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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: '7,. .. LV .....~-;...~,\7." DateffL' Il"~""" ~ .' ... ~: ~§/..... \~~ ".~;*\ ;Q,f*=%&,.. . ~ij ~~~..................... .# 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 "'­...../2/j ""I ./ /'..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 ........ :I: ~ I~"­ I­Z .... I-"'--j~ x-r:::It If ..\D CI"'" w .c­~, 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 \ l ,~ ·. 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