HomeMy WebLinkAboutLance Baxter 07152014Texas Ethics Commission PO Box 12070 Austin , Texas 78711-2070 (512) 463-5800 (TOO 1-800-735-2989)
FORM JC/OH
:lIGIl\LAL COVER SHEET PG 1
1 ACCOUNT # 2 Total pages filed:
(EthicsCommission Filers) ll-)
MI3 CANDIDATE I MS/MRS/MR FIRST
OFFICEHOLDER
NAME ~. Ii ''Ire <)
NICKNAME LAST
t5 t1; f r r
4 CANDIDATE I ADDRESS I POBOX; APT I SUITE #; CITY; STATE;
OFFICEHOLDER
MAILING ?o Bu!, 5('(6', fl-I<!. /<', ;,,, ",?,'Tf,t'/t3
ADDRESS
o change of address
5 CANDIDATEI AREA CODE PHONE NUMBER EXTENSION
OFFICEHOLDER
PHONE ( 972) '72'1, t(76?'
6 CAMPAIGN MS/MRSI@ FIRST
TREASURER
NAME ()Otl 11 ~ t.
NICKNAME LAST
~rp~/DI\ CPP~/~' 01'1
7 CAMPAIGN STREETADDRESS (NOPO BOX PLEASE); APT I SUITE #; CITY;
TREASURER
ADDRESS
(residence or business)
2-)0
'
UI7'~y ~1lA p~ r({'~'/tv(
8 CAMPAIGN AREA CODE PHONE NUMBER EXTENSION
TREASURER
PHONE ( )
9 REPORT TYPE D January 15 D 30th day Dbefore election Runoff
[]I' July 15 D 8th Dday before election Exceeded $500
limit
10 PERIOD Month Day Year Month
COVERED (/ ( /241t(" THROUGH
11 ELECTION ELECTIONDATE ELECTIONTYPE
Month Day Year D D RunoffPrimary
/ /
12 OFFICE OFFICE HELD (~any) (. cL {,~ 13.'
J"ZJ S· e/ L<J(J t\ f y CO~.t. t" it (
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Date Processed ., 'S -\'-\
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SUFFIX
STATE; ZIP CODE
'7<:;$ 71r #(1 let ;" .1 (/' lP
D 15th day after campaign
treasurer appointment
(officeholderonly)
D Final report (Mach C/OH - FR)
Day Year
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" OFFICE SOUGHT (~known) , k1r i" .
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JUDICIAL CANDIDATE I OFFICEHOLDER
CAMPAIGN FINANCE REPORT
The JC/OH Instruction Guide explains how to complete this form.
www.elhics.slale.lx.us Revised 04/1912013
., mission PO. Box 12070 Austin, Texas 78711-2070 (512) 463-5800 (TDD 1-800-735-2989)-
_.JCIAL CANDIDATE I OFFICEHOLDER REPORT: FORM JC/OH
SUPPORT & TOTALS ~~ I G" I r:,.! .COVER SHEET PG 2
".0 -c.s i~\1 ~n:,AL
115 ACCOUNT # (Ethics Commission Filers) 14 CtOH NAME
16 NOTICE
FROM
POLITICAL
COMMITTEE(S)
o additional pages
17 CONTRIBUTION
TOTALS
EXPENDITURE
TOTALS
CONTRIBUTION
18 AFFIDAVIT
MINDY QUINT
MY COMMISSION EXPIRES
August 10, 2014
AFFIX NOTARY STAMP I SEAL ABOVE
'si~ nclNre of ~r administering oath
1MIS BOX IS FORNOTICEOF POUTICAL CONTRIBUTIONSACCEPTED OR POUTICAL EXPENDITURES MADE BY POLITICAL COMMITTEES TO SUPPORT1ME
CANDIDATE 1OFFICEHOLDER. THESE EXPENDITURES MAY HAVE BEEN MADE WITHOUT THE CANDIDATE'S OR OFRCEHOLDER'S KNOWLEDGE OR
CONSENT. CANDIDATESAND OFFICEHOLDERSARE REQUIREDTO REPORT1MISINFORMATIONONLYIF 1MEYRECEIVENOTICEOF SUCHEXPENDITURES.
COMMITTEE TYPE
D GENERAL
D SPECIFIC
COMMITTEE NAME
tJ/A
COMMITTEE ADDRESS
COMMITTEE CAMPAIGN TREASURER NAME
COMMITTEE CAMPAIGN TREASURER ADDRESS .:~
o
C)
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
TOTAL POLITICAL CONTRIBUTIONS MAINTAINED AS OF THE LAST DAYBALANCE OF THE REPORTING PERIOD
OUTSTANDING 6. TOTAL PRINCIPAL AMOUNT OF ALL OUTSTANDING LOANS AS OF THE LOAN TOTALS LAST DAY OF THE REPORTING PERIOD
4. TOTAL POLITICAL EXPENDITURES
5.
$ r
$ ~.
$ P
$ 'ftz-.r;(.7
$ L71~,51f q~
$ p'
I swear, or affirm, under penalty of perjury, that the accompanying report is
true and correct and includes all information require to be reported by me ""de~~~ // ~ tkJ~Fl;;-
Signature of Candidate or Officeholder
this the
~V\ RA Ir.l·~
Title of officer adlninistering oath
www.ethics.state.tx.us Revised 04119/2013
2
Texas Ethics Commission PO Box 12070 Austin Texas 78711-2070 (512) 463-5800 (TDD 1-800-735-2989)
POLITICAL CONTRIBUTIONS SCHEDULE A (J)OTHER THAN PLEDGES OR LOANS (JUDICIAL) ;
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1 Total pages Schedule A(J):
The Instruction Guide explains how to complete this form.
FILER NAME
3 ACCOUNT # (Ethics Commission Filers)
7 Amount of Is In-kind contribution
contribution ($) description(if applicable)
4 Date 5 Full name of contributor [Put-<>f-state PAC (ID#:. ---'
I
ICity; State; Zip Code
I
I
(If travel outside of Texas, complete Schedule T)
9 Contributor's principal occupation 1 0 Contributor's job title
12 Law firm of contributor's spouse (if any)11 Contributor's employer/law firm
13 If contributor is a child, law firm of parent(s) (if any)
Amount of I In-kind contribution
contribution ($) I description(if applicable)
Date Full name of contributor [Put-<>f-state PAC(ID#: ---'
I
I
I
Contributor address; City; State; Zip Code
(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)
Amount of I In-kind contribution
contribution ($) I description(if applicable)
Date Full name of contributor [Put-<>f-state PAC(ID#· .)
IContributor address; City; State; Zip Code
I
I --4" , ,< ;qt-.. ..•
(If travel outside of Texas, comPlete SchedlJ\e li
Contributor's principal occupation Contributor's job title
Contributor's employer/law firm Law firm of contributor's spouse (if any) en
If contributor is a child, law firm of parent(s) (if any)
a a -_ ..~-./
If contributor is
ATTACH ADDITIONAL COPIES OF THIS SCHEDULE AS NEEDED
out-of-state PAC, please see instruction guide for additional reporting requirements.
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'-'I 1www.ethics.state.tx.us RevisedCJl4/19/2013
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Texas Ethics Commission PO Box 12070 Austin Texas 78711-2070 (512) 463-5800 (TDD 1-800-735-2989)
PLEDGED CONTRIBUTIONS (JUDICIAL) . SCHEDULE B (J)
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2
4
5
10
12
14
FILER NAME
Date
Date
Date
1 Total pages Schedule B(J):
The Instruction Guide explains how to complete this form.
3 ACCOUNT # (Ethics Commission Filers)
VNil
TOTAL OF UNITEMIZED PLEDGES:
6 8 Amount of 19 In-kind description
pledge ($) (if applicable)
Full name of pledgor o out-at-state PAC (tOO: )
I
7 Pledgor address; City; State; Zip Code I
I
I
(If travel outside of Texas, complete Schedule T)
Pledgor's principal occupation 11 Pledgor's job title
13 Law firm of pledgor's spouse (if any)Pledgor's employer/law firm
9 9 9 9 9 9 [$
If pledgor is a child, law firm of parentis) (if any)
Amount of I In-kind description
pledge ($) (if applicable)
Full name of pledgor o out-at-state PAC(ID#' )
I
IPledgor address; City; State; Zip Code
1
I
(If travel outside of Texas, complete Schedule T)
Pledgor's job titlePledgor'S principal occupation
Pledgor's employer/law firm Law firm of pledgor's spouse (if any)
If pledgor is a child, law firm of parentis) (if any)
Amount of I In-kind description
pledge ($) (if applicable)
Full name of pledgor o out-at-state PAC (ID#: )
I
IPledgor address; City; State; Zip Code
I
I
(If travel outside of Texas, complete Schedule T)
Pledgor's principal occupation Pledgor's job title
Pledgor'S employer/law firm Law firm of pledgor's spouse (if any)
--,,"If pledgor is a child, law firm of parentis) (if any) '" .s
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www.ethics.state.tx.us Revised 04/19/2013
Texas Ethics Commission PO Box 12070 Austin Texas 78711-2070 (512) 463-5800 (TOO 1-800-735-2989)
LOANS (JUDICIAL)
II
2 FILER NAME A/II/V-
4
TOTAL OF UNITEMIZED 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
D none
19 GUARANTOR 20 Name of guarantor
INFORMATION
21 Guarantor address;
D 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
'"..,., SCHEDULE E (J)~,,~lnI4£
1 Total pages Schedule E(J):
The Instruction Guide explains how to complete this form.
3 ACCOUNT # (Ethics Commission Filers)
c:> c:> c:> c:> c:> c:> $
9 LoanAmount ($)D out-or-state PAC(10#: )
1 0 I nterest rateState; Zip Code
11 Maturity date
13 Lender's Job Title
15 Law Firm of lender's spouse (if any)
18 Check if personal funds were deposited into political account
D
22 Amount Guaranteed ($)
City; State; Zip Code
24 Guarantor's Job Title
26 Law Firm of guarantor's spouse (if any)
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www.ethics.state.tx.us Revised 04/19/2013
Texas Ethics Commission PO Box 12070 Austin Texas 78711-2070 (512) 463-5800 (TOO 1-800-735-2989)
SCHEDULE F
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Office held
Office held
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POLITICAL EXPENDITURES
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EXPENDITURE CATEGORIES FOR BOX ala)
Advertising Expense Gift/Awards/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 ContributionslDonations 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.
1 Total pages Schedule F: 2 FILER NAME ~(1)6Ir;~
1
3 ACCOUNT # (Ethics Commission Filers) l (f'" (("
4 DtrgllV 5 paYf5ameoS·hvr4-7,f?v
6 Amount ($) 7 Payee address; City; State; Zip Code
~ {18cE.-
a PURPOSE (a) Category (Seecategories listedatthetopofthis schedule) (b) Description (If traveloutside of Tex~~ Sc~le T) "
OF Pe~5-PO B£fk:EXPENDITURE PO. B,VKJ /1 r Il
9 Complete Ql':I.I..Y: if direct Candidate / Officeholder name Office sought
expenditure to benefit C/OH
Da~II'f((Y p~na7e • {'oU fltt:,U ( (V'
Amount ($) Payee address; City; St"'e; Zip Code
t; uo-:
PURPOSE Category (Seecategories listedatthetopofthis schedule) Description (Iftraveloutside of Texas, C~fete Schedule T)
OF e~'11-b\cPtN~C-~ (7N cl~ i;/r: 6 f'\EXPENDITURE
Complete Q.!iLY: if direct Candidate / Officeholder name Office sought
expenditure to benefit C/OH
o;;elb 11y: Payee p;.yrrrt A ~ +r r:
~C>;lntio Payee address; City; State; Zip Code
PURPOSE Category (Seecategories listedatthetopofthis schedule) Description (If traveloutside ofTexas, complete Schedule T)
OF y::=fu p Oej-z{X<'EXPENDITURE
Complete ONLY if direct Candidate / Officeholder name Office sought V'
expenditure to benefit C/OH
~(~(I,(
Payee name
()f.1 ± ~l\) C~ (( /2.-''1 'St ['I 01 ~ ,,~ .t.;};,;pCut((~
Amount ($) Payee address; Cit/; State; Zip Code
fi { I,JJ....00
PURPOSE Category (See categories listedatthetopofthis schedule) Description (Iftraveloutside of Texas, complete Schedule T)
OF S'olt G"',f-Jtff~ (ht ..dt-1l1~ ~~\ ~ rJt1 It l-;... ___EXPENDITURE
Complete Ql':I.I..Y: if direct Candidate / Officeholder name V Office sought
expenditure to benefit C/OH
ATTACH ADDITIONAL COPIES OF THIS SCHEDULE AS NEEDED
www.ethics.state.tx.us Revised 04/19/2013
Texas Ethics Commission P.D Box 12070 Austin Texas 78711-2070 (512) 463-5800 (TDD 1-800-735-2989)
Advertising Expense
Accounting/Banking
Consulting Expense
Event Expense
Fees
1 Total pages Schedule F: 22-.
4 Date 5J((£ !It(
6 Amount ($) 7
1i··7~6.-·
8 PURPOSE
OF
EXPENDITURE
9 Complete QIiLY if direct
expenditure to benefit C/OH
Date
Amount ($)
PURPOSE
OF
EXPENDITURE
Complete ONLY if direct
expenditure to benefit C/OH
Date
Amount ($)
PURPOSE
OF
EXPENDITURE
Complete ONLY if direct
expenditure to benefit C/OH
Date
Amount ($)
PURPOSE
OF
EXPENDITURE
Complete Q.liI.Y if direct
expenditure to benefit C/OH
www.elhics.state.lx.us
[J ORIG!r,,' SCHEDULE F
,d..
Loan RepaymentlReimbursement
Transportation Equipment & Related Expense
ContributionslDonations Made By
Candidate/Officeholder/Political Committee
OTHER (enter a category not listed above)
13 ACCOUNT # (Ethics Commission Filers)
1'1/ Y7 t-t-n./a f7 0"",,
Description (Iftraveloutside of Texas, complete Schedule T)
(;Jf V41rl1~e7"",
Office held
Description (Iftraveloutside of Texas, complete Schedule T)
Office held
Description (If traveloutside of Texas, complete Schedule T)
Office held
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POLITICAL EXPENDITURES
EXPENDITURE CATEGORIES FOR BOX 8(a)
Gift/Awards/Memorials Expense Salaries/Wages/Contract Labor
Legal Services Solicitation/Fund raising Expense
Food/Beverage Expense Travel In District
Polling Expense Travel Out Of District
Printing Expense Office Overhead/Rental Expense
The Instruction Guide explains how to complete this form.
FILER NAME
pa'0Jar, <
( (V"Cdi,d=rj ~I\~
Payee address; City; State; Zip Code
(a) Category (Seecategories listedatthetopofthis schedule) (b)
Mwr-P;'I/~ tlcf)I.A.F;L
Candidate / Officeh6lder name Office sought
Payee name
Payee address; City; State; Zip Code
Category (Seecategories listedatthetopofthis schedule)
Candidate / Officeholder name Office sought
Payee name
Payee address; City; State; Zip Code
Category (Seecategories listedatthetopofthis schedule)
Candidate / Officeholder name Office sought
Payee name
Payee address; City; State; Zip Code
Category (See categories listedatthetopofthis schedule)
Candidate / Officeholder name Office sought
ATTACH ADDITIONAL COPIES OF THIS SCHEDULE AS NEEDED
Revised 04/1912013
Texas Ethics Commission PO Box 12070 Austin Texas 78711-2070 (512) 463-5800 (TOO 1-800-735-2989) ,
POLITICAL EXPENDITURES \ ,
i T~!Glr!~L SCHEDULE G':' :1 , . L ~: ': "."."",MADE FROM PERSONAL FUNDS
;
Advertising Expense
Accounting/Banking
Consulting Expense
Event Expense
Fees
1 Totalpages Schedule G:
4 Date
6 Amount ($)
0 Reimbursement from
political contributions
intended
8 PURPOSE
OF
EXPENDITURE
Date
Amount ($)
0 Reimbursement from
political contributions
intended
PURPOSE
OF
EXPENDITURE
Date
Amount ($)
0 Reimbursement from
political contributions
intended
PURPOSE
OF
EXPENDITURE
Date
Amount ($)
0 Reimbursement from
political contributions
Intended
PURPOSE
OF
EXPENDITURE
EXPENDITURE CATEGORIES FOR BOX 8(a)
Gift/Awards/Memorials Expense Salaries/Wages/Contract Labor Loan Repayment/Reimbursement
Legal Services Solicitation/Fund raising Expense Transportation Equipment & Related Expense
Food/Beverage Expen se Travel In District Contributions/Donations Made By
Polling Expense Travel Out Of District Candidate/Officeholder/Political Committee
Printing Expense Office Overhead/Rental Expense OTHER (enter a category not listed above)
The Instruction Guide explains how to complete this form.
3 ACCOUNT # (Ethics Commission Filers) 2 FILER NAME
I /1
5 Payee fd ! /~~
7 Payee address; City; State; Zip Code
(a) Category (Seecategories listedatthetopofthis schedule) (b) Description (Iftraveloutside of Texas,complete Schedule T)
Payee name
Payee address; City; State; Zip Code
Category (Seecategories iistedatthetopofthis schedule) Description (Iftraveloutside of Texas, complete Schedule T)
Payee name
Payee address; City; State; Zip Code
Category (Seecategories listedatthetopofthis schedule) Description (Iftravel outside of Texas, complete Schedule T)
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'~t;;,!• .;,;o'~Payee name -(11 .
"""",.;)1"""'"-U ,:x "IPayee address; City; State; Zip Code <j .. Iir'
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Category (See categories listedatthetopofthis schedule) Description (Iftraveloutside of Texas,complete Schedule T)
ATTACH ADDITIONAL COPIES OF THIS SCHEDULE AS NEEDED
www.ethics.state.tx.us Revised 04/19/2013
Texas Ethics Commission PO Box 12070 Austin Texas 78711-2070 (512) 463-5800 (TDD 1-800-735-2989)
PAYMENT FROM POLITICAL
Advertising Expense
Accounting/Banking
Consulting Expense
Event Expense
Fees
1 Total pages Schedule H:
4 Date
6 Amount ($)
8 PURPOSE
OF
EXPENDITURE
9 Complete QliLY if direct
expenditure to benefit C/OH
Date
Amount ($)
PURPOSE
OF
EXPENDITURE
Complete QliLY if direct
expenditure to benefit C/OH
Date
Amount ($)
PURPOSE
OF
EXPENDITURE
Complete ONLY if direct
expenditure to benefit C/OH
Date
Amount ($)
PURPOSE
OF
EXPENDITURE
Complete ONLY if direct
expenditure to benefit C/OH
'-~<t.HEDULE HCONTRIBUTIONS TO A BUSINESS OF C/OH
EXPENDITURE CATEGORIES FOR BOX 8(a)
GifUAwards/Memorials Expense Salaries/Wages/Contract Labor Loan Repayment/Reimbursement
Legal Services Solicitation/Fund raising Expense Transportation Equipment & Related 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.
2 FILER NAME ACCOUNT # (Ethics Commission Filers) 13
•A
5
BUS1f1 n1k1l--
7 BUSiness/address; City; State; Zip Code
(a) Category (Seecategorieslistedatthetopofthis schedule) (b) Description (Iftraveloutsideof Texas, complete ScheduleT)
Candidate / Officeholder name Office sought Office held
Business name
Business address; City; State; Zip Code
Category (Seecategorieslistedatthetopofthisschedule) Description (Iftraveloutsideof Texas, completeScheduleT)
Candidate / Officeholder name Office sought Office held
Business name
Business address; City; State; Zip Code
Category (Seecategorieslistedatthetopofthis schedule) Description (If traveloutsideof Texas, completeScheduleT)
Candidate / Officeholder name Office sought Office held
Business name
','0. .,Business address; City; State; Zip Code ..;:-~
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-U :x ~=rc~
f-m';~'~Candidate / Officeholder name Office sought OfficEfheld .~;
c::> .;'
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ATTACH ADDITIONAL COPIES OF THIS SCHEDULE AS NEEDED
www.ethics.state.tx.us Revised 04/19/2013
I
Texas Ethics Commission PO Box 12070 Austin Texas 78711-2070 (512) 463-5800 (TOO 1-800-735-2989)
;'(I' I"'J SCHEDULEMADE FROM POLITICAL CONTRIBUTIONSc::; i V""'{ .F·/:1 L
The Instruction Guide explains how to complete this form.
NON-POLITICAL EXPENDITURES
1 Total pages Schedule I:
4 Date 5 Payee name
6 Amount ($) 7 Payee address; City; State; Zip Code
8 PURPOSE
OF
EXPENDITURE
(a) Category (See instructions for examples of acceptable
categories)
Date Payee name
Amount ($) Payee address; City; State; Zip Code
PURPOSE
OF
EXPENDITURE
(a) Category (See instructions for examples of acceptab
categories)
le
Date Payee name
Amount ($) Payee address; City; State; Zip Code
PURPOSE
OF
EXPENDITURE
(a) Category (See instructions for examples of acceptab
categories)
le
Date Payee name
Amount ($) Payee address; City; State; Zip Code
PURPOSE
OF
EXPENDITURE
(a) Category (See instructions for examples of acceptab
categories)
le
2 F'LEiV7/t
•
3 ACCOUNT # (Ethics Commission Filers)
(b) Description (See instructions regarding type of information
required.)
(b) Description (See instructions regarding type of information
required.)
(b) Description (See instructions regarding type of information
required.)
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ATTACH ADDITIONAL COPIES OF THIS SCHEDULE AS NEEDED
www.ethics.state.tx.us Revised04/19/2013
Texas Ethics Commission P.O. Box 12070 Austin, Texas 78711-2070 (512) 463-5800 (TDD 1-800-735-2989)
INTEREST EARNED, OTHER CREDITS/GAINS/ ~
REFUNDS, AND PURCHASE OF INVESTMENTS
The Instruction Guide explains how to complete this form.
2 FILER NAME
ATlfA-I v ( ,
4 Date 5 Name of person from whom amount is received
6 Address of person from whom amount is received; City; State; Zip Code
7 Purpose for which amount is received
Date Name of person from whom amount is received
Address of person from whom amount is received; City; State; Zip Code
Purpose for which amount is received
Date Name of person from whom amount is received
Address of person from whom amount is received; City; State; Zip Code
Purpose for which amount is received
Date Name of person from whom amount is received
Address of person from whom amount is received; City; State; Zip Code
Purpose for which amount is received
ATTACH ADDITIONAL COPIES OF THIS SCHEDULE AS NEEDED
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Total pages Schedule K:
ACCOUNT # (Ethics Commission Filers)
8 Amount
($)
Amount
($)
Amount
($)
Amount
($)
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Texas Ethics Commission P.O. Box 12070 Austin Texas 78711-2070 (512) 463-5800 (TOO 1-800-735-2989)
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6 Name of guarantor
7 Guarantor address; City; State; Zip Code
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GUARANTOR
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LENDER
INFORMATION
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www.ethics.state.tx.us Revised 04/19/2013
ATTACH ADDITIONAL COPIES OF THIS SCHEDULE AS NEEDED
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FILER NAME
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
Texas Ethics Commission PO Box 12070 Austin Texas 78711-2070 (512) 463-5800 (TDD 1-800-735-2989)
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www.ethics.state.lx.us Revised 04/1912013
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Texas Ethics Commission PO Box 12070 Austin, Texas 78711-2070 (512) 463-5800 (TOO 1-800-735-2989)
IN-KIND CONTRIBUTION OR POLITICAL EXPENDITURE
SCHEDULE TFOR TRAVEL OUTSIDE OF TEXAS n nQIGII\.LAL
1 Total pages Schedule T:The Instruction Guide explains how to complete this form. ,
FILER NAME 3 ACCOUNT # (Ethics Commission Filers)
4 Name of Contributor 1c~tratic/1 c Labor Organization I Pledgor I Payee
5 Contribution I Expenditure reported on:
D ScheduleA D Schedule B D Schedule C D Schedule 0 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:
D Schedule A D Schedule B
D Schedule H D Schedule N
Dates of travel Name of person(s) traveling
D
D
Schedule C
COH-UC
D
D
Schedule 0
COH-T
D
D
Schedule F
PAC-C
D
D
Schedule G
PAC-E
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)
Name of Contributor I Corporation or Labor Organization I Pledgor I Payee
Contribution I Expenditure reported on:
D Schedule A D Schedule B D Schedule C Schedule 0 D Schedule F Schedule GDD
PAC-E
Dates of travel Name of persorus) traveling
Departure city or name of departure location
D Schedule H D Schedule N D COH-UC D COH-T D PAC-C D
c.;Destination city or name of destination location e::
Means of transportation Purpose of travel (including name of conference, seminar, or other event) CJl
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ATTACH ADDITIONAL COPIES OF THIS SCHEDULE AS NEEDED
www.elhics.slate.lx.us Revised04/19/2013