HomeMy WebLinkAboutCFR-10.28.2019-Fuller, AlexisCANDIDATE / OFFICEHOLDER
CAMPAIGN FINANCE REPORT
FORM C/OH
COVER SHEET PG 2
14 C/OH NAME A /e,� � / /�
115 Filer ID (Ethics Commission Filers)
16 NOTICE FROM
THIS BOX IS FOR NOTICE OF POLITICAL CONTRIBUTIONS ACCEPTED OR POLITICAL EXPENDITURES MADE BY POLITICAL COMMITTEES TO
POLITICAL
SUPPORT THE CANDIDATE / OFFICEHOLDER. THESE EXPENDITURES MAY HAVE BEEN MADE WITHOUT THE CANDIDATES OR OFFICEHOLDERS
COMMITTEE(S)
KNOWLEDGE OR CONSENT. CANDIDATES AND OFFICEHOLDERS ARE REQUIRED TO REPORT THIS INFORMATION ONLY IF THEY RECEIVE NOTICE
OF SUCH EXPENDITURES.
COMMITTEE TYPE
I COMMITTEE NAME
❑ Additional Pages
17 CONTRIBUTION
TOTALS
EXPENDITURE
TOTALS
❑ GENERAL
COMMITTEE ADDRESS
SPECIFIC
COMMITTEE CAMPAIGN TREASURER NAME
COMMITTEE CAMPAIGN TREASURER ADDRESS
1. TOTAL POLITICAL CONTRIBUTIONS OF $50 OR LESS (OTHER THAN
PLEDGES, LOANS, OR GUARANTEES OF LOANS), UNLESS ITEMIZED S50 .
2. TOTAL POLITICAL CONTRIBUTIONS
(OTHER THAN PLEDGES, LOANS, OR GUARANTEES OF LOANS) �I �� .
3. TOTAL POLITICAL EXPENDITURES OF $100 OR LESS, $
UNLESS ITEMIZED
4. TOTAL POLITICAL EXPENDITURES I $ L D
CONTRIBUTION
BALANCE 5'
OUTSTANDING 8
LOAN TOTALS
TOTAL POLITICAL CONTRIBUTIONS MAINTAINED AS OF THE LAST DAY
OF REPORTING PERIOD
TOTAL PRINCIPAL AMOUNT OF ALL OUTSTANDING LOANS AS OF THE
LAST DAY OF THE REPORTING PERIOD
�ilrC Aipt� 15, 2022
AFFIX NOTARY STAMP / SEALABOVE
$
$ Si ez77
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, lection Code.
Signature of Candidate or Officeholder
Sworn to and subscribed before me, by the said Al this the 2g
day of , 20-1%_, to certify which, witness my hand and seal of office.
Signature of officer administering oath Printed Rame of officer administering oath
officer
Forms provided by Texas Ethics Commission www.ethics.state.tx.us Revised 9/8/2015
CANDIDATE / OFFICEHOLDER
FORM C/OH
CAMPAIGN FINANCE REPORT
COVER SHEET PG 1
1
Filer ID (Ethics Commission Filers)
2 Total pages filed:
The C/OH Instruction Guide explains how to complete this form.
1
3 CANDIDATE /
OFFICEHOLDER
MS / MRS 40 FIRST
/��
lull
�-
OFFICE USE ONLY
NAME
Date Received
NICKNAME
SUFFIX
RECEIVED
q CANDIDATE /
ADDRESS / PO BOX; APT / SUITE #; CITY;
STATE; ZIP CODE
OFFICEHOLDER
MAILING
11!�1 0 t�
/� �]
OCT 2 8 2019
ADDRESS
`'� lr►/� ` _x
/
-1 �b 71 1
❑ Change of Address
City Secretary
5 CANDIDATE/
AREA CODE PHONE NUMBER
EXTENSION
Date Hand -delivered or Date Postmarked
OFFICEHOLDER
6 %
( S't20 (-33 O •
PHONE
6 CAMPAIGN
MSrmnay MR FIRST
MI
Receipt #
Amount $
L
TREASURER
C
Date Processed
NAME.
,
. . . . . . . . . . . . .
. . . . . . . . . . . . .
NICKNAME LAST
SUFFIX
r
Date Imaged
7 CAMPAIGN
STREET ADDRESS (NO PO BOX PLEASE)); APT / SUITE
#; CITY; STATE; ZIP CODE
TREASURADDRESS
/S 3 �F� Wes, -7E6 2� f..,
1 Yl
l /
(Residence or Business)
AREA CODE PHONE NUMBER
EXTENSION
8 CAMPAIGN
TREASURER
/ si / 2 (� 6
1 (0 2
PHONE
9 REPORT TYPE
January 15 30th day before election Runoff ❑ day after campaign
treasurer appointment
treasurer
(Officeholder Only)
July 15 8th day before election
Exceeded $500 limit Final Report (Attach C/OH - FR)
10 PERIOD
Month Day Year
Month Day Year
COVERED
}
/O
THROUGH / ! T
11 ELECTION
ELECTION DATE
ELECTION TYPE
Month Day Year
❑ Primary
❑ Runoff ❑ Other
! /
r. }
General
^^C
Description
❑ Special — —
12 OFFICE
OFFICE HELD (if any)
13 OFFICE SOUGHT (if known)
GO TO PAGE 2
Forms provided by Texas Ethics Commission www.ethics.state.tx.us Revised 9/8/2015
SUBTOTALS - C/OH FORM C/OH
COVER SHEET PG 3
19
FILER NAME N
�
20 Filer ID (Ethics Commission Filers)
21
SCHEDULE SUBTOTALS
NAME OF SCHEDULE
SUBTOTAL
AMOUNT
1.
SCHEDULEAI: MONETARY POLITICAL CONTRIBUTIONS
$
2•
SCHEDULE A2: NON -MONETARY (IN -KIND) POLITICAL CONTRIBUTIONS
$
3.
SCHEDULE B: PLEDGED CONTRIBUTIONS
$
4.
SCHEDULE E: LOANS
$ Z 0
5•
®
SCHEDULE F1: POLITICAL EXPENDITURES MADE FROM POLITICAL CONTRIBUTIONS
$
f —
6•
SCHEDULE F2: UNPAID INCURRED OBLIGATIONS
$
7.
8.
SCHEDULE F3: PURCHASE OF INVESTMENTS MADE FROM POLITICAL CONTRIBUTIONS
SCHEDULE F4: EXPENDITURES MADE BY CREDIT CARD
$
$
9.
SCHEDULE G: POLITICAL EXPENDITURES MADE FROM PERSONAL FUNDS
$ z( 9
J
10.
El
SCHEDULE H: PAYMENT MADE FROM POLITICAL CONTRIBUTIONS TO A BUSINESS OF C/OH
$
11,
SCHEDULE I: NON -POLITICAL EXPENDITURES MADE FROM POLITICAL CONTRIBUTIONS
$
12.
ElSCHEDULE
K: INTEREST, CREDITS, GAINS, REFUNDS, AND CONTRIBUTIONS
RETURNED TO FILER
$
Forms provided by Texas Ethics Commission www.ethics.state.tx.us Revised 9/8/2015
MONETARY POLITICAL CONTRIBUTIONS SCHEDULE Al
The Instruction Guide explains how to complete this form. 1 Total pages Schedule Al:
2 FILER NAME
/
AI -ex
3 Filer ID (Ethics Commission Filers)
4 Date
5 Full name of contributor ❑ out-of-state PAC (ID#: )
�o✓G�/�e � T� �•lar�
7 Amount of contribution ($)
/o o'lm
-
$ Contributor address; City; Slate; zip Cad�-
k-7 ��
8 Principal occupation / Job title (See Instructions) 9 Employer (See Instructions)
Date
Full name of contributor ❑ out-of-state PAC (Ip#: —1 Amount of contribution ($)
Contributor address; / City; Stale; Zip Coe
AG. S-Hn, 'C
Principal occupation / Job title (See Instructions)
Employer (See Instructions)
Date
Full name of contributor ❑ out-of-state PAC (ID#: )
V" &Xvs
Amount of contribution ($)
101f '
-,b,4 0
Contributor address; City; State; Zip Code
_
Z�/os
r,f
� -2-/37
Principal occupation / Job title (See Instructions)
Employer (See Instructions)
Date
Fult name of contributor ❑ out-of-state PAC (IDS: 1
61AY�j I X10
Amount of contribution ($)
-
Contributor address; Cily; Sl te; Zip Code
y �
w�7x7S 1,z
Principal occupation / Job title (See Instructions)
Employer (See Instructions)
ATTACH ADDITIONAL COPIES OF THIS SCHEDULE AS NEEDED
If contributor is out-of-state PAC, please see instruction guide for additional reporting requirements.
Forms provided by Texas Ethics Commission www.ethics.state.tx.us Revised 9/8/2015
MONETARY POLITICAL CONTRIBUTIONS SCHEDULE Al
The Instruction Guide explains how to complete this form.
1 Total pages Schedule At:
3 Filer ID (Ethics Commission ^Filers)
2 FILER NAME
A
4 Date
5 Full name of contributor ❑ out -or -stale PAC (ID#: i 7 Amount of contribution ($)
"z9WVV'-0s �4cobS
6 Contributor address; City; State; Zip Code Le)v
8 Principal occupation
/ Job title ( Instructions) 9 Employer (See Instructions)
Date
Full name of contributor ❑ ovt•ol-Vats PAC (109; t
evs-s-� Amount of contributionl'l/
/oi�
�rtc
d-1—
Contributor address-, City' ate: Zip Code
_
G 744 ccr� 7 7 6
Principal occupation / Job title See Instructions) Employer (See Instructions)
Date
Full name of contrihuto ❑ oul-or-state PAC Illy#:
Amount of contribution ($)
Contributor address; City; Slate; ip Cade
C d,� wn --7--7 S 6 3 3
Principal occupation / Job title (See structlons)
Employer (See Instructions)
Date
Full name of contributor. ❑ oul-or-slate PAC OMI; I
1 n �
Amount of contribution ($)
Contributor address; City; State; Zip Code
/6T 0
e w--,
Principal occupation / 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.
Forms provided by Texas Ethics Commission www.ethics.state.tx.us Revised 9/8/2015
LOANS SCHEDULE E
The Instruction Guide explains how to complete this form.
1 Total pages Schedule E:
2 FILER NAME A le , � / /
3 Filer ID (Ethics Commission Filers)
4 TOTAL OF UNITEMIZED LOANS
$
5 Date of loan
7 Name of lender ❑ out-of-state PAC (IDs: )
9 Loan Amount ($)
/to A2/�q
....A. r(4 ll-� ................
8 Lender address: City; State- Zip Code
r
'9�' Z
6 Is lender
a financial
10 Interest rate
Instilutl n?
'
1 /45
11 Maturity date
Y N
�f
r r ltz� "Ot f (X 71-k,
12 Principal occupation / Job title (See I structions)
13 Employer (See Instructions)
14 Description of Collateral
15 Check if personal funds were deposited into political
one
acc unt (See Instructions)
16 GUARANTOR
17 Name of guarantor
19 Amount Guaranteed ($)
INFORMATION
18 Guarantor address; City; State; Zip Code
not applicable
20 Principal Occupation (See Instructions)
21 Employer (See Instructions)
Date of loan
Name of lender ❑ out-of-state PAC (ID#: )
Lender address; City; State; Zip Code
Loan Amount ($)
Is lender
Interest rate
a financial
Institution?
Maturity date
Y N
Principal occupation / Job title (See Instructions)
Employer (See Instructions)
Description of Collateral
Check if personal funds were deposited into political
account (See Instructions)
❑ none
❑
GUARANTOR
Name of guarantor
Amount Guaranteed ($)
INFORMATION
. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
Guarantor address; City; State; Zip Code
❑ not applicable
Principal Occupation (See Instructions)
_ __ j
Employer (See Instructions)
ATTACH ADDITIONAL COPIES OF THIS SCHEDULE AS NEEDED
If lender is out-of-state PAC, please see instruction guide for additional reporting requirements.
Forms provided by Texas Ethics Commission www.ethics.state.tx.us Revised 9/8/2015
POLITICAL EXPENDITURES MADE
FROM POLITICAL CONTRIBUTIONS SCHEDULE F1
EXPENDITURE CATEGORIES FOR BOX 8(a)
Advertising Expense Event Expense Loan Repayment/Reimbursement Solicitation/FundraisingExpense
Accounting/Banking Fees Office Overhead/Rental Expense Transportation Equipment & Related Expense
Consulting Expense Food/Beverage Expense Polling Expense Travel In District
Contributions/Donatlons Made By Gift/Awards/Memorials Expense Printing Expense Travel Out Of District
Candidate/Officeholder/Political Committee Legal Services Salarles/Wages/Contract Labor Other (enter a category not listed above)
Credit Card Payment
The Instruction Guide explains how to complete this form.
1 Total pages Se dule F1:
2 FILER NAME /
3 Filer ID (Ethics Commission Filers)
4 Date
q/Z7/�9
5 Payee npme
^�
P/
r n w'e M �
6 Amount ($)
3 2-3 . /4i
7 Payee address; City; State; Zip Code
S A-u S-6
Cae`f
d"LAP-- Tx
8
(a) Category (See Categories listed at the top of this schedule)
(b) Description
PURPOSE
OF
t
r yt G (/ / Y /y��,,
❑ Check if travel outside of Texas. Complete Schedule
❑ Check it Austin, TX, officeholder living expense
EXPENDITURE
,1
9 Complete ONLY if direct Candidate / Officeholder name Office sought Office held
expenditure to benefit C/OH
/Payee
Date 12-
/D
_ 3
name
/71 f /i W6c /Y cv v ?/W,4.-i
Payee address; City; States; ip Code
0z) <�' �' A-U s-f I 6A.Ae-'
Amount ($)
Category (81A Categories listed at the top of this schedule)
Description
PURPOSE
j/' y� / �.(�
F
❑Check if travel outside ofTexas. Complete Schedule T.OF
❑ Check if Austin, TX, living
EXPENDITURE
officeholder expense
Complete ONLY if direct Candidate / Officeholder name Office sought Office held
expenditure to benefit C/OH
Date
019 M
Payee name r^
e�(Vy �z 6--�-:07'4o&q
Amount ($)
Payee City; State(; Zip Code
/address;
QA�✓� —L/J 6
Category (See Categories Ilst at the lop of this ache le) Description
/ ❑Check if travel outside ofTexas. Complete Schedule T.
PURPOSE
OF
f
/l / Jh I ❑ Check if Austin, TX, officeholder living expense
l7�
EXPENDITURE
w�
r
Complete ONLY if direct Candidate / Officeholder name Office sought Office held
expenditure to benefit C/OH
ATTACH ADDITIONAL COPIES OF THIS SCHEDULE AS NEEDED
Forms provided by Texas Ethics Commission www.ethics.state.tx.us Revised 9/8/2015
POLITICAL EXPENDITURES MADE
FROM POLITICAL CONTRIBUTIONS SCHEDULE F1
EXPENDITURE CATEGORIES FOR BOX 8(a)
Advertising Expense Event Expense Loan Repayment/Reimbursement Solicitation/Fundraising Expense
Accounting/Banking Fees Office Overhead/Rental Expense Transportation Equipment & Related Expense
Consulting Expense Food/Beverage Expense Polling Expense Travel In District
Contributlons/Donatlons Made By Gift/Awards/Memorials Expense Printing Expense Travel Out Of District
Candidate/Officeholder/Political Committee Legal Services Salaries/wages/Contract Labor Other (enter a category not listed above)
Credit Card Payment
The Instruction Guide explains how to complete this form.
1 Total pages 3 ule F1:
2 FILER NAME /`ex 1::7"
3 Filer ID (Ethics Commission Filers)
4 Date
5 Pay m (� ` �� ?�
6 Amount ($)
7 Payee address; City; State: ZZII Code
3e
2-4,
8
(a) Category (See Categories listed at the top of this schedule)
(b) Description
PURPOSE
11 ^ �'
�
❑ Check if travel outside of Texas. Complete Schedule T.
❑
OF
EXPENDITURE
n.41
/ Y
Check if Austin. TX, officeholder living expense
9 Complete ONLY if direct Candidate / Officeholder name Office sought Office held
expenditure to benefit C/OH
[leis
Payee name M
1 A 4MC4,7
Amount ($)
it'60
Payee address; City; State; Zip Code
l 9 e)�( - • 541k,
( � ��^ , �jC -7 6?�
Category (See Ca egorles listed at the top of this schedule)
Description
PURPOSE
/ ! Y
Piz-,!
/ Check if travel outside of Texas. Complete ScheduleT.
OF
EXPENDITURE
v
n J�
AaVe
❑ Check If Austin, TX, officeholder living expense
Complete ONLY if direct Candidate / Officeholder name Office sought Office held
expenditure to benefit C/OH
Date
d o'r711�
Payee name
l i,,,6
Amount ($)
Payee address; City; State; Zip Code
+C),V-V, k-16 2--(,
Category (See Categories listed at the top of this schedule)
Description
PURPOSE
OF
�7
❑ Check if travel outside of Texas. Complete Schedule
❑ Check if Austin. TX, living
EXPENDITURE
(�
officeholder 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
Forms provided by Texas Ethics Commission www.ethics.state.tx.us Revised 9/8/2015
POLITICAL EXPENDITURES MADE
FROM POLITICAL CONTRIBUTIONS SCHEDULE F1
EXPENDITURE CATEGORIES FOR BOX 8(a)
Advertising Expense Event Expense Loan Repayment/Reimbursement Solicitation/Fundraising Expense
Accounting/Banking Fees Office Overhead/Rental Expense Transportation Equipment & Related Expense
Consulting Expense Food/Beverage Expense Polling Expense Travel In District
Contrlbutlons/Donatlons Made By Gift/Awards/Memorials Expense Printing Expense Travel Out Of District
Candidate/Officeholder/Political Committee Legal Services Salaries/Wages/Contract Labor Other (enter a category not listed above)
Credit Card Payment
The Instruction Guide explains how to complete this form,
1 Total pages So ule F1:
E
2 FILER NAM�//,, / ,r
�. t—vli
3 Filer ID (Ethics Commission Filers)
4 Date
1-!:�/fir
5 Payee name
l #1 519n n,
6 Amount )
7 Payee address; City; State: Zip Cade
7o7 s 414(1#1
8
(a) Category (See Categories listed al the top of this schedule)
(b) Description
PURPOSE
❑ T. Check if travel outside of Texas. Complete Schedule
OF
EXPENDITURE
F( ✓�r�( ,S J A, S
❑ Check if Austin. TX, officeholder living expense
9 Complete ONLY if direct Candidate / Officeholder name Office sought Office held
expenditure to benefit C/OH
Date
, 24 /(
Payee name �/�
/Yl r n u
Aunt ($)
Payee address; City; State; Zip Code
Act. S4r ^l iUe-
C �r n c,-r^ sae 2-.6
Category (St ategories listed at the top of this schedule)
Description
PURPOSE
OF
—F ` k)4 i `
ate- x
ElCheckif travel outside of Texas. Complete ScheduleT.
❑ Check if Austin, TX, living
EXPENDITURE
officeholder expense
Complete ONLY if direct Candidate / Officeholder name Office sought Office held
expenditure to benefit C/OH
Date
2A 4F
Payee nameI'D1,7-
M / n W'� MCV111I
Amount ($)
Payee address; City; State; Zip ode
rile wY� 6
Category (Se tegorles listed at the top of this schedule)
Description
PURPOSE
OF
N/!
71'' 2` �' •
❑ Check if travel outside of Texas. Complete Schedule I
❑ Check it Austin, TX, officeholder living expense
EXPENDITURE
I
Complete ONLY if direct Candidate / Officeholder name Office sought Office held
expenditure to benefit C/OH
ATTACH ADDITIONAL COPIES OF THIS SCHEDULE AS NEEDED
Forms provided by Texas Ethics Commission www.ethics.state.tx.us Revised 9/8/2015
POLITICAL EXPENDITURES MADE
FROM POLITICAL CONTRIBUTIONS SCHEDULE F1
EXPENDITURE CATEGORIES FOR BOX 8(a)
Advertising Expense Event Expense Loan Repayment/Reimbursement Solicitation/Fundraising Expense
Accounting/Banking Fees Office Overhead/Rental Expense Transportation Equipment & Related Expense
Consulting Expense Food/Beverage Expense Polling Expense Travel In District
Contributions/Donations Made By Gift/Awards/Memorials Expense Printing Expense Travel Out Of District
Candidate/Offlceholder/Political Committee Legal Services Salaries/Wages/Contract Labor Other (enter a category not listed above)
Credit Card Payment
The Instruction Guide explains how to complete this form.
1 Total pages Schedule Fl:
2 FILER NAME/J /Bl
&1
3 Filer ID (Ethics Commission Filers)
�
4 Date ry
5 Payee name 6
r�
6 Amount ($)
? Payee juddress; Ci[yi Sia le; Zip Code �
?(o s 3 7
8
(a) Category (See Categories listed at the top of this schedule)
(b) Description
PURPOSE
r c ,,,,��
I
❑ Check if Iravel outside of Texas. Complete ScheduleT.
❑
OF
■ .]
Check if Austin, TX, officeholder living expense
EXPENDITURE
9 Complete ONLY if direct Candidate / Officeholder name Office sought Office held
expenditure to benefit C/OH
Data
Ig,/
°1
Payee name
Amount [$)
Pays address: � City; ,$1a� � ig Code
71? acf _44 1 if
%"1� ��
'7
�� F40 Z (�
Category (See Catego s listed at the top of this schedule)
Description
PURPOSE
OF
_ /
y� T� �/.'
❑ Check if travel outside of Texas. Complete ScheduleT.
ElCheckif Austin, TX, officeholder living expense
EXPENDITURE
1 , l 7
Complete ONLY if direct Candidate / Officeholder name Office sought Office held
expenditure to benefit C/OH
Date
Payee name
Amount ($)
Payee address; City; State; Zip Code
Category (See Categories listed at the lop of this schedule)
Description
PURPOSE
OF
❑ Check if travel outside of Texas, Complete Scheduler.
❑
EXPENDITURE
Check if Austin, 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
Forms provided by Texas Ethics Commission www.ethics.state.tx.us Revised 9/8/2015
POLITICAL EXPENDITURES
MADE FROM PERSONAL FUNDS SCHEDULE G
EXPENDITURE CATEGORIES FOR BOX 8(a)
Advertising Expense Event Expense Loan Repayment/Reimbursement Solicitation/Fundralsing Expense
Accounting/Banking Fees Office Overhead/Rental Expense Transportation Equipment & Related Expense
Consulting Expense Food/Beverage Expense Polling Expense Travel In District
Contributions/Donations Made By Gift/Awards/Memorials Expense Printing Expense Travel Out Of District
Candidate/Officeholder/Political Committee Legal Services Salaries/Wages/Contract Labor Other (enter a category not listed above)
Credit Card Payment
The Instruction Guide explains how to complete this form.
1 Total pages Si.,hedule G:
2 FILER NAME n (ex 3 Filer ID (Ethics Commission Filers)
5 Payee na'4 I/e)C
7 Payee address; City; State; Zip Code
4 Date , 49/ Ile,
6 Amount ($)
� // Sod. ov
Pa 6cX �3
j Rtendedsnmuntfrom
pollllcalcarltdCutions
_
/� rr� ��, /�) 2 7
/`'J�jJ / (0 J
/lq`1
lntendsd
✓V�
j
s
(a) Category (See Categories listed at the lop of this schedule)
(b) Description
PURPOSE
•/v/
❑ Texas. Complete Schedule T.
of
EXPENDITURE
✓e- r �15/
Check if Travel outside of
❑Check if Austin, TX, officeholder living expense
9 Complete ONLY if direct Candidate / Officeholder name Office sought Office held
expenditure to benefit C/OH
Date
/,D//-7
Payee name
19':5�6
Amount ($)
Payee address; City; State; Zip Code
�r9v
-?�- /Reimburse"Fit
from
political contributions
intended
Category (See Categories listed at the top of this schedule) (b) Description
PURPOSE ❑ Check if[ravel outside ofTexas. Complete Schedule T.
OF S'e—
EXPENDITURE ❑ Check if Austin. TX, officeholder living expense
Complete ONLY if direct Candidate / Officeholder name Office sought Office held
expenditure to benefit C/OH
Date
Payee name
Amount ($)
Payee address; City; State; Zip Code
❑Reimbursement from
political contributions
intended
Category (See Categories listed at the top of this schedule)
(b) Description
PURPOSEEl OF
Check if travel outside of Texas. Complete Schedule
EXPENDITURE
❑ Check if Austin, 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
Forms provided by Texas Ethics Commission www.ethics.state.tx.us Revised 9/8/2015