OFFICE USE ONLY OFFICEHOLDER NAME ... NICKNAME LAST SUFFIX

Transcription

1 Texas Ethics Commission P.O. Box Austin, Texas (512) (TOO ) CANATE FCEHOLER FORM C/OH CAMPAGN FNANCE REPORT CovER SHEET PG 1 The COH nstruction Guide explains how to complete this form. 1 ACCOUNT# 2 Total pages filed: (Ethics Commission Filers) 3 CANATE MSMRSMR FRST Ml FCE USE ONLY FCEHOLER NAME MR. ANY ate Received NCKNAME LAST SUFFX, (ll) r- c:::::t -< f"\ ::t. NGUYEN i' ("') _..., - c.t\ :::0 4 CANATE ARESS PO BOX; APT/SUTE#; CTY; STATE; ZP COE --;o ::0 FCEHOLER,.t: % MALNG ate Han f::j t:fftma"cb ARESS 0 change of address Receipt# 8 o.,. F :; :x:e n.., zlw"':e C: 5 CANATE/ AREA COE PHONE NUMBER EXTENSON (;) X FCEHOLER ate Proce ed ::0 - PHONE 0 6 CAMPAGN MSMRSMR FRST Ml ate maged\ """ TREASURER MR. TOM NAME < NCKNAME LAST SUFFX HA 7 CAMPAGN STREET ARESS (NO PO BOX PLEASE); APT/SUTE#; CllY; STATE; ZP COE TREASURER ARESS (residence or business) 8 CAMPAGN AREA COE PHONE NUMBER EXTENSON TREASURER ( ) PHONE 9 REPORT TYPE O January 15 30th day before election Runoff 15th day after campaign treasurer appointment (officeholder only) [X] July 15 8th day before election Exceeded $500 limit Final report (Attach COH - FR) 10 PERO Month ay Year Month ay Year COVERE THROUGH 01 /01 / / 30 / ELECTON ELECTON ATE Month ay Year / / ELECTONlYPE Primaly Runoff General Special 12 FCE FCE HEL (H any) 13 FCESOUGHT (Hknown) TARRANT COUNTY COMMSSONER PCT.2 GOTOPAGE2

2 Texas Ethics Commission P.O. Box Austin, Texas (512) (TOO } CANATE FCEHOLER REPORT: FORM C/OH SUPPORT & TOTALS CovER SHEET PG 2 14 C/OH NAME 115 ACCOUNT# (Ethics Commission Filers) ANY NGUYEN 16 NOTCE FROM THS BOX S FOR NOTCE POU1lCAl. CONTRBU1'10NS ACCEPC OR POU1CAl. EXPENTURES MAE BY POLTCAL COMMTTEES TO SUPPORT THE POLTCAL CANATE/ FCEHOLER. THESE EXPENTURES MAY HAVE BEEN MAE WTHOUT THE CANATE'S OR fiij'ceer's KNfj6EGE OR COMMTTEE(S) CONSENT. CANATES AN FCEHOLERS ARE REQURE TO REPORT THS NFORMA110N ONLY F THEY RECEVt'tkmcECH 0 additional pages -c-., COMMTTEE NAME -:::o c_ ::0 COMMTTEE TYPE 0)> c::: ::t.j :z:%,... (.1') >., )> x- GENERAL o:!! co --.r COMMTTEE ARESS i- ::!:.- :i npl SPECFC ao U)- _.., :::ouj w 2'.. -, COMMTTEE CAMPAGN TREASURER NAME!6.z:- COMMTTEE CAMPAGN TREASURER ARESS c 17 CONTRBUTON 1. TOTAL POLTCAL CONTRBUTONS $50 OR LESS (OTHER THAN TOTALS PLEGES, LOANS, OR GUARANTEES LOANS), UNLESS TEMZE $ 2. TOTAL POLTCAL CONTRBUTONS (OTHER THAN PLEGES, LOANS, OR GUARANTEES LOANS)..... EXPENTURE TOTALS 3. TOTAL POLTCAL EXPENTURES $100 OR LESS, UNLESS TEMZE TOTAL POLTCAL EXPENTURES $ $ $ CONTRBUTON 5. TOTAL POLTCAL CONTRBUTONS MANTANE AS THE LAST AY BALANCE REPORTNG PERO..... $ OUTSTANNG 6. TOTAL PRNCPAL AMOUNT ALL OUTSTANNG LOANS AS THE LOAN TOTALS LAST AY THE REPORTNG PERO $ 18 AFFAVT e AU NOTARY PU8UC,...,, OffiM, "- ;zm _m,..,ylog '"""" is true and correct and inclu all informatio, equired to be reported by me under Title 15, Elefti STATE TEXAS (> )\ /-.. My Comm. Ellp Signatre of Candidate fromceholder 1 AFFX NOTARY STAMP SEAL ABOVE Sworn to and subscribed before me, by the said A-nAu f\, this the j day of --s-v-1'6 20 (), to certify which, witness my hand and seal of office. djj t 1\A fd '\.lt h. A ca.jt'c Sec...-.:- -;;fad'rrll"nistenngoath Printed name of officer administering oath Title of officer administering qj{tti

3 Texas Ethics Commission P.O. Box Austin, Texas (512) (TOO ) POLTCAL CONTRBUTONS OTHER THAN PLEGES OR LOANS SCHEULE A 2 FLER NAME The nstruction Guide explains how to complete this form.. ANY NGUYEN 4 ate 5 Full name of contributor 0 out-of-state PAC(#: 04/ NGUY.EN, LONG. 6 Contributor address; City; state; Zip Code 3108 Atrium rive Grand Prairie, TX Principal occupation Job title (See nstructions) RETRE 1 Total pages Schi41jJie A:rn U\ )> f 1?6 3 ACCOUNT# (Ed ics CorJil1!!on Fh'f's) ')>.,., (/):;'! ' X;;:: "0 co... ). 7 Amount of ln-i$i;p:ontioq C Employer {See nstructions) contribution {$) descri {if glica (J)-o % ;1c.n ca _. - --< 1oo.oo.r:- (lf travel outside Tels, complete Schedule T) ate Full name of contributor 0 out-of-state PAC(#:.,) Amount of n-kind contribution 04/17/15. NGUYEN. STEVE... Contributor address; City; state; Zip Code Primrose rive rving, TX Principal occupation Job title {See nstructions).,.,.-rni<"t contribution ($) description (if applicable) (f travel outside of Texas, complete Schedule T) Employer (See nstructions) ate Full name of contributor 0 out-of-statepac(#:,l Amount of n-kind contribution 04/17/15. HANSON MARK Contributor adbress; City; state; Zip Code 2705 Butler r. Arlington, TX Principal occupation Job title (See nstructions) OPTOMETRST Employer (See nstructions) contribution ($) description (if applicable) 50.oo 1 (f travel outside of Texas, complete Schedule T) ate Full name of contributor 0 out-of-state PAC (10#: l Amount of n-kind contribution., contribution ($) description {if applicable) Contributor address; City; State; Zip Code Principal occupation Job title (See nstructions) (f travel outside of Texas complete Schedule T) Employer {See nstructions) ate Full name of contributor 0 out of-statepac(#:.,) Amount of n-kind contribution Contributor address; City; State; Zip Code Principal occupation Job title (See nstructions) contribution {$) description (if applicable) (f travel outside of Texas comolete Schedule Tt Employer (See nstructions) ATTACH ATONAL COPES THS SCHEULE AS NEEE f contributor s out-of-state PAC, please see instruction guide foradditional reporting requirements.

4 Texas Ethics Commission PO Box12070 Austin Texas ' POLTCAL EXPENTURES (512) (TOO ) SCHEULE F EXPENTURE CATEGORES FOR BOX B(a) Advertising Expense Gift/Awards/Memorials Expense Salaries/Wages/Contract Labor Loan Repayment/Reimbursement Accounting/Banking Legal Services Solicitation/Fundralsing Expense Transportation Equipment & Related Expense Consulting Expense Food/Beverage Expense Travel n istrict Contributions/onations Made By Event Expense Polling Expense Travel Out Of istrict Candidate/Officeholder/Political Committee Fees Printing Expense Office Overhead/Rental Expense OTHER (enter a category not listed above) The nstruction Guide explains how to complete this form. 1 Total pages Schedule F: 2 FLER NAME 13 ACCOUNT# (Ethics Commission Filers) 1/5 ANY NGUYEN 4 ate 5 01/14/15 MWSEA 6 Amount($) 7 Payee address; City; state; Zip Code POBOX , ARLNGTON, TX , f"''l Cl:)!:;! -== 8 (a) Category (See categories listed at the top of this schedule) (b) escription (f travel outside oft xes, coom!ltchedgj) ::u ;o o F EXPENTURE l>., CONSULTNG 0 Check if Austin, TX, oflicehol erliving ;::: 9 complete QJlll.Y if direct Candidate Officeholder name Office sought ehefcf' %.- _...- S? ate... U» - :r: :0 ca -"" 01/15/15 RLRW!t -< Amount ($) Payee address; City; state; Zip Code ;;,f:' PO BOX , ARLNGTON, TX az Category (See categories listed at the top of this schedule) escription (f travel outside of Texas, complete Schedule T) EXPENTURE 0 Check if Austin, TX, officeholder living expense CONTRBUTON Complete QJlll.Y if direct Candidate Officeholder name Office sought Office held ate 01/21/15 TARRANT COUNTY REPUBLCAN PARTY Amount ($) Payee address; City; state; Zip Code GRAVEL R. FTW, TX Category (See categories listed at the top of this schedule) escription (f travel outside oftexas, complete Schedule T) EXPENTURE CONTRBUTON 0 Check if Austin, TX, officeholder living expense Complete QJlll.Y if direct Candidate Officeholder name Office sought Office held expenditure to benefit C/H ate 01/25/15 CHRS PHAN Amount ($) Payee address; City; state; Zip Code GAREN GROVE, CA Category (See categories listad atthe top of this schedule) escription (f travel outside of Texas, complete Schedule T) EXPENTURE CONTRBUTON 0 Check if Austin, TX, officeholder Mng expense Complete QJlll.Y if direct Candidate Officeholder name Office sought Office held ATTACH ATONAL COPES THS SCHEULE AS NEEE

5 Texas Ethics Commission PO Box12070 Austin Texas ' POLTCAL EXPENTURES (512) (TOO ) SCHEULE F EXPENTURE CATEGORES FOR BOX 8(a) Advertising Expense Gift/Awards/Memorials Expense Salaries/Wages/Contract Labor Loan Repayment/Reimbursement Accounting/Banking Legal Services Solicitation/Fundraising Expense Transportation Equipment & Related Expense Consulting Expense Food/Beverage Expense Travel n istrict Contributions/onations Made By Event Expense Polling Expense Travel Out Of istrict Candidate/Officeholder/Political Committee Fees Printing Expense Office Overhead/Rental Expense OTHER (enter a category not listed above) The nstruction Guide explains how to complete this form. 1 Total pages Schedule F: 2 FLER NAME 13 ACCOUNT # (Ethics Commission Filers) 2/5 ANY NGUYEN 4 ate 5 2/25/15 NOVAL-FW 6 Amount ($) 7 Payee address; City; State; Zip Code SHERRY ST. ARLNGTON, TX 76010, 8 (a) Category (See categories listed at the top of this schedule) (b) escription (lftravel outside oft"'. comed..,., -;a <- c,_ C:: :;:o EXPENTURE CONTRBUTON Check f Austin, TX, officeholdo r living ":- )>""'' ;.._ 9 Complate.Qti.L.Y if direct Candidate Officeholder name Office sought heo) [ :r.!e :;;r- -n ("') ate c.n-... c 03/18/15 FORT WORTH JUNOR STOCK SHOW ,.,..,..., ;a en (..) :z: 1:1! < Category (See categories listed at the top of this schedule) escription (f travel outside of Texas, complete Schedule T) EXPENTURE CONTRBUTON 0 Check f Austin, TX, officeholder living expense Complete QNl.Y if direct Candidate Officeholder name Office sought Office held ate 03/20/15 TC COLLEGE FOUNATON :.0 Category (See categories listed at the top of this schedule) escription (f travel outside of Texas, complete Schedule T) EXPENTURE CONTRBUTON Check if Austin, TX. officeholder living expense Complete if direct Candidate Officeholder name Office sought Office held ate 03/25/15 TARANTX Category (See categories listed at the top of this schedule) escription (lftravei outside oftexas, complete Schedule T) EXPENTURE CONTRBUTON Check f Austin, TX, officeholder living expense Complete.Qti.L.Y if direct Candidate Officeholder name Office sought Office held ATTACH ATONAL COPES THS SCHEULE AS NEEE Revised 07/

6 Texas Ethics Commission PO Box12070 Austin Texas ' POLTCAL EXPENTURES (512) (TOO ) SCHEULE F EXPENTURE CATEGORES FOR BOX B(a) Advertising Expense Gift/Awards/Memorials Expense Salaries/Wages/Contract Labor Loan Repayment/Reimbursement Accounting/Banking Legal Services Solicitation/Fundraising Expense Transportation Equipment & Related Expense Consulting Expense Food/Beverage Expense Travel n istrict Contributions/onations Made By Event Expense Polling Expense Travel Out Of istrict Candidate/Officeholder/Political Committee Fees Printing Expense Office Overhead/Rental Expense OTHER (enter a category not listed above) 1 Total pages Schedule F: 2 FLER NAME The nstruction Guide explains how to complete this form. 13 3/5 ANY NGUYEN... 4 ate /15 ACCOUNT# (Ethics Commission Filers) r- = _... f'll (") - :t> RECH, ARRON en -t""t "' zz r- (h;:ll: l>"'t r= ("') (T u;!: :X oc -.-o c: CONTRBUTON Check if Austin, TX, oftlcehotd rliving '!!" z -<! 6 Amount($) 7 Payee address; City; State; Zip Code 0 c:: ::::: o:s!, C 8 (a) Category (See categories listed at the top of this schedule) (b) escription (f travel outside ofte as, comhed EXPENTURE 9 Complete.Qt!ll.Y if direct Candjdate Officeholder name Office sought sncehe!p -< expenditure to benefit COH ::0 ate 04128/15 SQ ARLNGTON CORPS Category (See categories listed at the top of this schedule) escription (f travel outside oftexas, complete Schedule T) EXPENTURE CONTRBUTON Check if Austin, TX, alllceholder living expense Complete QW.Y if direct Candidate Officeholder name Office sought Office held ate 0506/15 SALVATON ARMY Category (See categories listed at the top of this schedule) escription (f travel outside of Texas, complete Schedule T) EXPENrTURE CONTRBUTON Check if Austin, TX, olllceholderllving expense Complete QW.Y if direct Candidate Officeholder name Office sought Office held expenditure to benefit COH ate Amount($) Payee address; City; State; Zip Code EXPENTURE Category (See categories listed at the top of this schedule) escription (f travel outside of Texas, complete Schedule T) Check if Austin, TX, officeholder living expense Complete.QJ':i.Y if direct Candidate Officeholder name Office sought Office held ATACH ATONAL COPES THS SCHEULE AS NEEE Revised 07/

7 Texas Ethics Commission PO Box12070 Austin, Texas (512) (T ) POLTCAL EXPENTURES SCHEULE F Advertising Expense Accounting/Banking Consulting Expense Event Expense Fees 1 Total pages Schedule F: 4/5 EXPENTURE CATEGORES FOR BOX 8(a) Gift/Awards/Memorials Expense Salaries/Wages/Contract Labor Loan Repayment/Reimbursement Legal Services Solicitation/Fundraising Expense Transportation Equipment & Related Expense Food/Beverage Expense Travel n istrict Contributions/onations Made By Polling Expense Travel Out Of istrict Candidate/Officehof41fr/Politi<fi'i:fommlttee Printing Expense Office Overhead/Rental Expense OTHER (enter! not lisiitabo The nstruction Guide explains how to complete this form...., :::0 2 FLER NAME 13 ACCO\ NT# (Corrpiision '*' V'J;:;: %-;::- 4 ate 5 Payeename 1:.J! C _, 04/17/15 THE PEARL RESTURANT 2!:' -o C> 0 6 Amount ($) 7 Payee address; City; State; Zip Code : ;RUt ' W. PONEER PKWY. GRAN PRARE, TX ":. -< 8 (a) Category (See categories listed at the top of this schedule) (b) escription (f travel outside of 1i. come Schedule T) EXPENTURE EVENT EXPENSE 0 Check if Austin, TX, ofticeholder living expense 9 Complete if direct expenditure to benefit COH Candidate Officeholder name Office sought :t- Office held (").' ate 01/12/15 Amount ($) CRACKER BARREL Payee address; City; State; Zip Code ARLNGTON, TX EXPENTURE Complete if direct expenditure to benefit COH ate 05/04/15 Amount ($) Category (See categories listed at the top of this schedule) FOO/BEVERAGE EXPENSE Candidate Officeholder name A 1 SUPER BUFFET Payee address; City; State; Zip Code escription (lftravel outside oftexas, complete Schedule T) 0 Check if Austin, TX, officeholder Mng expense Office sought Office held EXPENTURE Complete QHL.Y if direct ate 01115/15 Amount($) NEW YORK AVE. ARLNGTON, TX Category (See categories listed at the top of this schedule) escription (f travel outside of Texas, complete Schedule T) 0 Check if Austin, TX, ofticeholder Mng expense FOO/BEVERAGE EXPENSE Candidate Officeholder name Office sought Office held CLASSC WORL MPORT Payee address; City; State; Zip Code 9200 JOHN W. CARPENTER FWY, ALLAS, TX EXPENTURE Complete if direct Category (See categories listed at the top oflhis schedule) escription (f travel outside of Texas, complete Schedule T) GFT EXPENSE 0 Check if Austin, TX, ofticeholder Mng expense Candidate Officeholder name Office sought Office held ATTACH ATONAL COPES THS SCHEULE AS NEEE Revised 07/28/2014

8 Texas Ethics Commission P.O Box Austin. Texas (512) (T ) POLTCAL EXPENTURES SCHEULE F EXPENTURE CATEGORES FOR BOX B(a) Advertising Expense Gift/Awards/Memorials Expense Salaries/Wages/Contract Labor Loan Repayment/Reimbursement Accounting/Banking Legal Services Soiicitation/Fundraising Expense Transportation Equipment & Related Expense Consulting Expense Food/Beverage Expense Travel in istrict Contributions/onations Made By Event Expense Polling Expense Travel Out Of istrict Candidate/Officeholder/Political Committee Fees Printing Expense Office Overhead/Rental Expense OTHER (enter a category not listed above) The nstruction Guide explains how to complete this form. 1 Total pages Schedule F: 2 FLER NAME 13 ACCOUNT# (Ethics Commission Filers) 5/5 ANY NGUYEN 4 ate 5 01/25/15 AWESOME BLOSSOMS,., C,... -<,.., -..,. 6 Amount ($) 7 Payee address; City; State; Zip Code..., :;:-; -:::o c:... c: :;o )> r S. Hampshire St., Saginaw, TX w 8 (a) Category (See categories listed at the top of this schedule) (b) escription (lflravel outside of Te &s,comed :t- EXPENTURE :;=.., GFT EXPENSE 0 Check if Austin, TX, ollicehold living :Z 9 Complete Qti1.Y if direct Candidate Officeholder name Office sought hetfe!; - -< ate 02/25/15 AA.COM ;o/. Category (See categories listed at the lop of this schedule) escription (lftravel outside oftexas, complete Schedule T) EXPENTURE 0 Check if Austin, TX, officeholder living expense TRAVEL N STRCT Complete Q1iL.Y if direct Candidate Officeholder name Office sought Office held ate 01/02/15 AV'SBBQ PARK ROW, PANTEGO, TX Category (See categories listed at the top of this schedule) escription (f travel outside of Texas, complete Schedule T) EXPENn"URE FOO EXPENSE 0 Check if Austin, TX. officeholder living expense Complete.QHbY if direct Candidate Officeholder name Office sought Office held ate EXPENTURE Category (See categories listed at the top of this schedule) escription (f travel outside of Texas, complete Schedule T) 0 Check if Austin, TX, officeholder living expense Complete Qti1.Y if direct Candidate Officeholder name Office sought Office held ATTACH ATONAL COPES THS SCHEULE AS NEEE