HomeMy WebLinkAboutJoe Jaynes 01152014Texas Ethics Commission P.O. Box 12070 Austin, Texas 78711-2070 (512) 463-5800 (TOO 1-800-735-2989)
CANDIDATE I OFFICEHOLDER
CAMPAIGN FINANCE REPORT
The e/OH Instruction Guide explains how to complete this form.
3 CANDIDATE 1 MS/MRSI~ FIRST
OFFICEHOLDER
.-:JAYNE.f
~
NAME .J.9 e....
NICKNAME LAST
4 CANDIDATE 1 ADDRESS I PO BOX: APT I SUITE #: CITY;
OFFICEHOLDER 'j)'D) {3l-AC'tC.-wA'1C-/lMAILING
ADDRESS
o change of address t11 ; k':;rN,-wy ~
5 CANDIDATEI AREA CODE PHONE NUMBER
OFFICEHOLDER (464 ) PHONE 'fS-3 -~ 7" u
6 CAMPAIGN MS/MRSIW FIRST
TREASURER .~e-. TAy~JNAME
NICKNAME LAST
7 CAMPAIGN STREET ADDRESS (NO PO BOX PLEASE); APT ISUITE II;
TREASURER ~SO~ !3L.ACJCw)J'1€>t.ADDRESS
(residence or business)
e fyn -/CYNI\.eL/ ~
8 CAMPAIGN AREA CODE PHONE NUMBER
TREASURER (.LIlli 1?r J g' 760
PHONE )
9 REPORT TYPE ~anuary 15 D 30th day before election
D .. July 15 D 8th day before election
10 PERIOD Month Dly Year
COVERED oj /01 ~J THROUGH
11 ELECTION ELECTION TYPE ELECTION DATE
Month Dly Year D Primary
/ /
12 OFFICE OFFICE HELD (~any)
rAv,.J1"1 r:...-SI"""-"'J_S".5 704A
GO TO PAGE 2
ZJ ORIGINAL
1 ACCOUNT #
(Ethics Commission Filers)
MI
SUFFIX
STATE; ZIP CODE
C£/c.. 1tf..
75""07 0
EXTENSION
MI
SUFFIX
CITY: STATE:
Ure. ~
7,57>10>
EXTENSION
FORM C/OH
COVER SHEET PG 1
2 Total pages filed:
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D"!Hand-~, .. \~~~"" 7""-..l~~
Receipt # I Arroult
Date Processed
(-/'-l-Ii-f
Date Imaged
I -1t..(-/1
15th day after campaignRunoffDD treasurer appointment
~holderOnIY)
D Exceeded $500 Final report (Attach CIOH -FR)
limit
Month Dly Year
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/'..1 .... ~i<~13... B~w
21~~ 1161 , Jy 4:
'IO~ f.I' tl'l nD ~ Runoff n General D;~peaal'l--
13 OFFICE SOUGHT (If known)
ZIP CODE ........
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IZ .... I-"'--j~
x-r:::It If
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www.ethics.state.tx.us Revised 04/19/2013
16
and subscribed
_--'C=___ day
Texas Ethics Commission P.O. Box 12070 Austin, Texas 78711-2070 (512) 463-5800 (TOO 1-800-735-2989)
CANDIDATE t OFFICEHOLDER REPORT: FORM CtOH
SUPPORT & TOTALS COVER SHEET PG 2
14 C/OH NAME 15 ACCOUNT # (Ethics Commission Filers)
llilS BOX IS FOR NOTICE OF pounCAL CONTRIBUTIONS ACCEPlED OR POUTICAL EXPENDITURES MADE BY POlITICAL COMMITnEES TO SUPPORT lliE
CANDIDATE I OFFICEHOLDER. THESE EXPENDITURES MAY HAVE BEEN MADE WITHOUT THE CANDIDATE'S OR OFFICEHOLDER'S KNOWLEDGE OR
, CONSENT. CANDIDATES AND OFFICEHOLDERS ARE REQUIRED TO REPORT llilS INFORMATION ONLY IF lliEY RECEIVE NOTICE OF SUCH EXPENDITURES.
COMMITTEE NAME
CO'~MfTTEE TYPE
o GENERAL
" COMMITTEE ADDRESS o 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. TOTAL POLITICAL CONTRIBUTIONS $(OTHER THAN PLEDGES, LOANS, OR GUARANTEES OF LOANS)
EXPENDITURE
TOTALS 3 TOTAL POLITICAL EXPENDITURES OF $100 OR LESS, UNLESS ITEMIZED $ :::;;-0
4. TOTAL POLITICAL EXPENDITURES $ I I if c?
CONTRIBUTION 5. TOTAL POLITICAL CONTRIBUTIONS MAINTAINED AS OF THE LAST DAYBALANCE $ 0OF REPORTING PERIOD
OUTSTANDING 6. TOTAL PRINCIPAL AMOUNT OF ALL OUTSTANDING LOANS AS OF THE £)LOAN TOTALS $LAST DAY OF THE REPORTING PERIOD
18 AFFIDAVIT
I swear, or affirm, under penalty of perjury, that the accompanying report
is true and co,u:,ect and includ s all information required to be reported by
me under T,ille h5, Electi ode.
RENEE H£lMl
My~~'
NoWftlIMr 3, 2017
AFFIX NOTARY STAMP I SEAL ABOVE ....--~
before me, by the said __'5-=~cQX-=_=-__Jct=-,,----,: ' this the
of j)noo.0,j , 20 \<1-'to certify which. ::ssm;h-a-n-d-a-n-d-s-e-al of office.
\ \&V\Z-e \
Printed name of officer administering oath Title of officer administering oath
www.ethics.state.tx.us Revised 04/19/2013
Texas Ethics Commission PO Box 12070 Austin Texas 78711-2070 (512) 463-5800 (TOO 1-800-735-2989)
2
4
9
POLITICAL CONTRIBUTIONS
OTHER THAN PLEDGES OR LOANS
The Instruction Guide explains how to complete this form.
FILER NAME
.\AV~rS
Date 5 Full name of contributor o out-at-state PAC (ID#:
6 Contributor address; City; State; Zip Code
Principal occupation I Job title (See Instructions)
Date Full name of contributor o out-at-state PAC (ID#:
Contributor address; City; State; Zip Code
Principal occupation I Job title (See Instructions)
Date Full name of contributor o out-at-slate PAC (ID#:
Contributor address; City; State; Zip Code
Principal occupation I Job title (See Instructions)
Date Full name of contributor o out-aI-state PAC (ID#:
Contributor address; City; State; Zip Code
Principal occupation I Job title (See Instructions)
Date Full name of contributor o out-of-state PAC(ID#:
Contributor address; City; State; Zip Code
Principal occupation I Job title (See Instructions)
SCHEDULE A
n nn II"IIlI A.
1
~ . r ~t!l ~ Schedule A:
3 ACCOUNT # (Ethics Commission Filers)
) 7 Amount of 18 In-kind contribution
contribution ($) I description (if applicable)
I
I
I
(If travel outside of Texas, complete Schedule T)
10 Employer (See Instructions)
) Amount of I In-kind contribution
contribution ($) description (if applicable)
I
I
I
I
!If travel outside of Texas, comolete Schedule n
Employer (See Instructions)
I
) Amount of I In-kind contribution
contribution ($) description (if applicable)
I
I
I
I
(If travel outside of Texas, complete Schedule T)
Employer (See Instructions)
I
) Amount of In-kind contributionI
contribution ($) I description (if applicable)
I
I
I
(If travel outside of Texas, comelete Schedule Tl
Employer (See Instructions)
I
I
) Amount of I In-kind contribution
contribution ($) description (if llmllicable)I .... ,
I L.
I -.--
r
-="""">0
I ~
.
i
(If travel outside of Texas, comelete Schedule Tl
Employer (See Instructions) ~ IT'! .. .,~
";W
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.stale.lx.us Revised 04/19/2013
Texas Ethics Commission PO. Box 12070 Austin Texas 78711-2070 (512) 463-5800 (TOO 1-800-735-2989)
PLEDGED CONTRIBUTIONS
,.., .
The Instruction Guide explains how to complete this torm.
2 FILER NAME
)AVAJf:r
4 TOTAL OF UNITEMIZED PLEDGES: ¢
5 Date 6 Full name of pledgor o out-Of-state PAC (100:
7 Pledgor address; City; State; Zip Code
10 Principal occupation I Job title (See Instructions)
Date Full name of pledgor o out-of-slale PAC(ID#:
Pledgor address; City; State; Zip Code
Principal occupation I Job title (See Instructions)
Date Full name of pledgor o out-at-state PAC (100:
Pledgor address; City; State; Zip Code
Principal occupation I Job title (See Instructions)
Date Full name of pledgor o out-of-state PAC (tOO:
Pledgor address; City; State; Zip Code
Principal occupation I Job title (See Instructions)
Date Full name of pledgor o out-of-slale PAC (100:
Pledgor address; City; State; Zip Code
Principal occupation I Job title (See Instructions)
SCHEDULE B
1 Total pages Schedule B:
3 ACCOUNT # (Ethics Commission Filers)
¢ ¢ ¢¢¢ 1$
8 Amount of 19 In-kind description
pledge ($)
)
(if applicable)I
I
I
I
(If travel outside of Texas, complete Schedule T)
Employer (See Instructions)11
1
Amountof In-kind description) I pledge ($) (if applicable)I
I
I
1
(If travel outside of Texas, complete Schedule T)
Employer (See Instructions)
I
Amount of In-kind description) I
pledge ($) (if applicable)I
I
1
I
(If travel outside of Texas, complete Schedule T)
Employer (See Instructions)
I
Amount of In-kind description) I
pledge ($) (if applica~)I
~
{--" . I
I .-:-.-f
~-r-"
I -~
(If travel outside of Texas. complete S~ule ~~
Employer (See Instructions) ::3: U J 1
\DI -
) Amount of I In-kind des~~ion\ .....-. ".
pledge ($) (if applica e)I
I
I
1
(If travel outside of Texas, complete Schedule T)
Employer (See Instructions)
I
ATTACH ADDITIONAL COPIES OF THIS SCHEDULE AS NEEDED
It contributor is out-ot-state PAC, please see instruction guide tor additional reporting requirements.
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)
LOANS SCHEDULE EDORIGINAl
1 Total pages Schedule E:
The Instruction Guide explains how to complete this form.
2 FILER NAME 3 ACCOUNT # (Ethics Commission Filers)
..s A'-Itv~J
4
TOTAL OF UNITEMIZED LOANS: ¢ ¢ ¢ ¢ ¢ ¢ $
5 Date of loan 7 Name of lender o out-of-state PAC (101/: ) 9 Loan Amount ($)
6 Is lender 8 Lender address; City; State; Zip Code 10 Interest rate
a financial
Institution?
11 Maturity date
y N
12 Principal occupation I Job title (See Instructions) 13 Employer (See Instructions)
14 Description of Collateral 15 Check if personal funds were deposited into political account
D none D
16 GUARANTOR 17 Name of guarantor 19 Amount Guaranteed ($)
INFORMATION
18 Guarantor address; City; State; Zip Code
D not applicable
20 Principal Occupation (See Instructions) 21 Employer (See Instructions)
Date of loan Name of lender o out-of-state PAC (101/: ) Loan Amount ($)
Is lender Lender address; City; State; Zip Code Interest rate
a financial
Institution?
Maturity date
y N
Principal occupation I Job title (See Instructions) Employer (See Instructions) +I ~
(l
-:r·~. 1.-..
-;...... I-Description of Collateral Check if personal funds were deposited into political account-
.-1
noneD D ~
'eIl!: 1-
Amount Guarant9:1 ($)1Name of guarantorGUARANTOR I~ ~
INFORMATION l.D l::::=t'.~
UJ
Guarantor address; City; State; Zip Code &'"" '0"1
D not applicable
Principal Occupation (See Instructions) Employer (See Instructions)
ATTACH ADDITIONAL COPIES OF THIS SCHEDULE AS NEEDED
If lender is out-of-state PAC, please see instruction guide for additional reporting requirements.
www.ethics.state.tx.us Revised 0411912013
Texas Ethics Commission PO Box 12070 Austin Texas 78711-2070 (512) 463-5800 (TDD 1-800-735-2989).
POLITICAL EXPENDITURES
Advertising Expense GifUAwards/Memorials Expense
Accounting/Banking Legal Services
Consulting Expense Food/Beverage Expense
Event Expense Polling Expense
Fees Printing Expense
1 Total pages Schedule F: 2 FILER NAME
3
4 Date 5 Payee name
6 Amount ($) 7 Payee address;
8 PURPOSE
OF
EXPENDITURE
9 Complete .Q.lli.t if direct
expenditure to benefit C/OH
Date Payee name
Amount ($) Payee address:
PURPOSE
OF
EXPENDITURE
Complete Qill:f if direct
expenditure to benefit C/OH
Date Payee name
Amount ($) Payee address;
PURPOSE
OF
EXPENDITURE
Complete .Q.lli.t if direct
expenditure to benefit C/OH
Date Payee name
Amount ($) Payee address;
PURPOSE
OF
EXPENDITURE
Complete .Q.lli.t if direct
expenditure to benefit C/OH
SCHEDULE F
EXPENDITURE CATEGORIES FOR BOX 8(a)
Salaries/Wages/Contract Labor Loan RepaymenUReimbursement
Solicitation/Fundraising Expense Transportation Equipment & Related Expense
Travel In District ContributionslDonations Made By
Travel Out Of District Candidate/Officeholder/Political Committee
Office Overhead/Rental Expense OTHER (enter a category not listed above)
The Instruction Guide explains how to complete this form.
13 ACCOUNT # (Ethics Commission Filers)
State; Zip Code
(a) Category (See categones listed at the top of this schedule) (b) Description (If travel outside of Texas. complete Schedule T)
Candidate / Officeholder name Office sought Office held
State; Zip Code
Category (See categories listed at the top of this schedule) Description (If travel outside of Texas. complete Schedule T)
Candidate / Officeholder name Office sought Office held
State; Zip Code
--"
~
'-,; r:0
Description (If travel outside of Texas. complete Sc~le T) Category (See categories listed at the top of this schedule) --I.
Candidate / Officeholder name Office sought Offi~ld:T; ,., . ~'
~' -.W I
~
State; Zip Code
Category (See categories listed at the lOP of thiS schedule) Description (If travel outside of Texas. complete Schedule T)
Candidate / Officeholder name Office sought Office held
ATTACH ADDITIONAL COPIES OF THIS SCHEDULE AS NEEDED
City;
City;
City;
City;
www.ethics.state.tx.us Revised 04/19/2013
01.15.13 Constant Contact
www.constantl:ontact.com
Fees for email database
$58
02.15.13 Constant Contact
www.constantcontact.com
Fees for email database
$58
02.15.13 Digittakes
400 Vicki Ln
Wylie, TX 75098
Fees for domain
$130
03.15.13 Constant Contact
www.constantcontact.com
Fees for email database
$58
04.15.13 Constant Contact
www.constantl.Ontact.com
$58
Fees for email database
07.22.13 I\lACO Annual Conference $146
Fort Worth, Texas
Expenses for annual conference
12.29.13 First Baptist Church $600
2101 E. Melissa Rd
Melissa, TX 75454
-"'" Contribution for building fund .....
<
%F12.30.13 Constant Contact $40
www.constant contact.com ~
Fees for email database ~ ::::x
Political expenditures of $100 or less unless itemized: $50 "!?
w .s:
Texas Ethics Commission PO. Box 12070 Austin, Texas 78711-2070 (512) 463-5800 (TDD 1-800-735-2989)
POLITICAL EXPENDITURES
MADE FROM PERSONAL FUNDS
Advertising Expense Gift/Awards/Memorials Expense
Accounting/Banking Legal Services
Consulting Expense Food/Beverage Expense
Event Expense Polling Expense
Fees Printing Expense
1 Total pages SChedulr G: 2 FILER NAME :s~ \.1 ,NG' ....
4 Date 5 Payee name
6 Amount ($) 7 Payee address; City;
D Reimbursement from
political contributions
intended
8 PURPOSE
OF
EXPENDITURE
Date Payee name
Amount ($) Payee address; City;
D Reimbursement from
political contnbutions
intended
PURPOSE
OF
EXPENDITURE
Date Payee name
Amount ($) Payee address; City;
D Reimbursement from
political contributions
intended
PURPOSE
OF
EXPENDITURE
Date Payee name
Amount ($) Payee address; City;
D Reimbursement from
political contributions
intended
PURPOSE
OF
EXPENDITURE
,if SCHEDULE G
"'-~
IGINA'
EXPENDITURE CATEGORIES FOR BOX 8(a)
SalarieslWages/Contract Labor Loan Repayment/Reimbursement
Solicitation/Fund raising Expense Transportation Equipment & Related Expense
Travel In District ContributionslDonations Made By
Travel Out Of District Candidate/Officeholder/Political Committee
Office Overhead/Rental Expense OTHER (enter a category not listed above)
The Instruction Guide explains how to complete this form.
3 ACCOUNT # (Ethics Commission Filers)
1
State; Zip Code
(a) Category (See calegories listed at the top of thiS schedule) (b) Description (If travel outside of Texas, complete Schedule T)
State; Zip Code
.
Category (See categories listed at the top of this schedule) Description (If travel outside of Texas, complete Schedule T)
State; Zip Code
Category (See categories listed at the top of thiS schedule) Description (If travel outside of Texas, complete S~ule T)1rI ,-J>
L-•
Z: ~
~
3
~
tn,
l,J.')State; Zip Code
w i:J(J1
Category (See calegories listed at the top of this schedule) Description (If Iravel outside of Texas. complete Schedule T)
ATTACH ADDITIONAL COPIES OF THIS SCHEDULE AS NEEDED
www.ethics.state.tx.us Revised 04/19/2013
PAYMENT FROM POLITICAL CONTRIBUTIONS
TO A BUSINESS OF C/OH
EXPENDITURE CATEGORIES FOR BOX 8(a)
Advertising Expense Gift/Awards/Memorials Expense
Accounting/Banking Legal Services
Consulting Expense Food/Beverage Expense
Event Expense Polling Expense
Fees Printing Expense
1 Total pages SCh(dUIe H: 2 FILER NAME
-S-A"'lrJl~ >
4 Date 5 Business name
6 Amount ($) 7 Business address; City; State;
8 PURPOSE (a) Category (See categories listed at the top of this schedule)
OF
EXPENDITURE
9 Complete .Q.tiL.Y. if direct Candidate I Officeholder name
expenditure to benefit C/OH
Date Business name
Amount ($) Business address; City; State;
PURPOSE Category (See categories listed at the top of Ihis schedule)
OF
EXPENDITURE
Complete ONLY if direct Candidate / Officeholder name
expenditure to benefit C/OH
Date Business name
Amount ($) Business address; City; State;
-----
PURPOSE Category (See categories lisled al the lap of Ihis schedule)
OF
EXPENDITURE
Complete .Q.tibY: if direct Candidate I Officeholder name
expenditure to benefit C/OH
Date Business name
Amount ($) Business address; City; State;
PURPOSE Category (See categories Iisled althe top of thiS schedule)
OF
EXPENDITURE
Complete .Q.tiL.Y. if direct Candidate I Officeholder name
expenditure to benefit C/OH
Texas Ethics Commission PO Box 12070 Austin Texas 78711-2070 (512) 463-5800 (TDD 1-800-735-2989),
SCHEDULE H
SalarieslWages/Contract Labor Loan Repayment/Reimbursement
Solicitation/Fund raising Expense Transportation Equipment & Related Expense
Travel In District ContributionslDonations Made By
Travel Out Of District Candidate/Officeholder/Political Committee
Office Overhead/Rental Expense OTHER (enter a category not listed above)
The Instruction Guide explains how to complete this form.
13 ACCOUNT # (Ethics Commission Filers)
Zip Code
(b) Description (If travel outside of Texas, complete Schedule T)
Office sought Office held
Zip Code
Description (Iflravel outside of Texas, complete Schedule T)
Office sought Office held
Zip Code
.....
lJL.. L
-_._~::..,.
Description (If Iravel oulside of Texas, complele ~dule I{ ,""""",c:'.
; -
~ ,Office sought Offi.:ig,eldl
~
~
-,"",'
W )
U1
Zip Code
Description (If Iravel oUlside of Texas, complete Scheduie T)
Office sought Office held
ATTACH ADDITIONAL COPIES OF THIS SCHEDULE AS NEEDED
www.ethics.state.tx.us Revised 04/19/2013
I
Texas Ethics Commission PO Box 12070 Austin Texas 78711-2070 (512) 463-5800 (TOO 1-800-735-2989)
NON-POLITICAL EXPENDITURES Q 01/. SCHEDULE
MADE FROM POLITICAL CONTRIBUTIONS ~GI/Jl ~I
The Instruction Guide explains how to complete this form.
1 Total pages Schedule I: 2 FILER NAME 3 ACCOUNT # (Ethics Commission Filers)
I 3~ 'vI" &"--J
4 Date 5 Payee name
6 Amount ($) 7 Payee address; City; State; Zip Code
8 PURPOSE (a) Category (See instructIOns for examples of acceplable (b) Description (See instructions regarding type of information
OF categones) required.)
EXPENDITURE
Date Payee name
Amount ($) Payee address; City; State; Zip Code
PURPOSE (a) Category (See instructions for examples of acceptable (b) Description (See Instructions regarding type of information
OF categories) required.)
EXPENDITURE
Date Payee name
Amount ($) Payee address; City; State; Zip Code
PURPOSE (a) Category (See instructions for examples of acceptable (b) Description (See instructions regarding type of information
OF categories) required.)
EXPENDITURE --" -+'.
(
Date Payee name
Z --~
+ •
.x:
Amount ($) Payee address; City; State; Zip Code ::::!: ~ n ~
\D..
W
U"l
.
--,
PURPOSE (a) Category (See instructions for examples of acceptable (b) Description (See instructions regarding type of Information
OF categories) reqUIred.)
EXPENDITURE
ATTACH ADDITIONAL COPIES OF THIS SCHEDULE AS NEEDED
www.ethics.state.tx.us Revised 04/19/2013
Texas Ethics Commission PO Box 12070 Austin Texas 78711-2070 (512) 463-5800 (TOO 1-800-735-2989)
2
4
INTEREST EARNED, OTHER CREDITS/GAINS/
SCHEDULE KREFUNDS, AND PURCHASE OF INVESTMENTS
1 Total pages Schedule K:The Instruction Guide explains how to complete this form.
FILER NAME 3 ACCOUNT # (Ethics Commission Filers)
3A"-fpJC f
Date 5 Name of person from whom amount ;s received 8 Amount
($)
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 Amount
($)
Address of person from whom amount is received; City; State; Zip Code
Purpose for which amount is received
Date Name of person from whom amount ;s received Amount
($)
--" .. .....
Address of person from whom amount is received: City; State: Zip Code ~
<.
E;: ~
-pz=
.r:.1
",
Purpose for which amount is received P 1f I \ --.
~ ---"'"-"
Date Name of person from whom amount is received Amo~ . ....
($
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
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)
IN-KIND CONTRIBUTION OR POLITICAL EXPENDITURE
FOR TRAVEL OUTSIDE OF TEXAS [JOIJ/,..
The Instruction Guide explains how to complete this form.
SCHEDULE T
2 FILE~ME
AvfV"Cf
4
5
D
D
6 Dates of travel
10 Means of transportation
D
D
Dates of travel
Means of transportation
0
0
Dates of travel
Means of transportation
1 Total Ill'",.Jlule T:
3 ACCOUNT # (Ethics Commission Filers)
Name of Contributor I Corporation or Labor Organization I Pledgor I Payee
Contribution I Expenditure reported on:
Schedule A Schedule B Schedule C Schedule FSchedule 0 Schedule G
Schedule H Schedule N COH-UC COH-T PAC-C PAC-E
D D D D D
D D D D D
7 Name of person(s) traveling
8 Departure city or name of departure location
9 Destination city or name of destination location
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 D Schedule B D Schedule C D Schedule 0 D Schedule F D Schedule G
Schedule H 0 Schedule N D COH-UC 0 COH-T 0 PAC-C 0 PAC-E
Name of person(s) traveling
Departure city or name of departure location
Destination city or name of destination location
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: -~ (iSchedule A 0 Schedule B D Schedule C 0 Schedule 0 D Schedule F 0 Sc~ule G __..:
-
' ......Schedule H Schedule N COH-UC COH-T PAC-C PA -.0 D 0 0 0 ,l-
Name of person(s) traveling -U
~ i.-r
Departure city or name of departure location ': W
'-cs:= -'!J
# , i
Destination city or name of destination location (Jl -..'
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 04/19/2013
Texas Ethics Commission P.O. Box 12070 Austin, Texas 78711-2070 1-800-735-2989)
CANDIDATE I OFFICEHOLDER REPORT:
DESIGNATION OF FINAL REPORT FORM C/OH -FR
1 C/OH NAME
3 SIGNATURE
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 with my candidacy. I understand that designating a
report as a final report terminates my campaign treasurer appointment. I also understand that I not accept any campaign contributions
or make any campaign expenditures without a campaign treasurer appointment on file.
1 Officeholder
4 FILER WHO IS NOT AN OFFICEHOLDER
•• Complete A & B below only if you are not an officeholder.••
A. CAMPAIGN FUNDS
Ch~OnIYone:
~ I do not have unexpended contributions or unexpended interest or income earned from political contributions.
~ D I have unexpended contributions or unexpended interest or income earned from political contributions. I understand tii't I m~y
not convert unexpended political contributions or unexpended interest or income earned on political contributions to .on
use. I also understand that I must file an annual report of unexpended contributions and that I may not retain une~nded
contributions or unexpended interest or income earned on political contributions longer than six years after filing ftffi; final'
report. Further, I understand that I must dispose of unexpended political contributions and unexpended interest or income
earned on political contributions in accordance with the requirements of Election Code, § 254.204.
B. ASSETS
Che~nlYone:
~ 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 from political contributions. I understand that
I may not convert assets purchased with political contributions or interest or other income from political contributions to personal
use. I also understand that I must dispose of assets purchased with political contri sin ac ance with the requirements
of Election Code, § 254.204.
5 OFFICEHOLDER
•• Complete this section only if you are an officeholder ••
o 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.slate.tx.us Revised 04/19/2013
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Texas Ethics Commission PO Box 12070 (512)4635800 Austin Texas 78711 -2070 -(TOO 1 -800-735 2989)
IN-KIND CONTRIBUTION OR POLITICAL EXPENDITURE SCHEDULE TFOR TRAVEL OUTSIDE OF TEXAS lJOJJJ_
The Instruction Guide explains how to complete this form. 1 Total ...4tule T:
2 FILE~ME
Ity~/
3 ACCOUNT # (Ethics Commission Filers)
4 Name of Contributor 1 Corporation or Labor Organization 1 Pledgor 1 Payee
5 Contribution 1 Expenditure reported on:
D Schedule A D Schedule B
D Schedule H D Schedule N
D
D
Schedule C
COH-UC
D
D
Schedule D
COH-T
D
D
Schedule F
PAC-C
D
D
Schedule G
PAC-E
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
6 Dates of travel
11 Purpose of travel (including name of conference, seminar, or other event)
Name of Contributor 1 Corporation or Labor Organization 1 Pledgor 1 Payee
Contribution 1 Expenditure reported on:
D Schedule A D
D Schedule H D
Schedule B
Schedule N
D
D
Schedule C
COH-UC
D
D
Schedule D
COH-T
D
D
Schedule F
PAC-C
D
D
Schedule G
PAC-E
Name of person(s) traveling
Departure city or name of departure location
Destination city or name of destination location
Means of transportation
Dates of travel
Purpose of travel (including name of conference, seminar, or other event)
Name of Contributor 1 Corporation or Labor Organization 1 Pledgor 1 Payee
~ _=::.Contribution 1 Expenditure reported on: ..-
Schedule A Schedule B Schedule C Schedule D Schedule F
Schedule H Schedule N COH-T PAC-C PA~ '.:r-'=;
D D D D D D Sc ~ule c:.,~
COH-UCDD D D D D -
UName of person(s) traveling Dates of travel
~ .~'
Departure city or name of departure location " U).. =' -~,Destination city or name of destination location U1
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 04/19/2013