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Dharia, Amit-COH 2021-04-05CANDIDATE / OFFICEHOLDER FORM C/OH CAMPAIGN FINANCE REPORT COVER SHEET PG 1 . .. . ...... . 1 Filer ID (Ethics Commission Filers) 2 Total pages filed: The C/01-11 Instruction Guide explains how to complete this form. 3 CANDIDATE/ OFFICEHOLDER MR FIRST MI A r -1 -i -r1-4 OFFICE USE ONLY NAME Date Received NICKNAME LASTD SUFFIX R 12-1 Clem 4 CANDIDATE/ ADDRESS PO BOX; APT / SUITE CITY; STATE: ZIP CODE OFFICEHOLDER MAILING GLPLAHAIA DAIVE ADDRESS Change of Address C0fPC–,L-L M -TS"W9 5 CANDIDATE/ AREA CODE PHONE NUMBER EXTENSION OFFICEHOLDER 2- 603 - 'S3 %7 Dairy ilan�d dckvere v Dale PuMrnarked PHONE 6 CAMPAIGN Nv--iL� I MR FIRST Mt Receipttd Amount $ TREASURER A MIT K Q H Date Processed NAME * NICKNAME LAST SUFFIX Date Imaged I) Hjqp 14 7 CAMPAIGN STREET ADDRESS (NO PO BOX PLEASE); APT / SUITE td: CITY, STATE; ZIP CODE TREASURER (a k a yn D%jVe C-opod 1, ADDRESS (Residence or Business) 8 CAMPAIGN AREA CODE PHONE NUMBER EXTENSION TREASURER PHONE 9 REPORT TYPE January 15 [?"*30th day before electionF-Runoff 1 15th day after campaign treasurer appointment (Officeholder Only) F-1 July 15 8th day before election Exceeded $500 limit Final Report (Attach &OH - FR) 10 PERIOD ------ — ------ ------ Month Day Year Month Day Year COVERED 0 2 27 262-4 THROUGH 3 2, 11 ELECTION ELECTION DATE IYPE ...... .... Month Day Year El Primary F-1 Runoff Cl 001PI Dasc6ramn ",0 1 ene,al Special 20? 1 12 OFFICE -j- OFFICE HELD (it any) 13 OFFICE SOUGHT (if known) counc*k P1401 -- --- -----– ----------------------- - - - - - GO TO PAGE 2 Forms provided by Texas Ethics Commission www.ethics. state.tx. us Revised 9/8/2015 CANDIDATE / OFFICEHOLDER FORM C/OH CAMPAIGN FINANCE REPORT COVER SHEET PG 2 -- --------- — ------- M�,LAvnar a aA'01- 15 Filer ID (Ethics Commission Filers) 14 C/OH NAME 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 CANDIDATE's OR OFFICEHOLDER's COMMITTEE(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 0 GENERAL COMMITTEE ADDRESS 0 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) EXPENDITURE 3. TOTAL POLITICAL EXPENDITURES OF $100 OR LESS, TOTALS UNLESS ITEMIZED $ 4. TOTAL POLITICAL EXPENDITURES $ 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 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 me under Title 15, Election Code. OtI" 81,4, ASHLEY M OWENS "'I Notary Public, State of Texas Corrim, Expires 02.24-2023 Signature of Candidate or Officeholder otafy ID 130128128 N Sworn to and subscribed before me, by the said..AVV this the ------------------ 20 o - I, v - viuIess my hand and seal of office. day of4k-Ii-t'v�-- 'a - to certify w NO S�gnaturo of officer k, ,dr inistering oath Printed name of officer adrynnistering oath --ifle of off'.e adrnirrister 1 11 Of" in" -1 1 "1 Forms provided by Texas Ethics Commission www.elhics.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 a Filer ID (Ethics Commission Filers) 4 Date 5 Full name of contributor F1 out-ot-Mate PAC . ........... 7 Amount of contribution zr o a, 6 Contributor address; City; State; Zip Code ® n , -TX 8 Principal occupation / Job title (See Instructions) 9 Employer (See Instructions) Date Full name of contributor El out-ot-state PAC (ID#: Amount of contribution Contributor address; City; State; Zip Code 'T)c Principal occupation / Job title (See Instructions) Employer (See Instructions) Date Full name of contributor E] out-of-state PAC n D#: Amount of contribution Contributor address; City; State; Zip Code Principal occupation / Job title (See Instructions) Employer (See Instructions) Date Full name of contributor El out -of -stale PAC (MM.-- Amount of contribution Contributor address; City; State; Zip Code Principal occupation / Job title (See Instructions) U 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 SUBTOTALS - C/OH FORM C/OH COVER SHEET PG 3 19 FILER NAME 20 Filer ID (Ethics Commission Filers) 21 SCHEDULE SUBTOTALS NAME OF SCHEDULE SUBTOTAL AMOUNT SCHEDULE Al: MONETARY POLITICAL CONTRIBUTIONS 2. ❑ SCHEDULE A2: NON -MONETARY (IN-KIND) POLITICAL CONTRIBUTIONS $ 3. SCHEDULE B: PLEDGED CONTRIBUTIONS 4. - - - ---------- SCHEDULEE:LOANS IMO 5. ❑ SCHEDULE F1: POLITICAL EXPENDITURES MADE FROM POLITICAL CONTRIBUTIONS $ 6. SCHEDULE F2: UNPAID INCURRED OBLIGATIONS $ 7. SCHEDULE F3: PURCHASE OF INVESTMENTS MADE FROM POLITICAL CONTRIBUTIONS $ 8. SCHEDULE F4: EXPENDITURES MADE BY CREDIT CARD $ 0 9. ❑SCHEDULE G: POLITICAL EXPENDITURES MADE FROM PERSONAL FUNDS 10. SCHEDULE H: PAYMENT MADE FROM POLITICAL CONTRIBUTIONS TO A BUSINESS OF C/OH 11. SCHEDULE 1: NON-POLITICAL EXPENDITURES MADE FROM POLITICAL CONTRIBUTIONS $ 12. ❑SCHEDULE K: RETURNED TO INTEREST, CREDITS, GAINS, REFUNDS, AND CONTRIBUTIONS FILER $ Forms provided by Texas Ethics Commission www. ethics. state.tx. us Revised 9/8/2015 NON -MONETARY (IN-KIND) POLITICAL CONTRIBUTIONS SCHEDULE A2 The Instruction Guide explains have to complete this form. 1 Total pages Schedule A2: 2 FILER NAME 3 Filer ID (Ethics Commission Filers) 4 TOTAL OF UNITEMIZED IN-KIND POLITICAL CONTRIBUTIONS $ 5 Date 6 Full name of contributor ❑ out-of-state PAC (ID#. E3 Amount of 9 In-kind contribution Contribution $ description 7 Contributor City; State: Code address; Zip Check if travel outside of Texas. Complete Schedule F. 10 Principal Occupation / Job title (FOR NON -JUDICIAL) (See Instructions) 11 Employer (FOR NON-JUDICIAL)(See Instructions) 12 Contributor's principal Occupation (FOR JUDICIAL) 13 Contributor's job title (FOR JUDICIAL) (See Instructions) 14 Contributor's employer/law firm (FOR JUDICIAL) 15 Law firm of contributor's spouse (if any) (FOR JUDICIAL) 16 It contributor is a child, law firm of parent(s) (if any) (FOR JUDICIAL) Date Full name of contributor ❑ out-of-state PAC (ID# Amount of In-kind contribution Contribution $ description Contributor address: City; State; Zip Code - ----------- Check it travel outside of Texas. Complete Schedule I. Principal occupation Job title (FOR NON -JUDICIAL) (See Instructions) Employer (FOR NON JUDICIAL)(See Instructions) Contributor's principal Occupation (FOR JUDICIAL) Contributor's job title (FOR JUDICIAL) (See Instructions) Contributor's employer/law firm (FOR JUDICIAL) -------- --- - Law firm of contributor's spouse (it any) (FOR JUDICIAL) It contributor is a child, law firm of parent(s) (it any) (FOR JUDICIAL) ATTACH ADDITIONAL COPIES OF THIS SCHEDULE AS NEEDED It 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 9/8/20 5 PLEDGED CONTRIBUTIONS SCHEDULE B 1 Total pages Schedule E: The Instruction Guide explains hcs to complete this form. 2 FILER NAIVE ® Filer ID (Ethics Commission Filers) 4 TOTAL OF UNITEMIZED PLEDGES $ 5 gate 6 Full name Of pledgor ❑ out-of-state PAC tID#: Amount g In-kind contribution of Pledge $ description . . . . . . . . . . . . . . . . . . . . . . . . 7 Pledgor address; City; State; . . . . . . . . . . Zip Code Check if travel outside of Texas. Complete Schedule T. 10 Principal Occupation / Job title (See Instructions) 11 Employer (See Instructions) Date Full name Of pledgor ❑ out of state PAC (ID#: Arnount In-kind contribution of Pledge $ description . . . . . . . . . . . . . . . . . . . . . . . . Pledgor address; City; State; . . . . . . . . . . . Zip Code Check if travel outside of Texas. Complete Schedule T. Principal Occupation ( Job title (See Instructions) Emplayer (=lee Instructions) — Date Full name Of pledgor ❑out -of-state PAC(ID#----------------------------------} Amount Of In-kind contribution Pledge $ description Pledgor address; City; State; Zip Code Check if travel outside of Texas. Complete Schedule T. Principal occupation / Job title (See Instructions) Employer (See Instructions) Cate Full name of pledgor ❑ out-of-state PAC (ID#: Arnount of In-kind contribution Pledge $ description Pledgor address; City; State; Zip Code Check if travel outside of Texas. Complete Schedule T. -- -- ------------- ---_... Principal occupation / Job title (See Instructions) - - -- -- - --- -- Employer ( See Instructions) ATTACH ADDITIONAL COPIES OF THIS SCHEDULE AS NEEDED If contributor is out-of-state RAC, please see instruction guide for additional reporting requirements. Forms provided by Texas Ethics Commission www.ethics,state.tx.us Revised 9/8(2415 LOANS SCHEDULE E The Instruction Guide explains how to complete this form. 1 Total pages Schedule E: 2 FILER NAME Filer ID (Ethics Commission Filers) 4 TOTAL OF LINT EMIZE® LOANS -- -- - - - — ------------- ---------- --- - -- 5 Date of loan 7 dame of lender Llout-of-statePAC (104:______________ ) --------------- Loan Amount ($) Is lender10 Lender address; City; State: Zip Code - ------ __... Interest rate a financial pp I n stat u t i "? _ Q" i � r -- ---- __ _----------� - - 11 Maturity date 12 Principal occupation ! Job title (See instructions) 13 Employer (See instructions) - - 14 Description of Collateral 15 Check if personal funds were deposited into political (See Instructions) ELI�accoun none - - ---- — 16 GUARANTOR 17 Blame ofguarantor 19 Amount Guaranteed ($) INFORMATION 18 Guarantor address; City; State; Zip Code not applicable 20 Principal Occupation (:lee Instructions) 21 Ernployer (See Instructions) - --------------- - Date of loan Blame of lender ❑ out-of-state PAC (104. Loan Amount ($) -------------- . . . . . . . . . . . . . . . . City; State; Zip Code Is lender Lender address; Cit _. Interest rate a financial Institution"? Maturity date V N ------------------ -- - ------ Principal occupation / Job title (See Instructions) ------------------------- Employer (See Instructions) Description of Collateral Check if personal funds were deposited into political account (See Instructions) E [� none t-1 ----- ---------------------------- ----------------------------------- ------ GUARANTOR dame of guarantor GUARANTOR -- -- ---- ------------ - - Amount Guaranteed ($) INFORMATION . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Guarantor address; City; State; Zip Code . not applicable --- — —-------- --------------- ------------------ -------------- Principal Occupation (See Instructions) Ernployer (See Instructions) ----------------------- ---- ---------- ATTACH ADDITIO AL COPIES OF THIS SCHEDULE AS NEEDED If lender is out-of-state RAG, please see instruction guide for additional reporting requirements. Forms provided by Texas Ethics Commission .ethics.state.tx.us Revised 9/8/2095 POLITICAL EXPENDITURES MADE FROM POLITICAL CONTRIBUTIONS SCHEDULE F1 EXPENDITURE CATEGORIES FOR BOX 8(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/Memorials Expense Printing Expense Travel Out Of District Candidate /Officeholder/Po litical Committee Legal Services Salares/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 Fl: 2 FILER NAME 3 Filer ID (Ethics Commission Filers) Arr� il: 4 Date 5 Payee name 6 Amount 7 Payee address; City; State; ZipCode 8 (a) Category (See Categories listed at the top of this schedule) (b) Description ❑ Check if travel outside of Texas. Complete Schedule I PURPOSE OF ❑ Check if Austin, TX, officeholder living expense EXPENDITURE 9 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 ❑ Check it Austin, TX. officeholder living expense 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 Category (See Categories listed at the top of this schedule) Description E]Check PURPOSE 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 Forms provided by Texas Ethics Commission www. et h I c s. s tat e. t x. to s Revised 9/8/2015 UNPAID INCURRED OBLIGATIONS SCHEDULE F2 EXPENDITURE CATEGORIES FOR BOX 10(a) Advertising Expense Event Expense Loan RepaymenUReirnbursement 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/Do nations Made By Gift/Awards/Mernorials Expense Printing Expense Travel Out Of District Candidate/OfficeViolder/PoliticaI Committee Legal Services SalariesfWages/Contract Labor Other (enter a category not listed above) The Instruction Guide explains how to complete this form. 1 Total pages Schedule F2: 1 2 FILER NAME 3 Filer ID (Ethics Commission Filers) I _A If CIL, 4 TOTAL OF UNITEMIZED UNPAID INCURRED OBLIGATIONS $ 5 Date 6 Payee name 7 Amount 8 Payee address; City; State; Zip Code 9 TYPE OF Political Non -Political EXPENDITURE 10 (a) Category (See Categories listed at the top of this schedule) (b) Description PURPOSE El Check if travel outside of texas. Complete Schedule T OF EXPENDITURE OCheck if Austin, TX, officeholder kving 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 Political Non -Political Category (See Categories listed at the lop of this schedule) Description PURPOSE ❑ Check it travel outside of Texas. Complete Schedule T 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 9/8/20 15 PURCHASE OF INVESTMENTS MADE FROM POLITICAL CONTRIBUTIONS SCHEDULE F3 ------ ---- -- -- — 1 Total pages Schedule F3: The Instruction Guide explains how to complete this form. — — ------ — — —-------- -- — -- -- ------- 2 FILER NAME, A3 Filer IC (Ethics Commission Filers) 4 Date 5 Name of person from whom investment is purchased . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Address of person from whom investment is purchased; City; State; Zip Code 7 Description of investment 8 Amount of investment ($} Cate Name of person from whom investment is purchased . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Address of person from whom investment is purchased; City; State; Zip Code Description of investment Amount of investment ($) ATTACH ADDITIONAL PI THIS SCHEDULE AS NEEDED Forms provided by Texas Ethics Commission .ethics.state.tx.us Revised 9!8!2015 Advertising Expense Evenl Expense Loan Repayment/ Reimbursement Accounting/Banking Fees Office Overhead/Rental Expense Consulting Expense Food/Beverage Expense Polling Expense Contributions/Donations Made By Gift/Awards/Memorials Expense Printing Expense Candidate/Officeholder/Political Committee Legal Services Salaries/Wages/Contract Labor The Instruction Guide explains how to complete this form. Solicitation/Fundraising Expense Transportation Equipment & Related Expense Travel In District Travel Out Of District Other (enter a category not listed above) 1 Total pages Schedule F4: 2 FILER NAME � Filer ID (Ethics Commission Filers) ---- ----- t ----------- -- - — 4 TOTAL OF UNITEMIZED EXPENDITURES CHARGED TOACREDIT CARD 5 Date ----------- 6 -- Payee name 7 Amount ($} 9 Payee address; City; State; Zip Code TYPE OF EXPENDITURE � Political � Non -Political 10 (a) Category (See Categories listed at the top of this schedule) (b) Description PURPOSE E] Check if travel outside of Texas. Complete Schedule T. OF E]Check if Austin, TX, officeholder living expense EXPENDITURE 11 Complete ONLY if direct Candidate ! Officeholder name Office sought Office held expenditure to benefit C/ON Date Payee name Amount ($} Payee address; City; State; Zip Code TYPE OF EXPENDITURE � Political Non -Political Category (See Categories listed at the top of this schedule) Description E] Check if travel outside of Texas. Complete Schedule T. PURPOSE if Austin, TX, officeholder living expense EXPENEXPENDITURECheck Complete ONLY it direct Candidate / Officeholder name Office sought Office held expenditure to benefit C/Ohl ATTACH ADDITIONAL COPIES OF THIS CHEDULE AS NEEDED Forms provided by Texas Ethics Commission www.ethics.state.tx.us Revised 9/8/2015 POLITICAL EXPENDITURES MADE FROM PERSONAL-FUNDS SCHEDULE G EXPENDITURE CATEGORIES FOR BOX 8(a) Advertising Expense Accounting Banking Event Expense Loan Repayment/Reirribursement Solicitation/Fundraising Expense Fees Office Overhead/Rental Expense Transportation Equipment& Related Expense Consulting Expense Food/Beverage Expense Polling Expense Travel In District Contributions/Donations Made By GiftAW2rds/Mernorials Expense Printing Expense Travel Out Of District Carididate/OfficeholdLr/PoliticaI 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 G 2 FILER NAME Filer ID (Ethics Commission Filers) YV, 4 Date 3 2- 5 Payee name 6 Amount 7 Payee address; City: State; Zip Code 46 ��10 ov, f'0C'tA' P rerl i, x -390 11 Reimbursement fforn political contributions intended 8 (a) Category (See Categories listed at the top of this schedule) (b) Description PURPOSE OF E] Check if travel outside of Texas. Complete Schedule T EXPENDITURE E] Check if Austin, TX, officeholder living expense 9 Complete ONLY if direct Candidate / Officeholder name Office sought Office held expenditure to benefit C/01-1 Date 12- (Z62-1 Payee name 'D-'ue-_8 cDUY\-VLi Amount Payee address; City; State: Zip Code Is R oa v-,% D eiJ 1 e-3,❑ Reimbursement from political contributions intended Category (See Categories listed at the lop of this schedule) (b) Description PURPOSE OF E] Check if travel outside of Texas. Complete Schedule T EXPENDITURE E] Check it Austin, TX. officeholder living expense Complete ONLY if direct Candidate Officeholder name Office sought Office held expenditure to benefit G/0H Date Payee name CSA-w 0 Amount Payee address; City; State; Zip Code Reimbursement from political contributions intended Category (See Categories listed at the top of this schedule) (b) Description PURPOSE OFE] Check it travel outside at Texas. Complete Schedule I A EXPENDITURE E] Check if Austin, TX, officeholder living expense ------ — — ----- Complete ONLY it direct — ----- Candidate / Officeholder name Office sought Office held expenditure to benefit C10H ATTACH ADDITIONAL COPIES OF THIS SCHEDULE AS NEEDED Forms provided by Texas Ethics Commission vvww.ethics.s1ate.1x.us Revised 9/8/2015 Forms provided byTexas Ethics Commission wwvwethica.atate.txua Revised 9/8/2015 POLITICAL EXPENDITURES MADE FROM PERSONAL -FUNDS SCHEDULE G EXPENDITURE CATEGORIES FOR BOX 8(a) Advertising Expense Accounting Banking EventExpense Loan Repayment/Reimbursernent Sohiatatrorill'undraising Expense Foos Office Overhead/Rental Expense I-ransponation Equipment & Related Expense Consulting Expense Contributions/Do nations Made By Food/Beverage Expense Polling Expense I -ravel In District GrijAwards/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 G: 2 FILER NAME 3 Filer ID (Ethics Commission Fliers) hmi-� ate 5 ... ............ ..... ........ Payee name Fnc-e 66-6k, 6 Amount 7 Payee address; City; State; ZipCode * n ( () I W - ( ik-Lie Y) u Ile- Reimbursernentfr rn political conneutions intended 8 (a) Category (See Categories listed at the top of this schedule) (b) Description PURPOSE OF Check it travel outside of Texas. Cornplele Schedule T. EXPENDITURE T�Xce 6n a k Check if Austin, TX, officeholder living expLnne 9 Complete ON - LY if direct Candidate / Officeholder name Office sought Office held expenditmi-e to benefit C/OH Date Payee name 9 122 (2-,o A N7" f-,,4 Annount Payee address; City; State; Zip Code Reimbui scment front political contributions intended Category (See CarLgolies listed at the top of this schedule) (b) Description PURPOSE OF Check if travel outside of Texas. Complete Schedule T. P a—i EXPENDITURE Check it Austin, TX. officeholder living expense Complete ON -LY if direct Candidate Officeholder name Office sought Office held expenditure to benefit C/OH Date Payee name Amount M Payee address; City; State-, Zip Code sw,�3 Reimbursement from political contributions intended Category (See Categories li�red at the top of this schedule) (b) Description PURPOSE OF EXPENDITURE Check if travel outside of Texas. Cornpare Schedule T F--:] Check it Austsr'T TX, officeholder living expense Complete ONLY it 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 POLITICAL EXPENDITURES MADE FROM PERSONAL -FUNDS SCHEDULE G EXPENDITURE CATEGORIES FOR BOX 8(a) Advertising Expense Accounting Banking EventExpense Loan Repayment/Rernlocusement Solicitation/Fundvaising Expense Fees Office Overhead/Rental Expense Transportation Equipment & Related Expense Consulting Expense Contributions/Donations Made By Food/Beverage Expense Polling Expense Travel In District Gift,'Awards/Mernorials Expense Printing Expense Travel Out Of District Candidate,Officr,�holder/PoliticaI 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 pag chedule G: 2 es S FILER NA 3 Filer ID (Ethics Commission Filers) 4 Date 5 3 (291a-6 tl Payee name .. .. . .. . ................... 6 Amount 7 Payee address; City; State; ZipCode 1� I �_ ReimbumemenWo '1_4 D �'r 5 eA Ty -7 S-6 political contributions intended (a) Category (See Categories listed at the top of this schedule) (b) Description PURPOSE 1:1 Check it travel outside of Texas. Complete Schedule T OF EXPENDITURE 0Check if Austin, TX, officeholder living expense 9 Complete ONLY it direct Candidate Officeholder name Office sought Office held expenditure to benefit C/OH Date 12— Payee name Amount Payee address; City; State: Zip Code -t2_--1 �_tflq.os" from -T ElReimbursement political contributions intended Category (See Categories listed at the top of this schedule) (b) Description PURPOSE OF 0 Check it travel outside of Texas. Complete Schedule I n 0Check EXPENDITURE 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 b ( ( <1�7_0 z I -- ----------- Amount Payee address� City: State; Zip Code dif .0 -� s— y 6 .9, 64 Li ERe micursoment frorn l politicalrontributions tA 0 Z4(q intended Category (See Calegores listed at the top of this schedule) (b) Description PURPOSE OF M KJF,,eJ Check if travel outside of Texas. Complete Schedule I 0 EXPENDITURE Check it Austin, TX. officeholder living expense Complete ONLY it 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 POLITICAL EXPENDITURES MADE FROM PERSONAL FUNDS SCHEDULEG EXPENDITURE CATEGORIES FOR BOX 8(a) Advertising Expense EventExpense Loan Repayment/Reimbursement Solicitation,'Fundraising Expense Accounting,'Banking Fees Office Overhead/Rental Expense I ransportation Equipment & Related Expense Consulting Expense Food/Beverage Expense Polling Expense Travel In District , ontributions/Donations Made By Gift/Awards/Mennorials Expense Printing Expense Travel Out Of District C Candidate/Officeholder/PoliticaI 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 G: 5— 2 FILER NAME A 3 Filer ID (Ethics Commission Filers) 4 Date 5 Payee name aA- 6 Amount 7 Payee address; City; State� Zip Code 1 0,3 Reirinbursementtrom -�)( 7S T� I boy r:'I()-� political contributions intended 8 (a) Category (See Categories listed at the top of this schedule) (b) Description PURPOSE OF Y— Check it travel outside of Texas Complete Schedule T. EXPENDITURE 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 Amount Payee adcl,ess� City; State; Zip Code Reimbursement from -7 political contributions intended Category iSee Categories listed at the top of this schedule) (b) Description PURPOSE OF Check if travel outside of Texas. Complete Srhedule T. EXPENDITURE Check if Austin, TX, officeholder living expense Complete ONLY if direct Candidate / Officeholder name Office sought Office held expenditure to benefit C/OH Date 31' 111 1, 1 Payee name -C '-p YouW ($)P' Payee address; City: State� ZipCode V9 I - O's, Reimbursementirom political contributions intended Category (Spe Categories listed at the top of lhis s0nedule) W Description PURPOSE OF t -r� Check if travel outside of Texas. Complete SOnedule T EXPENDITURE A Check it Austin. TX, officelholder 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 9/8/2015 PAYMENT MADE FROM POLITICAL CONTRIBUTIONS TO A BUSINESS OF C/OH SCHEDULE H EXPENDITURE CATEGORIES FOR BOX 8(a) Adve,r`,,,nq Expense Event Expense Loan Repayment/ I laimbursement Solicitation/Fundraising Expense Ai7counting/Danking Fees Office Overhead/Rental Expense Transportation Equipment & Related Expense Consulting Expense Food/Beverage Expense Polling Expense Travel In District Continbutio ns/Do nations Made By Gift/Awards/Memorials Expense Printing Expense Travel Out Of District Candidate/Officeholder/PoliticaI Committee Legal Services Salanes/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 H- 2 711� (Ethics Commission Filers FILER NAM?�. 3 Fil-r 4 Dale 5 Business name --- - --- - -------- 6 Amount 7 — - ------- — --------- ---------- -- — - ----- Business address; City; State; ZipCode --- — - — -- - ------ - ----- -- — — ---- ------- ------ ------- 8 (a) Category (See Categories listed at the top of thisschedule� (b) Description PURPOSE Cherk it travel outside at Texas. Complete Schedule I OF Check living EXPENDITURE if Austin, TX, officeholder expense 9 Complete ONLY if direct Candidate / Officeholder name Office sought Office held expenditure to benefit C/OH - - - -------------------- - ----------------- ----------------- Date -------- ---------- ---- - - — ------- ---------------- ------- - — -- - - ---------- ---- Business name W / k Amount — - ----------------- ----- Business address; City; State: Zip Code \--J Category (See Categories listed at the top of this schedule) Description PURPOSE Check if travel outside of Texas. Complete Schedule I OF Check Austin, TX. living EXPENDITURE if officeholder expense Complete ONLY if direct Candidate / Officeholder name Office sought Office held expenditure to benefit C/OH -- — --------------------- Date --- - ---- - ----------- — — — — ------------------------ - Business name A- -- - -------- Amount - - ---------- - - - ------------ ------- Business address; City; State; Zip Code Category (See Categories listed at the top of this schedule) Description PURPOSE Clierk it travel outside of Texas. Complete Schedule T. OF Check it 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 NON-POLITICAL EXPENDITURES MADE FROM POLITICAL CONTRIBUTIONS SCHEDULEI ------------ °The Instruction Guide explains how to complete this forret, ---------- -- ----------------------------- ---------------------------- 1 Total pages Schedule I: 2 FILER NAME Filer ID (Ethics Commission Filers) 4 Date 5 Payee name 6 Amount ($} 7 Payee address; City; State; Zip Code (a)Category (See instructions for examples of acceptable (b)Description (See instructions regarding type of information PURPOSE categories.) required.) OF EXPENDITURE Date Payee name Amount ($} Payee address; City; State; Zip Code (See instructions for examples of acceptable Description (See instructions regarding type of information PURPOSE categories.) categories.) required.) OF EXPENDITURE Date Payee name Amount ($) Payee address; City; State; Zip Code PURPOSE Category (See instructions for examples of acceptable Description (See instructions regarding type of information OF categories.) required.) EXPENDITURE Date Payee name Amount ($} Payee address; City; State; Zip Code Category (See instructions for examples of acceptable Description (See instructions regarding type of information PURPOSE categories.) required.) OF EXPENDITURE AT'T'ACH ADDITIONAL COPIES OF THIS SCHEDULE AS NEEDED Forms provided by Texas Ethics Commission www.ethics.state.tx.us Revised 90(2015 INTEREST, CREDITS, GAINS, REFUNDS, AND CONTRIBUTIONS RETURNED TO FILER SCHEDULE K The Instruction Guide explains how to complete this form. 1 Total pages Schedule K: --------- ---------------- FILER NAME `- %gyp ------------- 3 Filer ID (Ethics Commission Filers) 4 Date 5 Name of person from whore amount is received 8 Amount ($} Address of person from whom amount is received; City; State; Zip Code 7 Purpose for which amount is received ❑ Check if political contribution returned to filer Date Name of person from whom amount is received Amount ($) . . . . . . . . . . . . . . . . . . . . . . . . . . Address of person from whom amount is received; . . . . City; . . . . . . . . . . . . . . State; Zip Code Purpose for which amount is received Check if political contribution returned to filer Date Name of person from whom amount is received Amount ($} . . . . . . . . . . . . . . . . . . . . . . . . . . Address of person from whom amount is received; . . . . City; . . . . . . . . . . . . . . State; Zip Code Purpose for which amount is received Check if political contribution returned to filer Date Name of person from whom amount is received Amount ($} . . . . . . . . . . . . . . . . . . . . . . . . . . Address of person from whom amount is received; . . . . City; . . . . . . . . . . . . . . State; Zip Code Purpose for which amount is received n Check if political contribution returned to filer ------------- ATTACH ADDITI NAL COPIES OF THIS SCHEDULE AS NEEDED Forms provided by Texas Ethics Commission .ethics.state.tx.us Revised 9(8!2015 IN-KIND CONTRIBUTIONS OR POLITICAL EXPENDITURES FOR TRAVEL OUTSIDE OF TEXAS SCHEDULE T The Instruction Guide explains how to complete this form. 1 Total pages Schedule T: — — — — - - ----------- - -------- 2 FILER NAME, 3 Filer ID (Ethics Commission Filers) ---- 4 Name of Contributor! Corporation or Labor Organization / Pledgor Payee ------ — ------.----- — --- - --------- --------- - ---- 5 Contribution / Expenditure reported on: ---------- - -- 1-1 Schedule A2 F]Schedule B 1-1 Schedule B(J) ❑ Schedule C2❑ Schedule D Schedule F1 EISchedule F2 ❑ Schedule F4 ❑ Schedule G ❑ Schedule H ❑ Schedule COH-UC 0 Schedule B -SS 6 Dates of travel 7 Name of person(s) traveling 8 Departure city or name of departure location - ----- ----- -- Destination city or name of destination location ---------- 10 Means of transportation 11 Purpose of travel (including name of conference, seminar, or other event} Name of Contributor! Corporation or Labor Organization / Pledgor Payee Contribution / Expenditure reported on: -1 Sc E] Schedule B hedule A2 El Schedule B(J) EISchedule C2 D Schedule D EISchedule F1 [-]Schedule F2 ❑ Schedule F4 El Schedule G ❑ Schedule H ❑ Schedule COI -UC [] Schedule B -SS Dates of travel Name of person(s) traveling -------------- _._____ — - ---- - ---- - ----- ----------- --------------- -------------------- -------- -------------------------------------- Departure city or name of departure location ----- ---------- - - --- __ ---- ---- - - - ----------------------------------------------------------------- Destination city or name of destination location -�-u-r�o-s---e-o-f—tra—vel------- Means of transportation (including name of conference, seminar, or other event) — — ------------- - - Name of Contributor / Corporation or Labor Organization / Pledgor / Payee ----------- ------ - Contribution / Expenditure reported on: 1-1 Schedule A2 EISchedule B El Schedule B(J) D Schedule C2 El Schedule D EISchedule F1 D Schedule F2 El Schedule F4 El Schedule G D Schedule H El Schedule COH-LIC ❑ Schedule B -SS Dates of travel Name of person(s) traveling Departure city or name of departure location Destination city or narne of destination location - ------ --- - Means of transportation Purpose of travel (including name of conference, seminar, or other event) —___ -- -------------------------------------------- ATTACH ADDITIONAL COPIES OF THIS SCHEDULE AS NEEDED .. ... ... ... . Forms provided by Texas Ethics Commission www.ethics. state. tx. us Revised 9/8/2015 CANDIDATE/ OFFICEHOLDER REPORT: DESIGNATION OF FINAL REPORT FORM C/OH - FR 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 1 2 Filer ID (Ethics Commission Filers) 3 SIGNATURE I do not expect any further political contributions or political expenditures in connection with my candidacy. I understand that designat- ing a report as a 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. Signature of Candidate / Officeholder 4 FILER WHO IS NOT AN OFFICEHOLDER .. Complete A & B below only if you are not an officeholder. -- zm.,.. ., E] I do not have unexpended contributions or unexpended interest or income earned from political contributions. I have unexpencled contributions or unexpencled interest or income earned from political contributions. I understand that I may not convert unexpencled political contributions or unexpencled interest or income earned on political contributions to personal use. I also understand that I must file an annual report of unexpencled contributions and that I may not retain unexpencled contributions or unexpencled interest or income earned on political contributions longer than six years after filing this final report. Further, I understand that I must dispose of unexpencled political contributions and unexpencled interest or income earned on political contributions in accordance with the requirements of Election Code, § 254.204. Check only one: [:::] I do not retain assets purchased with political contributions or interest or other income from political contributions. E] 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 it 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 file. I am also aware that I will be required to file reports of unexpencled contributions if, after filing the last required report as officeholder, I retain political contributions, interest or other income from political contributions, or assets purchased with po I cal contributions or interest or other income from political contributions. Signature of Officeholder Forms provided by Texas Ethics Commission www.ethics.state.tx.us Revised 9/8/2015