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
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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)
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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
$
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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