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Dharia, Amit-COH 2021-04-23CANDIDATE / 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/ MS / MRS / R FIRST MI OFFICEHOLDER l� �� k (� M - OFFICE USE ONLY NAME . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Date Received NICKNAME LAST SUFFIX H-011 p H" I Ilk *L0 4 CANDIDATE/ ADDRESS / PO BOX; APT /SUITE #; CITY; STATE; ZIP CODE OFFICEHOLDER MAILING c� / 38 + 6y A 0 Pi M p� �L r k 7 S� 9 r (,i'2 •� I/� ADDRESS 1 ❑ Change of Address 5 CANDIDATE/ AREA CODE PHONE NUMBER EXTENSION FFI Y - I YZ \ 9 ( Q S I Date Hand-delivered or Date Postmarked EHOLDER PHO 6 CAMPAIGN s1 / MR FIRST MI Receipt # Amoun[ $ TREASURER Xt-i-n k<UM a K N - Date Processed NAME . . . . . . NICKNAME LAST SUFFIX DI n l\ Date Imaged 7 CAMPAIGN STREET ADDRESS (NO PO BOX PLEASE); APT/ SUITE #; CITY; STATE; ZIP CODE TREASURER /LAA H AM Dp • CYPCt- 1 k �V ADDRESS (Residence or Business) 8 CAMPAIGN AREA CODE PHONE NUMBER EXTENSION TREASURER PHONE 9 REPORT TYPE January 15 30th day before election Runoff 15th day after campaign treasurer appointment July 15 (Officeholder Only) Exceeded $500 limit Final Report C/OH FR) ❑ 8th day before election (Attach - 10 PERIOD Month Day Year Month Day Year COVERED ©3 /j /2 0 THROUGH 11 ELECTION ELECTION DATE ELECTION TYPE Month Day Year ❑ Primary ❑ Runoff ❑ Qlberr,. -- - " 5 /(� 1 /� 02� General ❑ Description Special 12 OFFICE. OFFICE HELD (if any) 13 OFFICE SOUGHT (if known) / >N -LL CIO NC �-L � o� Pc 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 14 C/OH NAME 15 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 OFFICEHOLDER'S COMMITTEE(S) KNOWLEDGE OR CONSENT. CANDIDATES AND OFFICEHOLDERS ARE REQUIRED TO REPORT THIS INFORMATION ONLY IF THEY RECEIVE NOTICE OF SUCH EXPENDITURES. "comm H TEE TYPE COMMITTEE NAME .F1 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 G (OTHER THAN PLEDGES, LOANS, OR GUARANTEES OF LOANS) EXPENDITURE TOTALSUNLESS 3. TOTAL POLITICAL EXPENDITURES OF $100 OR LESS, ITEMIZED 4. TOTAL POLITICAL EXPENDITURES $ CONTRIBUTION 5. TOTAL POLITICAL CONTRIBUTIONS MAINTAINED AS OF THE LAST DAYBALANC $ d 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 ♦♦�,PY PI'S/i ASHLEY M. OWENS under Title 15, Election Code. r:° �: Notary Public, State of Texas �+ Comm. Expires 02-24-202311 ''n,°;,,o♦♦ Notary ID 130128128 1 Signature of Candidate or Officeholder AFFIX NOTARY STAMP/ SEALABOVE Aim Sworn to and subscribed before me, by the said this the J da of20_a_, to certify which, witnes my hand and seal of office. Ss AA s Signature of offic administering oath Printed name 4 officer administering oath Title of kicer administering th Forms provided by Texas Ethics Commission www.ethics.state.tx.us Revised 9/8/2015 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 1• SCHEDULE Al: MONETARY POLITICAL CONTRIBUTIONS $ O 2• SCHEDULE A2: NON -MONETARY (IN-KIND) POLITICAL CONTRIBUTIONS $ 0 3. SCHEDULE B: PLEDGED CONTRIBUTIONS $ t`J 4. El SCHEDULE E: LOANS $ 5. SCHEDULE F1: POLITICAL EXPENDITURES MADE FROM POLITICAL CONTRIBUTIONS $0 6• SCHEDULE F2: UNPAID INCURRED OBLIGATIONS $ V 7• SCHEDULE F3: PURCHASE OF INVESTMENTS MADE FROM POLITICAL CONTRIBUTIONS $ d,l 8. El SCHEDULE F4: EXPENDITURES MADE BY CREDIT CARD $ V 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 I: 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 MONETARY POLITICAL CONTRIBUTIONS SCHEDULE Al The Instruction Guide explains how to complete this form. 1 Total pages Schedule Al: 1 2 FILER NAME Ar ��� Dh R � ► � 3 Filer ID (Ethics Commission Filers) 4 Date 5 Full name of contributor ❑ out-of-state PAC (ID#: I 7 Amount of contribution ($) tJ / A— . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 6 Contributor address; City; State; Zip Code 8 Principal occupation / Job title (See Instructions) g Employer (See Instructions) Date Full name of contributor ❑ out-of-state PAC (ID#: Amount of contribution ($) lam' U Contributor address; City; State; Zip Code Principal occupation / Job title (See Instructions) Employer (See Instructions) Date Full name of contributor❑ out-of-state PAC (ID#: ) Amount of contribution ($) ^ n / v � ►T� . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Contributor address; City; State; Zip Code Principal occupation / Job title (See Instructions) Employer (See Instructions) Date Full name of contributor/ ❑ out-ot-state PAC (ID#: 1 Amount of contribution ($) 1"` (4. . . . . . . . . . . . . . . . . . . v 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 NON—MONETARY (IN—KIND) POLITICAL CONTRIBUTIONS SCHEDULE A2 The Instruction Guide explains how to complete this form. 1 Total pages Schedule A2: c 2 FILER NAME ( ?l \ D H A- R -44- 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#: I 8 Amount of 9 In-kind contribution Contribution $ description 7 Contributor address; City; State; Zip Code ❑ 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) f i / V 12 Contributor's principal occupation (FOR JUDICIAL) 13 Contributor's job title (FOR JUDICIAL) (See Instructions) ] f`i / 14 Contributor's employer/law firm (FOR JUDICIAL) 15 Law firm of contributor's spouse (if any) (FOR JUDICIAL) rj ) X 16 If contributor is a child, law firm of parent(s) (if any)(FORJUDICIAL) Date Full name of contributor ❑ out -of -slate PAC (ID#: ) Amount of In-kind contribution Contribution $ description aJ J r�- Cont ributor address; City; State; Zip Code iJ ' �- D Check if travel outside of Texas. Complete Schedule T. Principal occupation / Job title (FOR NON -JUDICIAL) (See Instructions) Employer (FOR NON-JUDICIAL)(See Instructions) W, / k Contributor's principal occupation (FOR JUDICIAL) 14 I A-- Contributor's job title (FOR JUDICIAL) (See Instructions) Contributor's employer/law firm (FOR JUDICIAL) tN I A Law firm of contributor's spouse (if any) (FOR JUDICIAL) If contributor is a child, law firm of parent(s) (if any) (FOR JUDICIAL) N 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 PLEDGED CONTRIBUTIONS SCHEDULE B The Instruction Guide explains how to complete this form. 1 Total pages I hedule B: 2 FILER NAME Am 3-1 b m n (4- 3 Filer ID (Ethics Commission Filers) 4 TOTAL OF UNITEMIZED PLEDGES 5 Date 6 Full name of pledgor ❑ out-of-state PAC (ID#: 1 8 Amount 9 In-kind contribution f of Pledge $ description . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 7 Pledgor address; City; State; Zip Code U ❑ 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#: Amount In-kind contribution of Pledge $ description �.I.d- .................... 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 Full name of pledgor F-1 out-of-state PAC (ID#: I Amount of In-kind contribution Pledge $ description .(.A. . . . . . . . . . . . . . . . . . . . Pledgor address; City; State; Zip Code Q [:]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 addrss- City; State; Zip Code �► t Jj v ❑ 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. Forms provided by Texas Ethics Commission www.ethics.state.tx.us Revised 9/8/2015 LOANS SCHEDULE E The Instruction Guide explains how to complete this form. 1 Total pages Schedule E: 2 FILER NAME 3 Filer ID (Ethics Commission Filers) 4 TOTAL OF UNITEMIZED LOANS s —1 !�-o 5 Date of loan 7 Name of lender ❑ out-of-state PAC (IDs: ) 9 Loan Amount ($) A -m `( i -D )-i A R P, ...................................... 8 Lender address; City; State; Zip Code 6 Is lender 10 Interest rate a financial Institution? 11 Maturity date Y N 12 Principal occupation / Job title (See Instructions) 13 Employer (See Instructions) j� �7,�n ert r,( p 0 n keo, -'-C rt r� Yn ; 14 Description of Collateral 15 Check if personal funds were deposited into political "'none account (See Instructions) rD— 16 GUARANTOR 17 Name of guarantor 19 Amount Guaranteed ($) INFORMATION 18 Guarantor address; City; State; Zip Code ❑ not applicable 20 Principal Occupation (See Instructions) 21 Employer (See Instructions) ri I A - Date of loan Name of lender ❑ out-of-state PAC (IDs: ) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Lender address; City; State; Zip Code Loan Amount ($) Is lender Interest rate a financial Institution? r Q Tom' Maturity date Y N Principal occupation / Job title (See Instructions) Employer (See Instructions) Description of Collateral Check if personal funds were deposited into political account (See Instructions) ❑ none ❑ GUARANTOR Name of guarantor Amount Guaranteed ($) 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 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 9/8/2015 -C . POLITICAL EXPENDITURES MADE FROM POLITICAL CONTRIBUTIONS SCHEDULE F1 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 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 FILER NAME 3 Filer ID (Ethics Commission Filers) 4 Date 5 Payee name 6 Amount ($) 7 Payee address; City; State; Zip Code V 8 (a) Category (See Categories listed at the top of this schedule) (b) Description PURPOSE ❑ Check if travel outside of Texas. Complete Schedule T. OF r�' I _ ❑ Check if Austin, TX, officeholder living expense EXPENDITURE 9 Complete ONLY if direct Candidate / Officeholder name Office sought Office held expenditure to benefit C/OH Date Payee name Amount ($) Payee address; City; State; Zip Code G 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 ❑ 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 Revised 9/8/2015 Forms provided by Texas Ethics Commission www.ethics.state.tx.us Revised 9/8/2015 UNPAID INCURRED OBLIGATIONS SCHEDULE F2 EXPENDITURE CATEGORIES FOR BOX 10(a) Advertising Expense Event Expense Loan Repayment/Reimbursement Solicitation/Fundraising Expense Aocounting/Banking Fees Office Overhead/Rental Expense Transportation Equipment 8 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 �- 3 Filer ID (Ethics Commission Filers) 4 TOTAL OF UNITEMIZED UNPAID INCURRED OBLIGATIONS $ 0 5 Date 6 Payee name N A- 7 Amount ($) a City; State; Zip Code Payee address;._ t Imo' 9 TYPE OF EXPENDITURE ❑ Political ❑ Non -Political 10 (a) Category (See Categories listed at the top of this schedule) (b) Description PURPOSE ❑ Check if travel outside of Texas. Complete Schedule T. OF EXPENDITURE ❑Check if Austin, TX, officeholder living expense / 11 Complete ONLY if direct Candidate / Officeholder name Office sought Office held expenditure to benefit C/OH Date Payee name Amount ($) Payee address; City; State; Zip Code /\ aI TYPE OF EXPENDITURE F-1 Political ❑ Non Political Category (See Categories listed at the top of this schedule) Description PURPOSED 1 V Check if travel outside of Texas. Complete Schedule T. OF I ❑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 PURCHASE OF INVESTMENTS MADE FROM POLITICAL CONTRIBUTIONS SCHEDULE F3 1 Total pages Schedule F3: The Instruction Guide explains how to complete this form. 1 -T D" A P, 1 2 FILER NAME JV 3 Filer ID (Ethics Commission Filers) 4 Date 5 Name of person from whom investment is purchased 0 ) A-- . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 6 Address of person from whom investment is purchased; City; State; Zip Code "i i A-- 7 Description of investment f` I 1l� 8 Amount of investment ($) Date Name of person from whom investment is purchased � 1 (� . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Address of person from whom investment is purchased; City; State; Zip Code Description of investment r' Amount of investment ($) ATTACH ADDITIONAL COPIES OF THIS SCHEDULE AS NEEDED Forms provided by Texas Ethics Commission www.ethics.state.tx.us Revised 9/8/2015 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 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 F4: 2 FILER NAME 3 Filer ID (Ethics Commission Filers) 1 gwi'l T D 1-+8 T A- 4 TOTAL OF UNITEMIZED EXPENDITURES CHARGED TO A CREDIT CARD $ 5 Date 6 Payee name 7 Amount ($) a Payee address; City; State; Zip Code 9 TYPE OF EXPENDITURE ❑ Political El Non -Political 10 (a) Category (See Categories listed at the top of this schedule) (b) Description PURPOSE " ) — Check if travel outside of Texas. Complete Schedule T. OF V EXPENDITURE ❑Check if Austin, TX, officeholder living expense 11 Complete ONLY if direct Candidate / Officeholder name Office sought Office held expenditure to benefit C/OH Date Payee name Amount ($) Payee address; City; State; Zip Code TYPE OF EXPENDITURE Political r Non -Political 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 P I Q 11 Office held expenditure to benefit C/OH f1r1-I1 P htQr- to Cal.kNCl- � �( F_ 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 Event Expense Loan Repayment/Reimbursement Solicitation/Fundraising Expense Aocounting/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 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 Filers) 3 -films JkAa- D�ik-,A-1A- 4 Date .,I (g(ztjz 5 Payee name .Q�fSl 6 Amount ($) 7 Payee address; City; State; Zip Code o. 2-0 Sl^�e -, (✓Jc �l �G r►� , h z -L' V1 , S LJy yy-),G-y.) ❑Reimbursement from political contributions intended 8 (a) Category (See Categories listed at the top of this schedule) (b) Description PURPOSE OF Check if travel outside of Texas. Complete Schedule T. EXPENDITURE ❑ Check if Austin, TX, officeholder living expense 9 Complete ONLY if direct Candidate / Officeholder name Office sought Office held expenditure to benefit C/OH 1_ _ �� (3 bil �r�oe�i Gawx'c+l N � Date Payee name Amount ($) Payee address; City; State; Zip Code 26 3s0 GYw P E 2c) ,7X ❑Reimbursement from political contributions intended Category (See Categories listed at the top of this schedule) (b) Description PURPOSE OF Check if travel outside of Texas. Complete Schedule 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 �vLt T 1D r1uZ ACar,vc� L- cy: u tJ c L L P `( Date Payee name Amount ($) Payee address; City; State; Zip Code A�; 313 ❑Reimbursement from political contributions intended Category (See Categories listed at the top of this schedule) (b) Description PURPOSE OF ❑ Check if travel outside of Texas. Complete Schedule T. ifr El Check it Austin, TX, officeholder living expense Complete ONLY if direct Candidate / Officeholder name Office sought Office held expenditure to benefit C/OH fT jp 10 LlU (� ���i..L C.,1 r� C� 1�— �A' -11 ATTACH ADDITIONAL COPIES OF THIS SCHEDULE AS NEEDED Forms provided by Texas Ethics Commission www.ethics.state.tx.us Revised 9/8/2015 POLITICAL EXPENDITURES MADE FROM PERSONAL-FUNDS SCHEDULE G EXPENDITURE CATEGORIES FOR BOX 8(a) Advertising Expense Event Expense Loan Repayment/Reimbursement Solicitation/Fundraising Expense Accounting/Banking Fees Office Overhead/Rental Expense Transportation Equipment & Related Expense Consulting Expense Food/Beverage Expense Polling Expense Travel In District Contributions/Donations Made By GifVAWards/Memorials Expense Printing Expense Travel Out Of District Candidate/Officeholder/Political Committee Legal Services Salaries/Wages/Contract Labor Other (enter a category not listed above) Credit Card Payment - The Instruction Guide explains how to complete this form. 1 Total pages Schedule G: 2 FILER NAME 3 Filer ID (Ethics Commission Filers) 3 AA kT 4 Date 5 Payee name y( 11 ( .X o z A C r p e--k k- Ctn r) Y, I'C � 6 Amount ($) 7 Payee address; City; State; Zip Code v ❑Reimbuementfrom political crsontributions 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. OFj' EXPENDITURE !, / C 1 C-- � � 5 t � � I M ❑ 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 '4(-112021 Payee name �wlA'_� Amount ($) Payee address; City; State; Zip Code _Zp d3❑ G, Ii"IP �. C ,,o lipcU , -T X / Reimbursement from / political contributions intended Category (See Categories listed at the top of this schedule) (b) Description PURPOSE OF �G iltravel outside olTexas. Complete ScheduleT. leT.(�IICi' EXPENDITURE va)❑Check 1-1��'� ❑Check it Austin. TX, officeholder living expense Complete ONLY if direct Candidate / Officeholder name Office sought Office held expenditure to benefit C/OH Date Payee name Z4 1 (9 (20L'( 'Efc�..�O'^���3 Amount ($) Payee address; City; State; Zip Code -1- "1 y � D 6 fA I6,spe l(, TK from Elpolitical political contributions DerY,� G�j intended i Category (See Categories listed at the top of this schedule) (b) Description PURPOSE OF �� f ❑ Check if travel outside of Texas. Complete Schedule T. EXPENDITURE EXPENDITURE Fc- ( ❑ Check if Austin, TX, officeholder living expense Complete ONLY if direct Candidate /Officeholder name Office sought o U h rt ( Co p (q Office held expenditure to benefit C/OH 11K4 Hf3oe hhA/f-IA- r(oe e 4 (, 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 Event Expense Loan RepaymenVReimtwrsement 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 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 Filers) 4 Date 14f 11Li 5 Payee name �- A C- 6 6 Amount ($) 7 Payee address; City; State; Zip Code ❑limbursement from political contributions intended 8 (a) Category (See Categories listed at the top of this schedule) (b) Description PURPOSE ❑ Check it travel outside of Texas. Complete Schedule T. OF EXPENDITURE 1n Y-' n ` r ❑ Check if Austin. TX, officeholder living expense 9 Complete ONLY if direct Candidate / Officeholder name Office sought Office held expenditure to benefit C/OH �t °� I—� '-'jV� I.J H1 �'12 I Date Payee name 11 t0 JXOZ( Amount ($) Payee address; City; State,;; Zip Code J_LA L1 UG-��(� C V� A� n l x -7 ❑Reimbursement from political contributions . V intended Category (See Categories listed at the top of this schedule) (b) Description PURPOSE ❑ Check if travel outside of Texas. Complete Schedule T. OF EXPENDITURE �� ❑ living Check it Austin. TX, officeholder expense Complete ONLY if direct Candidate / Officeholder name Office sought Office held expenditure to benefit C/OH A r` i P,� R li l F+ Date Payee name L_ Amount ($) Payee address; City; State; Zip Code b u ``1' I t� t �� V 0.� 3 ❑Reimbursementtrom ` political contributions intended Category (See Categories listed at the top of this schedule) (b) Description PURPOSE OF 6I (;' ❑ Check if travel outside of Texas. Complete Schedule T. EXPENDITURE f 0 j � ❑ Check if Austin, TX, officeholder living expense Complete ONLY if direct Candidate / Officeholder name Office sought Office held expenditure to benefit C/OH ATTACH ADDITIONAL COPIES OF THIS SCHEDULE AS NEEDED Forms provided by Texas Ethics Commission www.ethics.state.tx.us Revised 9/8/2015 POLITICAL EXPENDITURES MADE FROM PERSONAL FUNDS SCHEDULE G EXPENDITURE CATEGORIES FOR BOX 8(a) Advertising Expense Event Expense Loan Repayment/Reimbursement Solicitation/Fundraising Expense Accounting/Banking Fees Office Overhead/Rental Expense Transportation Equipment 8 Related Expense Consulting Expense FoodBeverage Expense Polling Expense Travel In District Contributions/Donations Made By Gift/Awards/Memorials Expense Printing Expense Travel Out Of District Candidate/Officeholder/Political Committee Legal Services Salaries/Wages/Contract Labor Other (enter a category not listed above) Credit Card Payment The Instruction Guide explains how to complete this form. 1 Total pages Schedule G: 2 FILER NAME 3 Filer ID (Ethics Commission Filers) iA A�I�� 4 Date 5 Payee name c� 4( a o 12- C� 1 A -V -V1 G-tC)' 1 6 Amount ($) 7 Payee address; City; State; Zip Code ❑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 '` V 1,��� ❑ 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 ($) Payee address; City; State; Zip Code ❑Reimbursement from political contributions intended Category (See Categories listed at the top of this schedule) (b) Description PURPOSE OF EXPENDITURE C�� Check if travel outside of Texas. Complete Schedule T. ❑ Check if Austin, TX, officeholder living expense Complete ONLY if direct Candidate / Officeholder name Office sought Office held expenditure to benefit C/OH Date (1 A .I-d-L Payee name T) -'t1 C4 ?A eAS Amount ($q) Payee address; City; State; Zip Code 12 ❑Reimbursement from political contributions intended Category (See Categories listed at the top of this schedule) (b) Description PURPOSE A ❑Check Texas. Complete Schedule T. OF n ^ it travel outside 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.ethics.state.tx.us Revised 9/8/2415 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/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 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 H: 2 FILER NAME 3 Filer ID (Ethics Commission Filers) 5 4 Date 5 Business name 6 Amount ($) 7 Business address; City; State; Zip Code r-� I+ A 8 (a) Category (See Categories listed at the top of this schedule) (b) Description PURPOSE ❑ Check if travel outside of Texas. Complete Schedule T. OF �f Iva, ❑ Check if Austin, TX, officeholder living expense EXPENDITURE to 9 Complete ONLY if direct Candidate / Officeholder name Office sought Office held expenditure to benefit C/OH Date Business name Amount ($) Business address; City; State; Zip Code 0 / P -- Category (See Categories listed at the top of this schedule) Description PURPOSE ❑ Check if travel outside of Texas. Complete Schedule T. OF EXPENDITURE .,,`1 ( ! (t �f ff ❑Check it Austin, TX, officeholder living expense Complete ONLY if direct Candidate / Officeholder name Office sought Office held expenditure to benefit C/OH Date Business name V Amount ($) Business address; City; Zip Code �ySt(rate;; Ov !- Category (See Categories listed at the top of this schedule) Description ❑ Check if travel outside of Texas. Complete Schedule T. PURPOSE OF ❑ EXPENDITURE I- Check if Austin, TX, officeholder living expense Complete ONLY if direct Candidate / Officeholder name Office sought Office held expenditure to benefit C/OH ATTACH ADDITIONAL COPIES OF THIS SCHEDULE AS NEEDED Forms provided by Texas Ethics Commission www.ethics.state.tx.us Revised 9/8/2015 NON-POLITICAL EXPENDITURES MADE FROM POLITICAL CONTRIBUTIONS SCHEDULE The Instruction Guide explains how to complete this form. 1 Total pages Schedule I: 2 FILER NAME 3 Filer ID (Ethics Commission Filers) 1 pf-MT1 1)HA,-I,a 4 Date 5 Payee name 0 6 Amount ($) 7 Payee address; City; State; Zip Code 0 1 @- 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 I I Amount ($) Payee address; City; State; Zip Code v4 rA. PURPOSE Category (See instructions for examples of acceptable Description (See instructions regarding type of information OF categories.) required.) EXPENDITURE Date Payee name Amount ($) Payee address; City; State; Zip Code IN r+ PURPOSE Category (See instructions for examples of acceptable Description (See instructions regarding type of information OF categories.) required.) EXPENDITURE Date Payee name Amount ($) Payee address; City; State; Zip (Cod/en PURPOSE Category (See instructions for examples of acceptable Description (See instructions regarding type of information OF EXPENDITURE categories.) required.) / ATTACH ADDITIONAL COPIES OF THIS SCHEDULE AS NEEDED Forms provided by Texas Ethics Commission www. ethics. state.tx.us Revised 9/8/2015 INTEREST, CREDITS, GAINS, REFUNDS, AND CONTRIBUTIONS RETURNED TO FILER SCHEDULE K The Instruction Guide explains how to complete this form. 1 Total pages Schedule K: 1 2 FILER NAME DHi _A (-VP, 3 Filer ID (Ethics Commission Filers) 4 Date 5 Name of person from whom amount is received 8 Amount ($) 0 1 >- . . . . . . . . . . . . . . . . . . . . . . . . . . 6 Address of person from whom amount is received; . . . . City; . . . . . . . . . . . . . . State; Zip Code U 1-1 01-), 7 Purpose for which amount is received F—] Check if political contribution returned to filer Date Name of person from whom amount is received Amount ($) . . . . . . . . . . . . . 1 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Address of person from whom amount is received; City; State; Zip Code U Y" 1 P, Purpose for which amount is received ❑ Check if political contribution returned to filer Date Name of person from whom amount is received Amount ($) � I � V ............................................ Address of person from whom amount is received; I City; State; Zip Code Purpose for which amount is received F—] Check if political contribution returned to filer Date Name of person from whom amount is received Amount ($) K' 1A ............................................ v 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 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: 2 FILER NAME 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 F1 ❑ Schedule F2 ❑ Schedule F4 ❑ Schedule G ❑ Schedule H ❑ Schedule COH-UC ❑ Schedule B -SS 6 Dates of travel 7 Name of person(s) traveling r' 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) r4 ` t -`- 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 COWLIC ❑ Schedule B -SS Dates of travel Name of person(s) traveling Departure city or name of departure location Uv / Destination city or name of destination location Means of transportation 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 COWLIC ❑ Schedule B SS Dates of travel Name of person(s) traveling 1_ 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 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 NAMES x T K U �'i p` _ p N j 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 file. /on Signature of Candidate / Officeholder 4 FILER WHO IS NOT AN OFFICEHOLDER •• Complete A& B below only if you are not an officeholder. -- A- CAMPAIGN FUNDS Check only one: 0'. I do not have unexpended contributions or unexpended interest or income earned from political contributions. F-1 I have unexpended contributions or unexpended interest or income earned from political contributions. I understand that I may not convert unexpended political contributions or unexpended interest or income earned on political contributions to personal use. I also understand that I must file an annual report of unexpended contributions and that I may not retain unexpended contributions or unexpended interest or income earned on political contributions longer than six years after filing this final report. Further, I understand that I must dispose of unexpended political contributions and unexpended interest or income earned on political contributions in accordance with the requirements of Election Code, § 254.204. B. ASSETS Check only one: E:2' I do not retain assets purchased with political contributions or interest or other income from political contributions. 0 I do retain assets purchased with political contributions or interest or other income from political contributions. I understand that I may not convert assets purchased with political contributions or interest or other income from political contributions to personal use. I also understand that I must dispose of assets purchased with political contributions in accordance with the requirements of Election Code, § 254.204. ` Signature of Candidate 5 OFFICEHOLDER •• Complete this section only if you are an officeholder •- [� I am aware that I remain subject to filing requirements applicable to an officeholder who does not have a campaign treasurer on file. I am also aware that I will be required to file reports of unexpended contributions if, after filing the last required report as an officeholder, I retain political contributions, interest or other income from political contributions, or assets purchased with politi- 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 Forms provided by Texas Ethics Commission www. ethics. state. tx.us Revised 6/5/2019 FORM SECURITY FOR: CAMPAIGN FINANCE FORM SECURITY- CF (Texas Ethics Commission Filers Only) Please print or type everything other than your signature. See the next page for OFFICE USE ONLY additional information. Date Received 1 FILER ID # (Ethics Commission Filers) 2 NAME OF FILER [vY Mr Mrs Ms SUBMITTING PRIMARY EMAILADDRESS APA i{ kQw6ra- 3 COMMITTEE NAME (if committee) N /A 4 REASON FORI —i/I want to provide my primary email address for the Texas Ethics 1 Date Hand -delivered or Date Postmarked FILING THIS FORM l Commission to send email password links and other notices. (check at least one) Date Processed F-1 I want the Texas Ethics Commission to set/reset my password. ❑ I want the Texas Ethics Commission to clear my Security Questions Date Imaged and Answers. 4A PRIMARY EMAIL ADDRESS -_ ` N y Q w� Ad h a h^Q.@arSYn 1 „ _1 5 FILER CONTACT AREA CODE PHONE NUMBER EXTENSION TELEPHONE (to be used if email —y (� �Z) - O S 1 6 address is invalid) 6 CAMPAIGN FINANCE FILER TYPE GOH CANDIDATE/OFFICEHOLDER ❑ CEC COUNTY EXECUTIVE COMMITTEE ❑ JC/OH JUDICIALCANDIDATE/OFFICEHOLDER ❑ MCEC MONTHLYCOUNTYEXECUIIVECOMMITTEE ❑ SCC/OH STATE/COUNTYCHAIR ❑ DCE DIRECTCAMPAIGNEXPENDIIURES ❑ MPAC MONTHLY GENERAL-PURPOSE ❑ ASIF SPAC AS IF -SPECIFIC -PURPOSE COMMITTEE COMMITTEE ❑ GPAC GENERAL-PURPOSE COMMITTEE ❑ LEG LEGISLATIVE CAUCUS ❑ JSPAC JUDICIAL SPECIFIC -PURPOSE COMMITTEE ❑ PTYCORP POLITICAL PARTY ❑ SC SPAC STATE/COUNTY SPECIFIC -PURPOSE ❑ SPK SPEAKER COMMITTEE ❑ SPAC SPECIFIC -PURPOSE COMMITTEE ❑ SPAC FILING FOR SCHOOL BOND ELECTIONS ONLY. Attach a copy of your treasurer appointment stamped by your school district. 7 FILER SIGNATURE I swear, or affirm, under penalty of perjury, that I am the person required by law under the Texas Ethics Commission jurisdiction to file Campaign Finance reports with the Texas Ethics Commission. This document is my official submission of a primary email address for the purpose of receiving a password link to be used to file electronic reports with the Texas Ethics Commission. A Signature Forms provided by Texas Ethics Commission www. ethics. state. tx.us Revised 6/5/2019 SECURITY -CF: FOR TEXAS ETHICS COMMISSION FILERS When you first login to the new filing application, you will bed irected to change your password and to answer three security questions. A password is required for you to file reports electronically with the Texas Ethics Commission. The Texas Ethics Commission's electronic filing application uses your unique Filer ID and applicable filertype and password to digitally encrypt your electronic reports. All password links will be emailed to the filer's primary email address on file with the Texas Ethics Commission. If you forget your password, you can reset it by correctly answering the three security questions. When to use this form: If you are required to file reports with the Texas Ethics Commission, you may use this form for any of the following purposes: 1. You area new Texas Ethics Commission filer who has not been assigned a Filer ID by the Texas Ethics Commission. 2. You have not yet provided to the Texas Ethics Commission a valid primary email address. 3. You want the Texas Ethics Commission to reset your password. 4. You want to clear your Security Questions and Answers. 5. You are locked out of your account due to an email issue. Complete this form and return it by (1) email to (2) mail to the Texas Ethics Commission, P.O. Box 12070, Austin, TX 78711-2070, or (3) hand -delivery to 201 E. 14th St., Sam Houston Building, 10th Floor, Austin, Texas 78701. INSTRUCTIONS FOR COMPLETING THIS FORM The following numbers correspond to the numbered boxes on the other side. All fields are required unless otherwise noted. 1. Filer ID. Enter the Filer ID number assigned to you by the Texas Ethics Commission. If you have not yet been assigned a Filer ID, leave this blank. 2. NAME OF FILER SUBMITTING PRIMARY EMAIL ADDRESS. The person submitting the primary email address must be the candidate/officeholder, the campaign treasurer of a political committee, the chair of a political party, a caucus chair, a person filing as if they were the campaign treasurer of a political committee, ora speaker/speaker candidate. 3. COMMITTEE NAME. Enter the committee name if this request is for a committee. 4. REASON FOR FILING THIS FORM. Check the appropriate boxes to indicate the reason you are filing this form (you may check more than one). If you want to provide a primary email address, enter it in box 4A. 5. FILER CONTACT TELEPHONE. Enter the telephone number of the filer submitting the primary email address. The Texas Ethics Commission will use this telephone number to contact the filer in the event there is a transmission error with the email address provided. 6. CAMPAIGN FINANCE FILER TYPE. Check the filer type for which you are submitting your primary email address. 7. FILER SIGNATURE. Sign after reading the statement. Forms provided by Texas Ethics Commission www. ethics. state.tx.us Revised 6/5/2019