HomeMy WebLinkAboutCFR-05.15.2015-Georgetown Trans PacTexas Ethics Commission P.O. Box 12070 Austin. Texas 78711-2070 (512) 463-5800 (TDD 1-800-735-2989)
SPECIFIC -PURPOSE COMMITTEE
FORM SPAC,
CAMPAIGN FINANCE REPORT
COVER SHEET PG 1
1 ACCOUNT#
2 Total pages filed:
The SPAC Instruction Guide
explains how to complete this form.
(Ethics Commission Filers)
3 COMMITTEE NAME
zi
&eO rSe �0 LAIN 7/--A iq5 TA,,f �90 16'
OFFICE USE ONLY
Date R RECEIVED
4 COMMITTEE
ADDRESS / PO BOX; APT / SUITE #; CITY; STATE: ZIP CODE
MAY 0 12015
ADDRESS
CIRV Spnrptnm
F] change of address
Dale Hand livered or Postmarked q
o rj
) 7
Receipt 9 Amount
5 CAMPAIGN
TREASURER
MSIMRS(O FIRST MI
Fohe f F
Date Processed
NAME
..........
NICKNAM LAST SUFFIX
Date Imaged
I th
6 CAMPAIGN
TREASURER'S
STREET ADDRESS (NO PO BOX PLEASE); APT / SUITE #; CITY; STATE;
—
ZIP CODE
STREET ADDRESS
(residence or business)
In
IeI6
7 CAMPAIGN
TREASURER'S
STREET OR PO BOX: APT SUITE #; CITY- STATE;
ZIP CODE
MAILING ADDRESS
El change of address
6co rj
8 CAMPAIGN
AREA CODE PHONE NUMBER EXTENSION
TREASURER
PHONE
_)
9 REPORT TYPE
Q January 15 1-1 30th day before election
�&h
Exceeded $500 limit
El July 15 FE day before election El
Dissolution (attach PAC -DR)
ElRunoff
10th day aftercampaigntre-,3surerterminafion
10 PERIOD
COVERED
Month Day Year
Month Day Year
ITHROUGH
11 ELECTION
ELECTION DATE
ELECTION TYPE
Month Day Year
-
5
Primary 1:1 Runoff
jet
El General vSPe
GO TO PAGE 2
www.ethics.state.tx.us Revised 07/28/2014
Texas Ethics Commission P.O. Box 12070 Austin, Texas 78711-2070 (512) 463-5800 (TDD 1-800-735-2989)
SPECIFIC -PURPOSE COMMITTEE REPORT: FORM SPAC
PURPOSE AND TOTALS COVER SHEET IPG 2
12 COMMITTEE NA
ACCOUNT # (Ethics Commission Filers)
oeor-qp_
13 COMMITTEE�
CANDIDATE / OFFICEHOLDER NAME
PURPOSE
(Attach lists on plain
paper to complete this
report if necessary.)
CANDIDATE
Ml/SUPPORT
F-1 OFFICEHOLDER
OFFICE SOUGHT (candidate) OFFICE HELD (officeholder)
(Candidate or Measure)
OPPOSE
(Candidate or Measure)
BALLOT IDENTIFICATION / # ELECTION DATE
Mon Day Year
C/
ASSIST
F—] A
(Officeholder)
MEASURE
DESCR(PTION
-5S Of AlCe 0�- 45.:� 00-D az
14 CONTRIBUTION
TOTALS
1. TOTAL POLITICAL CONTRIBUTIONS OF $50 OR LESS (OTHER THAN
$
PLEDGES, LOANS, OR GUARANTEES OF LOANS), UNLESS ITEMIZED
2. TOTAL POLITICAL CONTRIBUTIONS
THAN PLEDGES, LOANS, OR GUARANTEES OF LOANS)
$ 5, 06
(OTHER
EXPENDITURE
TOTALS
3. TOTAL POLITICAL EXPENDITURES OF $100 OR LESS, UNLESS ITEMIZED
$
4. TOTAL POLITICAL EXPENDITURES
$ 11,710
CONTRIBUTION
BALANCE
5. TOTAL POLITICAL CONTRIBUTIONS MAINTAINED AS OF THE LAST DAY
OF THE REPORTING PERIOD
$
W/1
OUTSTANDING
6, TOTAL PRINCIPAL AMOUNT OF ALL OUTSTANDING LOANS AS OF THE
$
LOAN TOTALS
LAST DAY OF THE REPORTING PERIOD
15 AFFIDAVIT
(swear, or affirm, under penalty of perjury, that the ac;tanying
------ report is and correct and include 11 info m tion Uiled to e
JESSICA ERIN BRETTLE re od by e under Title 15, Cti Coe.
NOTARY PUBLIC
State of Texas
.... . ...... Comm. Exp. 06-01-2015
Signa of mpaign Tre user
AFFIX NOTARY STAMP /SEAL ABOVE
tr
Sworn to d subscribed before me, by the said
this the
ro, day of C 20 to certify which, witness my hand and seal of office.
Sin
_( a) e ofofficerad'ministering oath Printed name of officer administering oath Titl"fficeraclministA 0gath
www.ethics.state.tx.us Revised 07128/2014
=;i.; r, _;�. . m can BOX 1207n Aimfin Ti -y;;-, 78711-2n70 (512)463-5800 (TDD 1-800-735-2989)
POLITICAL CONTRIBUTIONS SCHEDULE A
OTHER THAN PLEDGES OR LOANS
The Instruction Guide explains how to complete this form.
I Total pages Schedule A:
2 FILER NAME "rn
LA -15 0's
eo reke- j to \A1N7r_!1 V, !A C 0(0
3 ACCOUNT# (Ethics Commission Filers)
4 Date
5 Full name of contributor
A
i _D Woe I N e_
7 Amountof 8 In-kind contribution
contribution (S) description (ifapplicable)
q1
6 Gontributor address; City; State; Zip Code
900
101 GAIAr— I 'A 'Dr
Av-s4-11N 0 - 7-8 75 (1
(if travel outside of Texas, complete Schedule T)
9 Principal occupation /Job title (See Instructions)
10 Em IoN_gr(See Instructions)
",/,j C
m
Date
Full name ofcontributor El out-of-statePAC(IDt,'----------------)
c5 -em
Amountof In-kind contribution
contribution ($) description (if applicable)
�IA016_
-T
te
Contributor address* ity, Zip Code
(if travel outside of Texas, complete Schedule T)
Principal occupation tJob title (See Instructions)
T
Employer (See Instructi" 1
Date
F ull name of contributor 0_out- of -state PAC (IDAE:
Amountof In-kind contribution
contribution (S) description (if applicable)
(:ontributor address; City; State; Zip Code
.4
(if travel outside of Texas, complete Schedule T)
Principal occupation Woo title (See Instructions)
Employer (See Instructions)
Date
F ull name of contributor ❑ out-of-state PAC
Amountof In-kind contribution
contribution description (ifapplicable)
Gont'ributor a*dd'ress; City; State-, Zip Code
(if travel outs— of Texas, complete Schedule T)
Principal occupation t Job titJe (See Instructions)
Employer (See Instructions)
Date
F ull name of contributor E] out-of-state PAC
Amountof In-kind contribution
contribution description (if applicable)
C;onttibutor address; City; State; Zip Code
(if travel outside of Texas, complete Schedule T)
Principal occupation I 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 07/2812014
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Te:<2s Ethics Commission P.O. Box 12070 A istin. Texas 78711-2070 (512)463-5800 (TDD 1-800-735-2989)
PLEDGED CONTRIBUTIONS SCHEDULE B
The Instruction Guide explains how to coriplete this form.
1 Total pages Schedule B:
2 FILER NAME
3 ACCOUNT # (Ethics Commission Filers)
dt TOT UNITEMIZED PLEDGES: E E :3 E_ 'D E D D E E E E E E _J
$
5 — Date
6 Full name of pledgor [j out-of-state I 6,C (09'
Amountof 1 91 ,9description
I
pledge (S) (if applicable)
7' ' Pledgor address t./'Z Co
I
(if travel outside of Texas, complete Schedule T)
Principal occupation / Job title (See Instructions)
11 Employer (See Instructions)
Date
Full name of pledgor ❑ out -of- late F 4,C
Amount of In-kind description
pledge (if applicable)
Pledgor address; City; late: Zip Code
(if travel outside of Texas, complete Schedule T)
Principal occupation / Job title (See Instructions)
Employer (See Instructions)
Date
Full name of pledgor E] ou of -state F 4C (ID#:
Amount of I In-kind description
pledge (if applicable)
Pledgor address; City; State; Zip Code
(If travel outside of Texas, complete Schedule T)
Principal occupation / Job title (See Instructions)
See Instructions)
Date
Full name of pledgor E] ut-of-state PAC(IC#:
Amountof In-kind description
pledge (if applicable)
Pledgor address; Cit State-, Zip Code
(if travel outside of Texas, complete Schedule T)
Principal occupation / Job title (See Instructions
Employer (See Instructions)
Date
Full name of pledgo\,EE] put-of-sta FC(IDT.
Amountof In-kind description
pledge (if applicable)
. . . . . .
Pledgor Cit tate; Zip Code
(if travel outside of Texas, complete Schedule T)
address;
(If travel outside of Texas, complete Schedule T)
Principal occupation / Job title (See Instruction
(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.
mw.ethics.state.tx.us Revised 07/28/2014
Texas Ethics Commission P.O, Box 12070 Austin, Texas 78711-2070 (512) 463-5800 (TDD 1-800-735-2989)
CORPORATE OR LABOR ORGANIZATION SCHEDULE C
CONTRIBUTIONS OTHER THAN PLEDGES OR LOANS
The Instruction Guide explains how to complete this form.
I Total pages Schedule C:
2 FILER NAME
Geor6s* P/*-- ogo /
3 ACCOUNT # (Ethics Commission Filers)
4 Date
5 Corporation / Labor Organization name
L_ _TA iFt4,3 wae -I N5
7 Amountof In-kind contribution
contribution ($) I description (if applicable)
....... . . . * . . . . . . . . . . . . . . . Code
6 Corporation/ Labor Organization address: City; State; Zip
bri'ArArk
e>o
(If travel outside of Texas, complete Schedule T)
Date
Corporation/ Labor Organization name
Ott
5
Amount of In-kind contribution
contribution (S) I description (ifapplicable)
Corporation Labor Organization address; City; State; Zip Code
6 r 14 5& 'I li!!!�)
v k ,, z) 1
V
(If travel outside of Texas, complete Schedule T)
Date
Corporation/ Labor Organization name
i U 0 A
Amountof I. -kind contribution
contribution description (ifapplicable)
Cor L:a Organization address; City; State; Zip Code .I- I cl,
, V"'i iv e- rs ,
%(if
travel outside of Texas, complete Schedule T)
Date
Corporation/ Labor Organization name
,
0 If P K 3E�4c, 7A C
Amount of IIn-kind contribution
contribution description (ifapplicable)
1
. .....................* ........
Corpora2tion I Labor Organization address; City: State; Zip Code
I T -. 0 pz� vj 5k. AC)o
D,4
I
if travel outside of Texas, complete Schedule T)
Date
Corporation/ Labor Organization name
14 5 1 t4 eC r 5,
PItlE
Amountof In-kind contribution
contribution description (ifapplicable)
.. ........
Let Organ t'naddress; C y S : Zip Code
Corporation Z io * it'; State: ate
7 )or e3 e/ .
YI
(If travel outside of Texas, complete Schedule T)
Date
Corporation/ Labor Organization name
Amountof I In-kind contribution
contribution description (if applicable)
Corporation'/ Labo'r Organization address; ' City; State'; , Zip Code
(If travel outside of Texas, complete Schedule T)
ATTACH ADDITIONAL COPIES OF THIS SCHEDULE AS NEEDED
vvvvw.ethics.state.tx.us Revised 07/2812014
Texas Ethics Commission P.O.Box 12o7o Austin, Texas 7n711'zo7o (512) 463-5800 (TDD 1-800-735-:!989)
PLEDGED CORPORATE OR LABOR ORGANIZATION
SCHEDULE D
CONTRIBUTIONS
I Total pages Schedule D:
The Instruction Guide explains how to complete this form.
2 FgNAME,,,,,,
3 ACCOUNT# (Ethics Commission Filers)
�/DUJA/ IrAMS PhC OW/
4 Date
5 Corjo ation'/ Labor Org'aniaJon name
7 Amountof 8 In-kind descriptit,n
!�J
pledge (if applicable)
6 Corporation/ Labor Organization ai ldress; City; State; Zip Code
(If travel outside of Texas, complete Schedul � T)
Date
Corporation Labor Organization m me
Amount of In-kind cle.cription
pledge (S) (if applicable)
Corporation Labor Organization i ddress; City; State; Zip Code
I
(if travel outside of Texas, complete Schedulo T)
Date
Corporation Labor Organization n me
Amount of In-kind clescription
pledge (S) (if applicable)
Corporation*/ Labor Organization aAdress; City; 'State; Zip Co . de
(If travel outside of Texas, complete Schedul - T)
Date
Corporation I Labor Organization na e
Amountof In-kind description
pledge (if applicable)
Corporation'/ La'bor Organization ad' ress; City; State; Zip Code
(If travel outside of Texas, complete Schedul � T)
Date
Corporation / Labor Organization narT e,
Amount of in-kind description
pledge (if applicable)
Corporation / Labor Organization add ss: City; State; Zip Code
I
(If travel outside o f Texas, complete Schedule T)
Date
Corporation/ Labor Organiiation nam
Amount of In-kind descriptii)n
pledge (if applicable)
Corporation/ Labor O,ganiz: i addr s City; State; Zip Code
V
(if travel outside o f Texas, complete Schedule T)
ATTACH ADDITIONAL COPIES OF THIS SCHEDULE AS NEEDED
www.ethics.state.tx.us Revised 07/28/; 10 14
Texas Ethics Commission P.O- Box 12070 Austin, Texas 78711-2070 (512)463-5800 (TDD 1-800-735-2989)
LOANS SCHEDULE E
I Total pages Schedule E:
The Instruction Guide explains how to complete this form.
I
2 FI1-ER NAME
3 ACCOUNT (Ethics Commission Filers)
g61-6-
T0'AL OF UN ITEMIZED LOANS': F 11 J i - t -, i --] E 7 F -I E
$
5 Date of loan
7 Name of lender ut- t -state P(I !D#:
.. . . . . . C . e . . . .
8 Lenderaddress; ity; State, i C
9 LoanAmount($)
6 Is lender
10 Interestrate
a financial
Institution?
11 Maturity date
Y N
12 Principal occupation / Job title (See Instructions)
13 Employer (See Instructions)
14 Description of Collateral
D none
15 GUARANTOR
16 Name ofguarantor
18 Amount Guaranteed ($)
INFORMATION
. .. . . . . . . . . . . . . . . . .
17 Guarantor address; City; State; Zip Code
not applicable
19 Principal Occupation (See Instructions)
20 Employer (See Instructions)
Date of loan
Nameoflencler Ej out-of-state PAC ([D#:
.. . .City;.. . . . . . . . . . . . . . . . . . . . . .
Lender address; State; Zip Code
Loan Amount (S)
Islander
Interest rate
a financial
Institution?
Maturity date
Y N
Principal occupation I Job title (See Instructions)
Employer (See Instructions)
Description of Collateral
F-1 none
GUARANTOR
Name ofquarantor
Amount Guaranteed
INFORMATION
Coc
Guarantor address; Stat Zip Code
® not applicable
Principal Occupation (See Instructions)
Employer (See Instructions)
ATTACH ADDITIONAL CIES 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 07/28/2014
Texas Ethics Commission P.O. Box 12070 Austin, Texas 78711-2070 (512) 463-5800 (TDD 1-800-735-2989)
POLITICAL EXPENDITURES SCHEDULE F
EXPENDITURE CATEGORIES FOR BOX 8(a)
Advertising Expense Gift/Awards/Memorials Sala ries/Wages/Contract Labor Loan Repayment/Reimbursement
Expense
Accounting/Banking Solicitation/Fundraising Expense Transportation Equipment & Related
Consulting Expense Legal Services Travel In District Expense
Event Expense Food/Beverage Expense Travel Out Of District Contributions/Donations Made By
Fees Polling Expense Office Overhead/Rental Expense Candidate/Officeholder/Political Committee
Printing Expense OTHER (enter a category not listed above)
The Instruction Guide explains howto, completethis form.
I Total pages Schedule F:
Z)
2&LER NAME
e0r'�Ie_4owN IrA 4C ;?C) 5
p
1 ACCOUNT # (Ethics Commission Filers)
9 (1
1yy
D to
1
5 Payee name
1qINV+eYri)q/4
6 Amount 1$)
7 Payee address; City; State; Zip Code
3 , A 575, e -F
I '�'Oq 5. Ao�+� 4 Ave. &wr5e4awI4, 1_94. 791096
8
PURPOSE
(a) Category (See categories listed at the top of this
schedule)
-Pr
(b) Description (if travel outside of Texas, complete Schedule T)
'
OF
EXPENDITURE
;
Check ifAustin, TXofficeholder living expense
9 Complete ONLY if direct Candidate Officeholder name Office sought Office held
expenditure to benefit C/OH
Date
Payee name
r
Amount
Payee address: City; State; Zip Code
111, 60
Av:5i '1WlAve, Gee'rc �'i;k; zwk
e /� wV"y'
_S
PURPOSE
Category (See categories listed at the top of this
schedule)
Description (if travel outside of Texas, complete Schedule T)
OF
EXPENDITURE
Advev+i�5hv '�t xPelv.,5-e
-,'> "\j 7115
Check ifAustin, TX, officeholder living expense
Complete ONLY if direct Candidate I Officeholder name Office sought Office held
expenditure to benefit C/OH
Dae
Payee name
;0/
4i'P�Qj ZA1 (2—
Xm6unt (s)
Payee address-, City; State; Zip Code
PURPOSE
Category (See categories listed at the top of this
Description (If travel outside of Texas, complete Schedule T)
OF
EXPENDITURE
schedule)
Advev-ri/4 )m❑Check
ifA.stin, TX, officeholder living expense
Complete ONLY it direct Candidate / Officeh-61cler nam Office sought Office held
expenditure to benefit C/OH
Urate
Payee name
ON *H7e
ArKount_.�) 0
ayee acldrCity; State; Zip Code
M 0
7D�3 5, JtAet-5�#i� 35; igeor!�e�aw4,
PURPOSE
Category (See categories listed at the top of this
Description (If travel outside of Texas, complete Schedule T)
OF
EXPENDITURE
hdl)
F 1--verAev E;Te'45C
Check ifAustin, TX, officeholder living expense
Complete ONLY if direct Candidate / Officeholder name Office sought Office held
expenditure to benefit C/OH
ATTACH ADDITIONAL COPIES OF THIS SCHEDULE AS NEEDED
vvvvw,ethics.state_tx.us Revised 07128/2014
ilaxas Limes
t-. U. nox I zu t u /Ausun, iexas ioi i-i-ziuitu
4 Dat 5 Payee name
I
6 Amount ($) 7 Payee address; City; State; Zip Code
Ave., rveor3e�bvhq) TX. M"Z6
(a) Category (See categories listed at the top of this (b) Description (if travel outside of Texas, complete Schedule T)
8 PURPOSE schedule)
OF
EXPENDITURE Adver-�1'eilV& E] Check ifAuMin, TX, officeholder living expense
9 Complete ONLY if direct Candidate / Officeholder name Office sought Office held
expenditure to benefit C/OH
I I .yee name
1)
Amount
00
EXPENDITURE CATEGORIES FOR BOX 8(a)
City;
Aos
Advertising Expense
Gift/Awards/Memorials
Salaries/Wages/Contract Labor
Loan Repaymem/Reimbursement
Accounting/Banking
Expense
Solicitation/Fundraising Expense
Transportation Equipment & Related
Consulting Expense
Legal Services
Travel In District
Expense
Event Expense
Food/Beverage Expense
Travel Out Of District
Contributions/Donations Made By
Fees
Polling Expense
Office Overhead/Rental Expense
Candidate/Officeholder/Political Committee
Printing Expense
OTHER (enter a category not listed above)
The Instruction Guide
explains howto complete this form.
I Total pages Sch d I F:
'2 C-2 a 25
2 FILER NAME
�
TrA �j,
3 ACCOUNT # (Ethics Commission Filers)
1 1
4 Dat 5 Payee name
I
6 Amount ($) 7 Payee address; City; State; Zip Code
Ave., rveor3e�bvhq) TX. M"Z6
(a) Category (See categories listed at the top of this (b) Description (if travel outside of Texas, complete Schedule T)
8 PURPOSE schedule)
OF
EXPENDITURE Adver-�1'eilV& E] Check ifAuMin, TX, officeholder living expense
9 Complete ONLY if direct Candidate / Officeholder name Office sought Office held
expenditure to benefit C/OH
I I .yee name
1)
Amount
00
Payee address:
I �O S
City;
Aos
State; Zip Code
�Iiq Ave-,
ge6r3e-�wtq
rr
*Description (if travel outside
,5 k P1,54y;
of Texas, complete Schedule T)
[:] Check ifAustin, TX, officeholder
living expense
PURPOSE Category (See categories listed at the top of this Deciptiop (if travel outside of Texas, complete Schedule T)
OF schedule) PC I I e r-5
EXPENDITURE Aave-v4,-s1'At,3 E-x)2cNse El Check ifAustin, TX, officeholder living expense
Complete ONLY if direct Candidate / Officeholder name Office sought Office held
expenditure to benefit C/OH
me
Afnount ($)
'Payee address; City; 1jWe: Zip Code
Thol-14 Wood Fj .'
I
e7e6r�erbwt,/,
7)-<.
PURPOSE
EXPENDITURE
Category (See categories listed at the top of this
Vuer TIS t N FxpeN 5e-
3
*Description (if travel outside
,5 k P1,54y;
of Texas, complete Schedule T)
[:] Check ifAustin, TX, officeholder
living expense
Complete ONLY it direct
Candidate / Officeholder name
Office sought
Office held
expenditure to benefit C/OH
I Date I Payee name I
Amount ($) 1 Payee address; City; State; Zip Code
PURPOSE Category (See categories listed at the top of this Description (If travel outside of Texas, complete Schedule T)
OF schedule)
EXPENDITURE Check ifAustin, TX, offireholder living expense
Complete DNLY if direct Candidate / Officeholder name Office sought Office held
expenditure to benefit C/OH
ATTACH ADDITIONAL COPIES OF THIS SCHEDULE AS NEEDED
vvwvv.ethics.state.tx.us Revised 07/28/2014
T,!XnEthi— (.nmmi-,-,inn P C) Rr)y 1 ?n7n Austin Texas 78711-2070 (512)463-5800 (TDD 1-800-735-2989)
PAYMENT FROM POLITICAL
SCHEDULE H
CONTRIBUTIONS TO A BUSINESS OF C/OH
EXPENDITURE CATEGORIES FOR BOX 8(a)
Advertising Expense Gift/Awards/Memorials Sala ries/Wages/Contract Labor Loan Repayment/Reimbursement
Accounting/Banking Expense Solicitation/Fundraising Expense Transportation Equipment & Related
Consulting Expense Legal Services Travel In District Expense
Event Expense Food/Beverage Expense Travel Out Of District Contributions/Donations Made By
Fees Polling Expense Office Overhead/Rental Expense Candidate/Officeholder/Political Committee
Printing Expense OTHER (enter a category not listed above)
The Instruction Guide explains how to complete this form.
I Total pages Schedule H:
2 FIAR NAME
M Ile 40 Aw M —S poar-
3 ACCOUNT # (Ethics Commission Filers)
4 Date
5 Business name)
6 Amount (S)
7 Business address; iky; joltate; Anp
07V/�
8 PURPOSE
(a) Category (See categori4 listed at the top of this
(b) Description (If travel outside of Texas, complete Schedule T)
OF
schedule)
EXPENDITURE
Check ifAustin, TX, officeholder living expense
9 Complete ONLY if direct Candidate I Officeholder name Office sought Office held
expenditure to benefit C/OH
Date
Business name
Amount
Business address; City; State; Zip Coe
PURPOSE
Category (See categories listed at the top of this
Description (if travel outside of Texas, complete Schedule T)
OF
schedule)
EXPENDITURE
I
[:] Check if Austin, TX, officeholder living expense
Complete ONLY if direct Candidate / Officeholder name Office sought Office held
expenditure to benefit C/OH
Date
Business name
Amount ($)
Business address; City; State; Zip Code
PURPOSE
Category (See categories listed at the top of this
Description (if travel outside of Texas, complete Schedule T)
OF
schedule)
EXPENDITURE
Check ifAustin, TX, officeholder living expense
Complete ONLY if direct Candidate / Officeholder name Office sought Office held
expenditure to benefit C/OH
Date
Business name
Amount
Business address; City; Stat A XP C de
PURPOSE
his
Category (See categories listed at the top ofDescription
(if travel outside of Texas, complete Schedule T)
OF
schedule)
/
EXPENDITURE
n Check ifAustin, TX, officeholder living expense
Complete ONLY if direct Candidate / Officeholder name Office sought Office held
expenditure to benefit C/OH
ATTACH ADDITIONAL COPIES OF THIS SCHEDULE AS NEEDED
w Nw.ethics.state.tx, us Revised 07/28/2014
Tpyn-- Fthir,-, (-.nnnnni—Sinn PC) Rnx 12070 Austin. Texas 75711-2070 (512) 463-5800 (TDD 1-800-735-2989)
NON-POLITICAL EXPENDITURES SCHEDULE
MADE FROM POLITICAL CONTRIBUTIONS
The Instruction Guide explains how to complete this form.
I Total pages Schedule 1
2 FILER NAME
2al-t>
5
3 ACCOUNT # (Ethics Commission Filers)
FO-
4 Date
5 Payee nar ie
st � Aj
6 Amount
7 Payee adc ress; City; State; Zip Code
8 PURPOSE
OF
EXPENDITURE
(a) Category See instructions for examples of accept ifile
categories)
(b) Description (See instructions regarding type of information
required.)
Date
Payee name
Amount (S)
Payee adc ress; City; State; Zi Code
PURPOSE
OF
EXPENDITURE
(a) Category (See instructions for examples of acptable
categories)
(b) Description (See instructions regarding type of information
required.)
Date
Payee nar ie,
Amount (S)
Payee adc ress; City; State; Zi)Code
PURPOSE
OF
EXPENDITURE
(a) Category (See instructions for examples of ace ptable
categories)
(b) Description (See instructions regarding type of information
required.)
Date
Payee nan ie
Amount
State Payee address; City; Zip aode
PURPOSE
OF
EXPENDITURE
(a) Category See instructions for exampsf acre able
categories)
(b) Description (See instructions regarding type of information
required.)
ATTA-_H ADDITIONAL COP, THIS SCHEDULE AS NEEDED
www. ethics state.tx. us Revised 07/28/2014
Tpyn-- Fthic- Commission P.O. Box 12070 Austin, Texas 711711-2070 (512) 463-5800 (TDD 1-800-735-2989)
POLITI,,r.'.'AL CONTRIBUTIONS RETURNED
SCHEDULE J
TO COMMITTEE
The Instruction Guide explains how to complete this form.
J,
1 Total pages Schedule /
2 FILER NAME
3 ACCOUNT # (Ethics Commission Filers)
rq e 7�o- iod
Z
4 Date Returned
5..&iginai payee name
�j
7 Amount Returned
6 Original payee address: City- State; Zip Code
Date Returned
Original payee name
Amount Returned ($)
Original payee address: City; State; Zip Code
Date Returned
Original payee name
Amount Returned
.. . . . . . . . . . . . . . . .
Original payee address; City; State; Zip Code
Date Returned
Original payee name
Amount Returned
. . . . . . . . . . . . . . . . . . . . . . . .
Original payee address; City; State; Zip Code
Date Returned
Original payee name
Amount Returned
. . . . . . . . . . .
Original payee address; City; State; Zip Code
Date Returned
Original payee name
Amount Returned
Original payee address; City; State; Zip Code
Date Returned
Original payee name
Amount Returned
. . .. . . . . . . . . . . . . . . . . . . . . . . . . .
Original payee address; City; State; Zip Code
ATTACH ADDITIONAL COPIES OF THIE SCHEDULE AS NEEDED
wvvw.ethics.state.:x.us Revised 07/28/2014
Texas Ethics Commission P.O. Box 12070 Austin, Texas 78711-2070 (512) 463-5E 00 1-800-325-8506
INTEREST EARNED, OTHER CREDITSIGAINS/
SCHEDULE K
REFUNDS, AND PURCHASE OF INVESTMENTS
The Instruction Guide explains how to complete this form.
I Total pages Schedu a K:
2 FILER NAME
—L-
3 ACCOUNT # (Ethic � Commission Filers)
7;FhA)5'
4 Date
5 Name of person from whom amount is reclived I; Amount
E (S)
. . . . . . . . . . . . . . . .
6 Address of person from whom amount is received: City; State; Zip Code
7 Purpose for which amount is receive
Date
Name of person from whom amount 5received
Amount
. . . . . . . . . . . . . . . .
Address of person from whom amou it is received; City; State; Zip Code
Purpose for which amount is receivec
Date
Name of person from whom amount ireceived
Amount
(S)
Address of person from whom amoun is received; City; State; Zip Code
Purpose for which amount is received
Date
Name of person from whom amount is eceived
Amount
M
. . . . . . . . . . . . . . . . . . . .
Address of person from whom ount recei ed; City; State; Zip Code
Purpose for which amount is receilleT
ATTACH ADDITIOb IAL COPIES OF THIS SCHEDULE AS NEEDED
Revised 09/28/2011
Inv r-thi— Cnmmiccinn P n Roy 1 qn7n Austin Texas 78711-2070 (512)463-5800 (TDD 1-800-735-2989)
IN-KIND CONTRIBUTION OR POLITICAL EXPENDITURE SCHEDULE T
FOR TRAVEL OUTSIDE OF TEXAS
The Instruction Guide explains how to complete this form.
I Total pages Schedule T. -
24F LER NAME I —
:�&DMle?�PaIAJ 9615
3 ACCOUNT# (Ethics Commission Filers)
4 Name of Can ibutor / Corporation or Labor Organization,/ Pledgor / Payee
1
5 Contribution / Expenditure reported on: ------
ScAchedul 1.)[
F-] Schedule A Schedu e B S he ule �F] chedul 1) F-] Schedule F ❑ Schedule G
F-1 schedule H Schedu e N H UC ❑ OH -T PAC -C ❑ PAC -E
CO OH_T
6 Dates of travel
7 Name f pe sons) t aveling
11-oe
8 Depart re city or name of departure location
V
9 Destination city or name of destination location
10 Means of transportation
1 1 Purpose of travel (including
name of conference, seminar, or other event)
Name of Contributor /Corporation or Labor Organization / P1 I
Idgor / Payee
Contribution / Expenditure reported on:
F-] Schedule F-] Schedule B 0
F-] Schedule H � Schedule N F-]
Schedule E] Schedule F-] Schedulel' ❑ Schedule
COH-UC F-] 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 destinatf
n location
Means of transportation
Purpose of travel (incl
ding name of conference, seminar, or other event)
Name of Contributor/ Corporation or Labor Organization /:P edgor/Payee
Contribution / Expenditure reported on:
ScheduleA le B Schedule C
❑0 Sch C ❑ edule D ❑ Schedule F ❑ Schedule G
,C _T
❑ Schedule H ❑ ScheZll�N COH-UC COH-T ❑ PAC -C ❑ -PAC-E
Dates of travel
Name of person(s) tray
Departure city or name of t ure locat 7
Destination city or name of de` ination I t ation
Means of transportation
Purpose of travel 'i�ludin[l name of conference, semir ar, or other event)
ATTACH ADDITIONAL COPIES OF THIS SCHEDULE P,S NEEDED
www.ethics.state.tx.us Revised 07/28/2014