Mathew, Biju-COH 2021-04-01CANDIDATE / OFFICEHOLDER
FORM C/OH
CAMPAIGN FINANCE REPORT
COVER SHEET PG 1
1 Filer ID (Ethics Commission Filers)
2 Total pages filed:
The C/OH Instruction Guide
explains how to complete this form.
3 CANDIDATE /
OFFICEHOLDER
MS / MRs JL6JR FIRST MI
T /
OFFICE USE ONLY
NAME.........................
Date Received
.. ...a........................ Pk .
NICKNAME LAST SUFFIX
4 CANDIDATE/
ADDRESS / PO BOX; APT /SUITE #, CITY; STATE, ZIP CODE
OFFICEHOLDER_
MAILING
/ / GLL •/
�
(_Q�rP/ �
A ,�
ADDRESS
❑ Change of Address
jjjj
5 CANDIDATE/
AREA CODE PHONE NUMBER EXTENSION
Date Hand-delivered or Date Postmarked
OFFICEHOLDER
PHONE
/
Receipt #
Amount $
6 CAMPAIGN
MS / MRS / MR FIRST MI
TREASURERp
n p /�
Date Processed
NAME
......................... . Rk �.t -ie- r! ...............................
NICKNAME LAST SUFFIX
Date Imaged
7 CAMPAIGN
STREETADDRESS (NOPOBOX PLEASE); / SUITE #, CITY
STATE. CODE
TREASURER
ADDRESS
�APT
c—ZIP
(Residence or Business)
8 CAMPAIGN
AREA CODE PHONE NUMBER EXTENSION
TREASURER
PHONE
/ 2 I LI) 5-6
\El
9 REPORT TYPE
January 15 30th day before election Runoff
15th day after campaign
treasurer appointment
(Officeholder Only)
❑ July 15 8th day before election Exceeded Modified
Final Report (Attach C/OH - FR)
Reporting Limit
10 PERIOD
Month Day Year Month
Day Year
COVERED
el II20 I THROUGH
11 ELECTION
ELECTION DATE
ELECTION TYPE
Month Day Year
❑ Primary ❑ Runoff ❑ Other
Description
OS/ O (�f
General ❑ Special
12 OFFICE
OFFICE HELD (if any)
13 OFFICE SOUGHT (if known)
>(L
C
14 NOTICE FROM
THIS BOX IS FOR NOTICE OF POLITICAL CONTRIBUTIONS ACCEPTED OR POLITICAL EXPENDITURES MADE BY POLITICAL COMMITTEES TO SUPPORT
POLITICAL
THE CANDIDATE I OFFICEHOLDER. THESE EXPENDITURES MAY HAVE BEEN MADE WITHOUT THE CANDIDATE'S OR OFRCEHOLDER'S KNOWLEDGE OR
CONSENT. CANDIDATES AND OFFICEHOLDERS ARE REQUIRED TO REPORT THIS INFORMATION ONLY IF THEY
RECEIVE NOTICE OF SUCH EXPENDITURES.
COMMITTEE(S)
COMMITTEE TYPE
COMMITTEE NAME
GENERAL
COMMITTEE ADDRESS
Additional Pages
COMMITTEE CAMPAIGN TREASURER NAME
SPECIFIC
COMMITTEE CAMPAIGN TREASURER ADDRESS
GO TO PAGE 2
Forms provided by Texas Ethics Commission www.ethics.state.tx.us Revised 8/17/2020
R
CANDIDATE / OFFICEHOLDER FORM C/OH
CAMPAIGN FINANCE REPORT COVER SHEET PG 2
15 C/OH NAME 16 Filer ID (Ethics Commission Filers)
1,TU AA 0 T I LJ
17 CONTRIBUTION 1. TOTAL UNITEMIZED POLITICAL CONTRIBUTIONS (OTHER THAN
TOTALS PLEDGES, LOANS, OR GUARANTEES OF LOANS, OR $
CONTRIBUTIONS MADE ELECTRONICALLY)
2. TOTAL POLITICAL CONTRIBUTIONS $
(OTHER THAN PLEDGES, LOANS, OR GUARANTEES OF LOANS)
..................
EXPENDITURE
TOTALS
...................
CONTRIBUTION
BALANCE
..................
OUTSTANDING
LOAN TOTALS
3. TOTAL UNITEMIZED POLITICAL EXPENDITURE.
$
4. TOTAL POLITICAL EXPENDITURES
$
1
3
502.9 q
5. TOTAL POLITICAL CONTRIBUTIONS MAINTAINED AS OF THE LAST DAY
$
G
r
O
OF REPORTING PERIOD
I
6. TOTAL PRINCIPAL AMOUNT OF ALL OUTSTANDING LOANS AS OF THE
$
/�
�O D O
LAST DAY OF THE REPORTING PERIOD
18 SIGNATURE I swear, or affirm, under penalty of perjury, that the accomn ing report is true and correct and includes all information
required to be reported by me under Title 15, Election Code
gnatur an idate or Officeholder
Please complete either option below:
�VP �ASHLEY M. OWENS
Notary Public, State of Texas
(1)Affidavit Comm. Expires 02-24-2023
Notary ID 130128128
NOTARY STAMP/ SEAL
Sworn to and subscribed before me by
20 2 ` to certifv which. witness
this the day of
(2) Unsworn Declaration
My name is and my date of birth is
My address is
(street) (city) (state) (zip code) (country)
Executed in County, State of on the day of 20
(month) (year)
Signature of Candidate/Officeholder (Declarant)
Forms provided by Texas Ethics Commission www.ethics.state.tx.us Revised 8/17/2020
Forms provided by Texas Ethics Commission www.ethics.state.tx.us Revised 8/17/2020
SUBTOTALS
- C/OH FORM C/OH
COVER SHEET PG 3
19
FILER NA E U
20 Filer ID (Ethics Commission Filers)
21
SCHEDULE SUBTOTALS
NAME OF SCHEDULE
SUBTOTAL
AMOUNT
1 .
SCHEDULEA1:
MONETARY POLITICAL CONTRIBUTIONS
$�
2•
SCHEDULE A2:
NON -MONETARY (IN-KIND) POLITICAL CONTRIBUTIONS
$
3.
SCHEDULE B:
PLEDGED CONTRIBUTIONS
$
4.
FN
SCHEDULE E:
LOANS
$
/O 00-
0-5.
5.
SCHEDULE F1:
POLITICAL EXPENDITURES MADE FROM POLITICAL CONTRIBUTIONS
$
3
6.
❑
SCHEDULE F2:
UNPAID INCURRED OBLIGATIONS
$
7.
❑
SCHEDULE F3:
PURCHASE OF INVESTMENTS MADE FROM POLITICAL CONTRIBUTIONS
$
8.
11
SCHEDULE F4:
EXPENDITURES MADE BY CREDIT CARD
$
9•
SCHEDULE G:
POLITICAL EXPENDITURES MADE FROM PERSONAL FUNDS
$
10.
SCHEDULE H:
PAYMENT MADE FROM POLITICAL CONTRIBUTIONS TO A BUSINESS OF C/OH
$
11.
El
SCHEDULE I: NON-POLITICAL EXPENDITURES MADE FROM POLITICAL CONTRIBUTIONS
$
12.
❑
SCHEDULE K:
INTEREST, CREDITS, GAINS, REFUNDS, AND CONTRIBUTIONS RETURNED
TO FILER
$
Forms provided by Texas Ethics Commission www.ethics.state.tx.us Revised 8/17/2020
MONETARY POLITICAL CONTRIBUTIONS SCHEDULE Al
If the requested information is not applicable, DO NOT include this page in the report.
The Instruction Guide explains how to complete this form.
1 Total pages Schedule A1:
2 FILER NAME
3 Filer ID (Ethics Commission Filers)
J3 i 7 U A T4,F
4 Date
5 Full name of contributor ❑ out-of-state PAC (ID#: )
7 Amount of contribution ($)
l
.L.HF.., V-L....G.1Cj.F.E►rj......................................
�/ /��2
6 Contributor address; City; State; Zip Code
�� 0
(/ .s
8 Principal occupation / Job title (See Instructions)
g Employer (See Instructions)
rel
o M -
Date
Full name of contributor ❑ out-of-state PAC (ID#: ) Amount of contribution ($)
I. -J
...............................
Contributor address; City; State; Zip Code 3 o o
Ssd L,4 -
e
Prriinn�cipal occupation / Job title (See Instructions)
Employer (See Instructions)
Yl r
Date
Full name of contributor ❑ out-of-state PAC (ID#: )
Amount of contribution ($)
J 05 I
Contributor address; City; State; Zip Code
/ v
2 1-1 I/V j�-u I a
Principal occupation / Job title (See Instructions)
Employer (See Instructions)
Date
Full name of contributor ❑ out-of-state PAC (ID#: )
Amount of contribution ($)
..................................................................................
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 8/17/2020
POLITICAL EXPENDITURES MADE
FROM POLITICAL CONTRIBUTIONS SCHEDULE F1
If the requested information is not applicable, DO NOT include this page in the report.
EXPENDITURE CATEGORIES FOR BOX 8(a)
Advertising Expense Event Expense Loan Repayment/Reimbursement Solicitation/Fundraising Expense
AccountingBanking 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/Memorials Expense Printing Expense Travel Out Of District
Candidate/Officeholder/Political Committee Legal Services Salaries/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 FILE`` NAME
3 Filer ID (Ethics Commission Filers)
/
✓1 /7 �
4 Date
ame
5 PaTS-Ta
/v
6 Amount ($
7 Payee address; City; State; Zip Code
8
(a) Category (See Categories listed at the top of this schedule)
(b) Description
PURPOSE
OF
j
EXPENDITURE
(C) Check if travel outside of Texas. Complete Schedule T. ❑ Check if Austin, TX, officeholder living expense
9 Complete ONLY if direct Candidate / Officeholder name Office sought Office held
expenditure to benefit C/OH
Date
Payee name
)//q�2-J
V ISTP Wj(UT
Amount ($)
Payee address; City; State; Zip Code
-A
Category (See Categories listed at he top of this schedule)
Description
PURPOSEOF
1/
EXPENDITURE
/
❑ Check if travel�.0of Texas. Complete Schedule T El Check if Austin, TX, officeholder living expense
Complete ONLY if direct Candidate / Officeholder name Office sought Office held
expenditure to benefit C/OH
Date
Payee name
Amount ($)
` City; State; Zip Code
Payee address; /J
)0
Category (See Categories listed at the top of this schedule)
Description
PURPOSE
OF
EXPENDITURE
�(
J 1 L
❑ Check iftraveloutsideofTexas.CompleteSchedule T. 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
Forms provided by Texas Ethics Commission www.ethics.state.tx.us Revised 8/17/2020
POLITICAL EXPENDITURES MADE
FROM POLITICAL CONTRIBUTIONS SCHEDULE F1
If the requested information is not applicable, DO NOT include this page in the report.
EXPENDITURE CATEGORIES FOR BOX 8(a)
Advertising Expense Event Expense Loan Repayment/Reimbursement Solicitation/Fundraising Expense
Accounting/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/Memorials Expense Printing Expense Travel Out Of District
Candidate/Officeholder/Political Committee Legal Services SalariesANages/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
3 Filer ID (Ethics Commission Filers)
4 Da
$ Payee name
-3713 1,2-1
6 Amount (
7 Payee address; City; State; Zip Code
8
PURPOSE
(a) Category(SeeCategories listed at the top of this schedule)
�
(b) Description
OF
r\ll r/ /~' `
EXPENDITURE
(C) Check if travel outside of Texas. Complete Schedule T. Check if Austin, TX, officeholder living expense
9 Complete ONLY if direct Candidate / Officeholder name Office sought Office held
expenditure to benefit C/OH
Date
Payee name
3j b/ zl
&r"-
Amount ($)
Payee address; City; State; Zip Code
Category (See Categories listed at the top of this schedule)
Description
PURPOSE
OF
EXPENDITURE
Check if travel outside of Texas. Complete Schedule Check if Austin, TX, officeholder living expense
Complete ONLY if direct Candidate / Officeholder name Office sought Office held
expenditure to benefit C/OH
Date
Payee name
h
V, S TIO Ae / A/T
3 � / -z-)
Amount ($)
Payee address; City; State; Zip Code
2
/-F-► NG,7ejP-/, M fi-
Category (See Categories listed at the top of this schedule)
Description
PURPOSEOF
EXPENDITURE
�/ r
Check if travel outside of Texas. Complete Schedule T. 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
Forms provided by Texas Ethics Commission www. ethics. state. tx.us Revised 8/17/2020
POLITICAL EXPENDITURES MADE
FROM POLITICAL CONTRIBUTIONS
SCHEDULE F1
If the requested information is not applicable, DO NOT include this page in the report.
EXPENDITURE CATEGORIES FOR BOX 8(a)
Advertising Expense
Accounting/Banking
Event Expense Loan Repayment/Reimbursement
Fees Office Overhead/Rental Expense
Solicitation/Fundraising Expense
Transportation Equipment & Related Expense
Consulting Expense Food/Beverage Expense Polling Expense
Contributions/Donations Made By Gift/Awards/Memorials Expense Printing Expense
Travel In District
Travel Out Of District
Candidate/Officeholder/Political Committee Legal Services SalariesANages/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
3 Filer ID (Ethics Commission Filers)
a 11
II I'7�
4 Date
g Payee name
Z 2
6 Amount ($)
7 Payee address;
City;
State; Zip Code
3 -0 2—
�E
(n TO n/
8
(a) Category (See Categories listed at the top of this schedule)
(b) Description
PURPOSE
OF
EXPENDITURE
J I
(c) El CheckiftraveloutsideofTexas.Complete ScheduleT.
❑ Check if Austin, TX, officeholder living expense
9 Complete ONLY if direct
Candidate / Officeholder name
Office sought
Office held
expenditure to benefit C/OH
Date
Payee name
3 21a
VS T14 rgi f\/T
Amount ($)
Payee address;
City;
State; Zip Code
�_ c -�, 7ol\) nn ✓�
Category (See Categories listed at the top of this schedule)
Description
PURPOSE
OF
fn� I Ue/f
4d
+
EXPENDITURE
1-1 Check iftrave utsideofTexas.Complete ScheduleT.
❑ Check if Austin, TX, officeholder living expense
Complete ONLY if direct
Candidate / Officeholder name
Office sought
Office held
expenditure to benefit C/OH
Date
Payee name
:5 �I I
Sopa C✓
Amount ($)
Payee address;
City;
State; Zip Code
0,q_3
y
9 o WA/� 6�
AA/'/71)
Category (See Categories listed at the top of this schedule)
Description
PURPOSEOF
A/
EXPENDITURE
ElCheck if travel outside of Texas.CompleteScheduleT.
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
Forms provided by Texas Ethics Commission www.ethics.state.tx.us Revised 8/17/2020
LOANS SCHEDULE E
If the requested information is not applicable, DO NOT include this page in the report.
The Instruction Guide explains how to complete this form.
1 Total pages Schedule E:
2 FILER NAME
3 Filer ID (Ethics Commission Filers)
—
8 I'T L A M'A -7 /�'j
4 TOTAL OF UNITEMIZED LOANS
$
5 Date of loan
7 Name of lender ❑out-of-statePAC (ID#: )
9 Loan Amount($)
2 11 k /
..t."7U.1... M. }.?..��.I,�f..........................................
8 Lender address; City; State; Zip Code
ab
6 Is lender
10 Interest rate
a financial
Institution?
11 Maturity date
j
�Q _ ( n
ea5z 29J9
12 Principal occupation / Job title (See Instructions)
13 Employer (See Instructions)
NA
sS-b
14 Description of Collateral
15
❑ Check if personal funds were deposited into political
❑ none
account (See Instructions)
16 GUARANTOR
17 Name of guarantor
19 Amount Guaranteed ($)
INFORMATION
..................................................................................
18 Guarantor address; City; State; Zip Code
❑ not applicable
20 Principal Occupation (See Instructions)
21 Employer (See Instructions)
Date of loan
Name of lender out-of-state PAC (ID#: )
..................................................................................
Lender address; City; State; Zip Code
Loan Amount ($)
Is lender
Interest rate
a financial
Institution?
Maturity date
Y N
Principal occupation / Job title (See Instructions)
Employer (See Instructions)
Description of Collateral
if personal funds were deposited into political
El
none
E] none
account (See Instructions)
GUARANTOR
Name of guarantor
Amount Guaranteed ($)
INFORMATION
..................................................................................
Guarantor address; City; State; Zip Code
❑ not applicable
Principal Occupation (See Instructions)
Employer (See Instructions)
ATTACH ADDITIONAL COPIES OF THIS SCHEDULE AS NEEDED
If lender 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 8/17/2020