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Majed, Raghib-COH 2021-11-05 CANDIDATE / 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 OFFICE USE ONLY OFFICEHOLDER RA4/IPS 7nA.1c' NAME Date Received NICKNAME LAST SUFFIX CANDIDATE/ ADDRESS /PO BOX; APT/SUITE#; CITY; STATE; ZIP CODE c�\IL\ a ` � MAILING OFFICEHOLDER c3L/8 6rJCitt.�ll/1riJ �n 6-y e'e Tx SD/!j \\ \ 0 Change of Address 5 CANDIDATE/ AREA CODE PHONE NUMBER EXTENSION Date Hand-delivered or Date Postmarked OFFICEHOLDER PHONE (m-. )•x4/6- //9/ Receipt# Amount$ 6 CAMPAIGN MS/MRS/MR FIRST MI TREASURER NAME ••...rinAAA/ /174-.�rr.6 . Date Processed NICKNAME LAST SUFFIX Date Imaged 7 CAMPAIGN STREET ADDRESS (NO PO BOX PLEASE); APT/SUITE#; CITY; STATE; ZIP CODE TREASURER 3y� e4u(94) Ai. ADDRESS 7 (Residence or Business) COpia?`/i 7-y 7509 8 CAMPAIGN AREA CODE PHONE NUMBER EXTENSION TREASURER PHONE (2//j ) 2eg— sff0j. 9 REPORT TYPE ❑ January 15 n 30th day before election n Runoff I—I 15th day after campaign I I treasurer appointment (Officeholder Only) n July 15 n 8th day before election n Exceeded Modified la Final Report(Attach C/OH-FR) Reporting Limit 10 PERIOD Month Day Year Month Day Year COVERED / / THROUGH / / 11 ELECTION ELECTION DATE ELECTION TYPE Month Day Year ❑ Primary 111Runoff n Other Description VS/Q ,/ /n OZ/ 14 General n Special 12 OFFICE OFFICE HELD (if any)G N// 13 OFFICE SOUGHT (If known) I . c , '(( Ceti e_OG/72C( 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 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) 17 CONTRIBUTION 1. TOTAL UNITEMIZED POLITICAL CONTRIBUTIONS (OTHER THAN TOTALS PLEDGES, LOANS, OR GUARANTEES OF LOANS, OR $ CONTRIBUTIONS MADE ELECTRONICALLY) 2. TOTAL POLITICAL CONTRIBUTIONS (OTHER THAN PLEDGES, LOANS, OR GUARANTEES OF LOANS) EXPENDITURE 3. TOTAL UNITEMIZED POLITICAL EXPENDITURE. TOTALS 4. TOTAL POLITICAL EXPENDITURES $ CONTRIBUTION 5. TOTAL POLITICAL CONTRIBUTIONS MAINTAINED AS OF THE LAST DAY BALANCE OF REPORTING PERIOD $ OUTSTANDING 6. TOTAL PRINCIPAL AMOUNT OF ALL OUTSTANDING LOANS AS OF THE LOAN TOTALS 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. L/Zo al Signature of Candidate or Officeholder Please complete either option below: (1)Affidavit NOTARY STAMP/SEAL Sworn to and subscribed before me by this the day of 20 ,to certify which,witness my hand and seal of office. Signature of officer administering oath Printed name of officer administering oath Title of officer administering oath OR (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 SUBTOTALS - C/OH FORM C/OH COVER SHEET PG 3 19 FILER NAME 20 Filer ID(Ethics Commission Filers) 21 SCHEDULE SUBTOTALS SUBTOTAL NAME OF SCHEDULE AMOUNT 1. n SCHEDULE A1: MONETARY POLITICAL CONTRIBUTIONS $ 2. ❑ SCHEDULE A2: NON-MONETARY(IN-KIND)POLITICAL CONTRIBUTIONS $ Q . V 3. SCHEDULE B: PLEDGED CONTRIBUTIONS $ Q , OAU 4. ❑ SCHEDULE E: LOANS $ o , v-d 5. SCHEDULE Fl: POLITICAL EXPENDITURES MADE FROM POLITICAL CONTRIBUTIONS $ () • O-0 6. 0 SCHEDULE F2: UNPAID INCURRED OBLIGATIONS $ G co 7. ❑ SCHEDULE F3: PURCHASE OF INVESTMENTS MADE FROM POLITICAL CONTRIBUTIONS $ Q © V 8. SCHEDULE F4: EXPENDITURES MADE BY CREDIT CARD $ 9. SCHEDULE G: POLITICAL EXPENDITURES MADE FROM PERSONAL FUNDS $ ). 0 0 10. n SCHEDULE H: PAYMENT MADE FROM POLITICAL CONTRIBUTIONS TO A BUSINESS OF C/OH $ , 496 11. El SCHEDULE I: NON-POLITICAL EXPENDITURES MADE FROM POLITICAL CONTRIBUTIONS $ U (J 12. n SCHEDULE K: INTEREST, CREDITS, GAINS, REFUNDS, AND CONTRIBUTIONS RETURNED $ b_ 00 I I TO FILER Forms provided by Texas Ethics Commission www.ethics.state.tx.us Revised 8/17/2020 MONETARY POLITICAL CONTRIBUTIONS p C°inVildi SCHEDULE Al N 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) ,f AG/N28 /114-jE b . 4 Date 5 Full name of contributor ❑out-of-state PAC(ID#: ) 7 Amount of contribution ($) 6 Contributor address; City; State; Zip ode $ Principal occupation/Job title(See Instructions) g Emplo er(See Instructions) Date Full name of contributor ❑out-of-state PAC(ID#: ) Amount of contribution ($) Contributor address; City; State; Zip Code Principal occupation/Job title (See Instructions) Em.loyer(See Instructions) Date Full name of contributor ❑out-of-state PAC(ID#: ) Amount of contribution ($) Contributor address; City; State Zip Code Principal occupation /Job title (See Instructions) E ployer(See Instructions) Date Full name of contributor ❑out-of-state PAC(ID#: 1 ) Amount of contribution ($) Contributor address; City; State; Zip Code +i 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 8/17/2020 NON-MONETARY (IN-KIND) POLITICAL CONTRIBUTIONS Jo c��' 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: 2 FILER NAME 3 Filer ID (Ethics Commission Filers) Ric36 fig, /3'1,110 4 TOTAL OF UNITEMIZED IN-KIND POLITICAL CONTRI=UTIONS $ 5 Date 6 Full name of contributor ❑out-of-state PAC(ID#: ) 8 Amount of I g In-kind contribution Contribution $ I description 7 Contributor address; City; State; Zip Code I I Check if travel outside of Texas.Complete Schedule T. 10 Principal occupation/Job title (FOR NON-JUDICIAL)(See Instructio s) 11 Employer (FOR NON-JUDICIAL)(See Instructions) 12 Contributor's 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 JUDICI' ) Full name of contributor ❑out-of-state PAC(ID#: ) I Date Amount of In-kind contribution Contribution $ I description Contributor address; City; .tate; Zip Code I nCheck 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 JUDI*AL) 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 PLEDGED CONTRIBUTIONS it)° �m SCHEDULE B If the requested information is not applicable, DO NOT include this page in the report. The Instruction Guide explains how to complete this f.rm. 1 Total pages Schedule B: 2 FILER NAME 3 Filer ID (Ethics Commission Filers) ,2AIf re . 27 ja)" 4 TOTAL OF UNITEMIZED PLEDGES $ 5 Date 6 Full name of pledgor ❑out-of-state PAC(ID ) 8 Amount I 9 In-kind contribution of Pledge$ I description 7 Pledgor address; City; State; Zip Code I. Check if travel outside of Texas.Complete Schedule T. 10 Principal occupation/Job title (See Instructions) 11 Employer(See Instructions) Date Amount In-kind contribution Full name of pledgor ❑out-of-state PAC(ID•: of Pledge$ description 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 ❑out-of-state PAC(ID Amount of In-kind contribution Pledge $ description Pledgor address; City; tate; Zip Code nCheck 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#: Amount of I In-kind contribution Pledge $ I description Pledgor address; City; State; Zip Code TiCheck if travel outside of Texas.Complete Schedule T. Principal occupation /Job title (See Instructions) Employer(See Instructions) I 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 • LOANS N) e_lea SCHEDULE E 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 E: 2 FILER NAME 3 Filer ID (Ethics Commission Filers) 4 TOTAL OF UNITEMIZED LOANS $ 5 Date of loan 7 Name of lender out-of-state PAC D#: ) 9 Loan Amount($) 6 Is lender 8 Lender address; City; State; Zip Code 10 Interest rate a financial Institution? 11 Maturity date Y N 12 Principal occupation / Job title (See Instructions) 3 Employer (See Instructions) 14 Description of Collateral 15 ❑ Check if personal funds were deposited into political ❑ none account (See Instructions) 16 GUARANTOR 17 Name of guarantor 19 Amount Guaranteed($) INFORMATION 18 Guarantor address; City; State; Zip Code ❑ not applicable 20 Principal Occupation (See Instructions) 21 Employer (See Instructions) Date of loan Name of lender ❑out-of- .te PAC(ID#: ) Loan Amount($) Is lender Lender address; City; State; Zip Code Interest rate a financial Institution? Maturity date Y N Principal occupation / Job title (See Instructions) Employer (See Instructions) Description of Collateral ❑ Check if personal funds were deposited into political account (See Instructions) ❑ none GUARANTOR Name of guarantor Amount Guaranteed($) 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 8/17/2020 POLITICAL EXPENDITURES MADEe /-wr►^ FROM POLITICAL CONTRIBUTIONS NU `"'��ineciCc,11�m�, HEDULE Fl 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 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 Fl: 2 FILER NAME 3 Filer ID (Ethics Commission Filers) RAA/-2c 6 /Y1 rjJc 4 Date 5 Payee name 6 Amount ($) 7 Payee address; City; State; Zip Code 8 (a) Category (See Categories listed at the top of this schedule (b) Description PURPOSE OF EXPENDITURE (c) ri Check if travel outside of Texas.CompleteSch-. Ie T. 1-7 Check if Austin,TX,officeholder living expense 9 Complete ONLY if direct Candidate/Officeholder name Office sought Office held expenditure to benefit C/OH Date Payee name Amount ($) Payee address; City; State; Zip Code Category (See Categories listed at the top.f this schedule) Description PURPOSE OF EXPENDITURE nCheck if travel outside of Texas.r ompleteScheduleT. F-7 Check if Austin,TX,officeholder living expense Complete ONLY if direct Candidate/Officeholder nam: Office sought Office held expenditure to benefit C/OH Date Payee name Amount ($) Payee address; City; State; Zip Code Category (See Categories li•ted at the top of this schedule) Description PURPOSE OF EXPENDITURE nCheck if travel.utside of Texas.Complete Schedule T. n 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 ickW UNPAID INCURRED OBLIGATIONS n id ���v U U � SCHEDULE F2 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 ContrlbutIons/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. I Total pages Schedule F2: 2 FILER NAME 3 Filer ID (Ethics Commission Filers) //J d 4 TOTAL OF UNITEMIZED UNPAID INCURRED OBLIGATIONS $ 5 Date 6 Payee name 7 Amount ($) 8 Payee address; City; State; Zip Code 9 TYPE OF EXPENDITURE Political Non-Political 10 (a) Category (See Categories listed at the top of his schedule) (b) Description PURPOSE OF EXPENDITURE (c) n Check if travel outside of Texas.Co plete Schedule T. Check if Austin,TX,officeholder living expense 11 Complete ONLY if direct Candidate/Officeholder na e Office sought Office held expenditure to benefit C/OH Date Payee name Amount ($) Payee address; City; State; Zip Code TYPE OF EXPENDITURE n Political Non-Political Category (See Categorie-listed at the top of this schedule) Description PURPOSE OF EXPENDITURE Check if trave•utside of Texas.Complete Schedule T. Check if Austin,TX,officeholder living expense Complete ONLY If direct Candidate /O Iceholder 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 PURCHASE OF INVESTMENTS MADE � „ , LY1 SCHEDULE F3 FROM POLITICAL CONTRIBUTIONSfirftvl 10046 � hic& If the requested information is not applicable, DO NOT include this page in the report. 1 Total pages Schedule F3: The Instruction Guide explains how to complete this form. 2 FILER NAME 3 Filer ID (Ethics Commission Filers) RA-4 HP,6 /Y2AI03 4 Date 5 Name of person from whom investment is purchased 6 Address of person from whom investment is purchased; City; State; Zip Code 7 Description of investment 8 Amount of investment($) Date Name of person from whom investment is purc ased Address of person from whom investment is .urchased; City; State; Zip Code Description of investment Amount of Investment($) 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 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) ,AC H1'8 /174ie- 4 TOTAL OF UN ITEMIZED EXPENDITURES CHARGED TO A CREDIT CARD $ 5 Date 6 Payee name 7 Amount ($) 8 Payee address; City; State; Zip Code 9 TYPE OF EXPENDITURE Political Non-P.litical 10 (a) Category (See Categories listed at the top of this schedule) (b) Description PURPOSE OF EXPENDITURE (c) n Check if travel outside of Texas.CompleteSch-. le T. n Check if Austin,TX,officeholder living expense 11 Candidate/Officeholder name Office sought Office held Complete ONLY if direct expenditure to benefit C/OH Date Payee name Amount ($) Payee address; City; State; Zip Code TYPE OF EXPENDITURE Political Non-Political Category (See Categories listed a the top of this schedule) Description PURPOSE OF EXPENDITURE nCheck if travel outsi.-of Texas.Complete Schedule T. n 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 PERSONAL FUNDS SCHEDULE G 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/Reimburse - t Solicitation/Fundraising Expense AccounUngBanking Fees Office Overhead/Rental E .-nse 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 :bor Other(enter a category not listed above) Credit Card Payment The Instruction Guide explains how to complete thi- form. 1 Total pages Schedule G: 2 FILER NAME 3 Filer ID (Ethics Commission Filers) /' H116 47.40' 4 Date 5 Payee name 6 Amount ($) 7 Payee address; City; State; Zip Code Reimbursement from J political contributions intended 8 (a) Category (See Categories listed at the top of this schedule) •) Description PURPOSE OF EXPENDITURE (c) Check if travel outside of Texas.Complete Schedule T. I I Check if Austin,TX,officeholder living expense 9 Candidate / Officeholder name Office sought Office held Complete ONLY if direct expenditure to benefit C/OH Date Payee name Amount ($) Payee address; City; State; Zip Code Reimbursement from IIpolitical contributions Intended Category (See Categories listed at the top of this sche•ule) Description PURPOSE OF EXPENDITURE ElCheck if travel outside of Texas.Complete Sch •uleT. ❑ 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 s hedule) Description PURPOSE OF EXPENDITURE nCheck if travel outside of Texas.Complete Sihedule T. n 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 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 NAME 2 Filer ID (Ethics Commission Filers) R/96 Nig /7/Jc,O. 3 SIGNATURE I do not expect any further political contributions or political expenditures in connection with my candidacy. I understand that designating 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 on file. 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: 5 I do not have unexpended contributions or unexpended interest or income earned from political contributions. I I 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: I do not retain assets purchased with political contributions or interest or other income from political contributions. n 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. .(. b \GtvY Signature of Candidate 5 OFFICEHOLDER •• Complete this section only if you are an officeholder -• I 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 political contributions or interest or other income from political contributions. Signature of Officeholder Forms provided by Texas Ethics Commission www.ethics.state.tx.us Revised 8/17/2020