HomeMy WebLinkAboutCFR-07.10.2013-Fought, SteveTexas Ethics Commission P.O. Box 12070 Austin, Texas 78711-2070 (512) 463-5800 (TDD 1-800-735-2989)
CANDIDATE / OFFICEHOLDER
FORM C/OH
CAMPAIGN FINANCE REPORT
COVER SHEET PG 1
1 ACCOUNT # 2 Total pages filed:
The C/OH Instruction Guide explains how to complete this form.
(Ethics Commission Filers)
3 CANDIDATE /
MS/MRSIMR FIRST
MI e�ccrf^earGFd +
OFFICEHOLDER
NAME
yG ItN
t
NICKNAME LAST
y
"
SUFFIX10
i
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ADDRESS/PO BOX; APTfSUITE#; CITY;
STATE; ZIPCODE
4 CANDIDATE /
OFFICEHOLDER
MAILING
, €
_
qt
ADDRESS
del rig a r
4.� _+
�
change of address
AREA CODE PHONE NUMBER
Receipt # Amount
EXTENSION
5 CANDIDATE/
OFFICEHOLDER('_
" /
Date Processed
PHONE
6 CAMPAIGN
MSIMRS /MR FIRST
MI Date Imaged
TREASURER,
�.
NAME
.........
NICKNAME LpASTT�+
SUFFIX
7 CAMPAIGN
STREETADDRESS (NO PO BOX PLEASE); APTfSUITE#;
CITY; STATE; ZIPCODE
TREASURER
ADDRESS
.✓
(residence or business)
8 CAMPAIGN
AREA CODE PHONE NUMBER
EXTENSION
TREASURER
PHONE
9 REPORT TYPE
January 15 30th day before election
Runoff 15th day after campaign
treasurer appointment
(officeholder only)
El July 15 El 8th day before election
El Exceeded $500 Final report (Attach C/OH - FR)
limit
10 PERIOD
Month Day Year
Month Day Year
COVERED,r111
/ff /l THROUGH
/1 /A
11 ELECTION
ELECTION DATE
ELECTION TYPE
Month Day Year
❑ Primary
El Runoff t3C I General Special
12 OFFICE
OFFICE HELD (if any)
13 OFFICESOUGHT (ffknown)
GaG� t f Gro,`vz
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www.ethics.state.tx.us Revised 04/1912013
Texas Ethics Commission P.Q. Box 12070 Austin, Texas 78711-2070 (512) 463-5800 (TDD 1-800-735-2989)
CANDIDATE / OFFICEHOLDER REPORT: FORM C/OH
SUPPORTi LS COVER SHEET PG 2
14 C/OH NAME
15 ACCOUNT # (Ethics Commission Filers)
��
V`f .Oft r 0 6^'" t..' Aeo /
16 NOTICE FROM
THIS BOX IS FOR NOTICE OF POLITICAL CONTRIBUTIONS ACCEPTED OR POLITICAL EXPENDITURES MADE BY POLITICAL COMMITTEES TO SUPPORT THE
POLITICAL
CANDIDATE / OFFICEHOLDER. THESE EXPENDITURES MAY HAVE BEEN MADE WITHOUT THE CANDIDATES OR OFFICEHOLDERS KNOWLEDGE OR
COMMITTEE (S)
CONSENT. CANDIDATES AND OFFICEHOLDERS ARE REQUIRED TO REPORT THIS INFORMATION ONLY IF THEY RECEIVE NOTICE OF SUCH EXPENDITURES.
COMMITTEE NAME
COMMITTEE TYPE
GENERAL
COMMITTEE ADDRESS
SPECIFIC
COMMITTEE CAMPAIGN TREASURER NAME
additional pages
COMMITTEE CAMPAIGN TREASURER ADDRESS
17 CONTRIBUTION
1. TOTAL POLITICAL CONTRIBUTIONS OF $50 OR LESS (OTHER THAN
TOTALS
PLEDGES, LOANS, OR GUARANTEES OF LOANS), UNLESS ITEMIZED
2. TOTAL POLITICAL CONTRIBUTIONS
$
(OTHER THAN PLEDGES, LOANS, OR GUARANTEES OF LOANS)
l
EXPENDITURE
TOTALS
3. TOTAL POLITICAL EXPENDITURES OF $100 OR LESS, UNLESS ITEMIZED
] /
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}
C
LOAN TOTALSLAST
DAY OF THE REPORTING PERIOD
>1 L5
r
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.
ERIN BRETTLE
.JESSICA
�--�° _
* := NOTARY PUBLIC J�G ii G.s'r
'•, '4; State of Texas
••;� ' I • Signature of Candidate or Officeholder
• Comm. Exp. 06-01-2015 g
AFFIX NOTARY STAMP / SEAL ABOVE
1r�
Sworn to and subscribed before me, by the said this the
day of 20 to certify which, witness my hand and seal of office.
J12Ssi cON-e- eC+&
Sig atur of officer administering oath Printed name of officer administering oath Title ok0fdcer administerin th
www. eth cs.state.tx.us Revised 04/19/2013
Texas Ethics Commission P.O. Box 12070 Austin, Texas 78711-2070 (512) 463-5800 (TDD 1-800-735-2989)
CANDIDATE/ PEKE L E EPO T: FORM C/OH 1=
DESIGNATION F FINAL REPORT
The Instruction Guide explains how to complete this form.
•• Complete only if "Report Type" on page 1 is marked "Final Report" ••
1 C/01-1 NAME
2 ACCOUNT # (Ethics Commission Filers)
Cl6 Gj%r Y"✓� r ✓IGS'%=��
3 SIGNATURE
1 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:
I do not have unexpended contributions or unexpended interest or income earned from political contributions.
0 I have unexpended contributions or unexpended interest or income earned from political contributions. 1 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.
0 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. 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
5 OFFICEHOLDER
•• Complete this section only if you are an officeholder •+
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
www.ethics.state.tx.us Revised 04/19/2013