of Texas. Complete Schedule T.
OF
❑
EXPENDITURE
Check If Austin, TX, officeholder living expense
Complete ONLY if direct Candidate / Officeholder name Office sought Office held
expenditure to benefit C/OH
ATTACH ADDITIONAL COPIES OF THIS SCHEDULE AS NEEDED
corms provided t)y texas Ethics commission www.ethics.stateAx.us Revised 9/8/2015
UNPAID INCURRED OBLIGATIONS SCHEDULE
EXPENDITURE CATEGORIES FOR BOX 10(a)
Advertising Expense Event Expense Loan Repayment/Reimbursement Solicitation/Fundraising Expense
Accounfing/Banking Fees Office Overhead/Rental Expense Transportation Equipment & Related Expense
Consulting Expense Food/Beverage Expense Polling Expense Travel In District
Contributions/Donations Made By Gift/Awards/MemorWs Expense Printing Expense Travel Out Of District
Candldate/Officeholder/PolidcalCommittee Legal Services Salaries/Wages/ContractLabor Other (enter a category not listed above)
The Instruction Guide explains how to complete this form.
1 Total pages Schedule F2:
2 FILER NAME
�Av W `SE�N'ST�i �!
3 'it er ID (Ethics Commission Filers)
4 TOTAL OF UNITEMIZED UNPAID INCURRED OBLIGATIONS
$
5 Date
6 Payee name
3-Z 9-18
(2- w1 --B c.f-e
7 Amount ($)
8 Payee address; City; State; Zip Code
X1000.00
6O6 LAriee pAeK
9 TYPE OF
EXPENDITURE
� Political Non -Political
10
(a) Category (See Categories listed at the top of this schedule)
(b) Description
PURPOSE_
OF
�U PCE
A �C� g%�
E]CheckIttraveloutsideofTexas.CompleteScheduleT.
❑Check
EXPENDITURE
Dv
If Austin, TX, officeholder living expense
11 Complete ONLY If direct Candidate / Officeholder name Office sought Office held
expenditure to benefit C/OH
Date
Payee name
Amount ($)
Payee address; City; State; Zip Code
TYPE OF
EXPENDITURE
El Political El Non -Political
Category (See Categories listed at the top of this schedule)
Description
❑ Check If travel outside Texas. Complete schedule T.
PURPOSE
of
OF
Check if Austin, TX; officeholder living expense
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
Forms provided by Texas Ethics Commission www.ethics.state.tx.us Revised 9/8/2015