HomeMy WebLinkAboutJacqueline Hamilton 01062015Texas Ethics Commission PO. Box 12070 Austin, Texas 78711-2070 (512) 463-5800 (TDD 1-800-735-2989)
CANDIDATE I OFFICEHOLDER FORM C/OH
CAMPAIGN FINANCE REPORT COVER SHEET PG 1
1 ACCOUNT#
The C/OH Instruction Guide explains how to complete this form.
2
SUFFIX
(Ethics Commission Filers)
~
ZIP CODE
MS I MRS I MR FIRST MI
OFFICEHOLDER
NAME
3 CANDIDATE 1
. ~)LJdejn~ LJ.
NICKNAME LAST7 4
CANDIDATE 1 ADDRESS IPOBOX; APT I SUITE #; CITY; STATE;
OFFICEHOLDER
MAILING
4 :4lJ 13c;{ £fJ1JADDRESS
o change of address ~~6~ /f?ZJ~ -[)
PHONE NUMBER EXTENSION
OFFICEHOLDER
5 CANDIDATEI
Date Processed
PHONE ~z/41 .:,j~2 --~5:3L J /7
Date Imaged MS/MRS/MR6 CAMPAIGN
tJ,IRST ~ TREASURER
NAME . . .V/t4d! .. JI 1/7{t S
NICKNAME LAST SUFFIX
7 CAMPAIGN STREET ADDRESS (NO PO BOX PLEASE); APT/SUITE#; CITY; STATE; ZIP CODE
TREASURER
ADDRESS II!R 1'3 ()UJIl PI ;J;jtJJ LJr (residence or business)
~
AREA CODE PHONE NUMBER EXTENSION8 CAMPAIGN
TREASURER
PHONE
REPORT TYPE 15th day after campaign~ January 15 30th day before election Runoff9 o o O treasurer appointment
(officeholder only) o July 15 o 6th day before election Exceeded $500 [g-'1'inal report (Attach C/O <-~R)o limit
10 PERIOD Month Day Year Month Day Year
COVERED THROUGH ~"lf/ 21?/y
ELECTION TYPE 11 ELECTION o Primary o Runoll ~eneral o Special
OFFICE HELD (~any)12 OFFICE
~
GOTO PAGE 2
www.ethics.state.tx.us Revised 07/2812014
16
Texas Ethics Commission FO. Box 12070 Austin, Texas 78711-2070 (512) 463-5800 (TOO 1-800-735-2989)
CANDIDATE IOFFICEHOLDER REPORT: FORM C/OH
SUPPORT & TOTALS COVER SHEET PG 2
THIS BOX is FOR NOTICE OF POLITICAL CONTRIBUTIONS ACCEPTED OR POLITICAL EXPENDITIJREs MAllE BY POLITICAL COMMITTEES TO SUPPORT THE
CANDIDATE I OFFICEHOLIDER. THESE EXPENDITURES MAY HAVE BEEN MADE WITHOUT THE CANDIDATE'S OR OFRCEHOLDER'S KNOWLEDGE OR
CONSENT. CANDIDATES AND OFFICEHOLDERS ARE REQUIRED TO REPORT THIS INFORMATION ONLY IF THEY RECEIVE NOTICE OF SUCH EXPENDITURES.
o additional pages
17 CONTRIBUTION
TOTALS
EXPENDITURE
TOTALS
COMMITTEE NAME
COMMITTEE TYPE
o GENERAL
COMMITTEE ADDRESS o SPECIFiC
COMMITTEE CAMPAIGN TREASURER ADDRESS
1. TOTAL POLITICAL CONTRIBUTIONS OF $50 OR LESS (OTHER THAN
PLEDGES, LOANS, OR GUARANTEES OF LOANS), UNLESS ITEMIZED
2. TOTAL POLITICAL CONTRIBUTIONS
(OTHER THAN PLEDGES, LOANS, OR GUARANTEES OF LOANS)
3. TOTAL POLITICAL EXPENDITURES OF $100 OR LESS, UNLESS ITEMIZED
4. TOTAL POLITICAL EXPENDITURES
CONTRIBUTION
BALANCE 5. TOTAL POLITICAL CONTRIBUTIONS MAINTAINED AS OF THE LAST DAY
OF REPORTING PERIOD
OUTSTANDING
LOAN TOTALS 6. TOTAL PRINCIPAL AMOUNT OF ALL OUTSTANDING
LAST DAY OF THE REPORTING PERIOD
LOANS AS OF THE
18 AFFIDAVIT
I swear, or . rm, under penalty of perjury, that the accompanying report
is true an co,, ect and includes all information required to be reported by
me und Tit 15, Election Code. BRENDA F DICKSON
NOTARY PUBLIC
STATE OF TEXAS
MY COMM. EXP. 06/24/201 f)
$
$ ~.9-'
$
$ Ill-8/
$ -e
$ / 9LfI. iJ ,
AFFIX NOTARY STAMP I SEAL ABOVE
Utlegtte//aeYml 5e flam,' {tooSworn to and subscribed before me, by the said ,this the
57If day of cJznua n/ 20 -L'-,5:..<....__ , to certify Which, witness my hand and seal of office.
I ---'-'~:::ig":'n-"a"t"'u"'re~O"'f"O=~:::::;I~~r-'-a-d""m::::'jn-i""st::>e=:ri:Lng~:::::'a~=-lh--=--.L------p-!>?3-in~le-'-~--'=~:::m~e"'O"'f""Offi::"l-ce..!.~-a--':--'m-'])'"in=-is..!.~-",r;k=inCl.g'-\o--,q"'t",?,,-,,-n-l-__----,M'----Ti"':~'-lIe--=1a-Of-o-1e-+--l,@(j:.~:,00"
www.ethics.state.tx.us Revised 07/2812014
Texas Ethics Commission P.O. Box 12070 Austin, Texas 78711-2070 (512) 463-5800 (TOO 1-800-735-2989)
POLITICAL CONTRIBUTIONS
SCHEDULE AOTHER THAN PLEDGES OR LOANS
1 Total pages Schedule A:
The Instruction Guide explains how to complete this form. /
3 ACCOUNT # (Ethics Commission Filers)
4 Date' ~ FI.UII~.ame 0;;~.:trib:~~. A D. OU.II-;J)-Of-7 Am""O'"' I 3 '0-"0' =o>rib""oo/e5( -=-~. -, l-/.}!!//,-"'t:J lj_....~<1l'/L4 '
contnbutlon ($) I description (If applicable)
• c~~'"e§ C><" S<a~, z,,~ •" ~bf'.M.I~15
(3/ #//;/:1; !)~j;;; ';; 750dk 19,fbJ!.l.",romp:!x.~::: >
9 Principal occupation I Job title (See Instructions) [10 Employer (See Instructions)
Date Full name of contributor o out-of-statePAC(IDIt ~) Amountof In-kind contributionI
contribution ($) I description (if applicable)
Contributor address; City; State; Zip Code I
I
I
(If travel outside of Texas, complete Schedule T)
Principal occupation I Job title (See Instructions) Employer (See Instructions)
I
Full name of contributor o Oul-of-slalePAC(IO#: -') Amount of I In-kind contribution
contribution ($) I description (if applicable)
Date
Contributor address; City; State; Zip Code I
I
I
(If travel outside of Texas, complete Schedule T)
Principal occupation I Job title (See Instructions) Employer (See Instructions)
I
Full name of contributor' 0 out·of-slale PAC (10#: -,) Amountof I In-kind contribution
contribution ($) I description (if applicable)
Date
Contributor address; City; State; Zip Code I
I
I
(If travel outside of Texas, complete Schedule T)
Principal occupation I Job title (See Instructions) Employer (See Instructions)
I
Date In-kind cori:tri'butiof'\''''-
description (if '1pplicableh•.
Full name of contributor o out-of-state PAC (10#:. ---'1
-.J
Contributor address; City; State; Zip Code
Principal occupation I Job title (See Instructions) Employer (See Instructions) <:....) ~_.'
I
ATTACH ADDITIONAL COPIES OF THIS SCHEDULE AS NEEDED
If contributor is out-of-state PAC, please see instruction guide foradditional reporting reqUirements.
www.ethics.state.tx.us Revised 07/28/2014
Texas Ethics Commission P.O. Box 12070 Austin, Texas 78711-2070 (512) 463-5800 (TOO 1-800-735-2989)
POLITICAL EXPENDITURES SCHEDULE F
EXPENDITURE CATEGORIES FOR BOX 8(a)
Advertising Expense GifUAwards/Memorials Expense Salaries/Wages/Contract Labor Loan RepaymenUReimbursement
Accounting/Banking Legal Services Solicitation/Fund raising Expense Transportation Equipment & Related Expense
Consulting Expense Food/Beverage Expense Travel In District Contributions/Donations Made By
Event Expense Polling Expense Travel Out Of District Candidate/Officeholder/Political Committee
Fees Printing Expense Office Overhead/Rental Expense OTHER (enter a category not listed above)
The Instruction Guide explains how to complete this form.
City; State; Zip Code6 ($)
3 ACCOUNT # (Ethics Commission Filers)
5,00
8 PURPOSE
OF
EXPENDITURE
(b) DescriPtl~n~;;;;Z~PleteSchedule T)
o check~n, TX, officeholderllvl~~nse
9 Complete ONLY if direct
expenditure to benefit C/OH
Office sought Office heldCandidate / Officeholder name
Payee address; Zip Code
1Y.[)O
Category (See calegones listed at the top of this schedule)PURPOSE Description (If i~et r;;icj';;;;x~/om~~leSchedule T)
OF
EXPENDITURE o CheckifAu~hold'lUeXpense
Office sought Office held
expenditure to benefit C/OH
Complete .Q.t:!.bX if direct
PURPOSE
OF
EXPENDITURE
Complete .QtlJ.'.( if direct
expenditure to benefit C/OH
Office sought Office held
PURPOSE
OF
EXPENDITURE
Complete ~ if direct
expenditure to benefit C/OH
Category (See categories listed at the top of this schedule)
Candidate I Officeholder name
Description (If Iravel oulside of Texas, complele Schedule T)
"U
:::'.: o Check if Austin, TX, officeholder living expense N
Office sought Office he~
W '
ATTACH ADDITIONAL COPIES OF THIS SCHEDULE AS NEEDED
www.elhics.slale.lx.us Revised 07/28/2014
Texas Ethics Commission P.O. Box 12070 Austin, Texas 78711-2070 (512) 463-5800 (TOO 1-800-735-2989)
POLITICAL EXPENDITURES SCHEDULE F
Advertising Expense
Accounting/Banking
Consulting Expense
Event Expense
Fees
EXPENDITURE CATEGORIES FOR BOX 8(a) _
Gift/Awards/Memorials Expense Salaries/Wages/Contract Labor LLoan RepaymenUReimbursement
Legal Services Solicitation/Fundraising Expense Transportallon equIpment ISo Kelaled Expense
Food/Beverage Expense Travel In District ContributionslDonations Made By
Polling Expense Travel Out Of District Candidate/Officeholder/Political Committee
Printing Expense Office Overhead/Rental Expense OTHER (enter a category not listed above)
The Instruction Guide explains how to complete this form.
8 PURPOSE
OF
EXPENDITURE
~) Descn/fln ro;;d1/;7/Ji;7
o c~tu~n, TX, officeholder liVing expense
9 Complete Qlli,'( if direct Candidate / Officeholder name Office sought Office held
expenditure to benefit C/OH
Date Payee name
Amount ($) Payee address; City; State; Zip Code
PURPOSE
OF
EXPENDITURE
Category (See categories listed at the top of this schedule) Description (If travel outside of Texas, complete Schedule T)
o Check if Austin, TX, officeholder living expense
Complete ONLY if direct Candidate / Officeholder name Office sought Office held
expenditure to benefit C/OH
Date
Amount ($)
PURPOSE Category (See calPgories listed allhe lop of this schedule) Description (If travel outside of Texas, complete Schedule T)
OF
EXPENDITURE o Check ifAustin, TX, officeholder living expense
Complete ONLY if direct Candidate / Officeholder name Office sought Office held
expenditure to benefit C/OH
Payee name
Payee address; City; Slate; Zip Code
Date
Amount ($)
PURPOSE
OF
EXPENDITURE
Payee name
Z
I
Payee address; City; State; Zip Code J
TTl
Description (If travel outside of Texas, complete ScheWe T) "',...._~ ICategory (See categories lisled at the top of this schedule) z:; . ~J
D Check jfAustin, TX., officeholder living expense
Complete QW.Y if direct
expenditure to benefit C/OH
Candidate / Officeholder name Office sought Office held
ATTACH ADDITIONAL COPIES OF THIS SCHEDULE AS NEEDED
www.elhics.stale.lx.us Revised 07/28/2014
Texas Ethics Commission p.o. Box 12070 Austin, Texas 78711-2070 (512) 463-5800 (TOO 1-800-735-2989)
CANDIDATE I OFFICEHOLDER REPORT:
DESIGNATION OF FINAL REPORT FORM C/OH -FR
1
3
The Instruction Guide explains how to complete this form .
•• Complete only if "Report Type" on page 1 is marked "Final Report" ••
2 ACCOUNT # (Ethics Commission Filers)
I do not expect any further political contributions or political expenditures in connection wit
report as a final report terminates my campaign treasurer appointment. I also understand
or make any campaign expenditures without a campaign treasurer appointment on file.
4 FILER WHO IS NOT AN OFFICEHOLDER
•• Complete A & B below only if you are not an officeholder.••
Check only one:
A. CAMPAIGN FUNDS
I do not have unexpended contributions or unexpended interest or income earned from political contributions.
I
-l
I have unexpended contributions or unexpended interest or income earned from political contributions. I understand thatl ma.y-,r,""''''''1
not convert unexpended political contributions or unexpended interest or income earned on political contributions to pesona\
use I also understand that I must file an annual report of unexpended contributions and that I may not retain unex~ded •
contributions or unexpended interest or income earned on political contributions longer than six years after filing tlli.J.tinal
report. Further, I understand that I must dispose of unexpended political contributions and unexpended interest or iA.&bme
earned on political contributions in accordance with the requirements of Election Code, § 254.204.
D
B. ASSETS
Check only one:
I do not retain assets purchased with political contributions or interest or other income from political contributions.
D I do retain assets purchased with political contributions or interest or other income fr m political contributions. I understand that
I may not convert assets purchased with political contributions or interest or other in i me from political contributions to personal
use. I also understand that I must dispose of assets purchased with political cont· tions in accordance with the requirements
of Election Code, § 254.204.
Signature of Candidate
5 OFFICEHOLDER
•• Complete this section only if you are an officeholder ••
D 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
www.ethics.state.tx.us Revised 07/28/2014