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HomeMy WebLinkAboutCheryl Williams 07152016 r.. • y • CANDIDATE / OFFICEHOLDER • FORM C/OH CAMPAIGN FINANCE REPORT U ORIGINAL 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. c' I 3 CANDIDATE/ MS/Q MR FIRST MI .� Pt OFFICE USE ONLY OFFICEHOLDER NAME CiAE 1 . Date Rec$61%stp,,:r,,,,. NICKNAME LAST SUFFIX ‘‘%‘,% 4 CANDIDATE/ ADDRESS /PO BOX; APT/SUITE#; CITY; STATE; ZIP CODE - \/ rt '� OFFICEHOLDER r— ThP �.��•� Q 0 _ ...dr '�., .� MAILING Z�Q ADDRESS • n Change of Address l� t it I 7S0 1p ; ..- ''�. ,.... ,... � ibi OS 5 CANDIDATE/ AREA CODE PHONE NUMBER EXTENSION ��� r,? OFFICEHOLDER4) -/ Date 'and-deny- eor o ePostmarked PHONE CO / , , ....../ w.. 6 CAMPAIGN MS/MRS/MR FIRST MI Receipt# Amount$ TREASURER ''11'f__-- NAME a-2NI L- 1Date Processed 7 _ /z_,(6) NICKNAME LAST SUFFIX .\4Date Imaged I L- -4 AMS ed I LsI l( e 7 CAMPAIGN STREET ADDRESS (NO PO BOX PLEASE); APT/SUITE 5; CITY; STATE; ZIP CODE TREASURER ADDRESS (Residence or Business) 4- 8 CAMPAIGN AREA CODE PHONE NUMBER EXTENSION TREASURER PHONE SM k5 5- 9 REPORT TYPE I I January 15 I I 30th day before election I I Runoff I I 15th day after campaign treasurer appointment (Officeholder Only) July 15 I I 8th day before election n Exceeded$500 limit n Final Report(Attach C/OH-FR) 10 PERIOD Month Day Year Month DayrYear COVERED i / j // J C _ / THROUGH �/ /go /.,1 Lo 11 ELECTION ELECTION DATE � ELECTION TYPE C;y Month Day Year El Primary El Runoff [1 Other r Description / / El General n Special ---...- '..-1 t 12 OFFICE OFFICE HELD (if any) nn 13 OFFICE SOUGHT (if known) CO�1 Al COJN -'-' d I SSI O +. L GO TO PAGE 2 Forms provided by Texas Ethics Commission www.ethics.state.tx.us Revised 9/8/2015 CANDIDATE / OFFICEHOLDER D ORIGINAL FORM C/OH CAMPAIGN FINANCE REPORT COVER SHEET PG 2 14 C/OH NAME/�� _ ( + 15 Filer ID (Ethics Commission Filers) UtE-Zi L�, AJ t LA_1 A1& 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 CANDIDATE'S OR OFFICEHOLDER'S COMMITTEE(S) KNOWL EDGE 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 .._a C.13 COMMITTEE CAMPAIGN TREASURER NAME Additional Pages COMMITTEE CAMPAIGN TREASURER ADDRESS -`I C cr3 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 T (OTHER THAN PLEDGES, LOANS, OR GUARANTEES OF LOANS) $ 500cia v TOTALS(TURF 3. TOTAL POLITICAL EXPENDITURES OF$100 OR LESS, $ UNLESS ITEMIZED ZO1,77 4. TOTAL POLITICAL EXPENDITURES $ Z-5-87. -5' (�7, •7 7 CONTRIBUTION 5. TOTAL POLITICAL CONTRIBUTIONS MAINTAINED AS OF THE LAST DAY BALANCE OF REPORTING PERIOD �$V�1L3f 7o$ 3o OUTSTANDING 6. TOTAL PRINCIPAL AMOUNT OF ALL OUTSTANDING LOANS AS OF THE LOAN TOTALS LAST DAY OF THE REPORTING PERIOD $ 010 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 0,114i�.k. DEBORA/I JOY PIMA under T'I e 15,Election Mode. w�• t Notary Poles 1 / _/- 44 .4 • STATE OF TEXAS 'r Adr or MyOmw.b Awn 18.2016 —"— ignature of Candidate or Officeholder AFFIX NOTARY STAMP/SEALABOVE I ,1 Sworn to/ap)d subscribed before me,by the said l v( / !moi glii,--,,, ,this the /i ,i day of C (.t../ ,20J ,"to ertify which,witness v sand and seal of office. I 7 . �; 1 /^ ! J / t T nature of officer adm97. 1 oath Printed name of officer administering oath Title o officer dministering oath Forms provided by Texas Ethics-Commission cs�ommisslon www. thi cs state.tx.us Revised 9/8/2015 SUBTOTALS - C/OH J Uj. �VlNAL FORM C/OH COVER SHEET PG 3 19 FILER NAME , I 20 Filer ID(Ethics Commission Filers) G2'� L . lr�,l I L L_1 A—As'l 21 SCHEDULE SUBTOTALS SUBTOTAL NAME OF SCHEDULE AMOUNT 1. A SCHEDULE Al: MONETARY POLITICAL CONTRIBUTIONS $ 5on, ' 2. SCHEDULE A2: NON-MONETARY(IN-KIND)POLITICAL CONTRIBUTIONS $ 3• I I SCHEDULE B: PLEDGED CONTRIBUTIONS• $ 4. 11 SCHEDULE E: LOANS $100 Qv c� 5. SCHEDULE F1: POLITICAL EXPENDITURES MADE FROM POLITICAL CONTRIBUTIONS $ SEC,� 6. n SCHEDULE F2: UNPAID INCURRED OBLIGATIONS $ 7. SCHEDULE F3: PURCHASE OF INVESTMENTS MADE FROM POLITICAL CONTRIBUTIONS $ 8. SCHEDULE F4: EXPENDITURES MADE BY CREDIT CARD $ 9. SCHEDULE G: POLITICAL EXPENDITURES MADE FROM PERSONAL FUNDS $ 10. SCHEDULE H: PAYMENT MADE FROM POLITICAL CONTRIBUTIONS TO A BUSINESS OF C/OH $ 11. SCHEDULE I: NON-POLITICAL EXPENDITURES MADE FROM POLITICAL CONTRIBUTIONS $ 12. I I SCHEDULE K: INTEREST,CREDITS, GAINS, REFUNDS,AND CONTRIBUTIONS $ RETURNED TO FILER _rl c.rt h c.D 4y. Forms provided by Texas Ethics Commission www.ethics.state.tx.us Revised 9/8/2015 D ORIGINAL MONETARY POLITICAL CONTRIBUTIONS SCHEDULE Al The Instruction Guide explains how to complete this form. 1 Total pages Schedule Al: 2 FILER NAME 3 Filer ID (Ethics Commission Filers) C 1 1:1::› VI a % /-AA S 4 Date 5 Full name of contributor 0 out-of-state PAC(ID#: ) 7 Amount of contribution ($) / � COL- -1- 1+1 COO NI o (o 6 Contributor address; City; State; Zip Code 500 8P0 g41 to r#.c 1A.1 .-4- IOc) M=- ( 4444 El Jr C.. 7S of 0 8 Principal occupation/Job title(See Instructions) 9 Employer(See Instructions) Date Full name of contributor 0 out-of-state PAC(ID#: ) Amount of contribution ($) Contributor address; City; State; Zip Code Principal occupation/Job title(See Instructions) Employer(See Instructions) Date Full name of contributor ❑out-of-state PAC(ID#: ) Amount of contribution ($) Contributor address; City; State; Zip Code Principal occupation/Job title (See Instructions) Employer (See Instructions) Date Full name of contributor ❑out-of-state PAC(ID#: ) Amount of contribution ($) Contributor address; City; State; Zip Code Principal occupation/Job title(See Instructions) Employer(See Instructions) y,. C_r) = 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 9/8/2015 DORIGINAL NON—MONETARY (IN—KIND) POLITICAL CONTRIBUTIONS - SCHEDULE A2 The Instruction Guide explains how to complete this form. 1 Total pages Schedule A2: 2 FILER NAME 3 Filer ID (Ethics Commission Filers) 4 TOTAL OF UNITEMIZED IN-KIND POLITICAL CONTRIBUTIONS $ 5 Date 6 Full name of contributor ❑out-of-state PAC(ID#: ) 8 Amount of g In-kind contribution Contribution $ description 7 Contributor address; City; State; Zip Code Check if travel outside of Texas.Complete Schedule T. 10 Principal occupation/Job title(FOR NON-JUDICIAL)(See Instructions) 11 Employer (FOR NON-JUDICIAL)(See Instructions) 12 Contributor's principal occupation (FOR JUDICIAL) 13 Contributor's job title(FOR JUDICIAL)(See Instructions) 14 Contributor's employer/law firm(FOR JUDICIAL) 15 Law firm of contributor's spouse(if any) (FOR JUDICIAL) 16 If contributor is a child,law firm of parent(s)(if any)(FOR JUDICIAL) Date Full name of contributor 0 out-of-state PAC(ID#: ) Amount of In-kind contribution Contribution $ . description Contributor address; City; State; Zip Code Check if travel outside of Texas.Complete Schedule T. Principal occupation/Job title(FOR NON-JUDICIAL)(See Instructions) Employer (FOR NON-JUDICIAL)(See Instructions) Contributor's principal occupation(FOR JUDICIAL) Contributor's job title(FOR JUDICIAL)(See Instructions) Contributor's employer/law firm(FOR JUDICIAL) Law firm of contributor's spouse(if any) (FOR JUDICIAL) If contributor is a child,law firm of parent(s)(if any)(FOR JUDICIAL) _;? a Ctl C7 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 9/8/2015 ORIGINAL PLEDGED CONTRIBUTIONS SCHEDULE B 1 Total pages Schedule B: The Instruction Guide explains how to complete this form. 2 FILER NAME 3 Filer ID (Ethics Commission Filers) 4 TOTAL OF UNITEMIZED PLEDGES • • $ 5 Date 6 Full name of pledgor ❑out-of-state PAC(ID#: ) 8 Amount . 9 In-kind contribution of Pledge$ description 7 Pledgor address; City; State; Zip Code ICheck if travel outside of Texas.Complete Schedule T. 10 Principal occupation/Job title(See Instructions) 11 Employer(See Instructions) Date Full name of pledgor ❑out-of-state PAC(ID#: I Amount • In-kind contribution led or of Pledge$ • description Pledgor address; City; State; Zip Code • nCheck if travel outside of Texas.Complete Schedule T. Principal occupation/Job title(See Instructions) Employer (See Instructions) Date Full name of pledgor El out-of-state PAC(ID#: I Amount of In-kind contribution Pledge$ description Pledgor address; City; State; Zip Code Check if travel outside of Texas.Complete Schedule T. Principal occupation/Job title(See Instructions) Employer (See Instructions) Date Full name of pledgor ❑out-of-state PAC(ID*: ) Amount of In-kind contribution Pledge$ description Pledgor address; City; State; Zip Code I I Check if travel outside of Texas.Complete Schedule T. Principal occupation/Job title(See Instructions) Employer (See Instructions) rf t"1 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 9/8/2015 • LOANS i314i6iNAL SCHEDULE E The Instruction Guide explains how to complete this form. 1 Total pages Schedule E: 2 FILER NAME 3 Filer ID (Ethics Commission Filers) ` 4 TOTAL OF UNITEMIZED LOANS• $ 4 / © O Q . ' 5 Date of loan 7 Name of lender ❑out-of-state PAC(IDB:_ ) �9 Loan Amount($) 119/3°1 CO) s At I1wj v.s �c�oaODD.. 6 Is lender10 Interest rate 8 Lender address; City; State; Zip Code a financial 5`)f, Institution? f� LD / g - Y ���7� 11 Maturity date S , t)( 7S-012)-5 L 0 Z" 12 Principal occupation /Job title (See Instructions) 13 Employer (See Instructions) 'a—AL ass; IPJ 4 ro 14 Description of Collateral 15 Check if personal funds were deposited into political account (See Instructions) cg none ❑ 16 GUARANTOR 17 Name of guarantor 19 Amount Guaranteed($) INFORMATION 18 Guarantor address; City; State; Zip Code X not applicable 20 Principal Occupation (See Instructions) 21 Employer (See Instructions) Date of loan Name of lender )J out-of-state PAC(IDB: ) Loan Amount($) Is lender Lender address; City; State; Zip Code Interest rate a financial Institution? Maturity date Y N Principal occupation /Job title (See Instructions) Employer (See Instructions) Description of Collateral Check if personal funds were deposited into political account (See Instructions) ❑ none ❑ GUARANTOR Name of guarantor Amount Guaranteed($) cs r INFORMATION Guarantor address; City; State; Zip Code ❑ not applicable Principal Occupation (See Instructions) Employer (See Instructions) c_n •7 ATTACH ADDITIONAL COPIES OF THIS SCHEDULE AS NEEDED If lender 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 9/8/2015 Di-- ORIGINAL POLITICAL EXPENDITURES MADE FROM POLITICAL CONTRIBUTIONS SCHEDULE Fl 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 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 NAME 3 Filer ID (Ethics Commission Filers) CSE «t.0M f, 4 Dap5 Payee name / Z'7 //Co --PCrl_.4JVCD i e--__ o- AA (- 6 Amount ($) 7 Payee address; City; State; Zip Code 11 1 S." -Fc /Zc9® G G . IS. .T -PLo, .7yc 7s-07 4- 8 (a) Category (See Categories listed at the top of this schedule) (b) Description PURPOSE 1-1 Check if travel outside of Texas.Complete Schedule T. OFI I Check if Austin,TX,officeholder living expense EXPENDITURE U 9 Complete ONLY if direct Candidate/Officeholder name Office sought Office held expenditure to benefit C/OH Date Payee name WOM '/f /�a 72 A•ij 0 �C 4 Amount ($) Payee address; State; Zip Code set Category (See Categories li d t at the top of this schedule) Description I PURPOSE I Check if travel outside of Texas.Complete Schedule T. OF I I Check if Austin,TX,officeholder living expense EXPENDITURE 5p,„,...12-..., 4s r Complete ONLY if direct Candidate/Officeholder name Office sought Office held expenditure to benefit C/OH Date Payee name iii ti i„, a,.....,_.N.1 cuJ 6--- 0 , P Amount ($) Payee address; City;�; Zip Code •,...-.1 SNki 1 t, Category (See Categories listed at the top of this schedule) Description .k PURPOSE I I Check if travel outside of Texas.Complete Schedule T. -� -a OF I I Check if Austin,TX,officeholder living expense -'� EXPENDITURE .S.S?`- t..15 J 2...S4‘ r_rt sl Complete ONLY if direct Candidate/Officeholder name Office sought Office held expenditure to benefit C/OH ATTACH ADDITIONAL COPIES OF THIS SCHEDULE AS NEEDED Forms provided by Texas Ethics Commission www.ethics.state.tx.us Revised 9/8/2015 D ORIGINAL POLITICAL EXPENDITURES MADE FROM POLITICAL CONTRIBUTIONS SCHEDULE F1 EXPENDITURE CATEGORIES FOR BOX 8(a) Advertising Expense Event Expense Loan Repayment/Relmbursement Solicitation/Fundraising Expense Accounting/Banking Fees Office Overhead/Rental Expense Transportation Equipent&Related Expense Consulting Expense Food/Beverage Expense Polling Expense Travel In District Contributions/Donations Made By Gift/Awards/Memorials Expense Printing Expense Travel Out Of.District Candidate/Officeholder/Political Committee Legal Services Salaries//ages/Contract Labor Other(enter a category not listed above) Credit Card Payment The instruction Guide explains how to complete this form. 1 Total pages Schedule Fl: 2 FILER NAME 3 Filer ID (Ethics Commission Filers) 4 Date 5 Payee name /..A i.1 / QA ô- - M i....2c22' 6 Amount ($) 7 Payee address; City; State; Zip Code 41 �r �_ 0 ." 3S(n LA\J 1 --tic., -7s1 tato 8 (a)Category (See Categories listed at the top of this schedule) (b) )Description PURPOSE IT Check if travel outside of Texas.Complete Schedule T. OF \ ( I Check If Austin,TX,officeholder living expense EXPENDITURE Il`r1 9 Complete ONLY if direct Candidate/Officeholder name Office sought Office held expenditure to benefit C/OH Date II Payee name (o'I V ( t IL I�= CkOrAit a��2 C MMC -- Amount ($) Payee address; City; State; Zip Code 3 ��?.L'4) SO--- 7 t� �prl.L-.�� 44a--I . Category (See Categories listed at the top of this schedule) Description PURPOSE 1 I Check if travel outside of Texas.Complete Schedule T. OF �� 1 i Check if Austin,TX,officeholder living expense EXPENDITURE (/J Complete ONLY if direct Candidate/Officeholder name Office sought Office held expenditure to benefit C/OH Date Payee name 4/, (( 9 ..n.I.‘11.i-c�Z�(�4 roil _ 3��t Cc-0 _o Amount ($)k Payee address; City; State; Zip Code 1 40 1 . M- I<c ideci cam( I ,L :i Category (See Categories listed at the top of this schedule) Description I PURPOSE t I Check It travel outside of Texas.Complete Schedule T. 4 EXPENDITURE J 7.5 l) J Check if Austin,TX,:officeholder living expense - °=" {,rt 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 DORIGINAL POLITICAL EXPENDITURES MADE FROM POLITICAL CONTRIBUTIONS SCHEDULE Fl 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 ConsultContnbutlons/OOonanons Made Expense Food/Beverage Expense Polling Expense Travel In District BY Gift/Awards/Memorials Expense Printing Expense Travel Out Of District Candidate/Officeholder/Political Committee Legal Services ' SalariesiWages/Contract Labor Otherenter a Credit Card Payment ( category not listed above) The instruction Guide explains how to complete this form. 1 Total pages Schedule F1: 2 FILER NAME 3 Filer ID (Ethics Commission Filers) C 12_ t`1 > t Lk-+14A/15 4 Dat 5 Payee name 5/4 I I cv CD %.J Cc:),.;,J C..• 0 ."-P. 6 Amount ($) 7 Payee address; City; State; Z Code Sao. 9 4-1 co , `h . . t I..t= K41tC510 8 (a)Category (See Categories listed at the top of this schedule) (b) Description flGheGcftravel outside ofTexas.Complete Schedule T.PURPOSE OF L!N+.C..Oti^ bp'I Check if Austin,TX,officeholder living expense EXPENDITURE p 9 Complete ONLY if direct Candidate/Officeholder name Office sought Office held expenditure to benefit C/OH Date Payee name iifiji(e, GOL--- Ail) ga-_,..rPETI3L t(_&4 CC-J3 Amount ($) Payee address; City; State,' Zip Code 0- .500 0y g�iI In i S tom-� -t 0 ct I -'44-c A.( , T 7 Category (See Categories listed at the top of this schedule) Description PURPOSE I I Check if travel outside of Texas.Complete Schedule T. I OF n 1 Check if Austin,TX,officeholder living expense EXPENDITURE �SDQ—S -I p Complete ONLY If direct Candidate/Officeholder name Office sought Office held expenditure to benefit C/OH Date Payee name a=) Amount ($) Payee address; City; State; Zip Code .� -71 ,_.) Category(See.Categories listed at the top of this schedule) Description .. PURPOSE t f Check if travel outside of Texas.Complete Schedule T. ":`n OF I I Check if Austin,TX,officeholder living expense EXPENDITURE Complete ONLY if direct Candidate/Officeholder name Office sought Office held expenditure to benefit C/OH ATTACH ADDITIONAL COPIES OF THIS SCHEDULE AS NEEDED Forms provided by Texas Ethics Commission www.ethics.state.tx.us Revised 9/8/2015 ORIGINAL UNPAID INCURRED OBLIGATIONS SCHEDULE F2 • EXPENDITURE CATEGORIES FOR BOX 10(a) Advertising Expense Event Expense Loan Repayment/Reimbursement Solicitation/Fundraising Expense Accounting/Banking Fees Office Overhead/Rental Expense Transportation Equipment&Related Expense Consulting Expense Food/Beverage Expense Polling Expense Travel In District Contributions/Donations Made By Gift/Awards/Memorials Expense Printing Expense Travel Out Of District Candidate/Officeholder/Political Committee Legal Services Salaries/Wages/Contract Labor Other(enter a category not listed above) The Instruction Guide explains how to complete this form. 1 Total pages Schedule F2: 2 FILER NAME 3 Filer ID (Ethics Commission Filers) 4 TOTAL OF UNITEMIZED UNPAID INCURRED OBLIGATIONS S 5 Date 6 Payee name 7 Amount ($) 8 Payee address; City; State; Zip Code 9 TYPE OF EXPENDITURE Political Non-Political 10 (a) Category (See Categories listed at the top of this schedule) (b) Description PURPOSE I I Check if travel outside of Texas.Complete Schedule T. OF EXPENDITURE I ICheck if Austin,TX,officeholder living expense 11 Complete ONLY if direct Candidate/Officeholder name Office sought Office held expenditure to benefit C/OH Date Payee name Amount ($) Payee address; City; State; Zip Code TYPE OF EXPENDITURE Political Non-Political Category (See Categories listed at the top of this schedule) Description PURPOSE I Check if travel outside of Texas.Complete Schedule T. OF riCheck if Austin,TX,officeholder living expense EXPENDITURE P..:7 Complete ONLY if direct Candidate/Officeholder name Office sought Office held expenditure to benefit C/OH • r ^) ATTACH ADDITIONAL COPIES OF THIS SCHEDULE AS NEEDED Forms provided by Texas Ethics Commission www.ethics.state.tx.us Revised 9/8/2015 L u iGINAL PURCHASE OF INVESTMENTS MADE FROM POLITICAL CONTRIBUTIONS SCHEDULE F3 1 Total pages Schedule F3: The instruction Guide explains how to complete this form. 2 FILER NAME 3 Filer ID (Ethics Commission Filers) • 4 Date 5 Name of person from whom investment is purchased 6 Address of person from whom investment is purchased; City; State; Zip Code 7 Description of investment 8 Amount of investment($) • Date Name of person from whom investment is purchased Address of person from whom investment is purchased; City; State; Zip Code Description of investment Amount of investment($) Cl') ; - ' ti) v e i'D - - ATTACH ADDITIONAL COPIES OF THIS SCHEDULE AS NEEDED Forms provided by Texas Ethics Commission www.ethics.state.tx.us Revised 9/8/2015 • DORIGINAL EXPENDITURES MADE BY CREDIT CARD SCHEDULE F4 EXPENDITURE CATEGORIES FOR BOX 10(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 Other(enter a category not listed above) The Instruction Guide explains how to complete this form. 1 Total pages Schedule F4: 2 FILER NAME 3 Filer ID (Ethics Commission Filers) 4 TOTAL OF UNITEMIZED EXPENDITURES CHARGED TO A CREDIT CARD $ 5 Date 6 Payee name 7 Amount ($) 8 Payee address; City; State; Zip Code 9 TYPE OF EXPENDITURE Political Non-Political 10 (a) Category (See Categories listed at the top of this schedule) (b) Description PURPOSE 1 Check if travel outside of Texas.Complete Schedule T. OF EXPENDITURE Check if Austin,TX,officeholder living expense 11 Complete ONLY if direct Candidate/Officeholder name Office sought Office held expenditure to benefit C/OH Date Payee name Amount ($) Payee address; City; State; Zip Code TYPE OF EXPENDITURE Political Non-Political Category (See Categories listed at the top of this schedule) Description PURPOSE Check if travel outside of Texas.Complete Schedule T. OF EXPENDITURE Check if Austin,TX,officeholder living expense Complete ONLY if direct Candidate/Officeholder name Office sought Office held _ expenditure to benefit C/OH U-1 tV c.n 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 E) ORIGINAL MADE FROM PERSONAL FUNDS SCHEDULE G 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 FoodBeverage Expense Polling Expense Travel In District Contributions/Donations Made By Gln/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 G: 2 FILER NAME 3 Filer ID (Ethics Commission Filers) • 4 Date 5 Payee name 6 Amount ($) 7 Payee address; City; State; Zip Code Icontrib Reimbursementfrom political utions intended 8 (a)Category (See Categories listed at the top of this schedule) (b) Description PURPOSEI I OF Check if travel outside of Texas.Complete Schedule T. EXPENDITURE I I Check if Austin,TX,officeholder living expense 9 Complete ONLY if direct Candidate/Officeholder name Office sought Office held expenditure to benefit C/OH Date Payee name Amount ($) Payee address; City; State; Zip Code (� Reimbursement from I I political contributions intended Category (See Categories listed at the top of this schedule) (b) Description PURPOSE OF Check if travel outside of Texas.Complete Schedule T. EXPENDITURE I I Check if Austin,TX,officeholder living expense Complete ONLY if direct Candidate/Officeholder name Office sought Office held expenditure to benefit C/OH Date Payee name Amount ($) Payee address; City; State; Zip Code Reimbursement from -- political contributions CT> intended Category (See Categories listed at the top of this schedule) (b) Description PURPOSE OF II Check if travel outside of Texas.Complete Schedule T. I EXPENDITURE I Check it Austin,TX,officeholder living expense Complete ONLY if direct Candidate/Officeholder name Office sought Office trod expenditure to benefit C/OH ijD + O ATTACH ADDITIONAL COPIES OF THIS SCHEDULE AS NEEDED Forms provided by Texas Ethics Commission www.ethics.state.tx.us Revised 9/8/2015 D - PAYMENT MADE FROM POLITICAL ORIGIN 4 CONTRIBUTIONS TO A BUSINESS OF C/OH SCHEDULE H EXPENDITURE CATEGORIES FOR BOX 8(a) Advertising Expense Event Expense Loan Repayment/Reimbursement Solicitation/Fundraising Expense Accounting/Banking Fees Office Overhead/Rental Expense Transportation Equipment&Related Expense Consulting Expense Food/Beverage Expense Polling Expense Travel In District Contributions/Donations Made By Glft/Awards/Memorlals Expense Printing Expense Travel Out Of District Candidate/Officeholder/Political Committee Legal Services Salaries/Wages/Contract Labor Other(enter a category not listed above) Credit Card Payment The Instruction Guide explains how to complete this form. 1 Total pages Schedule H: 2 FILER NAME 3 Filer ID (Ethics Commission Filers) 4 Date 5 Business name • 6 Amount ($) 7 Business address; City; State; Zip Code 8 (a) Category (See Categories listed at the top of this schedule) (b) Description PURPOSE OF Check N travel outside of Texas.Complete Schedule T. EXPENDITURE I Check if Austin,TX,officeholder living expense 9 Complete ONLY if direct Candidate/Officeholder name Office sought Office held expenditure to benefit C/OH Date Business name Amount ($) Business address; City; State; Zip Code Category (See Categories listed at the top of this schedule) Description Del PURPOSE j I Check if travel outside of Texas.Complete Schedule T. OF EXPENDITURE I I Check if Austin,TX,officeholder living expense Complete ONLY if direct Candidate/Officeholder name Office sought Office held expenditure to benefit C/OH Date Business name Amount ($) Business address; City; State; Zip Code Category (See Categories listed at the top of this schedule) Description PURPOSE I Check if travel outside of Texas.Complete Schedule T. OF 1 EXPENDITURE I I Check if Austin,TX,officeholder living expense TJ iV Complete ONLY if direct Candidate/Officeholder name Office sought Officelleld expenditure to benefit C/OH Cj1 G7 ATTACH ADDITIONAL COPIES OF THIS SCHEDULE AS NEEDED Forms provided by Texas Ethics Commission www.ethics.state.tx.us Revised 9/8/2015 NON-POLITICAL EXPENDITURES ORIGINAL MADE FROM POLITICAL CONTRIBUTIONS SCHEDULE I The Instruction Guide explains how to complete this form. 1 Total pages Schedule I: 2 FILER NAME 3 Filer ID (Ethics Commission Filers) 4 Date 5 Payee name 6 Amount ($) 7 Payee address; City; State; Zip Code 8 (a)Category (See instructions for examples of acceptable (b)Description (See instructions regarding type of information PURPOSE categories.) required.) OF EXPENDITURE Date Payee name Amount ($) Payee address; City; State; Zip Code PURPOSE Category (See instructions for examples of acceptable Description (See instructions regarding type of information categories.) required.) OF EXPENDITURE Date Payee name Amount ($) Payee address; City; State; Zip Code PURPOSE Category (See instructions for examples of acceptable Description (See instructions regarding type of information OF categories.) required.) EXPENDITURE Date Payee name Amount ($) Payee address; City; State; Zip Code PURPOSE Category (See instructions for examples of acceptable Description (See instructions regarding type of information' categories.) required.) OF EXPENDITURE r`J ATTACH ADDITIONAL COPIES OF THIS SCHEDULE AS NEEDED Forms provided by Texas Ethics Commission www.ethics.state.tx.us Revised 9/8/2015 ORIGINAL INTEREST, CREDITS, GAINS, REFUNDS, AND CONTRIBUTIONS RETURNED TO FILER SCHEDULE K The Instruction Guide explains how to complete this form. 1 Total pages Schedule K: 2 FILER NAME 3 Filer ID (Ethics Commission Filers) 4 Date 5 Name of person from whom amount is received 8 Amount($) 6 Address of person from whom amount is received; City; State;• Zip Code 7 Purpose for which amount is received n Check if political contribution returned to filer Date Name of person from whom amount is received Amount($) Address of person from whom amount is received; City; State; Zip Code Purpose for which amount is received I I Check if political contribution returned to filer Date Name of person from whom amount is received Amount($) Address of person from whom amount is received; City; State; Zip Code Purpose for which amount is received n Check if political contribution returned to filer Date Name of person from whom amount is received Amount($) c7� Address of person from whom amount is received; City; State; Zip Code --- ,t 1 Purpose for which amount is received f�I p I I Check if political contribution returned to filer" CD J1 ATTACH ADDITIONAL COPIES OF THIS SCHEDULE AS NEEDED Forms provided by Texas Ethics Commission www.ethics.state.tx.us Revised 9/8/2015 ■ ■■ •• I OM . ORIGINAL IN-KIND CONTRIBUTIONS OR POLITICAL EXPENDITURES FOR TRAVEL OUTSIDE OF TEXAS SCHEDULE T The Instruction Guide explains how to complete this form. 1 Total pages Schedule T: 2 FILER NAME 3 Filer ID (Ethics Commission Filers) - 4 Name of Contributor/Corporation or Labor Organization/Pledgor/Payee 5 Contribution/Expenditure reported on: ❑Schedule A2 ❑Schedule B ❑Schedule B(J) ❑Schedule C2 LI Schedule D ❑ Schedule Fl ❑Schedule F2 ❑ Schedule F4 ❑Schedule G ❑Schedule H ❑Schedule COH-UC ❑ Schedule B-SS 6 Dates of travel 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 11 Purpose of travel(including name of conference,seminar,or other event) Name of Contributor/Corporation or Labor Organization/Pledgor/Payee Contribution/Expenditure reported on: ❑Schedule A2 ❑Schedule B ❑Schedule B(J) ❑Schedule C2 ❑ Schedule D ❑ Schedule Fl ❑Schedule F2 ❑ Schedule F4 ❑Schedule G ❑Schedule H ❑Schedule COH-UC ❑ Schedule B-SS Dates of travel Name of person(s)traveling Departure city or name of departure location Destination city or name of destination location Means of transportation Purpose of travel(including name of conference,seminar,or other event) Name of Contributor/Corporation or Labor Organization/Pledgor/Payee Contribution/Expenditure reported on: ❑Schedule A2 ❑Schedule B ❑Schedule B(J) ❑Schedule C2 ❑ Schedule D ❑Schedule Fl ❑Schedule F2 ❑ Schedule F4 ❑Schedule G ❑Schedule H ❑Schedule COH-UC ❑ Schedule B-SS Dates of travel Name of person(s)traveling �J i Departure city or name of departure location Destination city or name of destination location Means of transportation Purpose of travel(including name of conference,seminar,or other event) t'^J C_J'7 ATTACH ADDITIONAL COPIES OF THIS SCHEDULE AS NEEDED Forms provided by Texas Ethics Commission www.ethics.state.tx.us Revised 9/8/2015 CANDIDATE / OFFICEHOLDER REPORT: flt1Rlf;lN1AI DESIGNATION OF FINAL REPORT FORM C/OH - FR The Instruction Guide explains how to complete this form. -- Complete only if "Report Type" on page 1 is marked "Final Report" •• • 1 C/OH NAME 2 Filer ID (Ethics Commission Filers) 3 SIGNATURE I do not expect any further political contributions or political expenditures in connection with my candidacy. I understand that designat- ing a report as a final report terminates my campaign treasurer appointment. I also understand that I may not accept any campaign contributions or make any campaign expenditures without a campaign treasurer appointment on file. Signature of Candidate/Officeholder 4 FILER WHO IS NOT AN OFFICEHOLDER •• Complete A& B below only if you are not an officeholder. -- A. CAMPAIGN FUNDS Check only one: I I do not have unexpended contributions or unexpended interest or income earned from political contributions. P1 I have unexpended contributions or unexpended interest or income earned from political contributions. I understand that I may not convert unexpended political contributions or unexpended interest or income earned on political contributions to personal use. I also understand that I must file an annual report of unexpended contributions and that I may not retain unexpended contributions or unexpended interest or income earned on political contributions longer than six years after filing this 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 Check only one: j 1 do not retain assets purchased with political contributions or interest or other income from political contributions. I 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 contributions in accordance with the requirements of Election Code,§254.204. Signature of Candidate r 5 OFFICEHOLDER •• Complete this section only if you are an officeholderI I •• I am aware that I remain subject to filing requirements applicable to an officeholder who does not have a campaign 1easurer on file. I am also aware that I will be required to file reports of unexpended contributions if,after filing the last requiredrr port as an- officeholder,I retain political contributions,interest or other income from political contributions,or assets purchaseirith politi- cal contributions or interest or other income from political contributions. Signature of Officeholder Forms provided by Texas Ethics Commission www.ethics.state.tx.us Revised 9/8/2015