HomeMy WebLinkAboutLance Baxter 01152015Texas Ethics Commission PO Box 12070 Austin Texas 78711-2070 (512) 463-5800 (TOO 1-800-735-2989) ,
. JUDICIAL CANDIDATE I OFFICEHOLDER FORM JC/OH
CAMPAIGN FINANCE REPORT il ORIGINAL COVER SHEET PG 1
1 ACCOUNT # 2 Total pages filed:
The JC/OH Instruction Guide explains how to complete this form. (Ethics Commission File",) \
3 CANDIDATE / MS/MRS/MR FIRST MI ~'~!AI'( ce.5 OF~ JOFFICEHOLDER ~ I
NAME Date Ratff······ ~ ..•.~ . . . . ... . . . .. . . . . . . . . . . .. .. ~ . ~ '.-:'
NICKNAME LAST SUFFIX fi'-r'I1\'BAkf-er \,\~ ~j}4 CANDIDATE / ADDRESS / PO BOX; APT/SUITE#; CITY; STATE; ZIP CODE
OFFICEHOLDER ~-~-"''''.' •••••• i. ,.:MAILING ~(O· g,O)O 51 'ftr (11 L k10n.~~ "'T)c 7s070 Date Hand ~ ,,-'ADDRESS I-1'+ -'~f ~","'\\-\' SrV1o change of address Receipt # Amount
5 CANDIDATE/ AREA CODE PHONE NUMBER EXTENSION
OFFICEHOLDER (q7A ~Y( lf7h~
Date Processed
PHONE 1-ILi· ~tS
6 CAMPAIGN MS/MRS/MR FIRST MI Date Imaged
TREASURER D()I1H; ,-ty. -;)G,SNAME . . . . ....
NICKNAME lAST SUFFIX
{$ rlf ~t7o tv l EPpeV-<;oN
7 CAMPAIGN STREET ADDRESS (NO PO BOX PLEASE); APT/SUITE#; CITY; STATE; ZIP CODE
TREASURER -r<"" .-
f{cwy / (ttt L f?-t 0 'tey ftJ 7C;-Or (ADDRESS 2--50 ( VIr-~'jI'\l~
(residence or business)
8 CAMPAIGN AREA CODE PHONE NUMBER EXTENSION
TREASURER ( )PHONE ......
Vl 0(,
.-:",,~
__A
9 REPORT TYPE ~ January 15 . -0 30th day before elec1lon 0 Runoff 0 15th day after ~palgn
treasurer appoitltment .
(officeholder only) -0
0 July 15 0 8th day before elec1lon 0 Exceeded $500 0 Final report (Atta6ii=c/OH FR
limit -.. I; --y
10 PERIOD Month Day Year Month Day Yeer -.~
COVERED ?/ ( / THROUGH (2-/31 / z-<J(f/ -uJlf
11 ELECTION ELECTION DATE ELECTION TYPE
Month Day Year o Primary o Runoff o General o Special
/ /
•
12 OFFICE OFFICE HELD (~any) :J"j;(tf/j< 13 OFFICE SOUGHT (~known)
~{fr~ CoUv'\*; Uud-Sa me--a. f-{a eN NIJ,. 3
GO TO PAGE 2
www.ethics.state.tx.us Revised 07/2812014
- ---- --
Texas Ethics Commission PO Box 12070 Austin Texas 78711-2070 (512) 463-5800 (TDD 1-800-735-2989)
JUDICIAL CANDIDATE I OFFICEHOLDER REPORT:
SUPPORT & TOTALS nno,~\NAL
14 C/OH NAME ~
FORM JC/OH
COVER SHEET PG 2
115 ACCOUNT # (Ethics Commission Filers)
16 NOTICE THIS BOX IS FOR NOTICE OF POUTlCAL CONTRlBUlJONS ACCEPTED OR POUTlCAL EXPENDITURES MADE BY POUTlCAL COMMITTEES TO SUPPORT THE
FROM CANDIDATE 10FACEHOLDER. THESE EXPENDITURES MAY HAVE BEEN MADE WTrHOUT THE CANDIDATE'S OR OFRCEHOlDER'S KNOWLEDGE OR
POLITICAL CONSENT. CANDIDATES AND OFFICEHOlDERS ARE REQUIRED TO REPORT THIS INFORMATION ONLY IF THEY RECEIVE NOTICE OF SUCH EXPENDITURES.
COMMITTEE(S)
COMMITTEE N~ ( ACOMMITTEE TYPE
D GENERAL COMMITTEE ADDRESS
D SPECIFIC
COMMITTEE CAMPAIGN TREASURER NAME
D additional pages
COMMITTEE CAMPAIGN TREASURER ADDRESS
17 CONTRIBUTION 1. TOTAL POLITICAL CONTRIBUTIONS OF $50 OR LESS (OTHER THAN
TOTALS PLEDGES, LOANS, OR GUARANTEES OF LOANS), UNLESS ITEMIZED
2. TOT AL POLITICAL CONTRIBUTIONS
(OTHER THAN PLEDGES, LOANS, OR GUARANTEES OF LOANS)
EXPENDITURE
TOTALS
3. TOTAL POLITICAL EXPENDITURES OF $100 OR LESS, UNLESS ITEMIZED
4. TOTAL POLITICAL EXPENDITURES
CONTRIBUTION 5. TOTAL POLITICAL CONTRIBUTIONS MAINTAINED AS OF THE LAST DAY BALANCE OF THE REPORTING PERIOD
OUTSTANDING
6. TOTAL PRINCIPAL AMOUNT OF ALL OUTSTANDING LOANS AS OF THELOAN TOTALS LAST DAY OF THE REPORTING PERIOD
18 AFFIDAVIT
,....,. ~~
01 !~
~;;;
-. _. -
~ ;
-~.
::i " j I .r.. --.{
-=
$ 7
$ r:f
$ (jf
$ SZ.S-it:--
$c;33r~7L
$ f
I swear, or affirm, under penalty of pe~ury, that the accompanying report is
true and correct and includes all information required to be reported by me
MINDY QUINT • ""~My Commission Expires ~ August 10, 201 B
\. ,,'.
-- ~ ~~kle'~\".~. ~w --
AFFIX NOTARY STAMP I SEAL ABOVE
Sworn to and subscribed before me, by the said I~DM 50. ¥':k r-- this the+Ir--.-~ day of ,jCLHv.kV L/ 20 1£ , to certify which, witness my hand and seal of office.
"-../1 ),,,;1,i",-.J-I f) 1, r.d~ J I JL, .".J- ~)cJ-kx
sign~lure of o~radminist:ring oath Print namebf officer administering oath Title of officer ~ministering oath
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 ORIGINAL SCHEDULE A (J)OTHER THAN PLEDGES OR LOANS ( DICIAL)
The Instruction Guide explains how to complete this form. 1 Total pages Schedule A(J):
2 FILER NAME 3 ACCOUNT # (Ethics Commission Filers)
5 Full name of contributor [PUI-<>f-state PAC (10#: )4 Date 7 Amount of 18 In-kind contribution
contribution ($) description(if applicable)I
IZip Code
I
I
(If travel outside of Texas, complete Schedule T)
9 Contributor's principal occupation 10 Contributor's job title
11 Contributor's employer/law firm 12 Law firm of contributor's spouse (if any)
13 If contributor is a child, law firm of parent(s) (if any)
Date Full name of contributpr [PUt-<>f-state PAC (10#: ) Amount of I In-kind contribution
contribution ($) I description(if applicable)
I
I
Contributor address; City; State; Zip Code
I
(If travel outside of Texas, complete Schedule T)
Contributor's principal occupation Contributor's jOb title
Contributor's employer/law firm Law firm of contributor's spouse (if any)
If contributor is a child, law firm of parent(s) (if any)
Date Full name of contributor [Put-<>f-state PAC (10#: ) Amount of
contribution ($)
II In-ki~contrlb.utIQn
descripliCfn(if app IcaOIe)
. -j
Contributor address; City; State; Zip Code : ; fl-l
I ..::. '~
(If travel outside of Texas, complete '~eewI T)
Contributor's principal occupation Contributor's job title
Contributor's employer/law firm Law firm of contributor's spouse (if any)
If contributor is a child, law firm of parent(s) (if any)
ATTACH ADDITIONAL COPIES OF THIS SCHEDULE AS NEEDED
If contributor is out-of-state PAC, please see instruction guide for additional reporting requirements.
www.ethics.state.tx.us Revised 07/2812014
Texas Ethics Commission PO Box 12070 Austin Texas 78711-2070 (512) 463-5800 (TOO 1-800-735-2989),
2
4
5
10
12
14
FILER NAME jV lIt-
TOTAL OF UNITEMIZED PL
Date 6 Full name of pledgor
7 Pledgor address;
Pledgor's principal occupation
Pledgor's employer/law firm
If pledgor is a child, law firm of parent(s) (if
Date Full name of pledgor
Pledgor address;
Pledgor's principal occupation
Pledgor's employerllaw firm
any)
EDGES:
If pledgor is a child, law firm of parent(s) (if
Date Full name of pledgor
Pledgor address;
Pledgor's principal occupation
Pledgor's employer/law firm
If pledgor is a child, law firm of parent(s) (if
If contributor is out-of-state
any)
any)
PAC, please
PLEDGED CONTRIBUTIONS (JUDICIAL ORIGINAL SCHEDULE B (J)
1 Total pages Schedule B(J):
The Instruction Guide explains how to complete this form.
3 ACCOUNT # (Ethics Commission Filers)
¢¢¢¢ ¢ ¢ 1$
o out-<lt-slate PAC (10it )
8 Amount of 19 In-kind description
pledge ($) (if applicable)I
City; State; Zip Code I
I
I
(If travel outside of Texas, compiete Schedule T)
11 Pledgor's job title
13 Law firm of pledgor's spouse (if any)
Amount of I In-kind description
pledge ($) (if applicable)
o out-<lf-statePAC(ID#: )
I
I
I
I -.
City; State; Zip Code
(If travel outside of Texas, com'PfE!te Schedule T)
:-..! .Pledgor's job title -~
Law firm of pledgor's spouse (if any) -~
::J: :-".;:
Amount of I In-lmld deScription
pledge ($) tiT'hpplicable)
o out-of-state PAC (10#: )
I
I
I
I
City; State; Zip Code
(If travel outside of Texas, complete Schedule T)
Pledgor's job title
Law firm of pledgor's spouse (if any)
ATTACH ADDITIONAL COPIES OF THIS SCHEDULE AS NEEDED
see instruction guide for additional reporting requirements.
www.ethics.state.tx.us Revised 07/28/2014
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TiexaS Eth'ICS CommlSSlon PO Box 12070 A ustIn, Texas 78711-2070 (512)463-5800 (TDD 1-800-735-2989)
SCHEDULE E (J)[J ORIGINALLOANS (JUDICIAL)
2 FILER NAME AliA-
4
TOTAL OF UN ITEMIZED LOANS:
5 Date of loan 7 Name of lender
6 Is lender 8 Lender address; City;
a financial
Institution?
y N
12 Lender's Principal Occupation
14 Lender's Employer/Law Firm
16 If lender is child, law firm of parent(s) (if any)
17 Description of Collateral
o none
19 GUARANTOR 20 Name of guarantor
INFORMATION
21 Guarantor address; o not applicable
23 Guarantor's Principal Occupation
25 Guarantor's Employer/Law Firm
27 If guarantor is child, law firm of parent(s) (if any)
If lender is out-of-state PAC, please see
1 Total pages Schedule E(J):
The Instruction Guide explains how to complete this form.
3 ACCOUNT # (Ethics Commission Filers)
~~~ ~ ~ ~ $
9 Loan Amount ($)o out-of-state PAC (10#: )
10 I nterest rateState; Zip Code
11 Maturitydate
13 Lender's Job Title
15 Law Firm of lender's spouse (if any)
18 Check if personal funds were deposited into political account
0
22 AmounB;uaranteed ($)
~ -'-, .
-
~
City; State; Zip Code
-0 j (oJ-
24 Guarantor's Job Title
N-'. ~:-:j
26 Law Firm of guarantor's spouse (if any)
ATTACH ADDITIONAL COPIES OF THIS SCHEDULE AS NEEDED
instruction guide for additional reporting requirements.
www.ethjcs.state.tx.us Revised 07128/2014
Texas Ethics Commission PO Box 12070 Austin, Texas 78711-2070 (512) 463-5800 (TDD 1-800-735-2989)
POLITICAL EXPENDITURES DORIGINAL SCHEDULE F
Advertising Expense
Accou nting/Banki ng
Consulting Expense
Event Expense
Fees
EXPENDITURE CATEGORIES FOR BOX 8(a)
Gift/Awards/Memorials Salaries/Wages/Contract Labor Loan Repayment/Reimbursement
Expense Solicitation/Fund raising Expense Transportation Equipment & Related
Legal Services Travel In District Expense
Food/Beverage Expense Travel Out Of D'st . t ContribulionslDonations Made By
Polling Expense Office overhea~/~:ntal Expense Candidate/Officeholder/Political Committee
Printing Expense OTHER (enter a category not listed above) The Instruction Guide explains how to complete this form.
1 Total pages Schedule F: 2 FILER NAME
7 Payee address; City; State; Zip Code
13 ACCOUNT # (Ethics Commission Filers)
8 PURPOSE
OF
EXPENDITURE
(a) Category (See categories listed at the lOP of this
sMtrf~M(H)
(b) D~~P~(~;;r;~xa:,complete Schedule T)
o Check ifAustin, TX, officeholder living expense
9 Complete Q.N!.Y if direct
expenditure to benefit C/OH
Candidate I Officeho1"der name Office sought Office held
Amount ($)
(00 !2-
Payee address; City; State; Zip Code
PURPOSE
OF
EXPENDITURE
Category (See categories lisled at the top of this
sChedule-V£1vte0pt tI~·
Description (If lravel outside of Texas, complete Schedule T)
o Ch~~~A~ffi~~ense
Complete Q.li!.Y if direct
expenditure to benefit C/OH
Candidate I Officeholder name Office sought Office held
DateCOr, (rtf
Amount ($) Payee addres~; V City; State; Zip Code
PURPOSE
OF
EXPENDITURE
Category (See categories listed at the top of this
sChe&,~~ $L
DescrGdl;ro;I;::o~duleT)
o Check ifAustin. TX, officeholder living expense
Complete Q.N!.Y if direct
expenditure to benefit C/OH
Date
Candidate I Officehol(jer name
Payee name
Office sought Office held
Amount ($) Payee address; City; State; Zip Code
PURPOSE
OF
EXPENDITURE
Complete Q.IiLY if direct
expenditure to benefit C/OH
Category (See categories listed at the top of this
schedule)
Candidate I Officeholder name
Description (If travel outside of Texas, complete ScheCliJre:'T)
o Check ifAustin. TX. officeholder living expense
Office sought O~e heldT,'
.c•
ATTACH ADDITIONAL COPIES OF THIS SCHEDULE AS NEEDED o
www.ethics.state.tx.us Revised 07/28/2014
Texas Ethics Commission PO Box 12070 Austin, Texas 78711-2070 (512) 463-5800 (TOO 1-800-735-2989)
POLITICAL EXPENDITURES SCHEDULE GMADE FROM PERSONAL FUNDS DORIGINAL
EXPENDITURE CATEGORIES FOR BOX 8(a)
Advertising Expense GifVAwards/Memorials Salaries/Wages/Contract Labor Loan Repayment/Reimbursement
Accou nti ng/Banking Expense . Solicitation/Fundraising Expense Transportation Equipment & Related
Legal Services Travel In District ExpenseConsulting Expense
Food/Beverage Expense Travel Out Of District ContribulionslDonations Made. By .Event Expense
Polling Expense Office Overhead/Rental Expense Candidate/Officeholder/Political Committee Fees
Pnnling Expense OTHER (enter a category not listed above)
The Instruction Guide explains how to complete this form.
3 ACCOUNT # (Ethics Commission
Filers)
v L. 5 P ayee name4 Date I
6 Amount ($) 7 Payee address; City; State; Zip Code
o Reimbursement from
political contributions
intended
(8) Category (See categories listed at the top of this (b) Description (If travel outside of Texas, complete Schedule T)
schedule)
8 PURPOSE
OF
EXPENDITURE o Check ifAustin, TX, officeholder living expense
Payee nameDate
Amount ($) Payee address; City; State; Zip Code
o Reimbursement from
political contributions
intended
Category (See categories listed at the top of this Description (If travel outside of Texas, complete Schedule T) PURPOSE schedule)OF
EXPENDITURE o Check ifAustin ,TX, officeholder living expense
Payee nameDate
Amount ($) Payee address; City; State; Zip Code
o Reimbursement from
political contributions
intended
oh ..' Category (See cetegories listed et the top of lhis Description (If travel outside of Texas, com~~ SChedule T)tPURPOSE schedule)
OF
EXPENDITURE .&:o Check ifAustin, TX, officeholder living expense ~
Date Payee name ~ ,;
, J". --. . Amount ($) Payee address; City; State; Zip Code
o Reimbursement from
political contributions
intended
Category (See categories listed et the top of this Description (If travel outside of Texes, complete SchedUle T) PURPOSE SChedule)OF
EXPENDITURE o Check ifAustin, TX, officeholder living expense
ATTACH ADDITIONAL COPIES OF THIS SCHEDULE AS NEEDED
www.ethies.state.tx.us Revised 07/28/2014
Texas Ethics Commission PO Box 12070 Austin, Texas 78711-2070 (512) 463-5800 (TDD 1-800-735-2989)
PAYMENT FROM POLITICAL lJ a HSCHEDULECONTRIBUTIONS TO A BUSINESS OF C/OH 'RIG/It I It
EXPENDITURE CATEGORIES FOR BOX 8(a} "'
Advertising Expense Gift/Awards/Memorials Salaries/Wages/Contract Labor Loan Repayment/Reimbursement
Accounting/Banking Expense Solicitation/Fundraising Expense Transportation Equipment & Related
Consulting Expense Legal Services Travel In District Expense
Food/Beverage Expense Travel Out Of District Contributions/Donations Made By
Polling Expense Office Overhead/Rental Expense Candidate/Officeholder/Political Committee
Event Expense
Fees
Pnntlng Expense OTHER (enter a category not listed above) The Instruction Guide explains how to complete this form.
1 Total pages Schedule H: 2 FILER NAME 13 ACCOUNT # (Ethics Commission Filers)
11./ / f':yf-
.. v t r4 Date 5 Business name
6 Amount ($) 7 Business address; City; State; Zip Code
(a) Category (See categories listed at the top of this (b) Description (If travel outside of Texas, complete Schedule T)
schedule)
8 PURPOSE
OF
EXPENDITURE o Check ifAustin, TX, officeholder living expense
9 Complete ONLY if direct Candidate I Officeholder name Office sought Office held
expenditure to benefit C/OH
Date Business name
Amount ($) Business address; City; State; Zip Code
Category (See categories listed at the top of this Description (If travel outside of Texas, complete Schedule T)
OF
PURPOSE
schedule)
EXPENDITURE l
U'Io Check ifAustin, TX. officeholder living expen~
Com plete .QJ:iI.Y if direct Candidate I Officeholder name Office sought O~ held
expenditure to benefit C/OH -. ,
Date Business name ""D
3:
~
~ "ff 1
Amount ($) Business address; City; State; Zip Code ~; -N 0
PURPOSE
OF
Category
schedule)
(See categories listed at the top of this Description (If travel outside of Texas, complete Schedule T)
EXPENDITURE o Check if Austin. TX. officeholder living expense
Complete ONLY if direct
expenditure to benefit C/OH
Candidate I Officeholder name Office sought Office held
Date Business name
Amount ($) Business address; City; State; Zip Code
PURPOSE
OF
EXPENDITURE
Category (See categories listed at the top of this
schedUle)
Description (If lravel outside of Texas, complete Schedule T)
o Check if Austin. TX. officeholder living expense
Complete .QJ:iI.Y if direct Candidate I Officeholder name Office sought Office held
expenditure to benefit C/OH
ATTACH ADDITIONAL COPIES OF THIS SCHEDULE AS NEEDED
www.ethies.state.tx.us Revised 07/28/2014
I
Texas Ethics Commission PO Box 12070 Austin Texas 78711-2070 (512) 463-5800 (TDD 1-800-735-2989) ,
NON-POLITICAL EXPENDITURES D ORIGI SCHEDULEMADE FROM POLITICAL CONTRIBUTIONS IVAL
The Instruction Guide explains how to complete this form.
1 Total pa 9r\/!ft
4 Date
6 Amount ($)
8 PURPOSE
OF
EXPENDITURE
Date
Amount ($)
PURPOSE
OF
EXPENDITURE
Date
Amount ($)
PURPOSE
OF
EXPENDITURE
Date
Amount ($)
PURPOSE
OF
EXPENDITURE
~ILERNAME
5 Payee name
7 Payee address; City; State; Zip Code
(a) Category (See instructions for examples of acceptable
categories)
Payee name
Payee address; City; State; Zip Code
(8) Category (See instructions for exemples of acceptable
categories)
Payee name
Payee address; City; Stale; Zip Code
(8) Category (See instructions for exemples of acceptable
categories)
Payee name
Payee address; City; State; Zip Code
(8) Category (See instructions for examples of accaptable
categories)
3 ACCOUNT # (Ethics Commission Filers)
(b) Description (See instructions regarding type of information
required.)
(b) Description (See instructions regarding typ infor~tion
required.)
L
~ -, -q
"U m
7. -N
(b) Description (See instructions regarding type of Information
required.)
(b) Description (See instructions regarding type of information
required.)
ATTACH ADDITIONAL COPIES OF THIS SCHEDULE AS NEEDED
www.ethics.state.tx.us Revised 07/2812014
Texas Ethics Commission Austin Texas 78711-2070 PO Box 12070 , (512) 463-5800 (TDD 1-800-735-2989)
D SCHEDULE K °R/~b'
1 Total pages SChedule'KV,ql
3 ACCOUNT # (Ethics Commission Filers)
8 Amount
($)
f 'C1t{
A
Amount
($)
ount
<..n($)
c......
:z: -.tg
-0
-"
.T
}
.r:
N
Amount
($)
. INTEREST EARNED, OTHER CREDITS/GAINS/
REFUNDS, AND PURCHASE OF INVESTMENTS
The Instruction Guide explains how to complete this form.
2 FILER NAIVb1" -:P A !tCL~~
4 Date
5 Na:r;;ro?(;F-E~Ccf((lf'
tt!5(~( 6 Address of person from whom amount is received; City; State; Zip Code
7 Purpose for w~ k~~;e:; ?(ttt-QCC<J
Date Name of person from whom amount is received
Address of person from whom amount is received; City; State; Zip Code
Purpose for which amount is received
Date Name of person from whom amount is received
Address of person from whom amount is received; City; State; Zip Code
Purpose for which amount is received
Date Name of person from whom amount is received
Address of person from whom amount is received; City; State; Zip Code
Purpose for which amount is received
ATTACH ADDITIONAL COPIES OF THIS SCHEDULEAS NEEDED
www.ethics.state.tx.us Revised 07/28/2014
----
Texas Ethics Commission PO Box 12070 Austin Texas 78711-2070 (512) 463-5800 (TOO 1-800-735-2989),
.
OUTSTANDING LOANS SCHEDULE LDORIGINAL
1 Total pages Schedule L:
The Instruction Guide explains how to complete this form.
k3 ACCOUNT # (Ethics Commission Filers)
2 FILER NAM~ j
4 Name of lender
INFORMAllON
LENDER
5 Lender address; City; State; Zip Code
6 Name of guarantorGUARANTOR
INFORMAllON
0 not applicable 7 Guarantor address; City; State; Zip Code
Name of lenderLENDER
INFORMAllON
Lender address, City; State; Zip Code
--'
U1 1Name of guarantor .GUARANTOR
IINFORMAllON
0 not applicable Guarantor address; City; State; Zip Code
lJ 't='j-,.~
Name of lender .r-~ LENDER .. ~
INFORMAllON -N
Lender address; City; State; Zip Code
Name of guarantorGUARANTOR
INFORMAllON
0 not applicable Guarantor address; City; State; Zip Code
Name of lender
INFORMATION
LENDER
Lender address; City; State; Zip Code
Name of guarantorGUARANTOR
INFORMAllON
0 not applicable Guarantor address; City; State; Zip Code
ATTACH ADDITIONAL COPIES OF THIS SCHEDULE AS NEEDED
www.ethics.state.tx.us Revised 07/28/2014
Texas Ethics Commission
.
2 FILER NAME
4 Description of Asset
Description of Asset
Description of Asset
Description of Asset
Description of Asset
Description of Asset
Description of Asset
Description of Asset
Description of Asset
Description of Asset
Description of Asset
Description of Asset
Description of Asset
Austin Texas 78711-2070 PO Box12070 , (512) 463-5800 (TDD 1-800-735-2989)
ASSETS VALUED AT $500 OR MORE SCHEDULE M[1 INAL
1 Total pages Schedule M:
The Instruction Guide explains how to complete this form.
~
3 ACCOUNT # (Ethics Commission Filers) fJ(A-
.......
CJ;
C-.!
~~
-J
...
\) rn.:J;:
-r-
N
ATTACH ADDITIONAL COPIES OF THIS SCHEDULE AS NEEDED
www.ethics.state.tx.us ReVised 07/28/2014
Texas Ethics Commission PO Box 12070 , (512) 463-5800 (TDD 1-800-735-2989) Austin Texas 78711-2070
• IN-KIND CONTRIBUTION OR POLITICAL EXPEITIITURE SCHEDULE TFOR TRAVEL OUTSIDE OF TEXAS ; ORIGINAL
1 Total pages Schedule T:The Instruction Guide explains how to complete this form.
r !
2 FILER NAME fJ 3 ACCOUNT # (Ethics Commission Filers) I'"
4 Name of Contributor I Corporation or Labor Organization I Pledgor I Payee
5 Contribution I Expenditure reported on:
D Schedule A D Schedule B D Schedule C D Schedule D D Schedule F D Schedule G
D Schedule H D Schedule N D COH-UC D COH-T D PAC-C D PAC-E
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 I Corporation or Labor Organization I Pledgor I Payee
Contribution I Expenditure reported on:
Schedule A Schedule B Schedule C Schedule 0 Schedule F Schedule GD D D D D D
D Schedule H D Schedule N D COH-UC D COH-T D PAC-C D PAC-E
Name of person(s) travelingDates of travel .......
U1
Departure city or name of departure location
2;
.~=-
<>Destination city or name of destination location
=--;g ,IIf
Q U •Means of transportation Purpose of travel (including name of conference, seminar, or other event) .r..
-
~
Name of Contributor I Corporation or Labor Organization I Pledgor I Payee
Contribution I Expenditure reported on:
Schedule A Schedule B Schedule C Schedule D Schedule F Schedule GD D D D D D
PAC-ESchedule H Schedule N COH-UC COH-T PAC-C
Dates of travel
D D D D D D
Name of person(s) traveling
Departure city or name of departure location
Destination city or name of destination location
Means of transportation Purpose of travel (including name of conference, seminar, or other event)
ATTACH ADDITIONAL COPIES OF THIS SCHEDULE AS NEEDED
www.ethics.state.tx.us Revised 07/28/2014