HomeMy WebLinkAboutCFR - McMichael - Amended - 12.31.2013Texas Ethics Commission P.O. Box 12070 Austin, Texas 78711 -2070 (512) 463 -5800 (TDD 1-800- 735 -2989)
FORMCOR—C/OH
CORRECTION/AMENDMENT AFFIDAVIT
FOR CAN DIDATEIOFFICEHOLDER
1 ACCOUNT# 4 2 Total pages filed:
OFFICE USE f?AtLY
3 CANDIDATE/ l MRS IMR FIRST MI Date RECEIVE-73
OFFICEHOLDER Ca C d=am
NAME . . . . . . . . . .
NICKNAME tAS SUFFIX APR 11 2014
4 ORIGINAL REPORT January 15 Runoff El Other (specify)
TYPE
July 15 Exceeded $504 limit
Date Hand - delivered or Postmarked
El30th day before election F1 15th day after treasurer
appointment (officeholder only) Receipt # Atnar
8th day before election El Final report
Date Pronessed
5 ORIGINAL PERIOD Month Day Year Month Day Year
COVERED �t THROUGHl�, /f Date Imaged
6 EXPLANATION OF CORRECTION
TM
I swear, or affirm, under penalty of perjury, that this corrected
7 AFFIDAVIT report is true and correct.
Check ONLY if applicable:
❑Semiannual reports: This report is an amendment/correction to a
semiannual report due on or after September 1, 2011. If amend -
ment/correction is filed on or after the eighth day after the original
report was filed, I swear, or affirm, that the original report was made
in good faith and without an intent to mislead Or to misrepresent the
information contained in the report.
Other reports (excluding semiannual reports due on Or after
Y p •. l�J September 1, 2011): t swear, or affirm, that I am filing this corrected
APR.. �s'• JESSICA ERIN BRETTLE
report not later than the 14th business day after the date I learned
NOTARY PUBLIC that the report as originally filed is inaccurate or incomplete. I swear,
State of Texas
v�.o� or affirm, that an error or omission in the re rt as i inall filed
Comm. Exp. 06- 41-2015 was made in goo faith. g y
Signature of Candidate or O ceholder
AFFIX NOTARY STAMP / SEAL ABOVE � i "
Sworn to and subscribed before me, by the said LAKE 4/V 4 ,n' y CM C -hCA& , this the day of
=ss my hand and seal of office.
Sigriatur of officer administering oath Printed name of officer administering oath Title of officer administering oath
Remember To Attach Any Part Of The Campaign Finance Report Form
Needed To Report And Explain Corrections
www.9thics.state.tx.us Revised 09/01/2011
Texas Ethics Commission P.O. Box 12070 Austin, Texas 78711-2070 (512) 463-5800 (TDD 1-800-735-2989)
CORRECTION/AMENDMENT AFFIDAVIT
FOR CAN DIDATE/OFFICEHOLDER
All Reports: A filer who files a corrected report must submit a correction affidavit. The affidavit must identify
the information that has changed.
Reports filed with Texas Ethics Commission: A corrected report (other than a report due 8 days before
an election or a special report near election) filed with the Ethics Commission after its due date is not
considered late for purposes of late-filing penalties if: (1) any error or omission in the report as originally filed
was made in good faith, and (2) the person filing the report files a corrected report and a good-faith affidavit
not later than the 14th business day after the date the person learns that the report as originally filed is
inaccurate or incomplete.
Semiannual Reports: Effective September 1, 2011, a semiannual report (due January 15 or July 15) that is
amended/corrected before the eighth day after the original report was filed is considered to have been filed
on the date the original report was filed. A semiannual report that is amended/corrected on or after the eighth
day after the original report was filed is considered to have been filed on the date the original report was filed
if- (1) the amend ment/correction is made before any complaint is filed with regard to the subject of the
amendment/correction; and (2) the original report was made in good faith and without intent to mislead or
misrepresent the information contained in the report.
Attach additional pages as necessary.
INSTRUCTIONS FOR COMPLETING THIS FORM
The following numbers correspond to the numbered boxes on the other side.
1. Account #. If you file with the Ethics Commission, you should have received a letter acknowledging
receipt of your campaign treasurer appointment and assigning you an account number. Put that number in
this box. If you do not file with the Ethics Commission, skip this box.
2. Total Pages Filed. After completing this form and any attachments, count the number of pages. Enter
that number in this box. Each side of a two-sided form counts as a page. In other words, this form is two
pages.
3. Candidate/Officeholder Name. Put your full name here. Enter your name in the same way as on the
report you are correcting.
4. Original Report Type. Mark the type of report you are correcting.
5. Original Period Covered. Enter the period covered by the report you are correcting. The year is important
because filers sometimes correct reports years after filing the original.
6. Explanation of Correction. Attach any part of the campaign finance report form needed to report and
explain corrections. Explain why there was an error on the original report. Also explain what information is
being corrected and how the new information is different from the information on the original report. (Use
additional pages if you need more space.) You may also use this area to request a waiver or reduction of a
late-filing penalty and state the basis of your request.
7. Affidavit. Read the affidavit before signing. You must sign the affidavit in the presence of an individual
authorized to take oaths. If signed before a notary public, the affidavit must include the notary's signature and
sea[.
w%vw.ethics.state.tx.us Revised 09/0112011
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CANDIDATE / OFFICEHOLDER FORM C10H
CAMPAIGN FINANCE REPORT COVER SHEET PG I
9 REPORT TYPE
January 15
X
1 ACCOUNT#
2 Total pages riled:
The C/01-1 Instruction Guide explains how to complete this form.
(Ethics Commission Filers)
If i
3 CANDIDATE
OFFICEHOLDER
Wi/MRS/MR FIRST
MI
OFFICE USE ONLY
Date Received
RECEIVED
NAME
............... * ...... * ....... .
NICKNAME LAST SUFFIX
(officeholder only)
F-1 July 15
El 8th day before election
Exceeded $500 Final report (Attach CJOH - FR)
APR 1 2014
4 CANDIDATE
ADDRESS / PD BOX; APVSUITE#; CITY".
STATE; ZJPCODE
OFFICEHOLDER
MAILING
10 PERIOD
Month Day
Date dk&.fred4A3P%0fdU
ADDRESS
COVERED
tar),,
change of address
7k �ZF,(-' 2-7
/-2�/ 211..9-01,3
Receipt #
Ambunt
5 CANDIDATE/
AREA CODE PHONE NUMBER
EXTENSION
Date Processed
OFFICEHOLDER
PHONE
� )
6 CAMPAIGN
MS /MRS M FIRST
MI
Date Imaged
TREASURER
NAME...........
............
NICKNAME LAST
SUFFIX
7 CAMPAIGN
STREETADDRESS (NO PO BOX PLEASE); APT/SUrrE#-,
CITY; STATE;
ZIP CODE
TREASURER
-)
ADDRESS
(residence or business)
8 CAMPAIGN
AREA CODE PHONE NUMBER
EXTENSION
TREASURER
(,
,
9 REPORT TYPE
January 15
X
El 30th day before election
El
Runoff 15th day after campaign
El
treasurer appointment
(officeholder only)
F-1 July 15
El 8th day before election
Exceeded $500 Final report (Attach CJOH - FR)
limit
10 PERIOD
Month Day
Year
Month Day Year
COVERED
/a -Z,? 3
12 THROUGH
/-2�/ 211..9-01,3
11 ELECTION ELECTION DATE ELEGnONTYPE
Month Day Year ❑ Primary Runoff It , Ccwml Special
12 OFFICE OFFICE HELD (ifany) 13 OFFICESOUGHT (ifknown)
� 4�4
www.ethics.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 / FFICE L. E l': FORS C/OH
SUPPORT TOTALS COVE4: SHEET PCB 2
14 C /OH NAME
15 ACCOUNT # (Ethics Commission Filers)
16 NOTICE FROM
THIS BOX is FOR NOTICE OF POLITICAL CONTRIBUTIONS ACCEPTED OR POLITICAL EXPENDITURES MADE BY PO L COMMITTEES TO SUPPORT THE
POLITICAL
CANDiTATE / OFFicEHOLDER. THESE EXPENDRURES MAY HAVE BEEN MADE WITHOUT THE CANDIDATES 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.
COMMITTEE NAME
COMMITTEETYPE
/
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)
EXPENDITURE
TOTALS
3. TOTAL POLITICAL EXPENDITURES OF $100 OR LESS, UNLESS ITEMIZED
$ /
4. TOTAL POLITICAL EXPENDITURES
$ 0
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 AFFIDAVIT
1 swear, or affirm, under penalty of perjury, that the accompanying report
p 'Jk w •. is true and correct and includes all information d to be reported by
o:PY.. JESSICA
'= NOTARY BLIC me under Title 15, Election Code.
;requi,
•. `r State oComm.
Ex p. 01 -2015
1
Signature of Candidate or Q ceholder
AFFIX NOTARY STAMP / SEAL ABOVE
,, {{
Sworn to and subscribed before me, by the � said i % Lv 1r m� t C �' this the
20 i to which, witness my hand and seal of office.
day of certify
t
Signature of officer administering oath Printed name of officer administering oath Title i6f icer administe(Q oath
z
i
www.ethics.state.tx.us Revised 04119/2013
Texas Ethics Commission P.O. Box 12070 Austin, Texas 78711 -2070 (512) 463 -5800 (TDD 1-800- 735 -2989)
POLITICAL EXPENDITURES
SCHEDULE G
MADE FROM PERSONAL FUNDS
EXPENDITURE CATEGORIES FOR BOX 8(a)
Advertising Expense Gift/Awards /Memorials Expense Salaries /Wages /Contract Labor Loan Repayment /Reimbursement
Accounting /Banking 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 /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 NAME
3 ACCOUNT # (Ethics Commission Filers)
�
f
4 Date
5 Payee name
-
67e 0 -i
'nip (t, To to, J 1'j Gf.�3- e t •l %/ f
6 Amount {$)
i
7 Payee addre s; City; State; Zip Code - '
Reimbursement from
political contributions
intended
8 PURPOSE
(a) Category (See categories listed at the top of this schedule)
(b){ Description (If travel outside of Texas, complete Schedule T)
OF
EXPENDITURE
f
Date
Payee name
Amount ($)
Payee address; City; State; Zip Code
Reimbursement from
❑ political contributions
intended
PURPOSE
Category (See categories listed at the top of this schedule)
Description (If travel outside of Texas, complete Schedule T)
OF
EXPENDITURE
Date
Payee name
Amount ($)
Payee address; City; State; Zip Code
Reimbursement from
F] political contributions
intended
PURPOSE
Category (See categories listed at the lop of this schedule)
Description (if travel outside of Texas, complete Schedule T)
OF
EXPENDITURE
Date
Payee name
Amount ($j
Payee address; City; State; Zip Code
Reimbursement from
political contributions
intended
PURPOSE
Category (See categories listed at the top of this schedule)
Description (If travel outside of Texas, complete Schedule T)
OF
EXPENDITURE
ATTACH ADDITIONAL COPIES OF THIS SCHEDULE AS NEEDED
www.ethics.state.tx.us Revised 04119/2013