Bernstein, Davin-COH 2021-05-28CANDIDATE / OFFICEHOLDER
FORM C/OH
CAMPAIGN FINANCE REPORT
COVER SHEET PG 1
The C/OH Instruction Guide explains how to complete this form.
1 Filer ID (Ethics Commission Filers)
2 Total pages filed:
3 CANDIDATE/
MS / MRS / MR FIRST
MI
OFFICEHOLDER
Mr Davin
OFFICE USE ONLY
NAME........................................
'
Da Received
Date ll
,
NICKNAME LAST
' ' '
SUFFIX
Bernstein
4 CANDIDATE/
ADDRESS I PO BOX; APT / SUITE #; CITY;
STATE; ZIP CODE
OFFICEHOLDER
PO Box 194
MAILING
Coppell, TX 75019
ADDR
Change of Address
5 CANDIDATE/
AREA CODE PHONE NUMBER
EXTENSION
Date Hand -delivered or Dat Postmarked
OFFICEHOLDER
PHONE
( 214 ) 717-1557
6 CAMPAIGN
MS / MRS I MR FIRST
MI
Receipt #
Amount $
TREASURER
Ms Jean
Date Processed
NAME.................................................................................
NICKNAME LAST
SUFFIX
Date Imaged
Shifflet
7 CAMPAIGN
STREET ADDRESS (NO PO BOX PLEASE); APT I SUITE #;
CITY; STATE; ZIP CODE
TREASURER
662 Cribbs Dr, Coppell, TX 75019
ADDRESS
(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
te
Exceeded Modified Final Report (Attach C/OH - FR)
1711
Ill_..e I
Reporting Limit — 11
10 PERIOD
Month Day Year
Month Day Year
COVERED
4 22 /21 THROUGH 5 /26 /21
11 ELECTION
ELECTION DATE
ELECTION TYPE
Month Day Year
Primary ■
Runoff Other
Description
6 /5 / 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 ! OFFICEHOLDER. THESE EXPENDITURES MAY HAVE BEEN MADE WITHOUT THE CANDIDATE'S OR OFFICEHOLDER'S KNOWLEDGE OR
COMMITTEE(S)
CONSENT. CANDIDATES AND OFFICEHOLDERS ARE REQUIRED TO REPORT THIS INFORMATION ONLY IF THEY RECEIVE NOTICE OF SUCH EXPENDITURES.
COMMITTEE TYPE
COMMITTEE NAME
GENERAL
COMMITTEE ADDRESS
Additional Pages
SPECIFIC
COMMITTEE CAMPAIGN TREASURER
NAME
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. TOTAL UNITEMIZED POLITICAL CONTRIBUTIONS (OTHER THAN
TOTALS
PLEDGES, LOANS, OR GUARANTEES OF LOANS, OR
$ 50 00
CONTRIBUTIONS MADE ELECTRONICALLY)
2. TOTAL POLITICAL CONTRIBUTIONS
(OTHER THAN PLEDGES, LOANS, OR GUARANTEES OF LOANS)
$ 500,00
...................
EXPENDITURE
3.
TOTAL UNITEMIZED POLITICAL EXPENDITURE.
$
23.96
...................
4. TOTAL POLITICAL EXPENDITURES
$ 5,212.86
CONTRIBUTION
ALANCE
5. TOTAL POLITICAL CONTRIBUTIONS MAINTAINED AS OF THE LAST DAY
$ 0.00
..................
OF REPORTING PERIOD
OUTSTANDING
LOAN TOTALS
6. TOTAL PRINCIPAL AMOUNT OF ALL OUTSTANDING LOANS AS OF THE
$ 0.00
LAST DAY OF THE REPORTING PERIOD
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.
Sig ature of Candidate or Officeholder
Please complete either option below:
PY P��G SILVIA CECILIA GANDARA�'f
� P U �
w d'
Notary Public, State of Texa.
(1)Affidavit �:N y_
Comm. Expires 03 31-2023
t9,•..,s�}��
n,°°;,�r`� Notary ID 124514748
NOTARY STAMP/ SEAL
Q c
Sworn to and subscribed before me by Dew! Y1 ►`7� r �J�ie't 1� this the �� day of MAN
20 t certify w witness my hand and seal of office.
r
re o office dministering oath Printed name of officer administering oath Title of officer administering oath
(2) Unsworn Declaration •
My name is and my date of birth is
My address is
(street) (city) (state) (zip code) (country)
Executed in County, State of on the day of 20
(month) (year)
Signature of Candidate/Officeholder (Declarant)
Forms provided by Texas Ethics Commission www.ethics.state.tx.us Revised 8/17/2020
Forms provided by Texas Ethics Commission www.ethics.state.tx.us Revised 8/17/2020
SUBTOTALS
- C/OH FORM C/OH
COVER SHEET PG 3
19 FILER NAME
Davin Bernstein
20 Filer ID (Ethics Commission Filers)
21
SCHEDULE SUBTOTALS
NAME OF SCHEDULE
SUBTOTAL
AMOUNT
1.
■ SCHEDULEAI:
MONETARY POLITICAL CONTRIBUTIONS
$
500.00
2.
SCHEDULEA2:
NON -MONETARY (IN-KIND) POLITICAL CONTRIBUTIONS
$
0.00
3.
SCHEDULE B:
PLEDGED CONTRIBUTIONS
$
0.00
4.
SCHEDULE E:
LOANS
$
0.000
5.
■ SCHEDULE F1:
POLITICAL EXPENDITURES MADE FROM POLITICAL CONTRIBUTIONS
$
1,274.88
6.
SCHEDULE F2:
UNPAID INCURRED OBLIGATIONS
$
0.00
7.
SCHEDULE F3:
PURCHASE OF INVESTMENTS MADE FROM POLITICAL CONTRIBUTIONS
$
0.00
6.
■ SCHEDULE F4:
EXPENDITURES MADE BY CREDIT CARD
$
3,445.44
9.
■ SCHEDULE G:
POLITICAL EXPENDITURES MADE FROM PERSONAL FUNDS
$
492.54
10.
SCHEDULE H:
PAYMENT MADE FROM POLITICAL CONTRIBUTIONS TO A BUSINESS OF C/OH
$
0.00
11.
SCHEDULE I: 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: 1
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 ($)
Barry Raven
05/26/2021..........
.......................................... ...........
a..te;
CityStZip Code
6 Contributorutor aaddrddress; ;201
200.00
Turnberry LaneCoppell TX 75019
8 Principal occupation / Job title (See Instructions)
g Employer (See Instructions)
Brinks
Date
Full name of contributor out-of-state PAC (ID#: )
Amount of contribution ($)
Lisa Armstrong
05/26/2021
...............................................................
Contributor address; City; State; Zip Code
100 O C
409 Hood CtCoppell TX 75019
■
Principal occupation / Job title (See Instructions)
Employer (See Instructions)
�NA
Date
Full name of contributor out-of-state PAC (ID#: )
Amount of contribution ($)
Janet Green
05/26/2021
.....................................................................
Contributor address; City; State; Zip Code731
100-00
Bankers Cottage LaneCoppell TX 75019
Principal occupation / Job title (See Instructions)
Employer (See Instructions)
NA
Date
Full name of contributor out-of-state PAC (ID#: )
Amount of contribution ($)
CL/J 1SGcc
os l )6�Zoz�
.............................
Contributor. .....address;.....City; .. State; Zip Code
, a
24 Z VEaeon)�c C 1k���,Qt,eeSBeAA;C
-75Z3q
Principal occupation / Job title (See Instructions)
Employer (See Instructions)
54:5 (� e
ATTACH ADDITIONAL COPIES OF THIS SCHEDULE AS NEEDED
If contributor is out-of-state PAC, please see Instruction guide for additional reporting requirements.
Forms provided by Texas Ethics Commission www.ethics.state.tx.us Revised 8/17/2020
POLITICAL EXPENDITURES MADE
SCHEDULE F1
FROM POLITICAL CONTRIBUTIONS
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 RepaymenttReimbursement Solicitation/Fundraising Expense
Accounting/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 SalariesNVages/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)
1
Davin Bernstein
4 Date
5 Payee name
04/29/2021
ViciMedia
6 Amount ($)
7 Payee address; City; State; Zip Code
11244.88
55101 Bonneville Bend, Austin, TX 78744
8
(a) Category (See Categories listed at the top of this schedule)
(b) Description
PURPOSE
Printing Expense
Design Services
OF
EXPENDITURE
(c) Check if travel outside of Texas. Complete Schedule Check if Austin, TX, officeholder living expense
9 Complete ONLY if direct Candidate / Officeholder name Office sought Office held
expenditure to benefit C/OH
Date
Payee name
05/18/2021
Carpenter Graphics & Designs
Amount ($)
Payee address; City; State; Zip Code
30.00
314 Stonemeade Way, Coppell, Texas, 75019
Category (See Categories listed at the top of this schedule)
Description
PURPOSE
Printing Expense
Design Services
OF
EXPENDITURE
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
Payee name
Amount ($)
Payee address; City; State; Zip Code
Category (See Categories listed at the top of this schedule)
Description
PURPOSE
OF
EXPENDITURE
Check if travel outside of Texas. Complete Schedule T. Check if Austin, TX, officeholder living expense
Complete ONLY if direct Candidate / Officeholder name Office sought Office held
expenditure to benefit C/OH
ATTACH ADDITIONAL COPIES OF THIS SCHEDULE AS NEEDED
Forms provided by Texas Ethics Commission www. ethics. state. tx.us Revised 8/17/2020
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 RepaymenVReimbursement 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 Salanes/Wages/Contract Labor Other (entera 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 A CREDIT CARD
$ 23.96
5 Date
6 Payee name
05/25/2021
Peerly
7 Amount ($)
8 Payee address, City; State; Zip Code
359.82
Peerly.com
9 TYPE OF
EXPENDITURE
r• Political Non -Political
10
(a) Category (See Categories listed at the top of this schedule)
(b) Description
Advertising Expense
Promotional Expense
PURPOSE
OF
EXPENDITURE
(c) Check if travel outside of Texas. Complete Schedule T. Check if Austin. TX, officeholder living expense
11 Candidate / Officeholder name Office sought Office held
Complete ONLY if direct
expenditure to benefit C/OH
Date
Payee name
05/12/2021
SAW Advisors
Amount ($)
Payee address; City, State; Zip Code
200.00
PO Box 860248, Plano, TX 75086
TYPE OF
EXPENDITURE
� Political Non-Political
Category (See Categories listed at the top of this schedule)
Description
Advertising Expense
Digital Advertising
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)
3
�QAv W _ NS N
4 TOTAL OF UNITEMIZED EXPENDITURES CHARGED TO A CREDIT CARD
$
5 Date
6 Payee name
04/28/2021
P ri ntplace
7 Amount ($)
8 Payee address; City; State; Zip Code
282.42
1110 Avenue H East, Arlington TX, 76011
9 TYPE OF
f.
EXPENDITURE
I- Political j' Non -Political
10
(a) Category (See Categories listed at the top of this schedule)
(b) Description
Printing Expense
Printing doorehangers
PURPOSE
OF
EXPENDITURE
(c) Check if travel outside of Texas. Complete Schedule T. Check if Austin, TX, officeholder living expense
11 Candidate / Officeholder name Office sought Office held
Complete ONLY if direct
expenditure to benefit C/OH
Date
Payee name
05/05/2021
Printplace
Amount ($)
Payee address; City; State; Zip Code
168.54
1110 Avenue H East, Arlington TX, 76011
TYPE OF
EXPENDITURE
r
I Political Non -Political
Category (See Categories listed at the top of this schedule)
Description
Printing Expense
Stickers
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 SalariesANages/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)
3
Davin Bernstein
4 TOTAL OF UNITEMIZED EXPENDITURES CHARGED TO ACREDIT CARD
$
5 Date
6 Payee name
05/03/2021
Printplace
7 Amount ($)
8 Payee address; City; State; Zip Code
508.68
1110 Avenue H East, Arlington TX, 76011
9 TYPE OF
(-
EXPENDITURE
( E Political I Non -Political
10
(a) Category (See Categories listed at the top of this schedule)
(b) Description
Printing Expense
Printing doorhangers
PURPOSE
OF
EXPENDITURE
(c) Check if travel outside of Texas. Complete Schedule T. Check if Austin, TX, officeholder living expense
11 Candidate / Officeholder name Office sought Office held
Complete ONLY if direct
expenditure to benefit C/OH
Date
Payee name
05/18/2021
Printplace
Amount ($)
Payee address; City; State; Zip Code
1,902.02
1110 Avenue H East, Arlington TX, 76011
TYPE OF
EXPENDITURE
�
IPolitical Non -Political
Category (See Categories listed at the top of this schedule)
Description
Printing Expense
Mailer printing and postage
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
AccountingBanking Fees Office Overhead/Rental Expense Transportation Equipment & Related Expense
Consulting Expense Food/Beverage Expense Polling Expense Travel In District
Contributions/Donations Made By Gift/Awards/Memorials Expense Printing Expense Travel Out Of District
Candidate/Officeholder/Political Committee Legal Services SalariesNVages/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)
Davin Bernstein
4 Date
5 Payee name
05/04/2021
Keepers Press
6 Amount ($)
7 Payee address; City; State; Zip Code
94.72
520 Loca Vista, Heath, TX 75032
Reimbursement from
political contributions
intended
8
(a) Category (See Categories listed at the top of this schedule)
(b) Description
PU F
Printing Expense
Signs
EXPENDITURE
(C) Check iftravel outside ofTexas. Complete Schedule T. Check if Austin, TX, officeholder living expense
9 Candidate / Officeholder name Office sought Office held
Complete ONLY if direct
expenditure to benefit C/OH
Date
Payee name
05/21/2021
Keepers Press
Amount ($)
Payee address, City; State; Zip Code
397.82
520 Loca Vista, Heath, TX 75032
Reimbursement from
political contributions
intended
Category (See Categories listed at the top of this schedule)
Description
PU F
Printing Expense
Signs
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
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