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HomeMy WebLinkAboutCampaign Finance Report - Jonathan Dade 04.28.2023CANDIDATE / 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. 3 CANDIDATE / MS / MRS / MR FIRST MI OFFICEHOLDER Mr. Jonathan L OFFICE USE ONLY NAME.... ........................................................................... Date Received NICKNAME LAST SUFFIX Dade EI V F) 4 CANDIDATE / ADDRESS / PO BOX; APT / SUITE #; CITY; STATE; ZIP CODE OFFICEHOLDER PO BOX 877, Georgetown TX 78627-0877 MAILING ADDRESS � Secret y Change of Address 5 CANDIDATE/ AREA CODE PHONE NUMBER EXTENSION Date Hand -delivered or Dale Postmarked OFFICEHOLDER 512 525.0736 D'i (Z ) Z.o 3 PHONE S Z Receipt # Amount $ 6 CAMPAIGN MS /MRS / MR FIRST MI TREASURER Mr- Kenneth Dale NAME................... ---••--- - ---- -..--.......-...........I.............. Date Processed 7 CAMPAIGN TREASURER ADDRESS (Residence or Business) 8 CAMPAIGN TREASURER PHONE NICKNAME LAST SUFFIX Jacobson Date I a ad STREET ADDRESS (NO PO BOX PLEASE); APT / SUITE #; CITY; STATE; ZIP CODE 500 W 2nd Street Suite 1900, Austin TX 78701 AREA CODE PHONE NUMBER (512 710-0890 EXTENSION 9 REPORT TYPE January 15 30th day before election Runoff 15th day after campaign treasurer appointment (Officeholder Only) July 15 n 8th day before election Exceeded Modified Final Report (Attach C/OH - FR) Reporting Limit 10 PERIOD Month Day Year Month Day Year COVERED Q4 f 19 j 23 THROUGH 04 / 28 / 23 / 11 ELECTION ELECTION DATE ELECTION TYPE Month Day Year Primary Runoff Other Description 05 / 06/ 23 General Special 12 OFFICE OFFICE HELD (if any) 13 OFFICE SOUGHT (if known) Mayor 14 NOTICE FROM THIS BOX IS FOR NOTICE OF POLITICAL CONTRIBUTIONS ACCEPTED OR POLITICAL EXPENDITURES MADE BY POLITICAL COMMITTEES TO SUPPORT POLITICAL THE CANDIDATE I OFFICEHOLDER. THESE EXPENDITURES MAY HAVE BEEN MADE WITHOUT THE CANDIDATE'S OR OFFICEHOLDER'S KNOWLEDGE OR CONSENT. CANDIDATES AND OFFICEHOLDERS ARE REQUIRED TO REPORT THIS INFORMATION ONLY IF THEY RECEIVE NOTICE OF SUCH EXPENDITURES. COMMITTEE(S) COMMITTEE TYPE I COMMITTEE NAME Additional Pages GENERAL I COMMITTEE ADDRESS SPECIFIC I COMMITTEE CAMPAIGN TREASURER NAME COMMITTEE CAMPAIGN TREASURER ADDRESS GO TO PAGE 2 Forms provided by Texas Ethics Car1i Reset Form " s Reset Page Revised 8/17/2020 CANDIDATE / OFFICEHOLDER FORM C/OH CAMPAIGN FINANCE REPORT COVER SHEET PG 2 15 C/OH NAME 16 Filer ID (Ethics Commission Filers) 17 CONTRIBUTION 1. TOTAL UNITEMIZED POLITICAL CONTRIBUTIONS (OTHER THAN TOTALS PLEDGES, LOANS, OR GUARANTEES OF LOANS, OR $ $0 CONTRIBUTIONS MADE ELECTRONICALLY) 2. TOTAL POLITICAL CONTRIBUTIONS (OTHER THAN PLEDGES, LOANS, OR GUARANTEES OF LOANS) $ $0 EXPETOTALS 3. TOTAL UNITEMIZED POLITICAL EXPENDITURE. $ $0 4. TOTAL POLITICAL EXPENDITURES $ $440.72 CONTRIBUTION 5, TOTAL POLITICAL CONTRIBUTIONS MAINTAINED AS OF THE LAST DAY BALANCE OF REPORTING PERIOD $ $0 OUTSTANDING 6. TOTAL PRINCIPAL AMOUNT OF ALL OUTSTANDING LOANS AS OF THE LOAN TOTALS LAST DAY OF THE REPORTING PERIOD $ $0 18 SIGNATURE I swear, or affirm, under penalty of perjury, that the accompanying report is and correct and includes all information required to be reported by me under Title 15, Election Code. Signature of Candidate or Officeholder Please complete either option below: t**'� "��, ROBYN LOUISE DENSMORE (1)Affidavit ' Notary ID 4125657056 �,� }� My Commission Expires 0has April 15, 2026 NOTARY STAMP/SEAL Sworn to and subscribed before me by this ft day of 20 Z to certify which, witness my hand and seal of office. Signature of o icer administering oath Printed name f officer administering oath TJtle of officer admintste ng oath (2) Unsworn Declaration My name is My address is Executed in Forms provided by Texas Ethics , 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) Reset Form '`" Reset Page Revised 8/17/2020 SUBTOTALS - C/OH 19 FILER NAME FORM C/OH COVER SHEET PG 3 20 Filer ID (Ethics Commission Filers) 21 SCHEDULE SUBTOTALS NAME OF SCHEDULE 1 SCHEDULEAI: MONETARY POLITICAL CONTRIBUTIONS $ 2 3. 4 5 6. 7 8 9. 10. 11 12. SCHEDULEA2: SCHEDULEB: SCHEDULE E: NON -MONETARY (IN -KIND) POLITICAL CONTRIBUTIONS PLEDGED CONTRIBUTIONS LOANS $ $ $ SCHEDULE F1: POLITICAL EXPENDITURES MADE FROM POLITICAL CONTRIBUTIONS $ SCHEDULE F2: SCHEDULE F3: SCHEDULE F4: SCHEDULE G: SCHEDULE H: UNPAID INCURRED OBLIGATIONS PURCHASE OF INVESTMENTS MADE FROM POLITICAL CONTRIBUTIONS EXPENDITURES MADE BY CREDIT CARD POLITICAL EXPENDITURES MADE FROM PERSONAL FUNDS PAYMENT MADE FROM POLITICAL CONTRIBUTIONS TO A BUSINESS OF C/OH $ $ $ $ $ SCHEDULE I: NON -POLITICAL EXPENDITURES MADE FROM POLITICAL CONTRIBUTIONS SCHEDULE K: INTEREST, CREDITS, GAINS, REFUNDS, AND CONTRIBUTIONS RETURNED TO FILER $ $ SUBTOTAL AMOUNT $0 $0 $0 $0 $440.72 $0 $0 $0 $0 $0 $0 $0 Forms provided by Texas Ethics Commi. Reset Form state Reset Page Revised 8/17/2020 MONETARY POLITICAL CONTRIBUTIONS SCHEDULE Al If the requested information is not applicable, DO NOT include this page in the report. The Instruction Guide explains how to complete this form. 1 Total pages Schedule At, 2 FILER NAME 3 Filer ID (Ethics Commission Filers) 4 Date 5 Full name of contributor out-of-state PAC (ID#: ) 7 Amount of contribution ($) 6 Contributor address; City; State; Zip Code 8 Principal occupation / Job title (See Instructions) g Employer (See Instructions) Date Full name of contributor out-of-state PAC (ID#: ) Amount of contribution ($) Contributor address; City; State; Zip Code Principal occupation / Job title (See Instructions) Employer (See Instructions) Date Full name of contributor out-of-state PAC (ID#: ) Amount of contribution ($) Contributor address; City; State, Zip Code Principal occupation / Job title (See Instructions) Employer (See Instructions) Date Full name of contributor out-of-state PAC (ID#: ) Amount of contribution ($) Contributor address; city; State; Zip Code 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 Com Reset Form s. st Reset Page Revised 8/17/2020 NON -MONETARY (IN -KIND) POLITICAL CONTRIBUTIONS SCHEDULE A2 If the requested information is not applicable, DO NOT include this page in the report. The Instruction Guide explains how to complete this form. 1 Total pages Schedule A2: 2 FILER NAME 3 Filer ID (Ethics Commission Filers) 4 TOTAL OF UNITEMIZED IN -KIND POLITICAL CONTRIBUTIONS $ 5 Date 6 Full name of contributor ❑ out-of-state PAC (ID#: ) 8 Amount of I g In -kind contribution Contribution $ I description I 7 Contributor address; City; State; Zip Code I Check if travel outside of Texas. Complete Schedule T. 10 Principal occupation / Job title (FOR NON-JUDICIAL)(See Instructions) 11 Employer (FOR NON-JUDICIAL)(See Instructions) 12 Contributor's principal occupation (FOR JUDICIAL) 13 Contributor's job title (FOR JUDICIAL) (See Instructions) 14 Contributor's employer/law firm (FOR JUDICIAL) 15 Law firm of contributor's spouse (if any) (FOR JUDICIAL) 16 If contributor is a child, law firm of parent(s) (if any) (FOR JUDICIAL) Date Full name of contributor ❑ out-of-state PAC (ID#: ) Amount of I In -kind contribution Contribution $ I description I .............................................. ..... Contributor address; City; State; Zip Code I Check if travel outside of Texas. Complete Schedule T. Principal occupation / Job title (FOR NON -JUDICIAL) (See Instructions) Employer (FOR NON-JUDICIAL)(See Instructions) Contributor's principal occupation (FOR JUDICIAL) Contributor's job title (FOR JUDICIAL) (See Instructions) Contributor's employer/law firm (FOR JUDICIAL) Law firm of contributor's spouse (if any) (FOR JUDICIAL) If contributor is a child, law firm of parent(s) (if any) (FOR JUDICIAL) 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 Comm Reset Form JslaFReset Page Revised 8/17/2020 PLEDGED CONTRIBUTIONS SCHEDULE B If the requested information is not applicable, DO NOT include this page in the report. The Instruction Guide explains how to complete this form. 1 Total pages Schedule B: 2 FILER NAME 3 Filer ID (Ethics Commission Filers) 4 TOTAL OF UNITEMIZED PLEDGES $ 5 Date 6 Full name of pledgor ❑ out-of-state PAC (ID#: ) 8 Amount I 9 In -kind contribution of Pledge $ I description 7 Pledgor address; City; State; Zip Code I i i. Check if travel outside of Texas. Complete Schedule T. 10 Principal occupation / Job title (See Instructions) 11 Employer (See Instructions) Date Full name of pledgor ❑ out-of-state PAC (ID#: ) Amount I In -kind contribution of Pledge $ I description i .............. ........ ......................... .................... Pledgor address; City; State; Zip Code I I, Check if travel outside of Texas. Complete Schedule T. Principal occupation / Job title (See Instructions) Employer (See Instructions) Date Full name of pledgor ❑ out-of-state PAC (ID#: ) Amount of In -kind contribution Pledge $ I description I _ Pledgor address; City; State; Zip Code I i. Check if travel outside of Texas. Complete Schedule T. Principal occupation / Job title (See Instructions) Employer (See Instructions) Date Full name of pledgor ❑ out-of-state PAC (ID#: ) Amount of I In -kind contribution Pledge $ I description ............................................... _ .................. Pledgor address; City; State; Zip Code I I Check if travel outside of Texas. Complete Schedule T- Principal occupation / Job title (See Instructions) Employer (See Instructions) ATTACH ADDITIONAL COPIES OF THIS SCHEDULEAS NEEDED If contributor is out-of-state PAC, please see Instruction guide for additional reporting requirements, Reset Page Revised 8/17/2020 Forms provided by Texas Ethics CTi,, Reset Form rd LOANS SCHEDULE E If the requested information is not applicable, DO NOT include this page in the report. The Instruction Guide explains how to complete this form. 1 Total pages Schedule E: 2 FILER NAME 3 Filer ID (Ethics Commission Filers) 4 TOTAL OF UNITEMIZED LOANS $ 5 Date of loan 7 Name of lender ❑ out-of-state PAC (ID#: I 9 Loan Amount ($) 6 Is lender 8 Lender address; City; State; Zip Code 10 Interest rate a financial Institution? _ 11 Maturity date Y N 12 Principal occupation / Job title (See Instructions) 13 Employer (See Instructions) 14 Description of Collateral 15 Check if personal funds were deposited into political account (See Instructions) none 16 GUARANTOR 17 Name ofguarantor 19 Amount Guaranteed ($) 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#: ) Loan Amount ($) ......................................... Is lender Lender address; ...................................... ....... City; State; Zip Code Interest rate a financial Institution? Maturity date Y N Principal occupation / Job title (See Instructions) Employer (See Instructions) Description of Collateral Check if personal funds were deposited into political account (See Instructions) none GUARANTOR Name of guarantor Amount Guaranteed ($) INFORMATION Guarantor address, City; State; Zip Code not applicable Principal Occupation (See Instructions) 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 Comm Reset Form t Sta I Reset Page I Revised 8/17/2020 POLITICAL EXPENDITURES MADE FROM POLITICAL CONTRIBUTIONS SCHEDULE F1 If the requested information is not applicable, DO NOT include this page in the report. EXPENDITURE CATEGORIES FOR BOX 8(a) Advertising Expense Event Expense Loan Re ment/Reimbursement paY 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/Officeholder/Political Committee Legal Services Salaries/Wages/Contract Labor Other (entera category not listed above) Credit Card Payment The Instruction Guide explains how to complete this form. 1 Total pages Schedule F1 2 FILER NAME 3 Filer ID (Ethics Commission Filers) 5 Payee name 4 Date 6 Amount ($) 7 Payee address; City; State, Zip Code 8 (a) Category (See Categories listed at the lop of this schedule) (b) Description PURPOSE OF EXPENDITURE (c) Check if travel outside of Texas. Complete Schedule Check if Austin, TX, officeholder living expense 9 Complete ONLY if direct Candidate / Officeholder name Office sought Office held expenditure to benefit C/OH Date Payee name Amount ($) Payee address; City; State; Zip Code Category (See Categories listed at the lop of this schedule) Description PURPOSE OF EXPENDITURE Check if travel outside of Texas. Complete Schedule 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 Category (See Categories listed at the top of this schedule) Description PURPOSE OF EXPENDITURE Check if travel outside of Texas. Complete Schedule 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 Corm Reset Form I CSs1 Reset Page I Revised 8/17/2020 UNPAID INCURRED OBLIGATIONS SCHEDULE F2 If the requested information is not applicable, DO NOT include this page in the report. EXPENDITURE CATEGORIES FOR BOX 10(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 Pdnting Expense Travel Out Of District Candidate/Officeholder/Political Committee Legal Services Salaries/VVages/Contract Labor Other (enter a category not listed above) The Instruction Guide explains how to complete this form. 1 Total pages Schedule F2: 2 FILER NAME 3 Filer ID (Ethics Commission Filers) 4 TOTAL OF UNITEMIZED UNPAID INCURRED OBLIGATIONS $ 5 Date 6 Payee name 8 Payee address; City; State; Zip Code 7 Amount ($) 9 TYPE OF EXPENDITURE Political Non -Political 10 (a) Category (See Categories listed at the top of this schedule) (b) Description PURPOSE OF EXPENDITURE (c) Check if travel outside of Texas. Complete Schedule Check if Austin, TX, officeholder living expense 11 Complete ONLY if direct Candidate / Officeholder name Office sought Office held expenditure to benefit C/OH Date Payee name Payee address; City; State; Zip Code Amount ($) TYPE OF EXPENDITURE Political Non -Political Category (See Categories listed at the top of this schedule) Description PURPOSE OF EXPENDITURE Check if travel outside of Texas. Complete ScheduleT 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 1om Reset Form cs s Reset Page Revised 8/17/2020 EXPENDITURES MADE BY CREDIT CARD SCHEDULE F4 If the requested information is not applicable, DO NOT include this page in the report. EXPENDITURE CATEGORIES FOR BOX 10(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/Officeholder/Political Committee Legal Services Salaries/Wages/Contract Labor Other (enter a category not listed above) The Instruction Guide explains how to complete this form. 1 Total pages Schedule F4: 1. 2 FILER NAME 3 Filer ID (Ethics Commission Filers) 4 TOTAL OF UNITEMIZED EXPENDITURES CHARGED TOACREDIT CARD $ 5 Date 6 Payee name 7 Amount ($) 8 Payee address; City; State; Zip Code 9 TYPE OF EXPENDITURE Political Non -Political 10 (a) Category (See Categories listed at the top of this schedule) (b) Description PURPOSE OF EXPENDITURE (c) Check if travel outside of Texas. Complete Schedule Check if Austin, TX, officeholder living expense 11 Candidate / Officeholder name Office sought Office held Complete ONLY if direct expenditure to benefit C/OH Date Payee name Amount ($) Payee address; City; State; Zip Code TYPE OF EXPENDITURE Political Non -Political Category (See Categories listed at the top of this schedule) Description PURPOSE OF EXPENDITURE Check if travel outside of Texas. Complete Schedule Check if Austin, TX, officeholder living expense Candidate / Officeholder name Office sought Office held Complete ONLY if direct expenditure to benefit C/OH ATTACH ADDITIONAL COPIES OF THIS SCHEDULE AS NEEDED —11 Forms provided by Texas Ethics Cornmtss Reset Form ate Reset Page Revised 8/17/2020 POLITICAL EXPENDITURES MADE FROM SCHEDULE G PERSONAL FUNDS If the requested information is not applicable, DO NOT include this page in the report. 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/Officeholder/Political Committee Legal Services Salades/VVages/Contract Labor Other(entera category not listed above) Credit Card Payment The Instruction Guide explains how to complete this form. 1 Total pages Schedule G: 2 FILER NAME 3 Filer ID (Ethics Commission Filers) 4 Date 5 Payee name 6 Amount ($) 7 Payee address; City; State; Zip Code Reimbursement from political contributions intended 8 (a) Category (See Categories listed at the top of this schedule) (b) Description PURPOSE OF EXPENDITURE (c) Check if travel outside of Texas Complete Schedule Check if Austin, TX, officeholder living expense 9 Candidate / Officeholder name Office sought Office held Complete ONLY if direct expenditure to benefit C/OH Date Payee name Amount ($) Payee address; City; State; Zip Code Reimbursement from political contributions intended Category (See Categories listed at the top of this schedule) Description PURPOSE OF EXPENDITURE Check if travel outside of Texas Complete Schedule Check if Austin, TX, officeholder living expense Candidate / Officeholder name Office sought Office held Complete ONLY if direct expenditure to benefit C/OH Date Payee name Amount ($) Payee address; City; State; Zip Code Reimbursement from political contributions intended Category (See Categories listed at the top of this schedule) Description PURPOSE OF EXPENDITURE Check if travel outside of Texas Complete Schedule Check if Austin, TX, officeholder living expense Candidate / Officeholder name Office sought Office held Complete ONLY if direct expenditure to benefit C/OH ATTACH ADDITIONAL COPIES OF THIS SCHEDULE AS NEEDED Forms provided by Texas Ethics ConyF Reset Form =FReset Page Revised 8/17/2020 PAYMENT MADE FROM POLITICAL CONTRIBUTIONS TO A BUSINESS OF C/OH SCHEDULE H If the requested information is not applicable, DO NOT include this page in the report. EXPENDITURE CATEGORIES FOR BOX 8(a) Advertising Expense Event Expense Loan Repayment/Reimbursement Solicitation/Fundraising Expense Accounting/Banking Fees Office Overhead/Rental Expense Transportation Equipment & Related Expense Consulting Expense Food/Beverage Expense Polling Expense Travel In District Contributions/Donations Made By Gift/Awards/Memorials Expense Printing Expense Travel Out Of District Candidate/Officeholder/Political Committee Legal Services Salaries/Wages/Contract Labor Other (enter a category not listed above) Credit Card Payment The Instruction Guide explains how to complete this form. 1 Total pages Schedule H 2 FILER NAME 3 Filer ID (Ethics Commission Filers) 4 Date 5 Business name 6 Amount ($) 7 Business address; City; State; Zip Code 8 (a) Category (See Categories listed at the top of this schedule) (b) Description PURPOSE OF EXPENDITURE (c) Check if travel outside of Texas Complete Schedule T Check if Austin, TX, officeholder living expense 9 Complete ONLY if direct Candidate / Officeholder name Office sought Office held expenditure to benefit C/01-1 Date Business name Amount ($) Business address; City; State, Zip Code Category (See Categories listed at the top of this schedule) Description PURPOSE OF EXPENDITURE Check iftravel outside ofTexas. Complete ScheduleT Check if Austin, TX, officeholder living expense Complete ONLY if direct Candidate / Officeholder name Office sought Office held expenditure to benefit C/OH Date Business name Amount ($) Business address; City; State; Zip Code Category (See Categories listed at the top of this schedule) Description PURPOSE OF EXPENDITURE Check if travel outside of Texas Complete Schedule T 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 SCHEDULEAS NEEDED Forms provided by Texas Ethics Corn " RReset Page Reset Form Revised 8/17/2020 NON -POLITICAL EXPENDITURES MADE FROM POLITICAL CONTRIBUTIONS SCHEDULE I If the requested information is not applicable, DO NOT include this page in the report. The Instruction Guide explains how to complete this form. 1 Total pages Schedule I: 2 FILER NAME 3 Filer ID (Ethics Commission Filers) 4 Date 5 Payee name 6 Amount ($) 7 Payee address; City State Zip Code 8 (a)Category (See instructions for examples of acceptable (b)Description (See instructions regarding type of information PURPOSE categories) required.) OF EXPENDITURE Date Payee name Amount ($) Payee address; City State Zip Code Category (See instructions for examples of acceptable Description (See instructions regarding type of information PURPOSE categories.) required.) OF EXPENDITURE Date Payee name Amount ($) Payee address; City State Zip Code Category (See instructions for examples of acceptable Description (See instructions regarding type of information PURPOSE categories) required.) OF EXPENDITURE Date Payee name Payee address; City State Zip Code Amount ($) Category (See instructions for examples of acceptable Description (See instructions regarding type of information PURPOSE categories) required ) OF EXPENDITURE ATTACH ADDITIONAL COPIES OF THIS SCHEDULE AS NEEDED Forms provided by Texas Ethics Coin Reset Form I ISS Reset Page Revised 8/17/2020 INTEREST, CREDITS, GAINS, REFUNDS, AND CONTRIBUTIONS RETURNED TO FILER SCHEDULE K If the requested information is not applicable, DO NOT include this page in the report. The Instruction Guide explains how to complete this form. 1 Total pages Schedule K: 2 FILER NAME 3 Filer ID (Ethics Commission Filers) 4 Date 5 Name of person from whom amount is received 8 Amount ($) 6 Address of person from whom amount is received; City; State; Zip Code 7 Purpose for which amount is received Check if political contribution returned to filer Date Name of person from whom amount is received Amount ($) Address of person from whom amount is received; City; State; Zip Code Purpose for which amount is received Check if political contribution returned to filer Date Name of person from whom amount is received Amount ($) Address of person from whom amount is received; City; . ....4 ........................ State; Zip Code Purpose for which amount is received Check if political contribution returned to filer Date Name of person from whom amount is received Amount ($) Address of person from whom amount is received; City; State; Zip Code Purpose for which amount is received Check if political contribution returned to filer ATTACH ADDITIONAL COPIES OF THIS SCHEDULE AS NEEDED Forms provided by Texas Ethics Corn Reset Form ISIS Reset Page Revised 8/17/2020 IN -KIND CONTRIBUTIONS OR POLITICAL EXPENDITURES SCHEDULE T FOR TRAVEL OUTSIDE OF TEXAS If the requested information is not applicable, DO NOT include this page in the report. The Instruction Guide explains how to complete this form. 1 Total pages Schedule T: 2 FILER NAME 3 Filer ID (Ethics Commission Filers) 4 Name of Contributor / Corporation or Labor Organization / Pledgor / Payee 5 Contribution / Expenditure reported on: Schedule A2 Schedule B Schedule B(J) Schedule C2 Schedule D Schedule F1 Schedule F2 Schedule F4 Schedule G Schedule H Schedule COH-UC Schedule B-SS 6 Dates of travel 7 Name of person(s) traveling 8 Departure city or name of departure location 9 Destination city or name of destination location 10 Means of transportation 11 Purpose of travel (including name of conference, seminar, or other event) Name of Contributor / Corporation or Labor Organization / Pledgor / Payee Contribution / Expenditure reported on: Schedule A2 Schedule B Schedule B(J) Schedule C2 Schedule D Schedule F1 Schedule F2 Schedule F4 Schedule G Schedule H Schedule COWLIC Schedule B-SS Dates of travel Name of person(s) traveling Departure city or name of departure location Destination city or name of destination location Means of transportation I Purpose of travel (including name of conference, seminar, or other event) Name of Contributor / Corporation or Labor Organization / Pledgor / Payee Contribution / Expenditure reported on. - Schedule A2 Schedule B Schedule B(J) Schedule C2 Schedule D Schedule F2 Schedule F4 Schedule G Schedule H Schedule COWLIC Dates of travel Name of person(s) traveling Departure city or name of departure location Destination city or name of destination location Means of transportation I Purpose of travel (including name of conference, seminar, or other event) Schedule F1 Schedule B-SS ATTACH ADDITIONAL COPIES OF THIS SCHEDULE AS NEEDED Forms provided by Texas Ethics Corn I Reset Form 71171F Reset Page Revised 8/17/2020 CANDIDATE / OFFICEHOLDER REPORT: DESIGNATION OF FINAL REPORT FORM C/OH - FR The Instruction Guide explains howto complete this form. •• Complete only if "Report Type" on page 1 is marked "Final Report" •- 1 C/OH NAME 1 2 Filer ID (Ethics Commission Filers) 3 SIGNATURE I do not expect any further political contributions or political expenditures in connection with my candidacy, I understand that designating a report as a final report terminates my campaign treasurer appointment. I also understand that I may not accept any campaign contributions or make any campaign expenditures without a campaign treasurer appointment on file. Signature of Candidate / Officeholder 4 FILER WHO IS NOT AN OFFICEHOLDER •• Complete A & B below only if you are not an officeholder •- A. CAMPAIGN FUNDS Check only one: I do not have unexpended contributions or unexpended interest or income earned from political contributions. I have unexpended contributions or unexpended interest or income earned from political contributions. I understand that I may not convert unexpended political contributions or unexpended interest or income earned on political contributions to personal use I also understand that I must file an annual report of unexpended contributions and that I may not retain unexpended contributions or unexpended interest or income earned on political contributions longer than six years after filing this final report. Further, I understand that I must dispose of unexpended political contributions and unexpended interest or income earned on political contributions in accordance with the requirements of Election Code, § 254.204, B. ASSETS Check only one: I do not retain assets purchased with political contributions or interest or other income from political contributions. I do retain assets purchased with political contributions or interest or other income from political contributions. I understand that I may not convert assets purchased with political contributions or interest or other income from political contributions to personal use. I also understand that I must dispose of assets purchased with political contributions in accordance with the requirements of Election Code, § 254 204. Signature of Candidate 5 OFFICEHOLDER •• Complete this section only if you are an officeholder •• I am aware that I remain subject to filing requirements applicable to an officeholder who does not have a campaign treasurer on file. I am also aware that I will be required to file reports of unexpended contributions if, after filing the last required report as an officeholder, I retain political contributions, interest or other income from political contributions, or assets purchased with political contributions or interest or other income from political contributions. Signature of Officeholder Forms provided by Texas Ethics Coml Reset Form Ics s{ Reset Page I Revised 8/17/2020