Bernstein, Davin-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 / MR FIRST MI
OFFICEHOLDER
OFFICE USE ONLY
NAME..........................aN.�
......................................
Date Received
NICKNAME LAST SUFFIX
�t�5�etr
4� � 5 5 fpm
4 CANDIDATE/
ADDRESS / PO BOX; APT / SUITE k: CITY; STATE; ZIP CODE
OFFICEHOLDER
PO Box 194MAILIN
ADDRESS
Coppell, TX 75019
Change of Address
5 CANDIDATE/
AREA CODE PHONE NUMBER EXTENSION
Date Hand-delivered or Date Postmarked
OFFICEHOLDER
(214 ) 717-1557
PHONE
Receipt #
Amount $
6 CAMPAIGN
MS / MRS / MR FIRST MI
TREASURER
Date Processed
NAME.................................................................................
NICKNAME LAST SUFFIX
Date Imaged
7 CAMPAIGN
STREET ADDRESS (NO PO BOX PLEASE); APT I SUITE #; CITY;
STATE; ZIP CODE
TREASURER
662 Cribbs Dr
ADDRESS
Coppell, TX 75019
(Residence or Business)
8 CAMPAIGN
AREA CODE PHONE NUMBER EXTENSION
TREASURER
PHONE
(469 ) 400-9287
9 REPORT TYPE
January 15 30th day before election Runoff
15th day after campaign
treasurer appointment
(Officeholder Only)
July 15 8th day before election Exceeded Modified
X I
Final Report (Attach C/OH - FR)
Reporting Limit
10 PERIOD
Month Day Year Month
Day Year
COVERED
3 / 23 / 21 THROUGH 4 /21 /21
11 ELECTION
ELECTION DATE
ELECTION TYPE
Month Day Year
Primary Runoff Other
Description
5 1 / 21
General ■ Special
12 OFFICE
OFFICE HELD (if any)
13 OFFICE SOUGHT (if known)
City Council Place 3
14 NOTICE FROM
THIS BOX IS FOR NOTICE OF POLITICAL CONTRIBUTIONS ACCEPTED OR POLITICAL EXPENDITURES MADE BY POLITICAL COMMITTEES TO SUPPORT
POLITICAL
THE CANDIDATE I OFFICEHOLDER. THESE EXPENDITURES MAY HAVE BEEN MADE WITHOUT THE CANDIDATE'S OR OFFICEHOLDER'S KNOWLEDGE OR
CONSENT. CANDIDATES AND OFFICEHOLDERS ARE REQUIRED TO REPORT THIS INFORMATION ONLY IF THEY
RECEIVE NOTICE OF SUCH EXPENDITURES.
COMMITTEE(S)
COMMITTEE TYPE
COMMITTEE NAME
GENERAL
COMMITTEE ADDRESS
Additional Pages
COMMITTEE CAMPAIGN TREASURER NAME
SPECIFIC
COMMITTEE CAMPAIGN TREASURER ADDRESS
GO TO PAGE 2
Forms provided by Texas Ethics Commission www. ethics. state.tx.us Revised 8/17/2020
CANDIDATE / OFFICEHOLDER FORM C/OH
CAMPAIGN FINANCE REPORT COVER SHEET PG 2
15 C/OH NAME 16 Filer ID (Ethics Commission Filers)
Davin Bernstein
17 CONTRIBUTION 1 1. TOTAL UNITEMIZED POLITICAL CONTRIBUTIONS (OTHER THAN
TOTALS PLEDGES LOANS OR GUARANTEES OF LOANS OR
..................
EXPENDITURE
TOTALS
CONTRIBUTION
BALANCE
..................
OUTSTANDING
LOAN TOTALS
CONTRIBUTIONS MADE ELECTRONICALLY)
2. TOTAL POLITICAL CONTRIBUTIONS
(OTHER THAN PLEDGES, LOANS, OR GUARANTEES OF LOANS)
3. TOTAL UNITEMIZED POLITICAL EXPENDITURE.
4. TOTAL POLITICAL EXPENDITURES
$ 0.00
$ 650.00
$ 10.05
$ 2,054.83
5. TOTAL POLITICAL CONTRIBUTIONS MAINTAINED AS OF THE LAST DAY $ 0.00
OF REPORTING PERIOD
6TOTAL
PRINCIPAL AMOUNT OF ALL
STANDING LOANS AS OF THE
AST DAYOFTHE REPORTING PERIOD $ 0.00
18 SIGNATURE 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.
Signature of eandidate or Officeholder
Please complete either option below:
ASHLEY M. OWENS
Notary Public, State of Texas
Comm. Expires 02-24-2023
(1)Affida t''�ir°;,���` Notary ID 130128128
NOTARY STAMP/ SEAL
Sworn to and subscribed before me by w�► P�S%1 this the day of
20 ` to cokfv which, witness my hand and seal of office. n V.
b-QI 1 *0 04 a 19 A ALZ
Signature of officer a inistering oath Printed name of officf r administering oath Tit f officer administering
(2) Unsworn Declaration
My name is _
My address is
Executed in
, and my date of birth is
(street) (city) (state) (zip code) (country)
County, State of on the day of 20
(month) (year)
Signature of Candidate/Officeholder (Declarant)
Forms provided by Texas Ethics Commission www.ethics.state.tx.us Revised 8/17/2020
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Forms provided by Texas Ethics Commission www.ethics.state.tx.us Revised 8/17/2020
SUBTOTALS
- C/OH FORM C/OH
COVER SHEET PG 3
19 FILER NAME
Davin Bernstein
20 Filer ID (Ethics Commission Filers)
21
SCHEDULE SUBTOTALS
NAME OF SCHEDULE
SUBTOTAL
AMOUNT
1.
0 SCHEDULEAI:
MONETARY POLITICAL CONTRIBUTIONS
$
650.00
2.
0 SCHEDULE A2:
NON -MONETARY (IN-KIND) POLITICAL CONTRIBUTIONS
$
70.36
3.
SCHEDULE B:
PLEDGED CONTRIBUTIONS
$
0,00
4.
SCHEDULE E:
LOANS
$
0.00
5•
SCHEDULE F1:
POLITICAL EXPENDITURES MADE FROM POLITICAL CONTRIBUTIONS
$
0,00
6.
SCHEDULE F2:
UNPAID INCURRED OBLIGATIONS
$
0,00
7•
SCHEDULE F3:
PURCHASE OF INVESTMENTS MADE FROM POLITICAL CONTRIBUTIONS
$
0.00
8.
SCHEDULE F4:
EXPENDITURES MADE BY CREDIT CARD
$
2,417.83
9•
SCHEDULE G:
POLITICAL EXPENDITURES MADE FROM PERSONAL FUNDS
$
363.00
10.
SCHEDULE H:
PAYMENT MADE FROM POLITICAL CONTRIBUTIONS TO A BUSINESS OF C/OH
$
0.00
11.
SCHEDULE 1: NON-POLITICAL EXPENDITURES MADE FROM POLITICAL CONTRIBUTIONS
$
0,00
12.
SCHEDULE K:
INTEREST, CREDITS, GAINS, REFUNDS, AND CONTRIBUTIONS RETURNED
TO FILER
$
0.00
Forms provided by Texas Ethics Commission www.ethics.state.tx.us Revised 8/17/2020
MONETARY POLITICAL CONTRIBUTIONS SCHEDULE Al
If the requested information is not applicable, DO NOT include this page in the report.
The Instruction Guide explains how to complete this form.
1 Total pages Schedule Al:
2 FILER NAME
3 Filer ID (Ethics Commission Filers)
Davin Bernstein
4 Date
5 Full name of contributor out-of-state PAC (ID#: )
7 Amount of contribution ($)
Jeff Varnell
03/30/2021
......................................................................
6 Contributor address; City; State; Zip Code
300.00
1601 E. Sandy Lake Rd, Coppell, TX 75019
8 Principal occupation / Job title (See Instructions)
g Employer (See Instructions)
Realtor
Self
Date
Full name of contributor out-of-state PAC (ID#: )
Amount of contribution ($)
Mike Wilcox
04/08/2021
..................................................................................
Contributor address; City; State; Zip Code
250.00
910 Mallard Dr, Coppell, TX 75019
Principal occupation / Job title (See Instructions)
Employer (See Instructions)
consultant
Date
Full name of contributor out-of-state PAC (ID#: )
Amount of contribution ($)
Susan B Cohrs
04/08/2021
..........................................................................
Contributor address; City; State; Zip Code
100.00
910 Brown Trail, Coppell, TX 75019
Principal occupation / Job title (See Instructions)
Employer (See Instructions)
retired
Date
Full name of contributor out-of-state PAC (ID#: )
Amount of contribution ($)
..................................................................................
Contributor address; City; State; Zip Code
Principal occupation / Job title (See Instructions)
Employer (See Instructions)
ATTACH ADDITIONAL COPIES OF THIS SCHEDULEAS NEEDED
If contributor is out-of-state PAC, please see Instruction guide for additional reporting requirements.
Forms provided by Texas Ethics Commission www.ethics.state.tx.us Revised 8/17/2020
NON-MONETARY (IN-KIND) POLITICAL
CONTRIBUTIONS SCHEDULE A2
If the requested information is not applicable, DO NOT include this page in the report.
The Instruction Guide explains how to complete this form.
1 Total pages Schedule A2:
I
2 FILER NAME
3 Filer ID (Ethics Commission Filers)
Davin Bernstein
4 TOTAL OF UNITEMIZED IN-KIND POLITICAL CONTRIBUTIONS
$ 70.36
v
5 Date
6 Full name of contributor Elout-of-statePAC (ID#: )
$ Amount of 1 g In-kind contribution
Contribution $ I description
I
7 Contributor address; City; State; Zip Code
I
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 Contributors 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 If contributor is a child, law firm of parent(s) (if any) (FOR JUDICIAL)
Date
Full name of contributor ❑ out-of-state PAC (ID#: )
I
Amount of In-kind contribution
Contribution $ I description
I
............................................................................
Contributor address; City; State; Zip Code
1
I
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 Revised 8/17/2020
EXPENDITURES MADE BY CREDIT CARD SCHEDULE F4
If the requested information is not applicable, DO NOT include this page in the report.
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 & 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)
Davin Bernstein
4 TOTAL OF UNITEMIZED EXPENDITURES CHARGED TO ACREDIT CARD
s 187.51
5 Date
6 Payee name
03/27/2021
Keepers Press
7 Amount ($)
8 Payee address; City; State; Zip Code
1,209.69
Heath, TX 75032
9 TYPE OF
EXPENDITURE
Political Non -Political
10
(a) Category (See Categories listed at the top of this schedule)
(b) Description
Printing Expense
Signs
PURPOSE
OF
EXPENDITURE
(c) Check if travel outside of Texas. Complete Schedule T. Check if Austin, TX, officeholder living expense
11 Candidate / Officeholder name Office sought Office held
Complete ONLY if direct
expenditure to benefit C/OH
Date
Payee name
03/31/2021
The Printplace
Amount ($)
Payee address; City; State; Zip Code
284.58
1130 Ave H East
Arlington, TX 76011
TYPE OF
EXPENDITURE
I- Political Non -Political
Category (See Categories listed at the top of this schedule)
Description
Printing Expense
Print Collateral
PURPOSE
OF
EXPENDITURE
Check if travel outside of Texas. Complete Schedule T. Check if Austin, TX, officeholder living expense
Candidate / Officeholder name Office sought Office held
Complete ONLY if direct
expenditure to benefit C/OH
ATTACH ADDITIONAL COPIES OF THIS SCHEDULE AS NEEDED
Forms provided by Texas Ethics Commission www.ethics.state.tx.us Revised 8/17/2020
EXPENDITURES MADE BY CREDIT CARD SCHEDULE F4
If the requested information is not applicable, DO NOT include this page in the report.
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 SalariesNVages/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)
Davin Bernstein
4 TOTAL OF UN ITEMIZED EXPENDITURES CHARGED TO ACREDIT CARD
$
5 Date
6 Payee name
04/04/2021
Star Local MEdia
7 Amount ($)
8 Payee address; City; State; Zip Code
363.00
PO Box 860248
Piano, TX 75086
9 TYPE OF
(.
N Political Non
EXPENDITURE
' -Political
10
(a) Category (See Categories listed at the top of this schedule)
(b) Description
Advertising Expense
Print
PURPOSE
OF
EXPENDITURE
(c) Check if travel outside of Texas. Complete Schedule T. Check if Austin, TX, officeholder living expense
11 Candidate / Officeholder name Office sought Office held
Complete ONLY if direct
expenditure to benefit C/OH
Date
Payee name
Amount ($)
Payee address; City; State; Zip Code
TYPE OF
EXPENDITURE
(�
! Political �� Non -Political
Category (See Categories listed at the top of this schedule)
Description
PURPOSE
OF
EXPENDITURE
Check if travel outside of Texas. Complete Schedule T. Check if Austin, TX, officeholder living expense
Candidate / Officeholder name Office sought Office held
Complete ONLY if direct
expenditure to benefit C/OH
ATTACH ADDITIONAL COPIES OF THIS SCHEDULE AS NEEDED
Forms provided by Texas Ethics Commission www.ethics.state.tx.us Revised 8/17/2020
POLITICAL EXPENDITURES MADE FROM
SCHEDULE G
PERSONAL FUNDS
If the requested information is not applicable, DO NOT include this page in the report.
EXPENDITURE CATEGORIES FOR BOX 8(a)
Advertising Expense Event Expense Loan Repayment/Reimbursement Solicitation/Fundraising Expense
Accounting/Banking Fees Office Overhead/Rental Expense Transportation Equipment & Related Expense
Consulting Expense Food/Beverage Expense Polling Expense Travel In District
Contributions/Donations Made By Gift/AWards/Mernorials 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)
1
Davin Bernstein
4 Date
5 Payee name
04/04/2021
USAA Credit Card Service
6 Amount ($)
7 Payee address; City; State; Zip Code
363.00
10750 McDermott Fwy, San Antonio, TX 78288
Reimbursement from
✓ politicalcontributions
intended
8
(a) Category (See Categories listed at the top of this schedule)
(b) Description
PURPOSE
Credit Card Payment
Y
As Reported on Schedule F4
p
of
EXPENDITURE
(c) Check if travel outside of Texas. Complete Schedule T. Check if Austin. TX, officeholder living expense
9 Candidate / Officeholder name Office sought Office held
Complete ONLY if direct
expenditure to benefit C/OH
Date
Payee name
Amount ($)
Payee address; City; State; Zip Code
Reimbursement from
political contributions
intended
Category (See Categories listed at the top of this schedule)
Description
PURPOSE
OF
EXPENDITURE
Check iftravel outside ofTexas. Complete ScheduleT Check if Austin. TX, officeholder living expense
Candidate / Officeholder name Office sought Office held
Complete ONif direct
LY
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)
Description
PURPOSE
OF
EXPENDITURE
Check if travel outside of Texas. Complete Schedule T. Check if Austin. TX, officeholder living expense
Candidate / Officeholder name Office sought Office held
Complete ONLY if direct
expenditure to benefit C/OH
ATTACH ADDITIONAL COPIES OF THIS SCHEDULE AS NEEDED
Forms provided by Texas Ethics Commission www. ethics. state. tx.us Revised 8/17/2020