HomeMy WebLinkAboutDenise Alberino 07152014Texas Ethics Commission P.O. Box 12070 Austin, Texas 78711-2070 (512) 463-5800 (TOO 1-800-735-2989)
CANDIDATE I OFFICEHOLDER
CAMPAIGN FINANCE REPORT [J FORM C/OH
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The C/OH Instruction Guide explains how to complete this form.
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www.ethics.state.tx.us Revised04/19/2013
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Texas Ethics Commission PO Box 12070 Austin Texas 78711-2070 (512) 463-5800 (TOO 1-800-735-2989)
CANDIDATE IOFFICEHOLDER REPORT:
SUPPORT & TOTALS
FORM C/OH
dGL~~R SHEET PG 2
o additional pages
COMMITTEE CAMPAIGN TREASURER NAME
COMMITTEE CAMPAIGN TREASURER ADDRESS
I
17 CONTRIBUTION
TOTALS
EXPENDITURE
TOTALS
CONTRIBUTION
BALANCE
OUTSTANDING
LOAN TOTALS
18 AFFIDAVIT
4.
5.
6,
TOTAL POLITICAL EXPENDITURES
TOTAL POLITICAL CONTRIBUTIONS MAINTAINED AS OF THE LAST DAY
OF REPORTING PERIOD
TOTAL PRINCIPAL AMOUNT OF ALL OUTSTANDING LOANS AS OF THE
LAST DAY OF THE REPORTING PERIOD
$/'."\....\I
$ 1 \ \,,,-,\\,
$ ".X
I swear, or affirm, under penalty of perjury, that the accompanying report .
\ is true and correct ~d includes all information,required to be reported by
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r i''''\~'''''''' i , . ,I '. ."J'--~) '-----~ : "~9 f-=/ ...;:-: .";
, <, Signature of Candidate or Officeholder
witness my hand and seal of office.
AFFIX NOTARY STAMP ( SEAL ABOVE
Sworn to and subscribed before
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Signature 0 oMcJr allministering oath
www.ethics.state.tx.us
me, by the said /Qen ,-Se,
20 ~ , to certify which,
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Printed name of officer administering oath
, this the
Title of officer apministering oath
Revised04/19/2013
14 CtOH \JAlyLE \ •• (" ,
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115 ACCOUNT # (Ethics Commission Filers)
16 NOTICE FROM
POLITICAL
COMMITTEE(S)
lHlS BOX IS FOR NOllCE OF POUllCAL CONlRIBUllONS ACCEPTED OR POUllCAL EXPENDITURES MADE BY POUllCAL COMMITIEES TO SUPPORT lHE
CANDIDATE 1OFFICEHOLDER. THESE EXPENDITURES MAY HAVE BEEN MADE WITHOUT THE CANDIDATE'S OR OFFICEHOLDER'S KNOWLEDGE OR
CONSENT. CANDIDATESAND OFFICEHOLDERS ARE REQUIRED TO REPORT lHlS INFORMAllON ONLYIF lHEY RECEIVE NOllCE OF SUCH EXPENDITURES.
COMMITTEE NAME
COMMITTEE TYPE
D GENERAL
COMMITTEE ADDRESS
D SPECIFIC
1.
2.
3,
TOTAL POLITICAL CONTRIBUTIONS OF $50 OR LESS (OTHER THAN
PLEDGES, LOANS, OR GUARANTEES OF LOANS), UNLESS ITEMIZED
TOTAL POLITICAL CONTRIBUTIONS
(OTHER THAN PLEDGES, LOANS, OR GUARANTEES OF LOANS)
TOTAL POLITICAL EXPENDITURES OF $100 OR LESS, UNLESS ITEMIZED
$ '\'C\.;$ (I\'
MELISSA SMITH I
NntGry Public, State 9Hexas
Mv Comrntsslop-Exptres I
March 08,f2017