HomeMy WebLinkAboutDerek Baker 07152014 Texas Ethics Commission P.O.Box 12070 Austin,Texas 78711-2070 (512)463-5800 (TDD 1-800-735-2989)
CANDIDATE / OFFICEHOLDER Erna,")-e ? FORM C/OH
CAMPAIGN FINANCE REPORT COVER SHEET PG 1
1 ACCOUNT# 2 Total pages filed:
The C/OH Instruction Guide explains how to complete this form. (Ethics Commission Filers)
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3 CANDIDATE / MS/MRS/MR FIRST MI , Ai,-,..
OFFICEHOLDER •
NAME MO �•E' Date`-- =. ``\2
;
NICKNAME LAST SUFFIX IC ..
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4 CANDIDATE / ADDRESS/PO BOX; APT/SUITE#; CRY; STATE; ZIP CODE %. k •'�.
OFFICEHOLDER PA... • •
MAILING Zg�j/b,�(,���PNEAS-A�-ti�tf/— DR 'tet .�ate Ian. ;`•• .ap y--,,AN is
ADDRESS /14662 EV( t x 7507 D1 nnnnr<t t�.```
0 change of address 15
Receipt# Amount
5 CANDIDATE/ AREA CODE PHONE NUMBER EXTENSION
OFFICEHOLDER ( Z(4) SII 4
` -b 4 Date Processed
PHO
6 CAMPAIGN MS/MRS/MR FIRST MI Date Imaged
TREASURER 7] 0),
l
NAME / �
NICKNAME LAST SUFFIX
7 CAMPAIGN STREET ADDRESS(NO PO BOX PLEASE); APT/SURE#, CITY; STATE; ZIP CODE
TREASURER
ADDRESS
(residence or business) •
8 CAMPAIGN AREA CODE PHONE NUMBER EXTENSION
TREASURER ~
PHONE
C.'
.3,„, -a-^.ax
9 REPORT TYPE
0 January 15 I I 30th day before election I I Runoff I I 15th day after campaigy
treasurer appointment
( holderonly)
IJ{I July 15 I I 8th day before election I I Exceeded$500 n Final report(Attach C/OH—FR) -
�\ limit
10 PERIOD Month Day Year Month Year
Day
COVERED I / ( /Zo(4- THROUGH / /70 /Z0 14
11 ELECTION ELECTION DATE ELECTION TYPE
Month Day Year I I Primary I I Runoff n Genes n Speaal
/ /
12 OFFICE OFFICE HELD(Navy) 13 OFFICE souGHT(dlmown)
WA Nle
GO TO PAGE 2
www.ethics.state.tx.us Revised 04/19/2013
Texas Ethics Commission P.O.Box 12070 Austin,Texas 78711-2070 (512)463-5800 (TDD 1-800-735-2989)
CANDIDATE / OFFICEHOLDER REPORT: FORM C/OH
SUPPORT & TOTALS - Q, \-2 COVER SHEET PG 2
14 C/OH NAME 15 ACCOUNT# (Ethics Commission Filers)
16 NOTICE FROM THIS BOX S FOR NOTICE OF POLITICAL CONIRIBUnoss ACCEPTED OR POLITICAL EXPENDITURES MADE BY POLTCAL COMMITTEES TO SUPPORT THE
POLITICAL CANDIDATE/OFFICEHOLDER. THESE EXPENDITURES MAY HAVE BEEN MADE WITHOUT THE CANDIDATE'S OR OFFICEHOLDERS KNOWLEDGE OR
COMMITTEE(S) CONSENT.CANDIDATES AND OFFICEHOLDERS ARE REOURED TO REPORT THIS INFORMATION ONLY F THEY RECEIVE NOTICE OF SUCH EXPENDITURES.
COMMITTEE NAME
COMMITTEE TYPE
n GENERAL
COMMITTEE ADDRESS
SPECIFIC
COMMITTEE CAMPAIGN TREASURER NAME
n additional pages
4_
COMMITTEE CAMPAIGN TREASURER ADDRESS C. T
17 CONTRIBUTION 1. TOTAL POLITICAL CONTRIBUTIONS OF$50 OR LESS(OTHER THAN
TOTALS PLEDGES,LOANS,OR GUARANTEES OF LOANS),UNLESS ITEMIZED s$
2. TOTAL POLITICAL CONTRIBUTIONS LJ
(OTHER THAN PLEDGES,LOANS,OR GUARANTEES OF LOANS)
N
EXPENDITURE
TOTALS 3. TOTAL POLITICAL EXPENDITURES OF$100 OR LESS,UNLESS ITEMIZED $
4. TOTAL POLITICAL EXPENDITURES $ Z-( V,?7
CONTRIBUTION 5. TOTAL POLITICAL CONTRIBUTIONS MAINTAINED AS OF THE LAST DAY //}. f�Q
BALANCE OF REPORTING PERIOD
C7t/ i�(->
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 correct and includes all info i-tion required to be reported by
me under Title 15,Election Code.
/ /
Signature of Candidate or Officeholder
AFFIX NOTARY STAMP I SEAL ABOVE
Sworn to and subscribed before me, by the said , this the.
day of , 20 , to certify which, witness my hand and seal of office.
Signature of officer administering oath Printed name of officer administering oath Title of officer administering oath
www.ethics.state.tx.us Revised 04/19/2013
Texas Ethics Commission P.O.Box 12070 Austin,Texas 78711-2070 (512)463-5800 (TDD 1-800-735-2989)
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POLITICAL EXPENDITURES \\ SCHEDULE F
EXPENDITURE CATEGORIES FOR BOX 8(a)
Advertising Expense Gift/Awards/Memorials Expense Salaries/Wages/Contract Labor Loan Repayment/Reimbursement
Accounting/Banking Legal Services Solicitation/Fundraising Expense Transportation Equipment&Related Expense
Consulting Expense Food/Beverage Expense Travel In District Contributions/Donations 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
edule F: 2 FILER NAMEt' 5� 3 ACCOUNT#(Ethics Commission Filers)
4 Date / 5 Payee name
f� tAC_Et3Oot<
6 Amount ($) 7 Payee address; City; State; Zip Code
wwrn/FActr3GaK.c (6i �c �a
nor ' 1C Zs-
8 PURPOSE (a)Category (SeeSecatteegg�o'rieessllisted
rat the top of this schedule) (b) Description (If travel outside/offTTexas,,�coompleteeSScchedule T)
OF
EXPENDITURE �APVER.s 6 f At'c / "`SMG
9 Complete ONLY if direct Candidate/Officeholder name Office sought Office held
expenditure to benefit C/OH
Date 171 / I Payee name -�
Amount ($) Payee address; City; State; Zip Code
Of61
1.816 —rxNA/
r2t
A^e-Kt WEYt -fx 7567o
PURPOSE Category(See
categories slisted at the top of this schedule) Description�on((if traveltr� outside of Texas,complete Schedule T)
OF
EXPENDITURE G'L µ'`ms 5 v P tr '/� C !Z ZE SU/P/Ly
Complete ONLY if direct Candidate/Officeholder name Office sought Office held
expenditure to benefit C/OH
Date Payee name
Amount ($) Payee address; City; State; Zip Code
PURPOSE Category(See categories listed at the top of this schedule) Description (If travel outside of Texas,complete Sche T) w�A
OF
EXPENDITURE
Complete ONLY if direct Candidate/Officeholder name Office sought Office pgid
expenditure to benefit C/OH fir
Date Payee name C2rJ -n
f\]
Amount ($) Payee address; City; State; Zip Code
PURPOSE Category(See categories listed at the top of this schedule) Description (If travel outside of Texas,complete Schedule T)
OF
EXPENDITURE
Complete ONLY if direct Candidate 1 Officeholder name Office sought Office held
expenditure to benefit C/OH
ATTACH ADDITIONAL COPIES OF THIS SCHEDULE AS NEEDED
www.ethics.state.tx.us Revised 04/19/2013