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Texas Ethics Canmission P.O Box 12070 Austin, Texas 78711-2070 (512)463-5800 1-800-325-8500
FORM COR-CtOH
CORRECTION AFFIDAVIT
FOR CANDIDATE/OFFICEHOLDE ORIGINAL
1 ACCOUNT# 2 Total pages filed:
3 CANDIDATE I MS/MRS M MI
OFFICEHOLDER
NAME
NICKNAME SUFFIX
EXPLANATION OF CORRECTION
AFFIDAVIT I swear, or affirm, under penalty of perjury, that this·Corre,c
report is true and correct. ~ ,-
DEBOaAH JOY PINA
NoWYPublic:
STATE OF TEXAS
My ee-. _ "..,.11.1016
Check ONLY if applicable:
D I swear, or affirm, that I am filing this corrected report not
later than the 14th business day after the date I learned
that the report a or" ina y file is' ccurate or incomplete.
I swear, or Ir t y err, r . mission in the report as
originally fi ed in faith.
AFFIX NOTARY STAMP I SEAL ABOVE
Sworn to a~d subscribed before me by ~ei-fL ~Jf this the ~day of Cf~J'
·tness my hand and seal of office.
4 ORIGINAL
REPORT
TYPE
1-T'""""
5 ORIGINAL
PERIOD
COVERED
D Janual)' 15 D Runoff D Other (specify)
[B'J"uly 15 D Exceeded $500 Iim~
D 30th day before election D 15th day after treasurer
appointment (officeholder only) Legal Totals
D 8th day before election D Final report
-t---1Date Processed
Month Day Year Month Day Year J-1'0' I~
Date Imaged C' 1/8/ ,/(}.OJLj THROUGH J~/..30 /0011' I . I
Printed name of officer administering oath
Remember To Attach Any Part Of The Campaign Finance Report Form
Needed To Report And Explain Corrections
Re .15e 0 r01 (20o-~
subscribed before
Texas EthicS Commission P.O. Box 12070 Austin, Texas 78711-2070 (512) 463-5800 (TDD 1-800-735-2!?89)
CANDIDATE I OFFICEHOLDER REPORT: FORM C/OH
SUPPORT & TOTALS COVER SHEET PG 2
COMMITTEE NAME
COMMITTEE TYPE
o GENERAL
o SPECIFIC
o additional pages
17 CONTRIBUTION 1.
TOTALS
2. TOTAL POLITICAL CONTRIBUTIONS
(OTHER THAN PLEDGES, LOANS, OR GUARANTEES OF LOANS) $.~
EXPENDITURE
TOTALS 3. TOTAL POLITICAL EXPENDITURES OF $100 OR LESS, UNLESS ITEMIZED
4. TOTAL POLITICAL EXPENDITURES
CONTRIBUTION 5. TOTAL POLITICAL CONTRIBUTIONS MAINTAINED AS OF THE LAST DAY BALANCE OF REPORTING PERIOD :f bj1/~w
f-------------------------------t-- ----I
OUTSTANDING 6. TOTAL PRINCIPAL AMOUNT OF ALL OUTSTANDING LOANS AS OF THE $LOAN TOTALS LAST DAY OF THE REPORTING PERIOD
18 AFFIDAVIT
TOTAL POLITICAL CONTRIBUTIONS OF $50 OR LESS (OTHER THAN
PLEDGES, LOANS, OR GUARANTEES OF LOANS), UNLESS ITEMIZED $
DEBORAH JOY PINA
NOlBfY Public:
STAlE Of TEXAS
My eama ElqJ. ~11.1016
AFFIX NOTARY STAMP I SEAL ABOVE
by the said ,this theL¥J"+L ,5e 1£
IS-to certify which, witness my hand and seal of office.~~pQ..'9""-"t'-'\-' 20 --'---=-
14 CIOH NAME
16 NOTICE FROM
POLITICAL
COMMITTEE(S)
15 ACCOUNT # (Ethics Commission Filers) 71/6err
THIS BOX 18 FOR NOlICE OF POLI1lCAL CONlRJIlU1lONS ACCEPTED OR POUl1CAL EXPENDlTIJRES MAllE BY POLmCAL COMMITTEES 10 SUPPORT THE
CANDIDATE I OFFICEHOLDER. THESE EXPENDITURES MAY HAVE BEEN MADE WfTHOUT THE CANDIDATE'S DR OFRCEHOLDER'S KNOWLEDGE OR
CONSEKT. CANDIDATES AKJ OFFlCeiOLDERS ARE REQUIRED 10 REPORT THIS INFORMAllON ONlY IF THEY RECEIVE NOTICE OF SUCH E~IJIlURES.
Revised 09/28/2011www.elhics.slale.lx.us