Smits, Mark-COH 2021-04-06CANDIDATE /OFFICEHOLDER
FORM C/OH
CAMPAIGN FINANCE REPORT COVER SHEET PG 1
The C/011Instruction Guide explains how to complete this Corm.
1 Filer ID (Ethics Commission Filers)
2 Total pages filed:
3 CANDIDATE/
MS / MRS / MR FIRST MI
OFFICEHOLDERi�1tf
OFFICE USE ONLY
NAME
Date Received
.
NICKNAME LAST SUFFIX
4 CANDIDATE /
ADDRESS / PO BOX; APT / SUITE #; CITY; STATE; ZIP CODE
OFFICEHOLDER
MAILING
J
ADDRESS
Cvq P -C K
❑ Change of Address
t
5 CANDIDATE/
AREA CODE PHONE NUMBER EXTENSION
OFFICEHOLDER
/ C` 1 •L ` ,(.� �: C. j
"L `
Date Hand -delivered or Date Postmarked
PHONE
I
6 CAMPAIGN
TREASURER
Ms / MRS / MR FIRST MI
�V��>fL
Receipt #
Amount $
l��17 "Uh
Date Processed
NAME
. . . . . _. . _ .
NICKNAME LAST SUFFIX
Date Imaged
7 CAMPAIGN
STREET ADDRESS (NO PO BOX PLEASE); APT I #; CITY; STATE;
ZIP CODE
TREASURESS
S�SUITE
,,�,ALU IJ✓'"
ADDR
�L
(Residence or Business)
LLP L� t TX '1 \-} Lu
8 CAMPAIGN
AREA CODE PHONE NUMBER EXTENSION
TREASURER
PHONE
�� ` ,� C S—S
9 REPORT TYPE
�(
❑ January 15 I yl 30th day before election ❑ Runoff
❑ 15th day after campaign
treasurer appointment
(Officeholder Only)
❑ July 15 ❑ 8th day before election ❑ Exceeded $500 limit
❑ Final Report (Attach CiOH - FR)
10 PERIOD
Month Day Year Month
Day Year
COVERED
[�
Z/ t 9 /-2 t %f / 11
"� l / 2C'Z
THROUGH
11 ELECTION
ELECTION DATE
ELECTION TYPE
Month Day Year
f9 Primary ❑ Runoff ❑ Other
L
Description General E]Special
12 OFFICE
OFFICE HELD (if any)
13 OFFICE SOUGHT (if known)
k 6 A-
ct+k 4'Y(11+ 0 l
P lIt(t 4
GO TO PAGE 2
Forms provided by Texas Ethics Commission www.ethics.state.tx.us Revised 9/8/2015
CANDIDATE / OFFICEHOLDER
CAMPAIGN FINANCE REPORT
FORM C/OH
COVER SHEET PG 2
14 C/OH NAME
15 Filer ID (Ethics Commission Filers)
16 NOTICE FROM
POLITICAL
THIS BOX IS FOR NOTICE OF POLITICAL CONTRIBUTIONS ACCEPTED OR POLITICAL EXPENDITURES MADE BY POLITICAL COMMITTEES TO
SUPPORT THE CANDIDATE / OFFICEHOLDER. THESE EXPENDITURES MAY HAVE BEEN MADE WITHOUT THE CANDIDATES 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.
2.
COMMITTEE TYPE
FIGENERAL
COMMITTEE NAME
A -
Ir [A -
COMMITTEE ADDRESS
COMMITTEE
SPECIFIC
Additional Pages
117 CONTRIBUTION
TOTALS
EXPENDITURE
TOTALS
CONTRIBUTION
BALANCE
OUTSTANDING
LOAN TOTALS
118 AFFIDAVIT
COMMITTEE CAMPAIGN TREASURER NAME
COMMITTEE CAMPAIGN TREASURER ADDRESS
1 .
TOTAL POLITICAL CONTRIBUTIONS OF $50 OR LESS (OTHER THAN
$
O
PLEDGES, LOANS, OR GUARANTEES OF LOANS), UNLESS ITEMIZED
2.
TOTAL POLITICAL CONTRIBUTIONS
$
(OTHER THAN PLEDGES, LOANS, OR GUARANTEES OF LOANS)
lam'
3.
TOTAL POLITICAL EXPENDITURES OF $100 OR LESS,
$
UNLESS ITEMIZED
4.
TOTAL POLITICAL EXPENDITURES
$
(�
5.
TOTAL POLITICAL CONTRIBUTIONS MAINTAINED AS OF THE LAST DAY
$
O
OF REPORTING PERIOD
6.
TOTAL PRINCIPAL AMOUNT OF ALL OUTSTANDING LOANS AS OF THE
$
0
LAST DAY OF THE REPORTING PERIOD
%0111111, ASHLEY M. OWENS
`�1P'R U6'i
Notary Public, State of Texas
Comm. Expires 02-24-2023
•...<
Notary ID 130128128
AFFIX NOTARY STAMP / SEALABOVE
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 T' Election C e.
S
Signature of Candidate or Officeholder
Sworn to and subscribed before me, by the said Moxy, Cthis the
day ofl 202_, to certify which, witness my hand and seal of office.
�11 *A1 AA,JA/L "U, Aon. Mo'
Signature of o I er administering oath
Printed name of o icer administering oath
Forms provided by Texas Ethics Commission WWW.CII uGJ.4)LOLUi.LA. -
Title of/offer administering
Ravicod Q/R/2015
Forms provided by Texas Ethics Commission www. ethics. state .tx.us nevisea aiu/20 i o
SUBTOTALS - C/OH FORM C/OH
COVER SHEET PG 3
19
FILER NAME
Ln 2k/ L
20 Filer ID (Ethics Commission Filers)
21
SCHEDULE SUBTOTALS
NAME OF SCHEDULE
SUBTOTAL
AMOUNT
1 •
D
SCHEDULE A1: MONETARY POLITICAL CONTRIBUTIONS
$
2.
El
SCHEDULE A2: NON-MONETARY (IN-KIND) POLITICAL CONTRIBUTIONS
$
3.
SCHEDULE B: PLEDGED CONTRIBUTIONS
$
4.
SCHEDULE E: LOANS
$
5.
SCHEDULE F1: POLITICAL EXPENDITURES MADE FROM POLITICAL CONTRIBUTIONS
$
6•
El
SCHEDULE F2: UNPAID INCURRED OBLIGATIONS
$
7•
El
SCHEDULE F3: PURCHASE OF INVESTMENTS MADE FROM POLITICAL CONTRIBUTIONS
$
8
SCHEDULE F4: EXPENDITURES MADE BY CREDIT CARD
$ l&
9•
r
SCHEDULE G: POLITICAL EXPENDITURES MADE FROM PERSONAL FUNDS
s
$
10-
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 Texas Ethics Commission www. ethics. state .tx.us nevisea aiu/20 i o
MONETARY POLITICAL
CONTRIBUTIONS SCHEDULE Al
The Instruction Guide explains how to complete this form.
1 Total pages Schedule Al:
2 FILER NAME y c
3 Filer ID (Ethics Commission Filers)
4 Date
5 Full name of contributor
6 Contributor address;
❑ out-of-state PAC (ID#: l
City; State; Zip Code
7 Amount of contribution ($)
�ao
8 Principal occupation / Job title (See Instructions)
g Employer (See Instructions)
Date
Full name of contributor
. . . . . . . . . . . . . . . . .
Contributor address;
❑ out-of-state PAC (ID#: t
. . . . . . . . . . . . . . . . . . . . .
City; State; Zip Code
Amount of contribution ($)
Principal occupation / Job title (See Instructions)
Employer (See Instructions)
Date
Full name of contributor
. . . . . . . . . . . . . . . . .
Contributor address;
❑ out-of-state PAC (ID#: 1
. . . . . . . . . . . . . . . . . . . . .
City; State; Zip Code
Amount of contribution ($)
Principal occupation / Job title (See Instructions)
Employer (See Instructions)
Date
Full name of contributor
. . . . . . . . . . . . . . . . .
Contributor address;
❑ out-of-state PAC (ID#:
. . . . . . . . . . . . . . . . . . . . .
City; State; Zip Code
Amount of contribution ($)
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 rsevisea afaicu i 0
NON -MONETARY (IN-KIND) POLITICAL
CONTRIBUTIONS SCHEDULE A2
The Instruction Guide explains how to complete this form.
1 Total pages Schedule A2:
2 FILER NAME r^ w �_- ; ` jT
3 Filer ID (Ethics Commission Filers)
4 TOTAL OF UNITEMIZED IN—KIND POLITICAL CONTRIBUTIONS
$ Q
5 Date
6 Full name of contributor ❑ out-of-state PAC (ID#:
7 Contributor address; City; State; Zip Code
I
8 Amount of g In-kind contribution
Contribution $ description
❑ Check if travel outside of Texas. Complete Schedule T.
10 Principal occupation / Job title (FOR NON-JUDICIAL)(See Instructions)
11
Employer (FOR NON-JUDICIAL)(See Instructions)
12 Contributor's principal occupation (FOR JUDICIAL)
1$
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 If contributor is a child, law firm of parent(s) (if any) (FOR JUDICIAL)
Date
Full name of contributor ❑ out-of-state PAC (ID#:
. . . . . . . . . . . . . . . .
Contributor address; City; State; Zip Code
1
. . . .
Amount of In-kind contribution
Contribution $ description
Check if travel outside of Texas. Complete Schedule T.
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 (if any) (FOR JUDICIAL)
If contributor is a child, law firm of parent(s) (if any) (FOR JUDICIAL)
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 rtevlseo V/ts/zut 5
PLEDGED CONTRIBUTIONS SCHEDULE B
1 Total pages Schedule B:
The Instruction Guide explains how to complete this form.
2 FILER NAME `
WL
3 Filer ID (Ethics Commission Filers)
4 TOTAL OF LINITEMIZED PLEDGES
$ t ,
5 Date
6 Full name of pledgor ❑ out-of-state PAC (ID#: )
g Amount 9 In-kind contribution
Pledge $ description
1of
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#: I
Amount In-kind contribution
of Pledge $ description
...................................
Pledgor address; City; State; Zip Code
0 Check if travel outside of Texas. Complete Schedule T.
Principal occupation / Job title (See Instructions)
Employer (See Instructions)
Date
Full name of pledgor ❑ out-of-state PAC (ID#: I
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)
Date
out-of-state PAC (ID#: I
Full name of pledgor E]de
Amount of 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 PAC, please see instruction guide for additional reporting requirements.
D—i—A oia»nt�
Forms provided by Texas Ethics Commission www.emlcs.state.uc.us
LOANS SCHEDULE E
The Instruction Guide explains how to complete this form.
1 Total pages Schedule E:
2 FILER NAME �A
3 Filer ID (Ethics Commission Filers)
4 TOTAL OF UNITEMIZED LOANS
$ 0 , 0C
5 Date of loan
7 Name of lender out-of-state PAC (ID#: )
......................................
8 Lender address; City; State; Zip Code
9 Loan Amount ($)
6 Is lender
10 Interest rate
a financial
Institution?
11 Maturity date
Y N
12 Principal occupation / Job title (See Instructions)
13 Employer (See Instructions)
14 Description of Collateral
15 Check if personal funds were deposited into political
account (See Instructions)
❑ none
❑
16 GUARANTOR
17 Name of guarantor
19 Amount Guaranteed ($)
INFORMATION
. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
18 Guarantor address; City; State; Zip Code
❑ not applicable
20 Principal Occupation (See Instructions)
21 Employer (See Instructions)
Date of loan
Name of lertder ❑ out-of-state PAC (ID#: )
. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
Lender address; City; State; Zip Code
Loan Amount ($)
Is lender
Interest rate
a financial
Institution?
Maturity date
Y N
Principal occupation / Job title (See Instructions)
Employer (See Instructions)
Description of Collateral
Check if personal funds were deposited into political
account (See Instructions)
❑ none
❑
GUARANTOR
Name of guarantor
Amount Guaranteed ($)
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 tender Is out-of-state PAC, please see instruction guide for additional reporting requirements.
Forms provided by Texas Ethics Commission www.ethics.state.tx.us rtevlsea v s/eu I o
POLITICAL EXPENDITURES MADE
FROM POLITICAL CONTRIBUTIONS SCHEDULE F1
EXPENDITURE CATEGORIES FOR BOX 8(a)
Advertising Expense Event Expense Loan RepaymenvReimbursemerd Solicitation/Fundraising Expense
Acoounting/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 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 Ft:
2 FILER NAME e /�_ _ '
3 Filer ID (Ethics Commission Filers)
4 Date
5 Payee name
6 Amount ($)`/
7 Payee address; City; State; Zip Code
`
y
(A—
(a) Category (See Categories listed at the top of this schedule)
(b) Description
❑ Check it travel outside of Texas. Complete Schedule T.
PURPOSE
OF
❑ Check if Austin. TX, officeholder living expense
EXPENDITURE
9 Complete ONLY if direct Candidate / Officeholder name Office sought Office held
expenditure to benefit C/OH
Date
Payee name
Amount ($)
Payee address; City; State; Zip Code
Category (See Categories listed at the top of this schedule)
Description
❑ Check if travel outside of Texas. Complete Schedule T.
PURPOSE
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
Date
Payee name
Amount ($)
Payee address; City; State; Zip Code
Category (See Categories listed at the top of this schedule)
Description
❑ Chedk if travel outside of Texas. Complete Schedule T
PURPOSE
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.etnlcs.stawax.us - ---
UNPAID INCURRED OBLIGATIONS SCHEDULE F2
EXPENDITURE CATEGORIES FOR BOX 10(a)
Advertising Expense Event Expense Loan Repayment/Reimbursement Solicitation/Fundraising Expense
AccountingBanking Fees Office OverheadYRental Expense Transportation Equipment b 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)
The Instruction Guide explains how to complete this form.
1 Total pages Schedule F2:
2 FILER NAME h l t I I -
4" V V� `�-' WU
3 Filer ID (Ethics Commission Filers)
4 TOTAL OF UNITEMIZED UNPAID INCURRED OBLIGATIONS
$ 0 00
5 Date
6 Payee name
7 Amount ($)
8 Payee address; City; State; Zip Code
9 TYPE OF
EXPENDITURE
1-1 Political Non Political
10
(a) Category (See Categories listed at the top of this schedule)
(b) Description
PURPOSE
❑ Check if travel outside of Texas. Compete Schedule T.
OF
EXPENDITURE
❑Check if Austin, TX, officeholder living expense
11 Complete ONLY if direct Candidate / Officeholder name Office sought Office held
expenditure to benefit C/OH
Date
Payee name
Amount ($)
Payee address; City; State; Zip Code
TYPE OF
El Political Non Political
Category (See Categories listed at the top of this schedule)
Description
❑ Check it travel outside of Texas. Compete Schedule T.
PURPOSE
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 I'ieviseu a/orcv j a
PURCHASE OF INVESTMENTS MADE
FROM POLITICAL CONTRIBUTIONS SCHEDULE F3
The Instruction Guide explains how to complete this form.
1 Total pages Schedule F3:
2 FILER NAME , ' 1
$ Filer ID (Ethics Commission Filers)
4 Date
111
5 Name of person from whom investment is purchased
6 Address of person from whom investment is purchased; City; State; Zip Code
7 Description of investment
8 Amount of investment ($)
Date
Name of person from whom investment is purchased
. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . ... . . . . . . . . . ... ... . . . . . . . . .
Address of person from whom investment is purchased; City; State; Zip Code
Description of investment
Amount of investment ($)
ATTACH ADDITIONAL COPIES OF THIS SCHEDULE AS NEEDED
Forms provided by Texas Ethics Commission www. ethics. slate .tx.us eviou
EXPENDITURES MADE BY CREDIT CARD SCHEDULE F4
EXPENDITURE CATEGORIES FOR BOX 10(a)
Advertising Expense Event Expense Loan Repayment/Reimbursement Solicitation/Fundraising Expense
Accounting/Banking Fees Office Overhead/Rental Expense Transportation Equipment & Related Expense
Consulting Expense FoodEleverage Expense Polling Expense Travel In District
Contributions/Donations Made By aft/Awards/Memorials Expense Printing Expense Travel Out Of District
Candidate/Officeholder/Potilical Committee Legal Services Salaries/Wages/Contract Labor Other (enter a category not listed above)
The Instruction Guide explains how to complete this form.
1 Total pages Schedule F4:
2 FILER NAME
3 Filer ID (Ethics Commission Filers)
(:T
4 TOTAL OF UNITEMIZED EXPENDITURES CHARGED TOACREDIT CARD
$� ( cG
5 Date
6 Payee name
7 Amount ($)
8 Payee address; City; State; Zip Code
-7k,--c41
&%ov wf Ey et46 S Pc _0 U t 3 F �A
9 TYPE OF
EXPENDITURE
I? f' ical Non Political
10
(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
�f
❑Check it Austin, TX, officeholder living expense
11 Complete ONLY it direct Candidate / Officeholder name Office sought Office held
expenditure to benefit C/OH
y�-
DatePayee
name
L av1A LL C.
Amount ($)
Payee address; City; State; Zip Code
G (
fty"
TYPE OF
EXPENDITURE
Political Non Political
❑
Category (See Categories listed at the top of this schedule)
T,
Description
E]Checkit travel outside of Texas. Complete Schedule T.
PURPOSE
OF
�`�/
e � d✓
❑Check if Austin. TX, officeholder living expense
EXPENDITURE
_
Complete ONLY if direct Candidate / Officeholder name Office sought Office held
expenditure to benefit C/OH rjq
' V A/
ATTACH ADDITIONAL COPIES OF THIS SCHEDULE AS NEEDED
Forms provided by Texas Ethics Commission www.ethics.state.tx.us r1Cvibvu arorcv
EXPENDITURES MADE BY CREDIT CARD
EXPENDITURE CATEGORIES FOR BOX 10(s)
Event Expense Loan RepaymeM/Reimbursement
Advertising Expense officeoverhead/Rental Expense
AccountingiBanking Fees
Consulting Expense FoodrBeverage 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.
1 Total pages S�� u F4: I 2 FILER NAME int L
V
4 TOTAL OF UNITEMIZED EXPENDITURES CHARGED TO A CREDIT CARD
5 Date 6 Payee name
2 - 23 `� � 1 �a in S
7 Amount W 8 Payee address; City; State; Zip Code
ik�116 �, 3
9 TYPE OFIll Political Non -Political
EXPENDITURE LJ
SCHEDULE F4
Solicitation/Fundraising Expense
Transportation Equipment S Related Expense
Travel In District
Travel Out Of District
Other (enter a category not listed above)
3 Filer ID (Ethics Commission Filers)
(a) Category (See Categories listed at the top of this schedule) (b) Description
10 Check if travel outside of Texas. Complete Schedule T.
PURPOSE
O F Check it Austin, TX, officeholder living expense
EXPENDITURE l
Office sought Office held
11 Complete ONLY if direct Candidate /Officeholder name
expenditure to benefit C/OH � /� �^„ j `Ov„ (A p d-4 �
L�' ` 1Iv�� `, v[
Date Payee name
'Din t
Amount M Payee address; City; State; Zip Code
TYPE OFpolitical Non -Political
EXPENDITURE
Category (See Categories listed at the top of this schedule)
Description
Check it travel outside of Texas. Complete Schedule T.
]--
PURPOSE ��j�A Check it Austin, TX, officeholder living expanse
OF V V[� ` t��vvs"L
EXPENDITURE
Office sought Office held
Complete ONLY if direct Candidate / Officeholder name }
expenditure to benefit C/OH c&( lf,.:.tw
ATTACH ADDITIONAL COPIES OF THIS SCHEDULE AS NEEDED Revised 9/8/201
Forms provided by Texas Ethics Commission
www.ethics. state.tx. us
EXPENDITURES MADE BY CREDIT CARD
SCHEDULE F4
EXPENDITURE CATEGORIES FOR SOX 10(g) golicitatoWFundraising Expense
Loan ReAaYrne^LReinbursement ton Equipment & Related Expen
Event Expense Office Overhead Rental Fxpense Transports
Advertising ExpanOv Fees polling Expense Travel O District
ACcounting'Banking FoodtBeverage Expense Travel Out r a District
Coruuttin9 Expense (,iftlgwardsRvterr�odais Expense Printing Expens �ntract Lebo' other (enter a category not listed above)
Com, X10nations Made BY Legal Services Safari to CID es
CaMyidetorOfficehofderlPotiticalCommittee The Instruction Guide expielns how to complete this form.
3 Filer ID (Ethics Commission Filers)
1 Total pages $ched le Fa: i 2 FILER NAME �i t
'ITEMIZED EXPENDITURES CHARGED TO ACREDIT CARD t
4 TOTAL OF UN
5 Date 1 6 Payee name I
ok
City; State; Zip Code e ��,( �(r;
7 Amount ($) 8 Payee address: N -W CZL P441
V
9 TYPE OF Non Political
Political
EXPENDITURE
b Description
Category (See Categories listed at the top of itis schedule) I )
1p (a) ` (p El Check it travel outside of Texas- Comdata Schedule 7.
nn e �v
PURPOSE ` ��Ucheck if Austin. U. officeholder living expense
OF
EXPENDITURE
�Officesought
Office held
11 Compiete ONLY if direct
Candidate/ Officeholder name
expenditure to benefit C'OH
Date
Amount ($)
cep
TYPE OF
EXPENDITURE
PURPOSE
OF
EXPENDITURE
Complete ONLY it direct
expenditure to benefit C/OH
Payee name....L.
r
Payee address;
City; State; Zip Code
Non -Political
Political
Description
Category (See Categories fisted at the top of this schedule) ❑ Check if travel outside of Texas. Complete Schedule T
�Chack it Austin. TX. officeholder living expense
V, n try .1 � j /'. .�(> 3
Office sought
Office held
Candidate / Officeholder name
e�nrH ADDITIONAL COPIES OF THIS SCHEDULE AS NEEDED Revised 9/8/2
www. ethics. state.tx-us
Forms provided by Texas Ethics Commission
EXPENDITURES MADE BY CREDIT CARD
SCHEDULE F4
EXPENDITURE CATEGORIES FOR BOX 10(a)
Loan RepayrrVMReimbursement Tran tationi on Fq time Expense
Event Expense Office Overhead,Rental Expense Transportation Equipment &Related Expense
Advertising Expense Fees Travel In District
Accounting'BankJng FoodBeverage Expense Polling Expense Travel Out Of District
Consulting Expense G tl/gwardslMemorials Expense Printing Expe��ntract Labor Other (enter a category not tisteo above)
ContributionsMonations Made BY Legal Services Satmes/Wa9
Candidate!OtficehotderiPolittcatCommittee
The Instruction Guide explains how to complete this form.
1 Total pages Sched., � { 3 Filer ID (Ethics Commission Filers)
ul.g F4: l 2 FILER NAME /_ _ ,
�t4 CC
4 TOTAL OF UNITEMIZED EXPENDITURES CHARGED TO A CREDIT CARD g
$ Date
6 Payee name
� j
1V City; State; Zip Code �Clrf�
7 Amount ($) i 8 Payee address;
SSC
i 'Au j �. P e+ S1
9 TYPE OF I 1 \X Political j� Non-political
EXPENDITURE ttt ���
b Description
10 (a) Category (See Categories listed at the top of this schedule) I (b)
` !` � Check it travel outside of Texas. Comdata Schedule T.
PURPOSE ft ]�/hC ://7� w�1 Check if Austin. TX. officeholder living expanse
OF rTZr 1 ' J rtuG
EXPENDITURE
Office held
Office sought �ML
11 Complete ONLY if direct Candidate /Officeholder name Rai
expenditure to benefit C+OH U� /^ _ , /• �-V,,Q,tI
Payee name
Date
Amount ($) Payee address;
City; State: Zip Code
TYPE FPolitical Non -Political
EXPENDITURE
7OC:,,'ec
cption
Category (See Categoriestisteda[thetopofthisschedufe)�iftraveloutssideofTexas.CompteteScheduteT
PURPOSEk if Austin. TX, officeholder living expense
OF
EXPENDITURE
i office held
Complete ONit direct
ONLY Candidate /Officeholder name
Office sought
expenditure to benefit C/OH
ATTACH ADDITIONAL COPIES OF THIS SCHEDULE AS NEEDED Revised 9/8/20'
wmrw.ethics.state.tx.us
Forms provided by Texas Ethics Commission
POLITICAL EXPENDITURES
SCHEDULE G
MADE FROM PERSONAL FUNDS
EXPENDITURE CATEGORIES FOR BOX 8(a)
Advertising Expense Event Expense Loan Repayment/Reirnbursemen[ Solicitation/Fundraising Expense
Fees Office Overhead/Rental Expense Transportation Equipment 8 Related Expense
ourrongBnse
sulting Expepense FoodrBeverage Expense Polling Expense Travel In District
Consulting
GifVAwards/Memonals Expense Printing Expense Travel Out Of District
ContributionsfDonatbns Made By
Candidate/Officeholder/Political 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.
I Total pages Schedule G:
2 FILER NAME 3 Filer ID (Ethics Commission Filers)
4 Date
5 Payee name
6 Amount ($)
7 Payee address; City; State; Zip Code
—1-0,60
❑Reimbursement from
political contributions
intended
8
(a) Category (See Categories listed at the top of this schedule)
(b) Description
PURPOSE
Check if travel outside of Texas. Complete Schedule T.
OF
EXPENDITURE
❑ Check if Austin, TX, officeholder living expense
9 Complete ONLY if direct Candidate / Officeholder name Office sought Office held
expenditure to benefit C/OH
Date
Payee name
Amount ($)
Payee address; City; State; Zip Code
❑Reimbursementfrom
political contributions
intended
Category (See Categories listed at the top of this schedule)
(b) Description
PURPOSE
❑ Check it 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
Date
Payee name
Payee address; City; State; Zip Code
Amount ($)
Reimbursement from
❑
political contributions
intended
Category (See Categories listed at the top of this schedule)
(b) Description
PURPOSE
❑ Check if travel outside of Texas. Complete Schedule T.
OF
Check if Austin. TX, officeholder living expense
EXPENDITURE
Complete ONLY it direct Candidate / Officeholder name Office sought Office held
expenditure to benefit C/OH
ATTACH ADDITIONAL COPIES OF THIS SCHEDULE AS NEEDED
Rn.,iacrL a/R/�nt5
Forms provided by Texas Ethics Commission www.etnfcs.state.uk.us
PAYMENT MADE FROM POLITICAL
CONTRIBUTIONS TO A BUSINESS OF C/OH SCHEDULE H
EXPENDITURE CATEGORIES FOR BOX 8(a)
Advertising Expense Event Expense Loan Repayment/Reintbursernent Solicitation/Fundratsing Expense
Accounting/Banking Fees Office Overhead/Rentai Expense Transportation Equipment & Related Expense
Consulting Expense Food/Beverage Expense Polling Expense Travel in District
Contributions/Donations Made By Gift/Awards/Memorials Expense Printing Expense Travel Out Of District
Candidate/Officeholder/Political Committee Legal Services Salanes/Wages/Contract Labor Other (enter a category not listed above)
Credit Card Payment
The Instruction Guide explains how to complete this form.
1 Total pages Schedule H:
2 FILER NAMih,,,,, A n �`� k
G_{J,,
3 Filer ID (Ethics Commission Filers)
trate
4 Date
5 Business name
6 Amount ($)
7 Business address; City; State; Zip Code
8
(a) Category (See Categories listed at the top of this schedule)
(b) Description
PURPOSE
❑ Check if travel outside of Texas. Complete Schedule T.
OF
EXPENDITURE
❑ Check if Austin, TX, officeholder living expense
g Complete ONLY if direct Candidate / Officeholder name Office sought Office held
expenditure to benefit C/OH
Date
Business name
Amount ($)
Business address; City; State; Zip Code
Category (See Categories listed at the top of this schedule)
Description
❑
PURPOSE
Check if travel outside of Texas. Complete Schedule T.
OF
Check if Austin, TX, officeholder living expense
EXPENDITURE
Complete ONLY if direct Candidate / Officeholder name Office sought Office held
expenditure to benefit C/OH
Date
Business name
Amount ($)
Business address; City; State; Zip Code
Category (See Categories listed at the top of this schedule)
Description
❑ Check if travel outside of Texas. Complete Schedule T.
PURPOSE
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 Hevlsea 9/8/2UiS
NON -POLITICAL EXPENDITURES
MADE FROM POLITICAL CONTRIBUTIONS SCHEDULE
The Instruction Guide explains how to complete this form.
I Total page Schedule I.
2 FILER NAME
3 Filer ID (Ethics Commission Filers)
P"
4 Date
5 Payee name
6 Amount ($)
7 Payee address; City; State; Zip Code
8
(a)Category (See instructions for examples of acceptable
(b)Description (See instructions regarding type of information
PURPOSE
categories.)
required.)
OF
EXPENDITURE
Date
Payee name
Amount ($)
Payee address; City; State; Zip Code
Category (See instructions for examples of acceptable
Description (See instructions regarding type of information
PURPOSE
categories.)
required.)
OF
EXPENDITURE
Date
Payee name
Amount ($)
Payee address; City; State; Zip Code
Category (See instructions for examples of acceptable
Description (See instructions regarding type of information
PURPOSE
categories.)
required.)
OF
EXPENDITURE
Date
Payee name
Amount ($)
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
ATTACH ADDITIONAL COPIES OF THIS SCHEDULE AS NEEDED
Forms provided by Texas Ethics Commission www.ethlcs.state.tx.us ^cvibtru D10 V
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:
2 FILER NAME Nut V, (31,�t �,
3 Filer ID (Ethics Commission Filers)
4 Date
5 Name of person from whom amount is received
. . . . . . . . . . . . . . . . . . . . . . . . . .
6 Address of person from whom amount is received;
. . . .
City;
. . . . . . . . . . . . . .
State; Zip Code
8 Amount ($)
7 Purpose for which amount is received
F --j
Check if political contribution returned to filer
Date
Name of person from whom amount is received
. . . . . . . . . . . . . . . . . . . . . . . . . .
Address of person from whom amount is received;
. . . .
City;
. . . . . . . . . . . . . .
State; Zip Code
Amount ($}
Purpose for which amount is received
Check if political contribution returned to filer
Date
Name of person from whom amount is received
. . . . . . . . . . . . . . . . . . . . . . . . . .
Address of person from whom amount is received;
. . . .
City;
. . . . . . . . . . . . . .
State; Zip Code
Amount ($)
Purpose for which amount is received
F-]
Check if political contribution returned to filer
Date
Name of person from whom amount is received
. . . . . . . . . . . . . . . . . . . . . . . . . .
Address of person from whom amount is received;
. . . .
City;
. . . . . . . . . . . . . .
State; Zip Code
Amount ($)
Purpose for which amount is received
F-�
Check if political contribution returned to filer
ATTACH ADDITIONAL COPIES OF THIS SCHEDULE AS NEEDED
Forms provided by Texas Ethics Commission www. 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: PIt
2 FILER NAMEJ%W _ /• _ , t
3 Filer ID (Ethics Commission Filers)
4 Name of Contributor / Corporation or Labor Organization / Pledgor / Payee
5 Contribution / Expenditure reported on:
❑ Schedule A2 ❑ Schedule B ❑ Schedule B(J) ❑ Schedule C2 ❑ Schedule D ❑ Schedule Ft
❑ Schedule F2 ❑ Schedule F4 ❑ Schedule G ❑ Schedule H ❑ Schedule COH-UC ❑ Schedule B -SS
6 Dates of travel
7 Name of person(s) traveling
8 Departure city or name of departure location
9 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:
❑ Schedule A2 ❑ Schedule B ❑ Schedule B(J)❑Schedule C2 [ISchedule D ❑ Schedule F1
❑Schedule F2 ❑ Schedule F4 ❑ Schedule G ❑ Schedule H ❑ Schedule COH-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
Means of transportation
7
Purpose of travel (including name of conference, seminar, or other event)
-
Name of Contributor / Corporation or Labor Organization / Pledgor / Payee
Contribution / Expenditure reported on:
❑ Schedule A2 ❑ Schedule B ❑ Schedule B(J) ❑ Schedule C2 ❑ Schedule D ❑ Schedule F1
❑Schedule F2 ❑ Schedule F4 ❑ Schedule G ❑ Schedule H ❑ Schedule COH-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
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