HomeMy WebLinkAboutWirth, Jason_CFR 10.26.2020CANDIDATE / OFFICEHOLDER
FORM C/OH
CAMPAIGN FINANCE REPORT
COVER SHEET PG 1
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1
Filer ID (Ethics Commission Filers)
2 Total pages filed:
The C/OH Instruction Guide
explains how to complete this form.
3 CANDIDATE /
M3 / MRS / MR FIRST
MI
OFFICE USE ONLY
OFFICEHOLDER
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Date Received
NAME
_ _
NICKNAME LAST
SUFFIX
RECEIVEDGcJ
irk
OCT 2 6 2020
q CANDIDATE /
ADDRESS / PO BOX; APT I SUITE #; CITY; STATE; ZIP CODE
OFFICEHOLDER
MAILING
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ADDRESS
Secretary
�+r� City
❑ Change of Address
5 CANDIDATE/
AREA CODE PHONE NUMBER
EXTENSION
Date Hand -delivered or Date Postmarked
[F7
PHONE OFFICEHOLDER
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I��lS6u
6 CAMPAIGN
MS / MRS / MR
MI
Receipt #
Amount $
TREASURER
�FIRST
2 -mil SoA-)
14
NAME
. . . . . . . . .
NICKNAME LAST
SUFFIX
Date Imaged
7 CAMPAIGN
STREET ADDRESS (NO PO BOX PLEASE); APT / SUITE #; CITY;
STATE; ZIP CODE
TREASURER
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ADDRESS
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(Residence or Business)
6 CAMPAIGN
AREA CODE PHONE NUMBER
EXTENSION
TREASURER
J g$_ 9�9v
l �O
PHONE
9 REPORT TYPE
❑ January 15 301h day before election El Runoff
day after campaign
E71
L
trey
treasurer appointment
(Officeholder Only)
❑ July 15 I { j Blh day before election
El Exc, eWi id Modified
El Final Report (Attach C/OH -FR)
f
ReporlIng Limit
ti
10 PERIOD
Month Day Year
Month
Day Year
COVERED
" r �' � 2,0
�v /Z /ZOZt7
THROUGH
11 ELECTION
ELECTION DATE
ELECTION TYPE
Month Day Year
❑ Primary
❑ Runoff ❑ Other
/ � 12aZv
General
Description
❑ Special
12 OFFICE
OFFICE HELD (If any)
13 OFFICE SOUGHT (If known)
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GO TOPAGE 2
CANDIDATE / OFFICEHOLDER
FORM C/OH
CAMPAIGN FINANCE REPORT COVER SHEET PG 2
U C/OH NAME
15 Flier ID (Ethics Commission Filers)
I
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 COMMITTEE NAME T
❑ GENERAL
SPECIFIC
COMMITTEE ADDRESS
COMMITTEE CAMPAIGN TREASURER NAME
Additional Pages
COMMITTEE CAMPAIGN TREASURER ADDRESS
17 CONTRIBUTION
1 . TOTAL UNITEMIZED POLITICAL CONTRIBUTIONS (OTHER THAN
p,)
• TOTALS
PLEDGES, LOANS, OR GUARANTEES OF LOANS, OR
$
CONTRIBUTIONS MADE ELECTRONICALLY)
2. TOTAL POLITICAL CONTRIBUTIONS
$ pc7
(OTHER THAN PLEDGES, LOANS, OR GUARANTEES OF LOANS)
TOTALS EXPENDITURE
3. TOTAL UNITEMIZED POLITICAL EXPENDITURE.
$ D�
4. TOTAL POLITICAL EXPENDITURES
BALANCE CONTRIBUTION
5. TOTAL POLITICAL CONTRIBUTIONS MAINTAINED AS OF THE LAST DAY
$ DO
OF REPORTING PERIOD
OUTSTANDING
LOAN TOTALS
6. TOTAL PRINCIPAL AMOUNT OF ALL OUTSTANDING LOANS AS OF THE
0-11
$/
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 be reported by me
underTitle 15, Election Code.
;�■ -, KELI J RUSS
NOTARY PUBLIC
*: ID# 128165091
q, ....,;r" Slate of Texas '`� Q�
Fo0.
rs: Comm.Cxp.02-01-2022 gnature of Candidate or Offlceholder
't
I
AF A I E L
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Sworn to and subscribed before me, by the said this the
day of LA 20�_, to certify which, witness my hand and seal of office. SON u3ky-A L-
,
Signature of officer administering oath Printed name of officer administering oath Title of officer administering oath