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HomeMy WebLinkAboutCFR-05.06.2013-Baxter,BrendaTexas Ethics Comrrission P.O. Box 12970 Austin, Texas 78711-2070 (512)463-5800 (TDD 1-800-735-2989) wwv v.ethics.state.lx.us Revised 00.i28f2011 CANDIDATE ; OFFICEHOLDER FORM CAMPAIGN FINANCE REPORT COVER HEFT PG I 1 ACCOUNT # 2 €tial pages t1ed: The C/0K Instruction Guide explains how to complete this form- i( 3 CANDIDATE 1 OFFICEHOLDER£3t-FIC1=USE %is: MRS tfkAw FIRST Mi; C7t~1'�Y NAME I E I'AY 06 2013 4 CANDIDATE i ADDRESS !PG ROK APTt5?•fTE¢ CITY, Te;:`E:. zip € ODE OFFICEHOLDER MAILING � t &ioi�r T nr o aarke& ADDRESS ( { e. t Elrhange of address 5 CANDIDATE/ AREA Co_�E PHONE hfJMBER ION OFFICEHOLDER, PHONE Date Processed 6 CAMPAIGN TREASURERNAME MS RS i MR FIRST ft; Da3t;imaga%l A $JSty#s:zdAPAE. litST SUFFIX 6l 0 7 CAMPAIGN STREETAI)DkESS (1%87 PO BOX PLEASE, AP SUIT 4; Ci YSAI E. 21pcoC E�-/') ADDONTREASURER Ir,D€3RESS ;t'85idt"�rlf:e car b;JSlr;ess} 8 CAMPAIGN .ASEra CODE PHOI E NUMBER uXFE1s C„V PHONETREASU 9 REPORT TYPE !artua.ry 15 F 30th. day bcvOis elerfion � s'iU;soFf t5 i day after Campaign � r'• fCisLFBf di'{?43fi EtTla(Fi {J7fF_'9."w c.nlyl I July 358.;3 slay !..�scre ese',:;io:n E:<ecerdc:C Y+UJ J Final report {An:.cfr 00H- Pst �t 10 PERIOD .ao,:s;-: � D;y Year #.� *, Di� tee COVERED THROUGH tZD13 -301 zo 3 11 ELECTION ELECT ONDA E � ELECT;CN^ f PC Lewy' ker Q 1201' 3 12 OFFICE 0FR EHELs7f aanVl 113 f. FICE5CUGHs fifth wal-- k (shc TE wwv v.ethics.state.lx.us Revised 00.i28f2011 Texas Ethics Commission P-0. Box 1§2070 Bustin1., Texas 787'31-2676 (512)463-5800 (TDD1-800-735-2989) CANDIDATE I OFFICEHOLDER REPORT: FORM COVERSUPPORT & TOTALS HEET PG 2 '14 C/OH NAME� 1S ACCOU€1fT= ;EtNcs Cornmiazior, Ftlersl 16 NOTICE FROM i 714JS BOX 4S FOR KanCECYrMADE BY POUTICAL COM,*.MITIEESTOSUPPORT THE POLITICAL CFNUJATctoFFTCEtsO$DER. THESEEXPENDITURESWAYHAWEsEIENMADEWrHOUrTHECAN00ATE'SOROFFICEHOLDER'SKxOWLE-1acOR COMMITTEE(S) £ CONSENT CPb,'dDMATES Me OFRCEHOLDER^s ARE REQUMID TO REPORT TMS MFtTSMA-1110N ONLY WTHEY RECENIENOTFCEE of SUCH EXPE34iiUPES. CC, %Ikii cTEE NAMP 4 GOPAWTTEE TYPE r I € GENERAL z COio@'W iEi.ADDRESS i SPECIFIC i gg¢ € J GGi:°Mkf3\ i EE CAMPAIGN TRcsASi. PER. NAME addHsonzd pages i tO`:WTTEECAMP IG^ITREASURER>ADDRESS i i S 11r CONTRIBUTION s TOTAL POL;T CAL CC9':�f 3RiBUTIONS of 550 OR LESS ,'O H.EP. THAN TC IACst PLEDGES LOANS. OR GUARANTEES OF LOANS1. UNLESS ; T EEMUZED € I 2. TOTAL POLITICAL CONTRIBUTIONS �2Vll t tOTHER THAN PLEDGES, LOANS.. OR GUARANTEES OF LOANS? EXPENDITURE I TOTALS # 3. TOTAL FOLTCAL EXPtITLtES7F}fO% LESS, UNLESS ITESZEiu' 4- TOTAL POLITICAL EXPENDITURES t �l CONTRIBUTION 5. TOTAL POT ;TICAL CONTRISUTTONS h ANI TAINED AS OF THE LAST DAY BALANCE i OF REPORT:NG PERIOD 0Ci E OUTSTANDING b. TOTAL PR=1 CfPAL AMOUNT OF ALL OUTSTANDING LOANS AS OF T14E I LOAN TOTALS s AST DA`( Of! THE REPORTING PERIOD l 418 AFFIDAVIT I swear, or affirm, under penalty of pfr;ur~y, that the accornpanyincg report is::rue and coir and includes all information r aired to be reported by `Lt.CRftY ��6JJJJ ROBYN LOUSE RYE rile under Tit[ ' 5, Election Cod=. O t� "= No Public, Stateof Texas my Commission Expires April i, 2(714 Jt({btt\tyt { &gnafure of Candidate or Officeholder E AVFFiX NOTARY STAiAP ! SEAL ABOVE- Sworn to and subscribed before me, by the said ._1� _ ------.----�� ------------_-, tris the div of -.__._.- 2C} to certify which, ,=rltness rT€y hand and seal of office. Signature o .ffioeradmir:roath Printed n meoFos?ons min'€steringoath Tittle ofoficeradministeringoati: W.ethics.state.tXA1S Reviml 0912812011 Texas Ethics Commission P-0- Box 12070 Austin, Texas 78711-2070 (512)463-5800 (TDD 1-800-735-2989) POLITICAL °" IONS SCHEDULE OTHER THAN The Instruction Guide explains mora to complete this form. ( E T6#21 ijag CGstec:u3e. {'�: ff— 2 FILER NAME 3 ACCOUNT (Ethics Comm scion Pillars) 4 Date 5 Full name of contributor 71�-'"'tof-slal*PAC(1 � � 7 Amountof � ii7-€£tncic3rfFritu;}on ra, C[ conFribu?ion ( ) description (if applicable) l �l � ✓ 6 Contributor ad Sr�SSs City; State , Zip Code ,Wf '��x/.�� 4� 2� Cis;► �r1G111 C(61,c t Ty 1 6 3� ScCheduie (ii travai outside of Texas, comcsiete T 9 Principal occupation I Job t€tit (See Instrsc:ions) E 'SEI Employer (See Instructions) € Date FU#i riBSTSe Of(�C.}OCSiCPt".rUtQi �J afi���e''',,,���^^ .{i':u^S. Amount, of In-kind ct7T1FCibution yrCM"fy�. ��i �� 1(,,,-{- � 11✓' � contribution (mow) Iii Cj>F'SCr#CkttCtn fit applicable) (�%� j Contributor address; City: State: Zip Cede iii �-� g Clab ! "* ` L/D {]f iru`'Vrii pCRS+"di:. Ot rB7�35, GD7li'M'lE7iF3 St hrsc=Wle T) Principal occupation /Job title. (See Instructions) Eniplorer (,See Instructions) i t Date f=ull name of contributor `� >xi a -site Pttc;ir='�.+ Arnoura of #n -kind contribution �� :,t34'iiribi7ti4ri (W) � description (if applicable) r,/� �} (� j `� 41 1 v, . . . . . � GonErzbu;or address; City; -State: Zipcode VIN� o -1c 6i kTXC '��� i.:�Uv 1 ! {ti i Texas., Schedule- 7) ,ei uutssCef eccn;,itxYe Principal occupation i .sob title (See instructions) Employer (See lnstructionsI 1 Gate Full(n'�ff I name of �:�:t-ai-siaiesPAcliiD, Amount of � in-kind contribution � ��li?L contribution E j t description (if applicable) I Confrbutor address; City State; Zip Code Leo Tri �D h CSC` " Hf # a.ei outside of Texas, cuaxe€eYe Scr,ecic;e T) Principal occupation r",Sob title (See Instructions) � Employer (See Instructions) E Gate Full name of contributor�, ,�# Yi_stat� PAC 1'00. fAmount off ! In-kind contribution ___—_-- contribution yw.l � description (if applicable) ic Contributor address; City: State: Zip Code # t +�6 CTeQ i -�. i owl i 1 ' f "' ca L -.'W i (if travel G?iS5E4f: of feXtS. t:f}irt Eo a_ete Schedule Tt Principe, OOCUpailori I Job Lt.it" (See #nsirUCt10!i5) � EC3lDIOf'x?i (See 1 {nS:rtlOitt7n9}. ATTACH ADDITIONAL COPIES OF THIS SCHEDULE AS NEEDED If contributor is out-of-state PACs please see instruction guide f€iradditiona; reporting requirements. "rvWt•,+.e<hics.si2,fe.;x.us Revised M28f2£11 Texas Ethics Commission P.O. Fox 12970 Austin, Texas 78711-2070 (512)46a-5800 (TDD 1--800-73:-2989) POLITICAL CONTRIBUTIONS OTHERPLEDGES LOANSSCHEDULE The Instruction Guide explains how to complete this form. '¢ Tetal paces Schedule A: ,tet 2 FILER NATE �, Z!661(6 Eat 3 ACCOUNT # ethics Commission Hers) 4 Date 5 Full nacre of contributor oe:t-et-siataPAc 7 Arnountof $ In-kind contribution - �1 � contribution (S) # description (if applicable) f - `- --- . - . . - . . . -. . . . . . . Fs Contributor ad City; State: Zip Code 1 i (if travel o_ kite of Texas, complete Schedule T) 9 Principal occupation i Job title (See instructions) i 1() Employer (See Instructions) t Date Full of contributor T out -of -stair fACttC�:_ Amount of � In -mind contribution yn;arne Lai Eon contribution ($) description (if apptica4tile} 1 V 11 '^.no}ntrGf7utt/¢o�`Tr(''(Ja,-d�dress, City; St2te. K p code € `€t travej o-oislrie fof Texas, complete Scnedule f) Principal occupation f Job title (See instructions) "Employer (See t Instructions; Date Full name of contributor Q out-of-state PAC{iGt.� Amount of In-kind contribution contribution O ! description (if applicable) Contributor address; City; State; Zip Code i (;f travei outi'de. of Texas, complete Scredule T) Principal occupation f Job title (See Instnictions) I E€vp over (See Instructions) I Date7C.u0,nt'nbutor'address:' narne of contributor Qac -os -s' iePAC(3i)w. Amount of S In-kind contribution contribution (,¢a} t description (if applicable, {� City,- State: Zip Cotte . . . - . . . . (if travel outside l E of Texas, coni lefe Scnedu!e T), Principal occupation ( Job title (See Instructions) Employer (See Instructions) i d Date Full name of contributor © ovt- f-staiePAC ODP: � �. � Amount of i fn -kind contribution contribudon (S) r description Qf applicable) Contributor address; City State; Zip Code 11 (if five€ outs€de of TeAs, cornotele Schoduie T) Principal occupation I Job title (See instructions) i Emps'oyer (See Instructions) i ATTACH ADDITIONAL COPES OF THIS SCHEDULE AS NEEDED If contributor is out-of-state PAC, please see instruction guide foradditionaf reporting requirements. WVVV.f.efhdcs.state.tx.us Revised 43912&12011 Texas Ethics Commission P 0. Box 12079 Austin, Texas 78711-2070 (512) 461-5800 (TDD 1-800-735-2989) WWW.ethics.siate.tx.us Reinsert 09i28f2i911 POLITICAL EXPENDITURES SCHEDULE EXPENDITURE t36"#'URE ATE ORIES FOR BOX 8(a) Adveitiszng Excen5e UsftLt'.:i 3FS`--°4;EJ„^iGr2ai5 Expense Sa4ariest ages'Crintract Labor :.car, RepayrnerittReirribur-ement Accr,unttng?Banking Legai Services So"citaticn'Fundraising ExpenseTra.tsportatio Egcrip ent? Related Expense ConsulVnq Expense FoodtBeverage Expense Travel in District Gcintribu ionslDontons Miade By Event Expense Pail:na Expcnse Travel Out Of district Candida€eTCfiicehoWerrPolitiical Committee Fees Printing Expense Office CvesriecrilRental Expense Ct`s HER (,enter a cate�, cry not listed above) The Instruction Guide explains haus to complete this form. 't total paces Schedule F: 2 FILER ivAMEe� � 3 AC GOUNT # iEthics Comm=ission Hers) ��� i A Da' fj 12,013 5 Payee name Ld'' __ ii and 4 q 3CGi- 6 Amount (j 7 Payee address: Cita,:; State; Zip Cad up(" 8 PURPOSE (a) Cateacry iisee catiigo iL s itistw at tui t^r of fhic sche{i,4e} (b) Description tff v�4 nutstde of Texas. cocnplute `;: hay uks T) OF EXPENDITURE lid viat' +1. VPICAJ C l � it) V.I d��� 9 Complete (_SNE. if direct Candidate f Clic older name Office Sought Office held exbenditure to benefit CION Lute f i Payee name 1 Arnount { ) Payee address; City; Sate; Zip Cade I i i PURPOSE Category (Se -e cateso es listetr at the top 1Y th:.t s4niaztulai F Desc%iption (;€+.ee�f � crtside ok Texas, �rrpd=tra Sche uis T? OF # EXPENDITURE Comoiete QN1t,Y if direct Candidate I Officeholder name Office sought Office heid exGeriditure to iaenef f {'.!i. H Date 1 Payee name Amount () Payee address; City; State. Zip Carie { PURPOSE Category Ga{egCPitj is ca ibj}{xT4tt655�tf8tdtrtE7) Description tiTfr3na.OEltSli{24i Se%as.Al�,t;rfe 6Chedu3c T} OF EXPENDITURE Corrtpiete t?t+iil_Y if direct Candidate 1 Officeholder name Office sought Office held expenditure to benefit C,'Ci-i Date Payee name i i Amount () i Payee address; City; State; Zip Cade i a PURPOSE Calle- gory ist'le caie{ ne,s hsk d rt r1a tee. a- ._ s hsduie? Description {if ;ace€ cutaide r, Teens. coanp a�rsScPelute z OF i EXPENDITURE t t Complete ONLY if direct Candidate d Officeholder name Office sought Office heir( expenditure to iteriefii C?OH ATTACH ADDITIONAL COPIES OF THIS SCHEDULE AS NEEDE€? WWW.ethics.siate.tx.us Reinsert 09i28f2i911 Texas Ethics Commission PCT, Sox 12070 Austin. Texas 78711-2070 15125463-5€300 {TDD 1 -800 - EXPENDITURE CATEGORIES FOR BC 8(a} Advertising Expense GiftlAwardsfF>4ernoriais Expense Salaries.'Wages!Contract Labor A �ounting!Banking Legak Services Sciicitat€oniFundraising Expense Consulting Expense FoodlSeverage Expense Traver In District Event Expense Polling Expense Tsave? Out 0" District Fees Printing Expense tOffice GverheadiRentai Expense Load Rep ayment?Reirnbursernent Transportation Equipment & Related Expense Contribu€ions'Donations Made 8v Cand;date(OEifcehotderlPok -cat Comair ttee OTHER tenter a category riot listed above) The Instruction Guide explains how to complete this form. I Totai pastes Schedule G: 2 FILER NAtv1E 3 ACCOUNT IT {Ethics Corrimisslon Fikersl a 4 Dat 5 Payee name �ln'f 6 Amount ($1 7 Payee address; City; State: Zip Code Ke::Y?.??Ii�Eit��tli iSUfit � V6lkpr(nf C ;:�;iStica€ contrknciias;s i;?3r:nc!e�3 i5i PURPOSE (a) fti�,ted at:'r(a,.,?,onof. hm S� he& Category (Se©©e ra. cr(- ( (b) Description Cif rrovl el outside &Tern. coma;e£e Schedule f ) OF EXPENDITURE � t^> j� li ��i tf�� t / !� per I�� Date,- l PBYL'e Ft3rTSE Amount ( i Payee address;v City; State; Zip Code 94q�riIlf5Ctn0lY: .1"ialS `+ 1 ' I p 4i:ca€ cor4rbutk�rss YYY _ ?d ii0i#'?UG' t E PURPOSE Cat :%ry.'See categories fisted at:ne for 0"kh sc e ula) Description OF EXPENDITURE Date t Payee name 61(a k cs Amount ($} Pavee address; City; State; Zia Code � � � � @ u `�ir Zt �'{ i � f _ 1 (J%' �U; contrs:wiia�,s V` -I l C� i yotECia:v4 ✓L/ ifi9n.':9d PURPOSE { Category fs9eE <aiego i$s fis:en at the toy of ttlis schedut8l 44 6 Description 0c lravOl oursE s of Texas, colnytete Sche luie li EXPENDITURE RE U ait i 7 4 � t r F�� Date Payee name Amar.rnt {) Payee address. City; State; Zip Code RwnlbumennanT Ssvm ElL`.3![iCL'"1;4`✓.ii(iu`�i l:i.S.f.^ PURPOSE Category ($o8 r a 4z e Q ot lig: dote d at*k, t0'0�0 1,f Ss Chedu to I�eSiY:�t#v yif lr o £ Ct i3%2S f } (81 aC r.�J4::•:i OF EXPENDITURE a .. wvm?.efhics.state_tx.us Revised W281201; Texas Ethics Commission P.0, Box 12070 Austin, Texas 785711-2070 (512)463-5800 {FDD 1-803-735-2989} PAYMENT FROM POLITICAL CONTRIBUTIONS SCHEDULE TO A BUSINESS OF C/OH -- ---EXPENDITURE CATEGORIES FOR BOX a(a) Advertising Exoerisa Gi tY:lxait�i�'rdslt4iernoriais Expense Sai3CFESF'd' ages1cointract Labor tear. RepaSfiieFit�Reiiiibtir5>e,riierit Accou ntirig" Bei F king Legal vennees Sol icitaflcu-i(Fund ra:S iiag Expense Trans tion Equipment 4'x Rested Expen5e vort Consulting Expense Foodffieverage Expanse TraveE ln, Disinct C,ontributionslDonations ibiade 8v Event Ext,ense r o!iing Expense Graves Out O District Candidate i SeiJEoSFtrnaal C mSni#tee Fees Fnntsno Expense Office OverheadtRentai Expense OTHER (enter a category not tested above) ., The Instruction Guide explains 'low to complete this form, I Tote; pages Schedule H. 2 FILER NAME 3 ACCOUNT » ;Ethics Con2mission Piers) i 4 Date t Business name 6 iarnount S) 7 Business address; City: State; Lip Code 8 PURPOSE (a) Category Description (if t,avMcut.,ire.=teeeny,C4mwa7teSch+dut; i} OF EXPENDITURE 3 Coat fete QNLY it direct Candidate J Officeholder name Office-` sought Office held expenditure to he nef i-A %i%H Date � Business namia Yl£Yiount { 1 Business address; City; State; SAP code F PURPOSE `aieC,J"CiV {SH(3-^.Htraaiida#iiuof .a.'ieteetat !3$SCS€v{:(t'[) DescRpifoR[rixdYfti^1.k.aKdFILoiTEtXcS.::r,;Ti�.IdteS�eibT)i.Fler) OF EXPENDITURE i k Complete ONLY if d,i eet Candidate I Otfi, eholde_r narne Office Sou ht Office held expenditure to bene€it CIO-1 Date Business name Amount Business address: City; State: Zip Code PURPOSE Category ;3eec a;ories ff e �ttz topa tf, a_t,Gw9 } Description tti ravel oot id of iexaa. cloni,;tete Schedule T} OF ( EXPENDITURE (� i 3 Complete ONLL :f direct Candidate ? Officeholder name Office Sought Office held expen6lure to benefit CtOH Date i i BktS.FtE:SS RaiYte ,mount (3) Business address; City; State; Zip Code i r r 4 _ PURPOSE or ors ;5s� cate_res @tete a #ham t, : ofth=s Se`eude} n ftY't.auni oz ie �iiBX£a', cpmtekes S , die Yi Description OF EXPENDITURE Complete Off"_ if direct Candidate I Officeholder name Office sought Office held expenditure to benef;t CfOH ATTACH ADDITIONAL COPIES OF THIS SCHEDULE AS NEEDED wvv Jd.ethics.s1ate.ct.us Revised 09128120 11 Texas Ethics Commission 1-0. Box 12070 Austin, Texas 78'€11-2070 (512)463-5800 (TOD 1-800-735-2989) www.ethics.siate.ix.us Revised 09/281'40111 NON. LITICAL EXPENDITURES SCHEDLJLE - EXPENDITURE CATEGORIES FOR BO 8(a) Adverbsinci Exile ase C!<ty'Rmaardslf ernorials Expense S =r� Self"v3'eSiCo=,iracfl Labor Loan Flea a;r1�e,3YlFiei ati� awea�erl€ r'LrcouF^ting1,'ion Tvr'n9 Legal Services Solicitation}Fun&aising Expense Transportation Ec"{Uipin6tlt Ru R£:!St8($ (_%},'e;1>e Consu ting Expense FoodiLkeveraje Expense Travel !n Mstnct Cat trittutrors:ii L'�ti.'Ssu'l4Gt?3 Made EV Eberit Expense Polling Expense Travei Out Of €1..;S.lTtct C-cn fidatee*'O lice:` older/Politirai Committee Fees P lung Expense Office OveYPeadiRenta' Expense OTHER (enter a category` not listed above) The Instruction Guide explains h©w to complete this fora:. I Fetal pages Sched .ie I: 2 FILER NAME S ACtOOUNT # (Ethics Cornnif sior, F'i'lers) 4 Elate 5 Payee name s ! 6 Arnount ($; Paya_s address: City; State; Zip Cade I I I 8 PURPOSE (a) Category 1Sep caaey-or;est:_t_siut The fwca, zlinscharJ00 i ) Description fdrains,rucfiu.rs:ea<.tnt.gtr pec#infcmaviut .e.}uire0 QP EXPENDITURE Y Amount (5t Payee address, City; State, Zip Code S{j$� i# F Ca:eCjU`ij+ $V£#calrr c Ye'S iis£td of `. J'y'E�t hta 5x: Trek Uivf Description (SLa,t,.:�11 C5!it ;„FCy_rdirg'tern, o7 SiiiOS'13`Y.f:F; ff :4.}U,+G'v i PURPOSE 6 f €3F { EXPENDITURE I{ Late Payee narrie ga 3 Arnount ($) Payee address; City: State; Zip wade Category (See Com? 7 ies !;CtFaC"i e. (Tr}a x..i ar. L ii 1, ScKt} t L ii { e., i d¢Lci?'vmS iEnBfiP: $'dpi t Or iciilQt} V 4`k -) PURPOSE OF EXPENDITURE yyy'y j tate Payee [game — Amount ($i Payee address; City: State: Zip Code category i-seaL.iiG3LJF,H.,t_ied ea. the Top r.,.R,s Description {SG..; eri-�.ix,x.'.Y flS:> 1�?frJi fi 'j l.�lr_: rt. 31ir3t1 :i361ll:.di5.} PURPOSE E OF EXPENDITURE I ATTACK ADDITIONAL COPIES OF THIS SCHEDULE AS NEEDED www.ethics.siate.ix.us Revised 09/281'40111 Texas Ethics Commission € 0. Box 12070 Austin, Texas 78711-2070 (512)463-5800 (TDD 1-800-735-2989) INTERESTCREDITS/GAINS/ REFUNDS,INVESTMENTS €� t�� I Total Gages Schedule K: The Instruction Guide explains how to complete this form, t 2 FR -ER Nfi.NIE 3 ACCOUNT :t Ftnpcs C'.'..^.ii;3SssI0Yi Rif?rsj S 4 Date j 5 Name -of person from 4L hoint-mounit is received .riiFl:unt 1 ............. .... ................. .... 6 Address of person from W'horu arnounIi is received; City; Sate; Zip Code i { t� i 7 PLHpose Tor Which arrbcum is received { t i Date Narne of person frorn *htharn amount is received amount {�3 Address of person from whom artx;uirt is received; City; Sate; Zip Coda: � r Purpose for which amount is received i Date � Name of person from whom arnount is received Amount {j ($! . . . . . . . . . . . . . . . . . . . . . . . . . . . .. . . . . . . . . . . . . . .S Address of persort from :vhurn amount is received; City; State; Lip Cotte F Purpose forwhich amount is received Date Narne of person from whom arraount is received i Amount s {t i e i Address of person from is nLoeive!d; CitySfate; Zip Code { I f t I d Purpose for which ar iount is received ATTACH ADDITIONAL COPIES C3F'€ HIS SCHEDULE AS NEEDED I p g3g f� www.ethics.stafe.tX_crs Revised 0912812011 Texas Ethics Commission P.O. Bax 12070 Austin, Texas 78711-2070 (512)463-5800 (TDD 1-800-735-2989) IN-KINDTTPOLITICAL EXPENDITURE SCHEDULE FOR TRAVEL OUTSIDE OF TEXAS The Instruction Guide explains how tocomple.€ � e this form, � icfai aagas Sc•t�edule l': 2 FILER NAtv3E E 3 E ACCOUNT # (Ethics Co emission Hers) 4 Mame of Contributor l Corporation or Labor Organization ? Pler y' -n I Payee 5COniSibuidiin i Expenditure reporfea on: Schedule A i1 Schedule B F-� Schedule C Ell Schedule 0 F-�j Schedule E_ Schedule Z Schedule r? Schedule 1 t C)H-FJC I�D COH-T- ❑ PAC -C PAG -E — 6 Fates of travel ; 7 Name of persons; traveling E Departure city or name of departure location 9 i3esEinahott City or name of des€irrason location f ' ( Means of transportation Purpose of travel (including name of conference, seminar. or other cu't'erill i i _ Marne of Contributor /Corporation or Labor Organizwion t Pledger / Payee Contribution / Expenditure reported on: Schedule A Schedule B Schedule C Schedule L Schedule F Schedule G l � t •_t ^ � Jf . T Schedule i-£ � Schedule CC3 3 C � S Pit C -C F, PAC -E Da.^es of travel Name of Pers n(sl traveling Departure city or name of departure:ocaldon Destination city or naive of destination location l Means of transportation Purpose of travel (including name of conference, seminar, or other event) f E Name of Contributor r` Corporation or Labor Organization / Pledger rPayee Contribution J Expenditure reported on: �j Schedule Scl'weduie B ScheduleC E] Schedule F Schedule F Schedule G S hedule N Soh dt.r:e i COPi -UC COO -T PAG -.0 E PAC -E Crates of travel dame of person(s) trave€fng 0 - Departure city or name of de pariure location ( Destination city or name of destination location Means of transportation a Purpose of travel (indudina naive of conference, seminar, or other event) ATTACH ADDITIONAL COPIES OF THIS SCHEDULE AS NEEDED <r�r.eihics.state.tx.us Revised 09/28120111 Texas Ethics Commission r"'.U_ Sox 12070 Mustin_ Texas 78711-2070 ^ V.(W.efhics.stafe.tx.us Revised 09,28/2011 OFFICEHOLDER 4 FORS g DESIGNATION The Instruction Guide explains how to complete this form. •• Complete only if " Rep€ rtType" on page 3 is marked "Final Report" �> ClOH Pel.+ ME. 2 AC OUN i # (Ethics Cornmissioll t-ii�rs) 3 SIGNATURE 1 do not expect any further political contributions or political expenditures in connection with n,y candidacy. 1 understand that designating a report as a final report terminates iny° 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 a- Complete A & 8 below only it you are not an officeholder. . A. CAMPAIGN FUNDS Check only one: I do Piot have unexpended contributions or unexpended tTlI'CreSt or iRCOiT1e B2rrit'd iri}C7i I3,JiEtECat contributions. I have unexpended contributions or unexpended interest or income earned from political contributions. . I u€ldersiand that 1 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 t 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 polifical contributions or interest lir other income from political contributions. i do retain assets purchased v61th political contributions or interest or other income from political contribtitiflnS. 1 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 vAtli political contributions in accordance with the requirements of Election Code, §.25+.2{,`-f. Signature of Candidate 5 OFFICEHOLDER •^ Complete this section only if you are an Off iceho§des -® ] I arra aware that I remain subject to filing requirements applicable to an o€iiceholder+.,vho does not have campaign treasurer on file. I arra 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 ogler income from political contributions. Signature of Officeholder ^ V.(W.efhics.stafe.tx.us Revised 09,28/2011