HomeMy WebLinkAboutCFR - McMichael - Amended - 04.09.2014np"^°Fthir-pcnmmwpmn Po.Box 1ao78 Austin. Texas 78711-2O78 (512)403-5800 (TDD 1-800-735-2989)
FORM COR—C/OH
CORRECTION/AMENDMENT AFFIDAVIT
FOR CAN DIDATE/OFFICEHOLDER
I ACCOUNT# 1411A
1 2 Total pages riled: Is-, OFFICE USE ONLY
3 CANDIDATE/
6l, MRS / MR FIRST MI DaIRE-CEIVED
OFFICEHOLDER
X'4P-P,' S,
NICKNAME SUFFIX APR 112014
[:] January 15 Runoff 0 Other (specify) C4 Secretary
4 ORIGINAL REPORT
TYPE
El July 15 F-1 Exceeded $500 limit Date Hand -delivered or Postmarked
day before election 15th day after treasurer
F]
'k]30th appointimemt (officeholder only) Receipt It
El8th day before election El Final report
Month Day Year Month Day Year
5 ORIGINAL PERIOD
&/ / 0/ gly THROUGH Gly/o Date Imaged
6 EXPLANATION OF CORRECTION
tZ A-
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
September 1, 2011): 1 swear, or affirm, that I am filing this corrected
JESSICA ERIN BRE report not later than the 14th business day after the date I learned
NOTARY PUBLIC filed is inaccurate incomple/tp. I
I that the report as originally or swear,
State of Texas 'inally
..... i or affirm, that any error or omission in the re as o filed
Comm. Exp. 06-01-2015
was made in good faith.
Candidate
07"older
AFFIX NOTARY STAMP f SEAL ABOVE Signature of or
SW to and, subscribed before me, by the said._MQ�—�t/jt OMi CA— this the day of
200 to W ss my hand and qpal of office.
Signa't f officer administering oath Printed name of officer administering oath Tihe-k officer adminQgs)hg oath
VRemember To Attach Any Part Of The Campaign Finance Report Form
Needed To Report And Explain Corrections
www.ethics.state.tx.us Revised 09/01/2011
Texas Ethics Commission P.O. Box 12070 Austin, Texas 78711-2070 (512)463-5800 (�1-800-735-298n)
CORRECTION/AMENDMENT AFFIDAVIT
FOR CAN DI FFICEHO0DER
All :A filer who files o 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 dun date is not
considered late for purposes of|abe�i|inQ 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 orincomplete.
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
it (1) the amendrnant/oorreotion is made before any complaint is filed with regard to the subject of the
amendmenKnorrmction; and(2)the original report was made in good faith and without intent tn mislead or
misrepresent the information contained in the report.
Attach additional pages osnecessary.
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 trmaaunareppoinbnentandasn' ningyouanancountnunmbecPutthatnunubnrin
this box. If you do not fi|ewith the Ethics Commission, skip this box.
2. Total Pages Filed. After completing this form and any attachnmmnto, count the number of pages. Enter
that number in this box. Each side of two-sided form counts as a page. In other words, this form is two
pages.
3. Name. Put your full name here. Enter your name in the same way asonthe
report you are correcting.
4. Original Report Type. Mark the type uf 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 napnd form needed to report and
explain corrections. Explain why there was on error onthe 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 opacn.) You may also use this area tu request o waiver nr reduction ofa
late-filing penalty and state the basis mf 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
Revised 09101/2011
Texas Ethics Commission P.O. Box 12070 Austin, Texas 78711 -2070 (512) 463 -5800 (TDD 1-800- 735 -2989)
CANDIDATE / OFFICEHOLDER FORMCIOH
CAMPAIGN FINANCE REPORT COVER SHEET PG "
1 ACCOUNT # 2 Total pages filed:
The C /OH Instruction Guide explains how to complete this form.
(Ethics Co �issienFilers) .,
3 CANDIDATE /
/MRS/MR FIRST MI OFFICE USE ONLY
OFFICEHOLDER
t �'✓J Date
NAME
/ l��
NICKNAME . . . . . . .
LAST . . . . . SUFFIX
�!.
2
ADDRESS IPOBOX; APT /SURE#; CITY; STATE; ZIPCODE
4 CANDIDATE /
OFFICEHOLDER
MAILING
Date Hand elivered or Postmarked wy
ADDRESS
' ' %� r � �
change of address
{ / l Receipt # Am
AREA CODE PHONE NUMBER EXTENSION _
5 CANDIDATE/
OFFICEHOLDER
/ [ Date Processed
6 CAMPAIGN
MS / MRS FIRST MI Date Imaged
TREASURER
j
/°-
NAME
. . . . . . .d':. . . . . �.�..e.�
NICKNAME LAST SUFFIX
7 CAMPAIGN
STREET ADDRESS (NO PO BOX PLEASE); AP /SUITE#; 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 F El Runoff 15th day after campaign
treasurer appointment
(officeholderonly)
El July 15 F-1 8th day before election El Exceeded $500 Final report (Attach C/OH - FR)
limit
10 PERIOD
Month Day Year Month Dry Year
COVERED
/c3%t THROUGH,
11 ELECTION
ELECTION DATE
ELECTION TYPE
Montt Day Year
� Primary � Rtxtolf R Genera! El special
,✓ ) ,j
12 OFFICE
OFFICE HELD (f any)
13 OFFICESOUGHT (ifknown)
or- cs t dotOk, .h;
/
GO TO PAGE 2
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/ FFI E L E T: FORM C/OH
SUPPORT & TOTALS C OVER SHEET PG 2
14 C /OH NAME // ` C
15 ACCOUNT (Ethics Commission Filers)
16 NOTICE FROM
THIS BOX IS FOR NOTICE OF POLITICAL CONTRiBUTiONS ACCEPTED OR POLITICAL EXPENDITURES MADE BY POLL L COMMITTEES TO SUPPORT THE
POLITICAL
CANDIDATE / OFFICEHOLDER. THESE EXPENDITURES MAY HAVE SEEN MADE MTHOUT THE CANDIDATE 5 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
a GENERAL
COMMITTEE ADDRE S
F7 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
OF $100 OR LESS, UNLESS ITEMIZED
$
TOTALS
3. TOTAL POLITICAL EXPENDITURES
4. TOTAL POLITICAL EXPENDITURES
$
! O�
CONTRIBUTION
BALANCE
5. TOTAL POLITICAL CONTRIBUTIONS MAINTAINED AS OF THE LAST DAY
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
I swear, or affirm, under penalty of perjury, that the accompanying report
* is true and correct and includes all information required to b ported by
JESSICA ERIN BRIMLE me under Title 15, Election Code.
- � } NOTARY PUBLIC �
tF State of Texas
�rfi 06-01-2015
+aF' t11?ttm, Exp.
Signature of Candidate orCifticeho er
AFFIX NOTARY STAMP f SEAL ABOVE
Sworn to and subscribed before me, by the said ' t/E�- ' r t� ! i t this the
day of ftZ 20 to certify which, witness my hand and seal of office.
l( WA J�ss�v-
Sig ure o officer a m nistering oath Printed name of officer administering oath Title Wfficer administ g oath
www.Ahics.state.tx.us Revised 04/19/2013
Texas Ethics Commission P.O. Box 12070 Ausfin, Texas 78711 -2070 (512) 463 -5800 (TDD 1-800- 735 -2989)
POLITICAL EXPENDITURES
SCHEDULE
A► 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.
I Total pages Schedule G:
2 FILER NAME
3 ACCOUNT it (Ethics Commission Filers)
4 Date J
JxT#jL�s
5 Payee name,
6 Amount ($)
7 Payee address; City; State; Zip Code
%e GuC:
r Lit✓ c �a r w Y Ld _,
Reimbursement from
F1 political contributions
f,x��
intended
4'''�.,t,�`
8 PURPOSE
(a) Category (See categories listed at the top of this schedule)
(b) Description (If travel outside of Texas, complete Schedule T)
OF
EXPENDITURE
OIKI�ec�i'
y
Date
Payee name
Amount {$)
Payee address; State; Zip Cod
9/c GAS.
°� �City;
L.l ., ,' " iGe 1 "t..b'`
F] Reimbursement from
political contributions
f /y
intended
,r
PURPOSE
Category (See categories listed at the top of this schedule)
Description (If travel outside of Texas, complete Schedule T)
� 1 r ,
OF
EXPENDITURE
Date
Payee name
Amount ($}
Payee address; City; State; Zip Code
Reimbursement from
F] political contributions
intended
PURPOSE
Category (See categories listed at the top of this schedule)
Description (If travel outside of Texas, complete Schedule T)
OF
EXPENDITURE
Date
Payee name
Amount ($)
Payee address; City; State; Zip Code
Reimbursement from
Elpolitical 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 04/19/2013