HomeMy WebLinkAboutCFR-01.15.2021-Triggs, MichaelCANDIDATE / OFFICEHOLDER
FORM C/OH
CAMPAIGN FINANCE REPORT
COVER SHEET PG 1
The C/OH Instruction Guide
1 Filer ID (Ethics Commission Filers)
explains how to complete this form.
P411-MR FIRST MI
j/� �
2 Total pages filed:
3 CANDIDATE /
OFFICEHOLDER
OFFICE USE ONLY
Date
ye ,
� LEW
NAME
--------------Y !.......... .. d..................... ..........
NICKtNAME LAST SUFFIX
4 CANDIDATE /
D
ADDRESS / PO BOX; APT /SUITE #; CITY; STATE; ZIP CODE
�
JAN 152021
OFFICEHOLDER
MAILING
ADDRESS
Change of Address
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6=,eo F -'ow d 1 A
C Ity Secretan
5 CANDIDATE/
AREA CODE PHONE NUMBER EXTENSION
Dat d•deliVar r Date Postmarked
OFFICEHOLDER
PHONE
Receipt #
Amount $
6 CAMPAIGN
TREASURER
NAME..
MS / MRS / MR FIRST MI
Q� .�............ ....... ............
Date Processed
NICKNAME LAST SUFFIX
Date Imaged
7 CAMPAIGN
STREET ADDRESS (NO PO BOX PLEASE); APT / SUITE #; CITY;
STATE; ZIP CODE
TREASURER
ADDRESS
(Residence or Business)
n,
/ V
8 CAMPAIGN
AREA CODE PHONE NUMBER EXTENSION
TREASURER
PHONE
) f %/)q
January 15 El 30th day before election Runoff
15th day after campaign
treasurer appointment
9 REPORT TYPE
(Officeholder Only)
El July 15 El 81h day before election Exceeded Modred
Reporting Limit
Month Day Year Month
❑ Final Report (Attach C/OH - FR)
Day Year
10 PERIOD
COVERED
/ + 1,26rlV THROUGH r / f 0
J
11 ELECTION
ELECTION DATE
ELECTION TYPE
Month Day Year
/
NIq
❑ Primary ❑ Runoff ❑ Other
❑ Description
General ❑ Special
—
12 OFFICE
OF DICE HELD (if any) 13 OFFICE OUGHT (if known)
4urc)c1 �- �7I�
THIS BOX IS FOR NOTICE OF POLITICAL CONTRIBUTIONS ACCEPTED OR POLITICAL EXPENDITURES MADE BY POLITICAL COMMITTEES TO SUPPORT
THE CANDIDATE / OFFICEHOLDER. THESE EXPENDITURES MAY HAVE BEEN MADE WITHOUT THE CANDIDATES OR OFFICEHOLDER'S KNOWLEDGE OR
CONSENT. CANDIDATES AND OFFICEHOLDERS ARE REQUIRED TO REPORT THIS INFORMATION ONLY IF THEY RECEIVE NOTICE OF SUCH EXPENDITURES.
14 NOTICE FROM
POLITICAL
COMMITTEE(S)
COMMITTEE TYPE
COMMITTEE NAME nn _
Additional Pages
GENERAL
COMMITTEE ADDRESS
COMMITTEE CAMPAIGN TREASURER NAME
SPECIFIC
COMMITTEE CAMPAIGN TREASURER ADDRESS
GO TO PAGE 2
Forms provided by Texas Ethics Commission www.ethics.state.tx.us Revised 8/17/2020
CANDIDATE / OFFICEHOLDER FORM C/OH
CAMPAIGN FINANCE REPORT COVER SHEET PG 2
15 C/Oki NAME; ./ 16 Filer ID (Ethics Commission Filers)
17 CONTRIBUTION 1. TOTAL UNITEMIZED POLITICAL CONTRIBUTIONS (OTHER THAN
TOTALS PLEDGES, LOANS, OR GUARANTEES OF LOANS, OR $
CONTRIBUTIONS MADE ELECTRONICALLY)
2. TOTAL POLITICAL CONTRIBUTIONS $
(OTHER THAN PLEDGES, LOANS, OR GUARANTEES OF LOANS) L
-F
EXPENDITURE 3. TOTAL UNITEMIZED POLITICAL EXPENDITURE.
TOTALS $
4. TOTAL POLITICAL EXPENDITURES I $ 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 SIGNATURE 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, Election Code.
rry�� r
r Signature of Candidate or Nficeholder
Please complete either option below:
ArINaN MAR1E SHI;LTON
= 'n tlotnry Ful,lit, State
of Texas
Camm. 19xggyres 06.19.2021
(1) Affidavit ` Notary 1A 12946428-4
NOTARY STAMP/SEAL ( _
Sworn to and subscribed before me by CieJ I / CIO,5 this the - day of�
20 i to certify which, witness my hl zndseal of office.
--��T - Jul I�
ign ofGc dministering oath Printed name of officer administering oath Title of officer a ministering oath
1 (2) Unsworn Declaration
My name is
My address is
Executed in
and my date of birth is
(street) (city) (state) (zip code) (country)
County, State of on the day of .20
(month) (year)
Signature of Candidate/Officeholder (Declarant)
Forms provided by Texas Ethics Commission www.ethics.state.tx.us Revised 8i17/ZUZL