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CANDIDATE / OFFICEHOLDER FORM C/OH
CAMPAIGN FINANCE REPORT COVER SHEET PG 1
1 Filer ID (Ethics Commission Filers) 2 Total pages filed:
The C/OH Instruction Guide explains how to complete this form.
3 CANDIDATE/ MS/MRS/MR FIRST MI
• OFFICEHOLDER 1111e/)
I Q^ L OFFICE USE ONLY
NAME 11 C./' . Date ReCeir'9 +„r�"��4,,
NICKNAME LAST SUFFIX ``���� ........... ,...
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GJ r114 --
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4 CANDIDATE/ ADDRESS /PO BOX; APT/SUITE#; CITY; STATE; ZIP CODE s r'
OFFICEHOLDER `/ ti,2 i' \�"
MAILING q O d C .,. A41/A T> 75� `:�
ADDRESS ��1 �.�C���W 't.- :,.. r;g��
n Change of Address --��i� •��`
5 CANDIDATE/ AREA CODE PHONE NUMBER EXTENSION ,'''--��� pt ����``````
OFFICEHOLDER n_ Date and-delivers or Date -• rked
PHONE � yo3 ) Z2- - ys
6 CAMPAIGN MS/MRS/MR FIRST MI Receipt# Amount$
TREASURER µa Ll,,
NAME Date Processed -2 ,)
NICKNAME LAST SUFFIX .Z (�
/�/� ��0 Date Imaged
/� _ a2--11
7 CAMPAIGN STREET ADDRESS (NO PO BOX PLEASE); APT/SUITE#; CITY; STATE; ZIP CODE
TREASURER /
ADDRESS C,1 ^I V: jO ) /'/Lde.nn5 TY —7.S M 7 G
(Residence or Business)
8 CAMPAIGN AREA CODE PHONE NUMBER EXTENSION
'"r1
TREASURERi ni
PHONE ( 2/' ' SIN - 7(0C-3 ,..., a-
r..
"fes-
9 REPORT TYPE
❑ January 15 ❑ 30th day before election n Runoff ❑ 15th day after ctlp)aign �xwa,
treasurer appointMent
(Officeholder Onlyj.)
❑ July 15 IA 8th day before election E Exceeded$500 limit ❑ Final Report(Attach C/OH-FR)-
10 PERIOD Month Day Year Month Day Year
COVERED
0. /3 1 /t S THROUGH 2/ aa/ ,
11 ELECTION ELECTION DATE ELECTION TYPE
Month Day Year ❑ Primary El Runoff ElOther
Description
" / / /AIb ® General ElSpecial
12 OFFICE OFFICE HELD (if any) 13 OFFICE SOUGHT (if known)
CC°14M^Ole. Po- 1 COA.S41461t, RT.
GO TO PAGE 2
Forms provided by Texas Ethics Commission www.ethics.state.tx.us Revised 9/8/2015
CANDIDATE / OFFICEHOLDER FORM C/OH
CAMPAIGN FINANCE REPORT COVER SHEET PG 2
14 C/OH NAME 15 Filer ID (Ethics Commission Filers)
Atte-7 s, tt) s //+i.,.z�
16 NOTICE FROM THIS BOX IS FOR NOTICE OF POLITICAL CONTRIBUTIONS ACCEPTED OR POLITICAL EXPENDITURES MADE BY POLITICAL COMMITTEES TO
POLITICAL SUPPORT THE CANDIDATE/OFFICEHOLDER. THESE EXPENDITURES MAY HAVE BEEN MADE WITHOUT THE CANDIDATES OR OFFICEHOLDER'S
COMMITTEE(S) KNOWLEDGE OR CONSENT. CANDIDATES AND OFFICEHOLDERS ARE REQUIRED TO REPORT THIS INFORMATION ONLY IF THEY RECEIVE NOTICE
OF SUCH EXPENDITURES.
COMMITTEE TYPE COMMITTEE NAME
❑GENERAL
COMMITTEE ADDRESS
SPECIFIC 1
4.
f-1
COMMITTEE CAMPAIGN TREASURER NAME CO •
N)
E Additional Pages J
COMMITTEE CAMPAIGN TREASURER ADDRESS
CO
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) $ f.�J , 00
EXPENDITURE 3. TOTAL POLITICAL EXPENDITURES OF $100 OR LESS,
TOTALS UNLESS ITEMIZED $
4. TOTAL POLITICAL EXPENDITURES $ /1 / I t/ 5.-5 .5.
CONTRIBUTION 5. TOTAL POLITICAL CONTRIBUTIONS MAINTAINED AS OF THE LAST DAY
BALANCE OF REPORTING PERIOD $ ?OS a
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 information required to be reported by me
of!"... DONNA GELVM under Ile 15,Electio Code.
`0 Notary Public
*I ;* •
•STATE OF TEXAS
4.Q"' My Comm.Exp.May U.20t7
•
Signature of Candidate or Officeholder
AFFIX NOTARY STAMP/SEALABOVE /
Sworn to and subscribed before me,by the said A 16. ..c/101-e- L \It co/IL( ,this the 2 2-
da
da of , ' II' • a,, ,20 I (e ,to certify which,witness my hand and seal of office.
Iiji.,
_//I�i:� ��..•/, 0b►„s4.. lelvAem l\iani)ublic Gu;4u,, y las
Signature of officer adm'nistering oath Printed name of officer administering oath Title of officer administering oath
Forms provided by Texas Ethics Commission www.ethics.state.tx.us Revised 9/8/2015
MONETARY POLITICAL CONTRIBUTIONS SCHEDULE Al
The Instruction Guide explains how to complete this form. 1 Total pages Schedule Al:
2 FILER NAME3 Filer ID (Ethics Commission Filers)
�t1� , 5. ,t f(,; s
4 Date 5 Full name of contributor ❑out-of-state PAC(ID#: ) 7 Amount of contribution ($)
400 74W
/-2 7(6 6 Contributor address; City; State; Zip Code
!d 70$ 5 ..i) f cke • r.`sco " 03
8 Principal occupation/Job title(See Instructions) g Employer(See Instructions)
(R.0 1-.4'.G9 fee
Date Full name of contributor ❑out-of-state PAC(ID#: 1 Amount of contribution ($)
(e)•` . +- lD ')e4
f_'"' Contributor address; City; State; Zip Code �0 O 0 C
Co 3 X(S% /77 ig,27 /Mk( 7r71A-7
Principal occupation/Job title(See Instructions) Employer(See Instructions)
.f•he • e.O
Date Full name of contributor ❑out-of-state PAC(ID#: ) Amount of contribution ($)
CA-flied C:).") �Z o e
-.� Contributor address; City; State; Zip Code .1 0 • 0 t
Principal occupation/Job title(See Instructions) Employer(See Instructions)
ctl !c e'er c 7��� SC/P
Date Full name of contributor ❑out-of-state PAC(ID#: ) Amount of contribution ($)
Contributor address; City; State; Zip Code
Principal occupation/Job title(See Instructions) Employer(See Instructions)
._e
w F.
ATTACH ADDITIONAL COPIES OF THIS SCHEDULE AS NEEDED
If contributor is out-of-state PAC,please see instruction guide for additional reporting requirements.
Forms provided by Texas Ethics Commission www.ethics.state.tx.us Revised 9/9/2015
•
NON-MONETARY (IN-KIND) POLITICAL
CONTRIBUTIONS SCHEDULE A2
The Instruction Guide explains how to complete this form. 1 Total pages Schedule A2:
2 FI =R NAME 3 Filer ID (Ethics Commission Filers)
S4Ne tirt ,;
•
POLITICAL EXPENDITURES MADE
FROM POLITICAL CONTRIBUTIONS SCHEDULE Fl
EXPENDITURE CATEGORIES FOR BOX 8(a)
Advertising Expense Event E
tense Loan Repayment/Reimbursement Solicitation/Fundraising Expense
Accounting/Banking Fees Office Overhead/Rental Expense Transportation Equipment&Related Expense
Consulting Expense Food/Beverage Expense Polling Expense Travel In District
Contributions/Donations Made By Gift/Awards/Memorials Expense Printing Expense Travel Out Of District
Candidate/Officeholder/Political Committee Legal Services Salaries/Wages/Contract Labor Other(enter a category not listed above)
Credit Card Payment
The Instruction Guide explains how to complete this form.
1 Total pages Schedule Fl: 2 FILER NA / ' 3 Filer ID (Ethics Commission Filers)
t(ei S (�✓ l�. 4� S
4 Date r 5 Payee name
- I(o �•r Sf la!' P Vi .t C St^/c tG 6
6 Amount ($) 7 Payee address; City; State; Zip Code
o 2 ej CA-rao-7 -7sa rld
8 (a)Category (See Categories listed at the top of this schedule) (b) Description
PURPOSE ElCheck if travel outside of Texas.Complete Schedule T.
OF ( (n ❑Check if Austin,TX,officeholder living expense
c
EXPENDITURE 46 0e,/ -,
9 Complete ONLY if direct Candidate/Officeholder name Office sought Office held
expenditure to benefit C/OH
Date Payee name
2— IG N►n co Pr:nr-.`Al
Amount ($) Payee address; City; State; Zip Code
.`��400c.
3 1 S S . j�ti ti,'s St . 5A ee,A-7�.�,7� 75— o go
Category (See Categories listed at the top of this schedule) Description
PURPOSE ❑Check iftravel outside of Texas.Complete Schedule T.
OF ❑Check if Austin,TX,officeholder living expense
EXPENDITURE / •\ +`�,(n.)
Complete ONLY if direct Candidate/Officeholder name Office sought Office held
expenditure to benefit C/OH
Date Payee name ca
2 17-16 60 4 S.t '
1 Ns riloee_
Amount ($) Payee address; City; State; Zip Code
c .2 1 t 11 7. A) • P ewe II ekc.).) 4n4 'LS e5
Category (See Categories listed at the top of this schedule) Description C+�
PURPOSE ❑Check if travel outside of Texas.Complete Schedule T.
OF ,/ ( ❑Check if Austin,TX,officeholder living expense
EXPENDITURE AD V �-� .},n
Complete ONLY if direct Candidate/Officeholder name Office sought Office held
expenditure to benefit C/OH
ATTACH ADDITIONAL COPIES OF THIS SCHEDULE AS NEEDED
Forms provided by Texas Ethics Commission www.ethics.state.tx.us Revised 9/8/2015
POLITICAL EXPENDITURES MADE
FROM POLITICAL CONTRIBUTIONS SCHEDULE F7
EXPENDITURE CATEGORIES FOR BOX 8(a)
Advertising Expense Event Expense Loan Repayment/Reimbursement Solicitation/Fundraising Expense
Accounting/Banking Fees Office Overhead/Rental Expense Transportation Equipment&Related Expense
Consulting Expense Food/Beverage Expense Polling Expense Travel In District
Contributions/Donations Made By Gift/Awards/Memorials Expense Printing Expense Travel Out Of District
Candidate/Officeholder/Political Committee Legal Services Salaries/Wages/Contract Labor Otherenter a category not listed above)
Credit Card Payment (
The Instruction Guide explains how to complete this form.
1 Total pages Schedule Fl: 2 FILER
4N E ( 3 Filer ID (Ethics Commission Filers)
� � e.�. S ' G.�, /� 1
4 Date 5 Payee name
l- 02C, O Rei'llS /9,f� "A -
6 Amount ($) 7 Payee address; 'city; State; Zip Code
027 'lo ,C•'» `f&-s— #49--7/,.4 T 75-50 9
8 (a)Category (See Categories listed at the top of this schedule) (b)Description
PURPOSE ❑Check if travel outside of Texas.Complete Schedule T.
OF1 ` ( CICheck if Austin,TX,officeholder living expense
EXPENDITURE AO�'T ' j�n cj ,v
r;re S
9 Complete ONLY if direct Candidate/Officeholder name Office sought Office held
expenditure to benefit C/OH
Date Payee name
2- 1 7-/6 $4e ie 6 I t,'n/
Amount ($) Payee address; City; State; Zip Code
/00 .t0 30c ,O . C/��v/`C,'l S - 13/(9 se_
Category (See Categories listed at the top of this schedule) Description
PURPOSE CICheckif travel outside of Texas.Complete Schedule T.
OF ` ElCheck if Austin,TX,officeholder living expense
EXPENDITURE lPoItJ,v_s ^L cC1 /,
Complete ONLY if direct Candidate/Officeholder name * Office sought Office held
expenditure to benefit C/OH
Date Payee name t
Fri
/^2I— I(3 :3 tge �e'Z
Amount ($) Payee address; City; State; Zip Code r
/ -p E;
Category (See Categories listed at the top of this schedule) Description
PURPOSE IT Check if travel outside of Texas.Complete Schedule*—
OF ❑Check if Austin,TX,officeholder living expense
EXPENDITURE LVe41 r+i(f-Arse
L W �icot AT, 1)14 4 cot,
Complete ONLY if direct Candidate/Officeholder name Office sought Office held
expenditure to benefit C/OH
ATTACH ADDITIONAL COPIES OF THIS SCHEDULE AS NEEDED
Forms provided by Texas Ethics Commission www.ethics.state.tx.us Revised 9/8/2015