CANDIDATE / OFFICEHOLDER CAMPAIGN FINANCE REPORT
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1 Texas Ethics Commission P.O. Box Austin, Texas CANDIDATE / FICEHOLDER FINANCE REPORT (512) (TDD t FORM C/OH COVER SHEET PG 'i The C/OH Instruction Guide explains how to complete this form. I ACCOUNT # (Ethics Commission Filets) 2 Total pages filed: 3 CANDIDATE / FICEHOLDER NAME MS / MRÿW,,ÿ..ÿFÿ FIRST MI Received FICE USE ONLY NICKNAME LAST SUFFIX 4 CANDIDATE / FICEHOLDER MAILING ADDRESS ADDRESS / PO BOX; APT/SUITE #; Zo"7oZ..I_ÿ.ÿ.e.:,,.._ &,.. CITY; STATE; ZIP CODE Hand-delivered or Postmarked D change of address Receipt # Amount CANDIDATE/ FICEHOLDER PHONE AREA CODE PHONE NUMBER EXTENSION Processed 6 NAME MS/ÿ-"ÿ MR FIRST MI L NICKNAME LAST SUFFIX Imaged 7 ADDRESS (ÿsidenceorbusiness) STREETADDRESS (NO PC BOX PLEASE); k:oÿ,i,-r'ÿ. "7"ÿ,+ÿ-ÿ APT/SUITE#; CITY; STATE; ZIP CODE PHONE AREA CODE PHONE NUMBER (2...ÿp ) 4.qÿ..oqo,ÿ EXTENSION 9 REPORT TYPE ] January 15 ] 30th day before election [] Runoff ] 15th day after campaign treasurer appointment (officeholder only) [ÿ July 15 [] 8th day before election [] Exceeded $500 limit ] reporÿ Final (Attach C/OH - FR) t0 PERIOD COVERED Month Day Year THROUGH Month Day "7 /IS' Year 11 ELECTION ELECTION DATE Month Day Year ELECTION TYPE [] Pnmary [] Runoff [ÿ General [] Specia! 12 FICE FICE HELD (if any) 13 FICE SOUGHT (if known) GO TO PAG E 2 www,ethics.state.tx.us Revised 04/19/2013
2 Texas Ethics Commission P.O. Box Austin, Texas (512) (TDD CAND DATE / FICEHOLDER REPORT: FORM C/OH SUPPORT & TOTALS COVER SHEET PG 2 14 C/OH NAME ÿ j' 15 ACCOUNT # (Ethics Commission Fliers) -40,.ÿ ibtj4ÿ,#,ÿ 16 N OTI C E F R O M -mls BOX IS FOR NOTICE POUTICAL CONTRIBUTIONS ACCEPTIED OR POLITICAL S MADE BY POLITICAL COMMITTEES TO SUPPORT THE POLITICAL COMMITTEE(S) CANDIDATE ÿ/ficeholder. Tÿ-ÿEÿÿÿXPENDÿTÿRESMAYHAVÿBEENMADEWÿTHÿUTTHECANDÿDATÿÿSÿRÿFFÿCEHÿLDEReSKNÿÿLÿDGEÿR CONSENT. CANDIDATES AND FICEHOLDERS ARE REQUIRED TO REPORT THIS INFORMATION ONLY IF THEY RECEIVE NOTICE SUCH S. COMMITTEE TYPE COMMITTEE NAME [ÿ] GENERAL [ÿ SPECIFIC COMMITTEE ADDRESS COMMITTEE NAME [] additional pages COMMITTEE ADDRESS 17 CONTRIBUTION TOTALS TOTAL POLITICAL CONTRIBUTIONS $50 OR LESS (OTHER THAN PLEDGES, LOANS, OR GUARANTEES LOANS), UNLESS ITEMIZED 2. TOTAL POLITICAL CONTRIBUTIONS (OTHER THAN PLEDGES, LOANS, OR GUARANTEES LOANS) $ /'::/3'4 TOTALS 3. TOTAL POLITICAL S $100 OR LESS, UNLESS ITEMIZED $,,... 4, TOTAL POLITICAL S $ s.--i CONTRIBUTION BALANCE 5. TOTAL POLITICAL CONTRIBUTIONS MAINTAINED AS THE LAST DAY REPORTING PERIOD $ """ OUTSTANDING LOAN TOTALS 6. TOTAL PRINCIPAL AMOUNT ALL OUTSTANDING LOANS AS THE LAST DAY THE REPORTING PERIOD $ AFFIDAVIT l} 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 Signature of Candidate or Officeholder AFFIX NOTARY STAMP / SEAL ABOVE Sworn to and subscribed before me, by the said ÿ,ÿr" ÿ'ÿ"3, this the /ÿ'ÿ" day of ÿ--ÿ"ÿ, 20 /.ÿ., to certify which, witness my hand and seal of office. of officer administering oath Pr oath Title of off g oath w ww. ethics.st at e.tx.u s Revised 04/19/2013
3 Texas Ethics Commission p.o. Box Austin, Texas ,ÿ(512) (TDD POUTlCAL S SCHEDULE F AdveÿisingExpense Accounting/Banking t Total pages Schedule F: CATEGORIES FOR BOX 8(a) Gift/Awards/Memorials Expense ÿlaries/wages/contract Labor Loan R epayment/reimbursement Legal Services Solicitation/Fundraising Expense Transportation Equipment & Related Expense Food/Beverage Expense Travel In District Contdbutions/Donations Made By ' Polling Expense Travel Out Of District CandidatelOfficeholdedPolitical Committee P'rinting Expense Office Overhead/Rental Expense OTHER (enter a category not listed above) 2 FILER NAME 3 ACCOUNT # (Ethics Commission Fliers) 4t 6 7 ' C i t y L St ate:ÿz.loÿcede.--- V v 8 (a) L_/b/ DA.qcrintion i'lflrÿulÿ_t3ÿ 9 7 s=/- / J3,ÿee name - PURPOS E IJo ÿ-..+ÿ-,"t-,l "7 nos:/- expenditure to benefit CIOH. P ÿ,ÿ name Zz9.2-_,# IK'AT-y, "r"x -ÿ-7 ÿ-q B Cÿa nvÿdiÿaÿt e/ÿ'jcÿ:ÿde r n a me Description (If travel outside of Texas, complete ScheduleT). /, P ddress; ',ÿ"rv, "T'-X.'7"7 ÿq?_ ATTACH ADDITIONAL COPIES THIS SCHEDULE AS NEEDED Revised 04/
4 Texas Ethics Commission P.O. Box Austin, Texas (512) (TDD POL TiCAL EXPEND TURES SCHEDULE F Advertising Expense Accounting/Banldng I Total pages Schedule F: CATEGORIES FOR BOX 8(a) Gift/Awards/Memorials Expense Salaries/Wages/Contract Labor Legal Services Solicitation/Fundraising Expense Food/Beverage Expense Polling Expense Printing Expense,2 FILER NAME Travel In District Travel Out Of District Office Overhead/Rental Expense Loan Repayment/Reimbursement Transportation Equipment & Related Expense Contributions/Donations Made By Candidate/Officeholder/Political Committee OTHER (enter a category not listed above) 3 ACCOUNT # (Ethics Commission Fliers) too. 8 (a) (b) 9 Complete ONÿifdirect Candidate/Offÿeholdername expendituretobenefitc!oh Omce sought Description (Iftravel outside of Texas, complete ScheduleT) EV'.lÿ.yvÿ ÿv...ÿ Complete ONLY if dh'ect Datÿ ÿ,ÿme ÿ.iÿ ÿ;ÿ..ÿ IQ..ÿ CÿZtate; Zip Code CompleteONÿifdirect ATTACH ADDITIONAL COPIES THIS SCHEDULE AS NEEDED Revised 04/19/2013
5 Texas Ethics Commission EO. Box Austin, Texas (512) (TDD POLITmCAL S MADE FROM PERSONAL FUNDS SCHEDULE G Advertising Expense Accounting/Banking 1 Total pages Schedule G: J 4 CATEGORIES FOR BOX 8(a) Gift/Awards/Memorials Expense Salaries/Wages/Contract Labor Legal Services Solicitation/Fundraising Expense Food/Beverage Expense Polling Expense Printing Expense 2 FILER NAME 5 Travel In District Travel Out Of District Office Overhead/Rental Expense Loan Repayment/Reimbursement Transportation Equipment & Related Expense Contributions/Donations Made By Candidate/Officeholder/Political Committee OTHER (enter a category not listed above) 3 ACCOUNT # (Ethics Commission Fliers) 6 Ip I oo, ÿ'o 7 mbursement from tical contributions (a) (b) ] Reimbursement political contributions from Reimbursement from ] political contributions Reimbursement from ] political contributions ATTACH ADDITIONAL COPIES THIS SCHEDULE AS NEEDED Revised 04/19/2013
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