HomeMy WebLinkAboutCFR-04.30.2013-Baxter,Brendalbxas Ethics Commission P.O. Box 12070 Austin, Texas 78711-2070 (512) 46x3-5800 (TDD 1-800-735-2989)
wwww ethics.state.tx.fis Revised 04119i2013
CANDIDATE 1 OFFICEHOLDER
FORM C/OH
CAMPAIGN
FINANCE
REPORT
COVER SHEET PG 'I
' i ACCOUNT #f
2 Total pages filed:
The C/01.1 Instruction
Guide explains how
to complete this force.
{Eth c Coram scion Fte s)
i
3
CANDIDATE t
MSIMRS/MR
FIRST
Ml
0 of ''
OFFICEHOLDER
NAME
iti!
ate I l� =
.
€
NICKNAME .
.LAST _ ,
.
SUFFIX
APR 3 2013
ADDRESS IPOBOX;
ii��}
P X7`'1 E
APTISU3TE#; CITY,
STATE; ZIP CODE
�
4 CANDIDATE / �
OFFICEHOLDER
MAILING
ADDRESS
(0 )'�
Dato Han el vera or ostm rk d
S T �. s C I Er t �. ' Al
El
change of address
li 1
W V�
t
e -
Receipt # A xxmt
5
CANDIDATE/
AREA CODE
PHONE NUMBER
EXTENSION
OFFICEHOLDER
PHONE
Date Processed
�
6
CAMPAIGN
MS,MRSiMR
FIRST
full
Datelma{Ied
TREASURER
NAME..
t
NICKNAME
LAST
SUFFIX
7
CAMPAIGN
STREET ADDRESS (NO PO BOX PLEASE), APTISUITEn:
CITY, STATE,
ZIPCODE
TREASURER
ADDRESS
(residence of business)
" 6 O 1A
8
CAMPAIGN
AREA CODE
PHONE NUMBER
EXTENSION
TREASURER
}
PHONE
(
9
REPORT TYPE
January Ira
[`) 301h day before election
a
Runoff
15th day after campaign
treasurer appointment
fohiceliuk kn oniy)
❑ July 15
h day before election
1� Exceeded $500
F --j Final report (Attach CtOH - FR)
limit
70
PERIOD..»
t.,t«r.?r: Day
Year
Mcnts; � Das:
� Year
COVERED
THROUGH
11
ELECTION
ELECTIONDATE ! ELECTION TYPE
Month Days
Year
Fraaary
L Ruf o9onefal L]Specie!
12
OFFICE
OFFICEI4ELD (if any)
13 OFFICE SOUGHT (if known)
GO TO PAIGE 2
wwww ethics.state.tx.fis Revised 04119i2013
Texas Ethics Commission P.Q. Box 12070 Austin, Texas 78711--2070 (512) 463-5800 (TDD 1-800-735-2989)
www ethics.state.tx.us Revised 04/1912013
CANDIDATE/ OFFICEHOLDER REPORT. FORM C/OH4
SUPPORT
& TOTALS COVER SHEET PG 2
14
C1OH NAME
j 15 ACCOUNT # (Ethics Co rrnission Filers)
16
NOTICE FROM
i THIS BOX IS FOR NOTICE OF POLITICAL CONTRIBUTIONS ACCEPTED OR POLITICAL EXPENDITURES MADE BY POLITICAL COMMITTEES TO SUPPORT THE
POLITICAL
IIt 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.
1
COMMITTEE NAAE
COMMITTEE TYPE
I
GENERAL
COMMITTEE ADDRESS
E1 a SPECIFIC
Ej
4
i
COMMITTEE TTEE CAM&AIGN TREASURER NAME
i
S
additional pages
I
1
i
COMMITTEE CAMPAIGN TREASURER ADDRESS
f
17
CONTRIBUTION
TATA
� 1. TOTAL. POLITICAL CONTRIBUTIONS OF $50 OR LESS (OTHER THAN
! PLEDGES, LOANS, OR GUARANTEES OF LOANS), UNLESS ITEMIZED
2. TOTAL POLITICAL CONTRIBUTIONS
(OTHER THAN PLEDGES, LOANS, OR GUARANTEES OF 'LOANS)y
9i
EXPENDITURE
,
TOTALS
3_ TOTAL POLITICAL EXPENDITURES OF 5100 OR LESS, UNLESS ITEMIZED
$ 7
i
v
4. TOTAL POLITICAL EXPENDITURES
1
CONTRIBUTION
5.
BALANCE
TOTAL POLITICAL CONTRIBUTIONS I.IAINTAINED AS OF THE LAST DAY
Z.OLt t,it
OF REPORTING PERIOD
& �LC f
OUT T G
� TOTAL PRINCIPAL AMOUNT OF ALL OUTSTANDING LOANS AS OF THE
LTOOTALTAL S
LOAN
LOAN
I LAST DAY OF THE REPORTING PERIOD
E
18
AFFIDAVIT
I swear, or affirm, under penalty of perjury, that the accompanying report
is true and correct and includes all information required to be reported by
me under Title 15, Election Code,
Signature of Candidate or Officeholder
AFFIX NOTARY STAMP f SEAL ABOVE
Sworn to and subscribed before me, by the said 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
www ethics.state.tx.us Revised 04/1912013
Texas Ethics Commission P.O, Box 12070 Austin, Texas 78711-2070 (512)463-5800 (TDD 1-800-735-2989)
POLITICAL CONTRIBUTIONS
SCHEDULE A
OTHER THAN PLEDGES OR LOANS
q Total pages Schedule A.
The Instruction Guide explains how to complete this form.
2 FILER NAME
3 ACCOUNT # (Ethics Commission Filers)
r,
4 Date
5 Fill name of contributor ❑ out-of-state PAC(ID#. }
7 Amount of 18 In-kind contribution
contribution (S) description (if applicable)
'J
6 Contributor address; City; State: Zip Code
CJ;
(If travel outside of Texas, complete Schedule T)
9 Principal occupation / Job title (See Instructions)
10 Employer (See Instructions)
Date
Full name of contributor ❑ out-of-statePAC (IM )
Amount of In-kind contribution
contribution ($) I description (if applicable)
Contributor address; City; State; Zip Code
Ul
Aa
�,�°�7 (fes' -x
+ _
T
,T
if travel outside of Texas, complete Schedule
Principal occupation / Job title (See Instructions)
Employer (See Instructions)
Date
Full name of contributor ❑ out-of-statePAC(ID#: }
Amount of In-kind contribution
� ( p
contribution (S) description (if applicable)
„
N fit- S ` .'� it""
Contributor address: City: State; Zip Code
'
g
G a%r
p p
i V
Jg.t'.�t
,,ppG. r
t
travel outside Texas. complete Schedule T)
(If u,
Principal occupation / Job title (See Instructions)
Employer (See Instructions)
Date
Full name of contributor ❑ out-of-stalePAC(ID# _ )
Amount of In-kind contribution
Alol I �q
contribution (S) description (if applicable)
Contributor address: City; State; Zip Code
t V KV N
Texas, tete Schedule T
!t travel outside of com
Principal occupation / Job title (See Instructions)
Employer (See Instructions)
Date
Full name of contributor ❑out-of-statePAC (ID#_„__ _. a
Amountof i In-kind contribution
contribution ($) description (if applicable)
M
Contributor address: City: State: Zip Code
j
0 6 Tom
j
' `' t
if travel outside of Texas- complete Schedule T
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 foradditional reporting requirements.
www.ethics.state.tx.us Revised 04/19!2013
Texas Ethics Commission RO. Box 12070 Austin, Texas 78711-2070 (512) 403-5800 (TDD 1-800-735-2980
POLITICAL CONTRIBUTIONS
SCHEDULE A
OTHER
THAN PLEDGES OR LOANS
I Total pages Schedule A.-
The
instruction Guide explains how tocompletethis form.`vµA
2 FILER NAME
3 ACCOUNT (Ethics Commission Filers)
4 Date
5 Full name of contributor El out -at -state PAC (0#
7 Amount of
8 In-kind contribution
} } ,
contribution (S)
i description (if applicable)
V 12
j
6 Contributor address; City; State: Zip Code
+
travel
of Texas, complete Schedule T)
(if outside
9 Principal occupation i Job title (See Instructions) 10 Employer (See Instructions)
n
Date
Full name of contributor El out-ofstate PAC(ILW „- ._
Amount of
In-kind contribution
/ (
contribution ($)
description (if applicable)
(I
I<
Contributor address, City; State; Zip Co e
(If travel outside
of Texas, complete Schedule T�
Principal occupation i Job title (See Instructions) Employer (See Instructions)
F
Date
Full name of contributor ❑ out-of-state PAC(in#.,,___.__,,-___.,,,_. -,_)
Amount of
In-kind contribution
contribution (S)
description (if applicable)
Contributor address; City: State: Zip Code
r
t
(if travel outside
of Texas, complete Schedule T)
Principal occupation 1 Job title (See Instructions) i Employer (See Instructions)
Date
^^�
Full name of contributor bout-ar-statePAC ttC#,,,_ _?
Amount of
In-kind contribution
contribution (S)
description (if applicable)
r
I
Contributor address: City: State: Zip Code
I
if travel outside
of Texas, Com lete Schedule T
Principal occupation 1 Job title (See Instructions) Employer (See
Instructions)
Date
Full name of contributor El out-of-siatePAC (IDfP _
Amountof
? In-kind contribution
contribution (S)
, description (if applicable)
AVLC
0
Contributor address: City; State: Zip Code
Atrjfi '.
t
€
(Ili travel outside
of Texas com_piet_e Schedule T
Principal occupation 1 Job title (See Instructions) - - JW Employer (See
Instructions)
F
ATTACH ADDITIONAL COPIES OF THIS SCHEDULE AS NEEDED
If contributor is out-of-state PAC, please see instruction guide foradditional reporting
requirements.
www.ethics.state.tx.us Revised 04/19/2013
Texas Ethics Commission P.O. Dox 12010 Austin, Texas 78711-2070 (512)463-5800 (TDD 1-800-735-2989)
PLEDGE® CONTRIBUTIONS
SCHEDULE B
t �Tc�tatpages5chedu4e�_,__.._.� ._....
The Instruction Guide explains how to complete this form.
2 FILER NAME
3 ACCOUNT it (Ethics Commission Filers)
4 TOTAL OF UNITEMIZED PLEDGES:
$
_
Amount of
S Date 6 Full name of pledgor out-cfstate PAC(Ok
8
g In-kind description
LA '�} qq
-
pledge (S)
g (if applicable)
7 Pledgor address; City; State; Zip Coda
�60 � � �. �� c�(r� _ i ``
'-`�'�'-�' t � t° �' &6
I
Teras, Schedule T}
(if travel outside
of complete
10 Principal occupation / Job title (See Instructions)
11 Employer (See
Instructions)
Date
Full name of pledgor out-of-state PAC€IDt
Amount of
in-kind description
i
6kGI J tCT ► i sw-f—
pledge (S)
(if applicable)
1�6v✓
Pledgor address; City; State; Zip Code i
r
(if travel outside
of Texas. complete Schedule T)
Principal occupation / Job title (See Instructions) Employer (See
Instructions)
Date Full name of pledgor 17 out -or, state PAC 01)9+ )
Amount of
In-kind description
pledge (S)
(if applicable)
Pledgor address-, City, State; Zip Code
{
(€f travel outside
OT Texas, complete Schedule T)
Principal occupation / Job title (See Instructions)
Employer (See
Instructions)
_
Date Full name of pledgor 17 out-oi-mtatePAC: (IOu )
Amount of
In-kind description
pledge (S)
(if applicable)
Pledgor address; City; State; Zip Code
i
(if travel outside
of Texas. complete Schedule T)
Principal occupation I Job title (See Instructions) Employee (See
Instructions)
Date Full name of pledgor 17 our-of-stato PAC (ID#,.__ _7
Amount of
In-kind description
_. _
pledge (S)
E (if applicable)
Pledgor address; City-, State; Zip Code
I
i
r
(If travel outside
of Texas, complete Schedule T)
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.
www. ethics. state. tx. us Revised 0411912013
Texas Ethics Commission P.O. Box 12070 Austin, Texas 78711-2070 (512) 463-5800 (TDD 1-800-735-2989)
www ethics.state.tx.us Revised 04119/2013
LOANS
SCHEDULE E
.1
%talpages Schedule €
The Instruction Guide explains haw to complete
this form.
2
FILER NAME
3 ACCOUNT # (Ethics Cornintssion Filers)
4
TOTAL OF UNITEMIZED LOANS:
$
5
Date of loan 7
Nance of tender
/ out-of-state PAC f,ID#:
p 9 Loan Amount ($)
6
Is tender $
Lender address; City; State;
Zip Code
10 Interest rate
a financial
r
Institution?
_
Maturity date
Y N
f`
12
Principal occupation 1
Job title (See Instructions)
Employer (See Instructions)
t
14
Description of Collateralmmm °jam€ 15 Check if personal funds were deposited into political account —
none
16
GUARANTOR � 17
Name ofguarantor
19 Amount Guaranteed ($)
INFORMATION
l
i6
j18
f
Guarantor address; City;
State; Zip Code
not applicable
/
j
20
Principal Occupation (See Instructions)
21 Erriployer (See Instructions)
Date of loan mmmN^u ~ Name of tent r�u N
N41 emmu Loan Amount ($j
PAC
put -of -state llik€.
Is lender
Lendersddress: 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
0 none
10
GUARAN'T'OR
Name of guarantor �
Amount Guaranteed (S)
INFORMATION
S
Guarantor address; City;
State; Zip Code
01 not applicable P
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.
www ethics.state.tx.us Revised 04119/2013
Texas Ethics Commission RO. Box 12070 Austin, Texas 78711-2070 (512)463-5800 (TDD 1-800-735-2989)
POLITICAL EXPENDITURES SCHEDULE F
EXPENDITURE CATEGORIES FOR SOX 8(a)
Advertising Expense
Gift?Awardsrftemorials Expense Sala ries!WageslCon'tract tabor Loan Repayment/Reimbursement
AccountingiBanking
Legal Services SoitatationlFundraising Expense Transportation Equipment & Related Expense
Consulting Expense
Food/Beverage Expense Travel In District Contributions/Donations Made By
Event Expense
Polling Expense Travel Out Of District CandidaterOf#ieeholderl?olitieal Committee
Fees
Printing Expense Office OverheadlRentai Expense OTHER (enter a category not listed above)
The Instruction Guide explains how to complete this form.
1 Total pages Schedule F: 2
FILER NAME 3 ACCOUNT # (Ethics Commission Filers)
4 Date
Payee na{me
{ 2C1 I �j
--.�
t
3
6 Amount (S) 7
Payee address; City: State; Zip Code
i
8 PURPOSE (a)
Category (See categories listed at the top of this schedule) ; (b) Description.1.1 travel outside of Texas, complete Schedule T)
OF
EXPENDITURE
s�
t tar p �i 4 Py= a x etz' tjs� �'`e-'t 1,t A-3 6, Li s i ..
9 Complete QNLY if direct
Candidate i Officeholder name Office sought Office held
expenditure to benefit. CIOH
Dateu.mw:Payee*
name��
Amount (S) (
Payee address; City, State: Zip Coda�/�
t
1'
PURPOSE a
Category (See categories listed at the topyf his schedule) Description (if travel outside of Texas, complete Schedule T;
OF 4
EXPENDITURE
...
_._ Candidate t Offceholdrriame Office sought — Office held
Complete gN-�tf direct
expenditure to benefit CfOH
1.
F
�. ' fir:-....�..a._.e........_...-,._......�..-...m. .�_.."..�....e....._�._............_.--........_.....�..�..,....�.....��..®�....._.-.......-e.._��..m.......,
�..__.._. ._... -_Payee
Da#e__..
�
name ,'
,
I!
Amount {$}
f�.�
Payee address; City; State; Zip Code
PURPOSE
C' t gory (See categories listed at the top of this schedule) i Description (If travel outside of Texas, complete Schedule T)
OF
EXPENDITURE
Complete Q df A.Y if direct
Candidate ; Officeholder name Office sought Office held
expenditure to benefit Cl 14
Date
{
Payee name
Amount ($)
Payee address; City; State; Zip Code
a
PURPOSE Category
(See categories listed at the top of this schedule)
Description (!f travel outside of Texas, complete Schedule T)
OF
EXPENDITURE
Complete QNLY if direct
Candidate ! Officeholder name Office sought Office held
expenditure to benefit CiOH
ATTACH ADDITIONAL COPIES OF THIS SCHEDULE AS NEEDED
www. ethics state. tx.us Revised 44/19/2013
Texas Ethics Commission P.0, Box 12070 Austin, Texas 713711--2070 (512) 403-5800 ("I"DD 1.800-735-2989)
POLITICAL. EXPENDITURES
SCHEDULE C
FADE FROM
PERSONAL FUNDS
EXPENDITURE CATEGORIES FOR BOX 8(a)
Advertising Expense
Gift/Awards/Tviemorials Expense SalariesiWages.<Contract tabor Loan Repay mcnt/Reirnbursement
Accountingi6anking
legal Services So€icitationiFundraising Expense Transportation Equipment & Related Expense
Consulting Expense
Food/Beverage Expense Travel in district ContributionsiConations Made By
Event Expense
Polling Expense Travel Out Of District Candidate/Officeholder/Political Committee
Fees
Printing Expense Office Overhead/Rental Expense OTHER (enter a category not listed above)
The Instruction Guide explains how to complete this form.
1 Total pages Schedule G: 2
FILER NAlv1E
1312COD
3 ACCOUNT # (Ethics Commission Filers)
4 Date}5
Payee name
u t I
6 Amount (S) 7
Payee address; City; State; Zip Code
reimbursement from
�� politicat contributions
rr,
� � 9 V u s T -P' r s , y� t { _ �q
V � f t
intended
�
�
W� �
PURPOSE (a° a)
Category (See categories listed at the top of this schedule) (io) Description {tt trav mi outsde at Texas ompiete Schedule Tt
OF
s
EXPENDITURE
( { _
l� �e-r2is�' L`
Date
Payee name}
,✓
4 �'�''7 L� j
�'�`� sic.. l`` �t A--�•i --'
Amount (S)
Payee address; City; State; Zip Code
Reimbursement from
contribuGcn<
political
tntosded E
w
.,..r._.___._ ._,__.._..._
___.,.uw,._..,.______�.__,.__._._,._._._....� __._......._.............m,..w�
PURPOSE
Category (See eafego es listed at the top of this schedule) Description (if travel outside of "Texas, complete Schedule 'T)
OF
EXPENDITURE
�r
Dated� I
Payee name
q[(j�
A
p
�yf 4 �'" C4,
Amount ($)
Payee address; City; State; Zip Code
4
Reimbursement from
cortrbutans l(
�7 8�'l Lf
0 q � a ` ( t Jq Com00 710 4,
intended
`
PURPOSE
Category (See categories listed at the top of this schedule) Description Of travel outside of Texas. complete Schedule T)
OF
�
EXPENDITURE
1
Date
Payee name
Amount ($)
Payee address; City; State; Zip Code
Reimbursement from
0 political contributions
intended
mCategory
PURPOSEry
(See categories listed at the top of this schedule) Description (If travel outside of Texas. cornpiete Schede€e T)
OF
EXPENDITURE
ATTACH ADDITIONAL COPIES OF THIS SCHEDULE AS NEEDED
www. ethics .state.tx.us Revised 04/19f2013
Texas Ethics Commission Ptd. Box 12070 Austin, Texas 78711-2070 (512)463-.5800 { FDD 1-800-73.5-2989)
www.ethics.state.tx us Revised 04/19/2013
PAYMENT FROM POLITICAL CONTRIBUTIONS
SCHEDULE H
TO A BUSINESS
OF C/OH
_,.EXPENDITURE
CATEGORIES
FOR BOX 8(a)
Advertising Expense
Gift`AwardslMemonals Expense Salaries/Wagestcontract
Labor Loan Repayment/Reimbursement
AccountinglBanking
Legal Services Solicitation/Fundraising Expense Transportation Equipment & Related Expense
Consulting Expense
Food/Beverage Expense Travel In District
Contributions/Donations Made By
Event Expense
polling Expense Travel Out Of District
Candidate/OfficehoidertPoiitical Committee
Fees
Printing Expense Office Overhead/Rental Expense OTHER (enter a category not listed above)
The instruction Guide explains how to
complete this form.
1
Total pages Schedule Fl: 12
V
FILER NAME
3 ACCOUNT # (Ethics Commission Filers)
€
4
Date i 5
Business name
6
AmountS
{) j 7
Business address: City: State: Zip Code
€
i
p�
$
PURPOSE (a)
Category (see categories Listed at the top of this schedule)
(b) Description of travel outside of Texas complete Schedule T)
OF
EXPENDITURE
9
Complete Q,f iLy if direct
Candidate 1 Officeholder name
Office sought Office field
expenditure to benefit CION
Date
Business name
Amount (S)
Business address; City; State; Zip Code
�
PURPOSE
Category (See categories listed at the top of this schedule)
Description (If travel outside of Texas. complete Schedule T)
OF
EXPENDITURE
Complete Cog' Y if direct
Candidate ` Officeholder name
Office sought Office held
expenditure to benefit CtOH
Date
Business name
Amount (S)
Business address; City; ~ State; Zip Code
s
PURPOSE ;
Category (See categories listed at the top of this schedule)
Description ilf travel outside of Texas, complete Schedule T}
OF
EXPENDITURE
Complete 9Nt Y if direct
Candidate / Officeholder name
Office sought Office held
expenditure to benefit CIOH
^
Date
Business name —�
Amount (S)
Business address; City; State; Zip Code
PURPOSE
Category {sea categories listed at the top of this schedule)
Description (if travel outside of Texas, complete Schedule Tj
OF
EXPENDITURE
- Complete ONLY if direct
w— Candidate t Officeholder name
Office soughtW ry Office held�+Wvvmm
expenditure to benefit CION
ATTACH ADDITIONAL COPIES OF THIS
SCHEDULE AS NEEDED
www.ethics.state.tx us Revised 04/19/2013
Texas Ethics Commission P.O. Box 12070 Austin, Texas 75711-2.070 (512) 463-5800 (TDD 1-800-735-2989)
www.ethics.state.tx us Revised 0411312013
NON-POLITICAL EXPENDITURES
SCHEDULE I
ADE FROM POLITICAL CONTRIBUTIONS
The Instruction Guide explains how
to complete
this farm.
1
Total pages Schedule 11
2 FILEN NAME
3 ACCOUNT t ('cthiiCS C'ortirriSSion Fitersl
I
4
Date
5 Payee name
6
Amount (S)
7 Payee address; City; State; Zip Code
I
8
PURPOSE
(a)Category (see instructions for examples; of acceptable
(b) Description
(See instructions regading type of mformattan
F
categories)
required.)
EXPENDITURE
i
.Payee
Date
name
Amount {S)
Payee address; City; State; Zip Code
v
PURPOSE^y
(a) Category (See Instructions for examples of acceptable
(b)Description
(See instructions regarding type of information
OF
categories)
required.)
EXPENDITURE
!
Date_,__��._._.a_._...�
Payee name
Amount {$)
Payee address; City, state; Zip Code
PURPOSE
(a) Category (see instructions for examples of acceptable s
(b) Description
.;See instructions regarding type of Information
OF
categories)
required.)
EXPENDITURE
s
Date
Payee name
Amount (S)
Payee address; City; state; Zip Code
�I
�(a)
PURPOSE
Category (see inshactions for examples of acceptable
(is) Description
(see instructions regarding type of information
OF
categories) irequired)
EXPENDITURE
i
F
ATTACH ADDITIONAL COPIES OF THIS SCHEDULE AS
NEEDED
www.ethics.state.tx us Revised 0411312013
Texas Ethics Commission P.O. Box 12070 Austin,'r'exas 78711.2070 (512) 463-5800 (TDD 1-800-735--2089)
INTEREST EARNED, OTHER CREDITS/GAINS/
SCHEDULE I�
REFUNDS,
AND PURCHASE ASE GP INVESTMENTS
_.._.._.--_The
—Total
y�..._...,.._m�m_n__.. s.._...
I
pages Schedule
rC
Instruction Guide explains how to complete this form.
2 f=1t_ER NAME
3
ACCOUNT ;Ethics
Commission Fliers)
4 Date
6 Name of person from whom amount is received
„ 8
Amount
6 Address of person from whom amount is received; City;. State; Zip Code
f
7 Purpose for which amount is received
Date
Name of person from whom amount is received
Amount
Address of person from whom amount is received; City; State; Zip Code
Purpose for which amount is received
Date
Name of person from whom amount is received
Amount
(S)
Address of person from whom amount is received; City; State; Zip Code
Purpose for which amount is received
i
Date
Name of person from whom amount is received
Amount
(S)
€[
1
Address of person from whom amount is received; City; State; Zip Code
r
e
6
F
i
i
i
i
Purpose for which amount is received
ATTACH ADDITIONAL COPIES OF THIS SCHEDULE AS
NEEDED
www.ethics.state.tx us Revised 04/19/2093
Texas Ethics Commission P.O. Box 12070 Austin. )"exas 78711-2070 (512) x#03-5800 {TDD 1-800-735-2989)
#WKIND CONTRIBUTION OR POLITICAL EXPENDITURE SCHEDULE T
FOR TRAVEL OUTSIDE OF TEXAS
The Instruction Guide explains how to complete this form. 1 Total pages Schedule 7
2 FILER NAME 3 ACCOUNT # (Ethics Commission Filers)
4 Name of Contributor i Corporation or Labor Organization / Pledgor I Payee
S Contribution lExpenditure reported on:
Schedule A Schedule B L'j Schedule C Schedule D Schedule F j Schedule G
r Schedule H Schedule N COH-UC COH-T ❑ PAC-G PAC-E=
6 Dates of travel 7 Name of person(s) traveling
�$ Departure city or name afdeparture location
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9 Destination city or name of destination location
10 Means of transportation 11 Purpose of travel (including name of conference, seminar, or other event)
Name of Contributor I Corporation or Labor Organization f Pledgor / Payee
Contribution t Expenditure reported on,
Fi Schedule A F i Schedule B Schedule G Schedule D Schedule F Schedule G
Schedule H Schedule N COH-UC COH-T ❑ PAC-C PAC-E
Dates of travel Name of person(s) traveling
Departure city or name of departure location
Destination city or name of destination location_
Means of transportation Purpose of travel (including name of conference, seminar, or other event)
Name of Contributor t Corporation or Labor Organization i Pledgor f Payee
Contribution/ Expenditure reported om
Schedule A ll Schedule B Schedule GSchedule D Schedule F Schedule G
L.J Schedule H ❑ Schedule N 0 COI-i-UC COH-T Ef PAC-C� PAG-E
Dates of travel Name of person(s) traveling
Departure city or name of departure location
Destination city or name of destination location
Means of transportation � � Purpose of travel (including name of conference, seminar, or other event) .... _.. _ _
ATTACH ADDITIONAL COPIES OF THIS SCHEDULE AS NEEDED
www. ethics. state.tx.us Revised 04/19/2013
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CANDIDATE / OFFICEHOLDER REPORT: FORM C/OH - FR
DESIGNATION OF FINAL REPORT
The Instruction Guide explains how to complete this form.
•+ Complete only if "Report Type," on page 1 is marked "Final Report" •+
ir1;t�7[1il:i�/=STI
2 ACCOUNT # (Ethics Commission Filers)
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 t 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:
i I do not have unexpended contributions or unexpended interest or income earned from political contributions.
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
Chock only one:
0 1 do not retain assets purchased with political contributions or interest or other income from political contributions.
I do retain assets purchased with political contributions or interest or other income from political contributions. € understand that
I may not convert assets purchased with political contributions or interest or other income from political contributions to personal
use. 1 also understand that I must dispose of assets purchased with political contributions in accordance with the requirements
of Election Code, § 254.204.
Signature of Candidate
OFFICEHOLDER
•• Complete this section only if you are an officeholder *•
(� I am aware that I remain subject to filing requirements applicable to an of6cehokler 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
www ethics, state. tx us Revised 0411912013