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Carroll, Don-COH 2021-06-01CANDIDATE / 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 Mr Don R OFFICE USE ONLY NAME................................................................................. Date Received NICKNAME LAST SUFFIX Carroll Jr j l 4 CANDIDATE/ ADDRESS / PO BOX APT / SUITE # CITY. STATE: ZIP CODE OFFICEHOLDER Coppell, Texas 75019 MAILING ADDRESS yy����'y�•tp/ �-e ' `�• "N Change of Address 5 CANDIDATE/ AREA CODE PHONE NUMBER EXTENSION Date Hand-delivered or Date Postmarked OFFICEHOLDER PHONE Receipt # Amount $ 6 CAMPAIGN MS / MRS / MR FIRST MI TREASURER Mr Don R Date Processed NAME................................................................................. NICKNAME LAST SUFFIX Date Imaged Carroll Jr 7 CAMPAIGN STREET ADDRESS (NO PO BOX PLEASE):. APT / SUITE # CITY: STATE, ZIP CODE TREASURER Coppell, Texas 75019 ADDRESS (Residence or Business) 8 CAMPAIGN AREA CODE PHONE NUMBER EXTENSION TREASURER PHONE 9 REPORT TYPE15th January 15 30th day before election � Runoff day after campaign treasurer appointment (Officeholder Only) (� 1 July 15 8th day before election ExceededModified � Final Report (Attach C/OH - FR) II iii9Limit 10F PERIOD Month Day Year Month Day Year COVERED 04 / 21 / 2 1 THROUGH 05 / 26 /21 11 ELECTION ELECTION DATE ELECTION TYPE Month Day Year Primary ■ Runoff Other Description 06 / 05/ 21 General Special 12 OFFICE OFFICE HELD (if any) 13 OFFICE SOUGHT (if known) none Coppell 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 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 SPECIFIC COMMITTEE CAMPAIGN TREASURER NAME COMMITTEE CAMPAIGN TREASURER ADDRESS GO TO PAGE 2 Forms provided by Texas Ethics Com Reset Form Reset Page Revised 811712020 CANDIDATE / OFFICEHOLDER FORM C/OH CAMPAIGN FINANCE REPORT COVER SHEET PG 2 15 C/OH NAME 16 Filer ID (Ethics Commission Filers) Don Carroll 17 CONTRIBUTION 1. TOTAL UNITEMIZED POLITICAL CONTRIBUTIONS (OTHER THAN 0 TOTALS PLEDGES, LOANS, OR GUARANTEES OF LOANS, OR $ CONTRIBUTIONS MADE ELECTRONICALLY) 2. TOTAL POLITICAL CONTRIBUTIONS 1050.00 ................... (OTHER THAN PLEDGES, LOANS, OR GUARANTEES OF LOANS) EXPENDITURE TOTALS 3. TOTAL UNITEMIZED POLITICAL EXPENDITURE. $ 0 6633.59 ................... 4. TOTAL POLITICAL EXPENDITURES $ CONTRIBUTION BALANCE 5. TOTAL POLITICAL CONTRIBUTIONS MAINTAINED AS OF THE LAST DAY 390.91 $ .................. OF REPORTING PERIOD OUTSTANDING LOAN TOTALS 6. TOTAL PRINCIPAL AMOUNT OF ALL OUTSTANDING LOANS AS OF THE 0 $ 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. r Signature of Candidate or Officehold Please complete either option below: ASHLEY M. OWENS U¢6' Notary Public, State of Texas (1) Affidavit r'� Comm. Expires 02-24-2023 4101111,111111 Notary ID 130128128 NOTARY STAMP/SEAL r' Q Sworn to and subscribed before me by 6.►�, t � lJl f 1 1 this the / day of C V t 20 to certify whi witness my hand and seal o ffice. JAAIJkA &A 01 Signature of officer administe g oath Printed name of officer Al oath Title of acer 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 Comm Reset FormReset Page Revised 8/17/2020 Forms provided by Texas Ethics Commistat� -- � Revised 8/17/2020 Reset Form Reset Page SUBTOTALS - C/OH FORM C/OH COVER SHEET PG 3 19 FILER NAME Don Carroll 20 Filer ID (Ethics Commission Filers) 21 SCHEDULE SUBTOTALS NAME OF SCHEDULE SUBTOTAL AMOUNT 1 ■ SCHEDULEAI: MONETARY POLITICAL CONTRIBUTIONS $ 1050.00 2, SCHEDULEA2: NON-MONETARY(IN-KIND)POLITICAL CONTRIBUTIONS $ 3. SCHEDULE B: PLEDGED CONTRIBUTIONS $ 4. SCHEDULE E: LOANS $ 5. 0 SCHEDULE F1: POLITICAL EXPENDITURES MADE FROM POLITICAL CONTRIBUTIONS $ 663.40 6. SCHEDULE F2: UNPAID INCURRED OBLIGATIONS $ 7 SCHEDULE F3: PURCHASE OF INVESTMENTS MADE FROM POLITICAL CONTRIBUTIONS $ 8. ■ SCHEDULE F4: EXPENDITURES MADE BY CREDIT CARD $ 5970.19 9. ■ SCHEDULE G: POLITICAL EXPENDITURES MADE FROM PERSONAL FUNDS $ 5970.19 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 Commistat� -- � Revised 8/17/2020 Reset Form Reset Page 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) Don Carroll 4 Date 5 Full name of contributor out-of-state PAC (ID# ) 7 Amount of contribution ($) Dana Starner 5/4/21 ......................................................................... 250 6 Contributor address; City, State: Zip Code 134 Washington Ct, Coppell, Texas 75019 8 Principal occupation / Job title (See Instructions) g Employer (See Instructions) Date Full name of contributor out-of-state PAC (ID#. ) Amount of contribution ($) Bill Southern 5/13/21 .................................................................................. 100 Contributor address; City, State; Zip Code 5100 Randol Mill Rd, Fort Worth, Texas 76182 Principal occupation / Job title (See Instructions) Employer (See Instructions) Date Full name of contributor out-of-state PAC (ID#: ) Amount of contribution ($) Don Carroll 5/10/21 .................................................................................. 500 Contributor address; City; State, Zip Code 924 Hidden Hollow Ct, Coppell, Texas 75019 Principal occupation / Job title (See Instructions) Employer (See Instructions) banker Bank of America Date Full name of contributor out-of-state PAC (ID# ) Amount of contribution ($) Kim Mobley 5/18/21 ........................................................................... 100 Contributor address, City, State; Zip Code 313 Dunlin Ln, Coppell, TX 75019 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 Com Reset Form I sReset Page 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 2 FILER NAME 3 Filer ID (Ethics Commission Filers) Don Carroll 4 Date 5 Full name of contributor out-of-state PAC (ID#. ) 7 Amount of contribution ($) Randall Rhea 5/26/21 ................................................................................... 100 6 Contributor address, City; State; Zip Code 123 Ridgewood Dr, Coppell, Texas 75019 8 Principal occupation / Job title (See Instructions) g Employer (See Instructions) Date Full name of contributor out-of-state PAC (ID# > Amount of contribution ($) .................................................................................. Contributor address; City; State, Zip Code Principal occupation / Job title (See Instructions) Employer (See Instructions) Date Full name of contributor out-of-state PAC (ID#: ) Amount of contribution ($) .................................................................................. Contributor address; City; State; Zip Code Principal occupation / Job title (See Instructions) Employer (See Instructions) banker Date Full name of contributor out-of-state PAC (ID#: ) Amount of contribution ($) .................................................................................. Contributor address; City; State; Zip Code Principal occupation / Job title (See Instructions) Employer (See Instructions) ATTACH ADDITIONAL COPIES OF THIS SCHEDULE AS NEEDED If contributor is out-of-state PAC, please see Instruction guide for additional reporting requirements. Forms provided by Texas Ethics Com A� Revised 8/17/2020 POLITICAL EXPENDITURES MADE FROM POLITICAL CONTRIBUTIONS SCHEDULE F1 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/Memorials Expense Printing Expense Travel Out Of District Candidate/Officeholder/Political Committee Legal Services SalanesANages/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 Don Carroll 4 Date 5 Payee name 5/10/21 Marni G Designs 6 Amount ($) 7 Payee address, City, State, Zip Code 568.31 602 Hood Dr, Coppell, TX 75019 8 (a) Category (See Categories listed at the top of this schedule) (b) Description PURPOSE printing expense signs OF EXPENDITURE (c) Check if travel outside of Texas. Complete Schedule Check if Austin, TX, officeholder living expense 9 Complete ONLY if direct Candidate / Officeholder name Office sought Office held expenditure to benefit C/OH Date Payee name 5/19/21 Amy Praytor (Gifted Sistas) Amount ($) Payee address; City; State; Zip Code 77.94 967 Laguna Dr, Coppell, TX 75019 Category (See Categories listed at the top of this schedule) Description printing expense shirts PURPOSE OF EXPENDITURE Check if travel outside of Texas. Complete Schedule 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 5/26/21 Paypal Amount ($) Payee address; City, State; Zip Code 17.15 2211 North First St, San Jose, CA 95131 Category (See Categories listed at the top of this schedule) Description PURPOSE fees online contribution processing fees 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 Com1 Reset Form I 's sl Reset Page I 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 Salanes/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) Don Carroll 4 TOTAL OF UN ITEMIZED EXPENDITURES CHARGED TOACREDIT CARD $ 5 Date 6 Payee name 5/25/21 Facebook 7 Amount ($) 8 Payee address: City; State, Zip Code 300.78 1 Hacker Way, Menlo Park, CA 94025 9 TYPE OF N Political Non EXPENDITURE j -Political 10 (a) Category (See Categories listed at the top of this schedule) (b) Description advertising expense ads PURPOSE OF EXPENDITURE (c) Check if travel outside of Texas. Complete Schedule Check if Austin, TX, officeholder living expense 11 Candidate / Officeholder name Office sought Office held Complete ONLY if direct expenditure to benefit C/OH Date Payee name 5/4/21 Coppell Gazette Amount ($) Payee address, City, State, Zip Code 926.00 3501 E Plano Parkway #200, Plano, TX 75074 TYPE OF EXPENDITURE �"'` Political 1 Non -Political Category (See Categories listed at the top of this schedule) Description advertising expense ads PURPOSE OF EXPENDITURE Check iftravel outside ofTexas. Complete ScheduleT 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 Commiss Reset Form " " Reset Page 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/Memohals Expense Printing Expense Travel Out Of District Candidate/Officeholder/Political Committee Legal Services Salaries/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) Don Carroll 4 TOTAL OF UNITEMIZED EXPENDITURES CHARGED TOA CREDIT CARD $ 5 Date 6 Payee name 5/12/21 PrintPlace 7 Amount ($) 8 Payee address, City, State; Zip Code 338.58 1130 Ave H East, Arlington, TX 76011 9 TYPE OFr— EXPENDITURE Fo— Political A Non -Political 10 (a) Category (See Categories listed at the top of this schedule) (b) Description printing expense door hangers PURPOSE OF EXPENDITURE (c) Check iftraveloutside ofTexas. Complete ScheduleT Check if Austin. TX, officeholder living expense 11 Candidate / Officeholder name Office sought Office held Complete ONLY if direct expenditure to benefit C/OH Date Payee name 5/19/21 PrintPlace Amount ($) Payee address, City; State, Zip Code 2124.30 1130 Ave H East, Arlington, TX 76011 TYPE OF EXPENDITURE f I s Political Non -Political Category (See Categories listed at the top of this schedule) Description printing expense ads PURPOSE OF EXPENDITURE Check iftravel outside ofTexas. Complete ScheduleT 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 Commiss Reset Form Reset Page 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 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) Don Carroll 4 TOTAL OF UNITEMIZED EXPENDITURES CHARGED TOACREDIT CARD $ 5 Date 6 Payee name 5/25/21 Pri nt P I ace 7 Amount ($) 8 Payee address, City, State, Zip Code 2190.09 1130 Ave H East, Arlington, TX 76011 9 TYPE OF (� n Political Non EXPENDITURE I -Political 10 (a) Category (See Categories listed at the top of this schedule) (b) Description printing expense postcards PURPOSE OF EXPENDITURE (C) Check if travel outside of Texas. Complete Schedule T. Check if Austin. TX, officeholder living expense 11 Candidate / Officeholder name Office sought Office held Complete ONLY if direct expenditure to benefit C/OH Date Payee name 5/17/21 Michael's Amount ($) Payee address, City; State, Zip Code 34.00 2325 S Stemmons Freeway, Unit 402, Lewisville, TX 75067 TYPE OF EXPENDITURE I Political Non -Political Category (See Categories listed at the top of this schedule) Description advertising expense shirts PURPOSE OF EXPENDITURE Check if travel outside ofTexas. Complete Schedule 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 Commiss Reset Form" Reset Page 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 Salaries=ages/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) Don Carroll 4 TOTAL OF UNITEMIZED EXPENDITURES CHARGED TOA CREDIT CARD $ 5 Date 6 Payee name 5/18/21 DollarTree 7 Amount ($) 8 Payee address, City; State; Zip Code 9.74 820 S Macarthur Blvd, Unit 125, Coppell, TX 75019 9 TYPE OF('�' EXPENDITURE I o Political Non -Political 10 (a) Category (See Categories listed at the top of this schedule) (b) Description other office supplies PURPOSE OF EXPENDITURE (c) Check if travel outside of Texas. Complete Schedule Check if Austin. TX, officeholder living expense 11 Candidate / Officeholder name Office sought Office held Complete ONLY if direct expenditure to benefit C/OH Date Payee name 5/22/21 SquareSpace Amount ($) Payee address, City, State, Zip Code 28.15 225 Varick St, 12th floor, New York, NY 10014 TYPE OF EXPENDITURE �� I ( Political F_ Non -Political Category (See Categories listed at the top of this schedule) Description advertising expense website PURPOSE OF EXPENDITURE Check iftravel outside ofTexas. Complete ScheduleT 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 Commiss Reset Form Reset Page 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 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 SalariesAA/ageatContract 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) Don Carroll 4 TOTAL OF UN ITEMIZED EXPENDITURES CHARGED TO A CREDIT CARD $ 5 Date 6 Payee name 5/12/21 Dallas County Elections 7 Amount ($) 8 Payee address, City; State, Zip Code 18.55 1520 Round Table Dr, Dallas, TX 75247 9 TYPE OF Political Non EXPENDITURE -Political 10 (a) Category (See Categories listed at the top of this schedule) (b) Description fees voter roll data PURPOSE OF EXPENDITURE (c) Check if travel outside of Texas. Complete Schedule Check if Austin. Tx. officeholder living expense 11 Candidate / Officeholder name Office sought Office held Complete ONLY if direct expenditure to benefit C/OH Date Payee name Amount ($) Payee address; City; State, Zip Code TYPE OF EXPENDITURE ('� L Political F Non -Political Category (See Categories listed at the top of this schedule) Description PURPOSE OF EXPENDITURE Check if travel outside of Texas. Complete Schedule 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 Commiss Reset Form Reset Page 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 GifUAwards/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 G: 2 FILER NAME 3 Filer ID (Ethics Commission Filers) 1 Don Carroll 4 Date 5 Payee name 5/26/21 Bank of America 6 Amount ($) 7 Payee address, City, State, Zip Code 468.85 100 North Tryon St, Charlotte, NC 28255 Reimbursement from ✓ political contributions intended 8 (a) Category (See Categories listed at the top of this schedule) (b) Description PURPOSE credit card payment p y OF EXPENDITURE (c) Check iftravel outside ofTexas. Complete ScheduleT Check if Austin, TX, officeholder living expense 9 Candidate / Officeholder name Office sought Office held Complete ONLY if direct expenditure to benefit C/OH Date Payee name 5/26/21 Bank of America Amount ($) Payee address; City, State; Zip Code 5501.34 100 North Tryon St, Charlotte, NC 28255 Reimbursement from political contributions intended Category (See Categories listed at the top of this schedule) Description PURPOSE credit card payment P y OF EXPENDITURE Check if travel outside of Texas. Complete Schedule 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 iftravel outside ofTexas .Complete Schedule 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 Com Reset Form Reset Page Revised 8/17/2020 AFFIDAVIT FOR x CANDIDATE OR OFFICEHOLDER: ELECTRONIC FILING EXEMPTION An exemption affidavit must be submitted with each paper report OFFICE USE ONLY Date Received Date Hand -delivered or Date Postmarked Beginning on January 1, 2021, a candidate or officeholder who has accepted more than $28,420 in political contributions or made more than $28,420 in political expenditures Receipt# in anv calendar year must file all subsequent reports electronically. Filer name Filer ID # o,-� C I�,2o L -I Date Processed Date Imaged Amount $ 1. I swear or affirm that I have not accepted more than $28,420 in political contributions or made more than $28,420 in political expenditures in a calendar year. 2. 1 further swear or affirm that I do not use computer equipment to keep current records of political contributions, political expenditures, or persons making political contributions to me. 3. 1 further swear or affirm that no person acting as my agent or consultant, and no person with whom I contract, uses computer equipment to keep current records of political contributions, political expenditures, or persons making political contributions to me. 4. 1 further swear or affirm that I understand that I am required to file my campaign finance reports electronically if I, my agent or consultant, or a person with whom I contract exceeds $28,420 in political contributions or political expenditures in a calendar year, or uses computer equipment to keep current records of political contributions, political expenditures, or persons making political contributions to me. 5. 1 am filing this affidavit with thee-AMPft l 6^1 fi&)AOCE report due on Mr4y 2-81 20 21 . I understand that this affidavit is required to be filed with each campaign finance report for which I am claiming an exemption from electronic filing. Please complete either option below: (1) Affidavit NOTARY STAMP/ SEAL Sworn to and subscribed before me by ISignatur0eller' G"" Z this the day of , 20 , to certify which, witness my hand and seal of office. Signature of officer administering oath (2) Unsworn Declaration My name is My address is Executed in Printed name of officer administering oath , and my date of birth is Title of officer administering oath (city) (state) (zip code) (country) County, State of on the day of 20 (month) (year) Signature of Filer (Declarant) FILERS WHO ARE EXEMPT FROM THE ELECTRONIC FILING REQUIREMENT ARE STILL REQUIRED TO FILE CAMPAIGN FINANCE REPORTS ON PAPER Forms provided by Texas Ethics Commission www. ethics. state. tx.us Revised 1/1/2021