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McCaskill Semi Jan 2016 CANDIDATE / OFFICEHOLDER FORM C/®H CAMPAIGN FINANCE REPORT COVER SHEET PG 1 I Filer ID (Ethics Commission Filers) 2 Total pages filed: The CIOH Instruction Guide explains how to complete this form. i I 3 CANDIDATE/ MS l MR !M.R FIRST MI OFFICEHOLDER OFFICE USE ONLY NAME Date Received NICKNAME LAST SUFFIX RECEIVED 4 CANDIDATE/ ADDRESS /PO BOX; APT/SUITE ft; CITY; STATE', ZIP CODE OFFICEHOLDER JAN 5- 2016 MAILING UO 1 (2.3 7-0 1✓1 ADDRESS a ❑ Change of Address Sou-1 t-� l.✓ Vi_ t r�i'L -�j (p 1 a- OFFICE Ci V p�' ISECRETARY S CANDIDATE/ AREA CODE_ PHONE NUMBER EXTENSION OFFICEHOLDER Date Hand-delivered or Date Postmarked PHONE Nil ) L4 k U- q_1-3 q I 6 CAMPAIGN MS!/URS/MR FIRST MIReceipt# Amount$ TREASURERv � �� 0 ` NAME . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Data Processed NICKNAME - LAST SUFFIX Date Imaged 7 CAMPAIGN STREETADDRESS (NO PO f30X PLEASE); APT!SUITE.#; CITY; STATE; ZIP CODE TREASURER p n ADDRESS i(9 Cf 1 PID I�I'�A-C r �✓OIA"t�-1 iA -�+� S I. (Residence or Business) I € �� l.pQa� 0 CAMPAIGN AREA CODE PHONE NUMBER EXTENSION TREASURER PHONE � 1 L4 U Cil 9 REPORT TYPE �anuary 15 30th day before election RunoffEl 15th day atter campaign treasurer appointment (Officeholder Orly) ❑ July 15 ❑ 8th day before election Exceeded$500 limit ❑ Final Report(Attach C/OH-FR) 10 PERIOD Month Day Year Month Day Year COVERED ' / THROUGH IJP C./ 3 11 ELECTION ELECTION DATE ELECTION TYPE Month Day Year ❑ Primary D Runolf ❑ Other Descdption MA-1/ 9 /autS General EI special 12 OFFICE OFFICE HELD (it any) 13 OFFICE SOUGHT (if known} .Ct-rll 5a �rH l�I�lil�. GO TO PAGE 2 I-arms provided by Texas Ethics Commission www.e€hics.state.tx.us Revised 9/8!2015 CANDIDATE / OFFICEHOLDER FORM C/OH CAMPAIGN FINANCE REPORT COVER BEET PG 2 14 C/OH NAME 15 Filer ID (Ethics Commission Filers) 5�1 A 6J CASK 16 NOTICE FROM THIS BOX IS FOR NOTICE OF POLITICAL CONTRIBUTIONS ACCEPTED OR POLITICAL EXPENDITURES MADE BY POLITICAL COMMITTEES TO POLITICAL SUPPORT THE CANDIDATE I OFFICEHOLDER, THESE EXPENDITURES MAY HAVE BEEN MADE WITHOUT THE CANDIDATES OR OFFICEHOLDERS 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 - Iv �T ❑GENERAL I COMMITTEE ADDRESS ❑SPECIFIC COMMITTEE CAMPAIGN TREASURER NAME ❑ 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) C EXPENDITURE 3. TOTAL POLITICAL EXPENDITURES OF$100 OR LESS,TOTALS � UNLESS ITEMIZED I 4. TOTAL POLITICAL.EXPENDITURES I CONTRIBUTION BALANCE 5. TOTAL POI-J{CAL CONTRIBUTIONS MAINTAINED AS OF THE LAST DAY r . OF REPORTING PERIOD �Q OUTSTANDING 6. TOTAL PRINCIPAL AMOUNT OF ALL OUTSTANDING LOANS AS OF THE LOAN TOTALS LAST DAY OF THE REPORTING PERIOD QUI lCsn . CA,) 18 AFFIDAVIT I swear,or affirm,under penalty of perjury,that the accompanying report is true and correct and includes all iniormation required to be reported by me under Title 15,Election Code. �puuupir Lori Poytte s'O`'PrAuNolory Public.State of Texps 1 A =Comm.Expires 10.27-2017 UfL Jl� s'kyrEpF ;�`� Notary ID 11014863 Signature of Candidate or Officeholder knn► AFFIX NOTARY STAMP ISEALABOVE Sworn to and subscribed before me,by the said S f'M !°� —Itl' CSS �L-- this the day of 5A4U.("—1 20_ to certify which,witness my hand and seal of office. Signature of officer Vrininistering oath Printed name of offic administering oath Title o Officer administering oath Forms provided by Texas Ethics Commission wwww.ethics.state.tx.us Revised 918,12015 SUBTOTALS - C/OH FORM C/OH COVER SHEET PG 3 19 FILER NAME / 20 Filer ID(Ethics Commission Filers) HAto '4 0 0 C�S11_ 21 SCHEDULE SUBTOTALS SUBTOTAL NAME OF SCHEDULE AMOUNT i 1- ❑ SCHEDULEAI: MONETARY POLITICAL CONTRIBUTIONS $ 2. SCHEDULE A2: NON-MONETARY(iN-KIND)POLITICAL CONTRIBUTIONS $ 3. SCHEDULE B: PLEDGED CONTRIBUTIONS $ 4. SCHEDULE E: LOANS $ 5• SCHEDULE F1: POLITICAL EXPENDITURES MADE FROM POLITICAL CONTRIBUTIONS $ 6. SCHEDULE F2: UNPAID INCURRED OBLIGATIONS $ 9 7. SCHEDULE Fa: 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• F-1 SCHEDULE H: PAYMENT MADE FROM POLITICAL CONTRIBUTIONS TO A BUSINESS OF C/OH $ 11. SCHEDULE I: NON-POLITICAL EXPENDITURES MADE FROM POLITICAL CONTRIBUTIONS $ 12. ❑ SCHEDULE K: INTEREST, CREDITS, GAINS. REFUNDS,AND CONTRIBUTIONS $ RETURNED TO FILER i I Forms provided by Texas Ethics Commission www.ethicsstate.tx.us Revised 9/8/2015 MONETARY POLITICAL CONTRIBUTIONS SCHEDULE Al The Instruction Guide explains how to complete this form. 1 Total pages Schedule At: 2 FILER NAME 3 Filer ID (Ethics Commission Filers) �M da wrJ PJ1 C L4 L� I 4 Date 5 Full name of contributor E]out-ot-state PAC.(ID#:-_..- I 7 Amount of contribution ($) 6 Contributor address; City; State; Zip Code $ Principal occupation 1 Job title (See Instructions) 9 Employer (See Instructions) Date Full name of contributor ©out-of-stale PAG(IDO: _I Amount of contribution {$) I Contributor address; City; State; Zip Code I Principal occupation/Job title (See Instructions) Employer(See Instructions) Date Full name of contributor ❑out-of-stare PAC gett: I Amount of contribution ($) Contributor address; City; State; Zip Code Principal occupation/Job title (See Instructions) Employer See Instructions Date Full name of contributor E]out-of-state PAC pD#:..--___.-.._..,.. I Amount of contribution ($) I . . . . . . . . . . . . . . - j Contributor address; City; State; Zip Code I Principai occupation/Job title (See Instructions) Employer(See Instructions) 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.lx.us Revised 9/8/2015 NON-MONETARY (IN-KIND) POLITICAL AL CONTRIBUTIONS SCHEDULE A2 1 Total pages Schedule A2: I,The Instrubtion Guide explains how to complete this form. or— 1 1 2 FILER NAME /� 3 Filer ID (Ethics Commission Filers) S ,�vN'I-1 �fe1 , CSS V_S L,.4 4 TOTAL OF UNITEMIZED IN-KIND POLITICA]_CONTRIBUTIONS $ S Date 6 Full name of contributor ❑cut-cl-state PAC(ID#: ti Amount of g fn-kind contribution Contribution $ description . . . . . . . . . . . . . . . . . . . . . . . . . . . . 7 Contributor address; City; State; Zip Code i ❑Check if travel outside of Texas.Complete Schedule T- 1G 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) 44 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) • II Date Full name of contributor ❑out-ol-state PAC(tort: _.,._ 1 Amount of In-kind contribution Contribution $ description Contributor address; City; State; Zip Code Check if travel outside of Texas.Complete Schedule 7. Principal occupation f Job title (FOR NON-JUDIGIAL)(See Instructions) Employer (FOR NON-JUDICIAL-)(See Instructions) Contributor's principal occupation (FOR JUDICIAL) Contributor's job title (FOR JUDICIAL)(See Instructions) Contributor's employerllaw 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) I ATTACH ADDITIONAL COPIES OF THIS SCHEDULE AS NEEDED It contributor is out-ot-state PAC, please see instruction guide for additional reporting requirements. Forms provided by Texas Ethics Commission www.ethics.staie.tx.us - Revised 31812015 i I 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) S 1-t *a.l ill C S V_ e.. 4 TOTAL OF UNITEMIZED PLEDGES $ 5 Date 6 Full name otpledgor ❑out-ol-state PAC(ID#:______-__ g Amount g In-kind contribution of Pledge $ description . . . . 7 Pledgor address; City; State; Zip Cada I ❑Check if travel outside of Texas.Complete Schedule T. 10 Principal occupation/Job title (See Instructions) 11 Employer (See Instructions) Date Amount In-kind contribution Full name of pledgor Elout-Df-statePAC(ID#: I I of Pledge $ description Pledgor address; City; State; Zip Code ❑Check if travel outside of Texas.Complete Schedule F Principal occupation/Job title (See Instructions) Employer (See Instructions) Date Ful€name of pledgor ❑out-of-state PAG pb#;_._._...-..- } Amount of In-kind contribution Pledge$ description Pledgor address; City; State; Zip Code DC heck it travel outside of Texas.Complete Schedule T. j I Principal occupation/Job title (See Instructions) Employer(See Instructions) Date Full name of pledgor ©out-of-state PAC IID#,_ .. Amount of In-kind contribution Pledge $ description Pledgor address; City; State; Zip Code ❑Check it travel outside of Texas.Complete Schedule T. Principal occupation/Job title (See Instructions) Employer(See Instructions) _ _ I A77ACH ADDITIONAL COPIES OF TI-118 SCHEDULE AS NEEDED If contributor is out-of-state PAC, please see instruction guide for additional.reporting requirements. Fortes provided by Texas Ethics Commission www.ethics.state.tx.us Revised 9/8/2015 LOANS SCHEDULE E The Instruction Guide explains how to complete this form. 1 Total pages Schedule E: R CTr M 2 FILER NAME 3 Filer ID (Ethics Commission Filers) S 1-1 A tss"� 0 t C li S 4L. 1 I.-\— 4 TOTAL OE UNITEMIZED LOANS $ S Date of loan 7 Name of lender ❑out-oi-state PAC(IDi: } 9 Loan Amount($) 6 Is lender 8 Lender address; City; State; Zip Code 10 Interest rate a financial Institution? 11 Maturity date Y N 12 Principal occupation I Job title (See Instructions) 13 Employer (See Instructions) 14 Description of Collateral 15 Check if personal funds were deposited into political account (See Instructions) ❑ none C] 16 GUARANTOR 17 Name of guarantor 19 Amount Guaranteed($) INFORMATION 16 Guarantor address; City; State; Zip Code ❑ not applicable 20 Principal Occupation (See Instructions) 21 Employer (See Instructions) Dale of loan Name of lender []out-cf-state PAC(01'___ ) Loan Amount($) Is lender Lender address; City; State; Zip Code Interest rate a financial Institution? Maturity date Y N I Principal occupation /Job title (See Instructions) Employer (See Instructions) Description of Collateral Chock if personal funds were deposited into political account (See Instructions) ❑ none ❑ GUARANTOR Name of guarantor Amount Guaranteed($) INFORMATION Guarantor address; City; State; Zip Code ❑ not applicable Principal Occupation (See Instructions) Employer (See Instructions) ATTACH ADDITIONAL COPIES OF THIS SCHEDULE AS NEEDED It lender is out-of-state PAC, please see instruction guide for additional reporting requirements. Forms provided by Texas Ethics Commission www.ethics.stale.tx.us Revised 9/8/2015 i . i I �I POLITICAL. EXPENDITURES MADE FROM POLITICAL CONTRIBUTIONS SCHEDULE F1 EXPENDITURE CATEGORIES FOR BOX 8(a) Advertising Expense Event Expense Loan RepaymenllReimbursement SolicitatienlFundralsingExpense AccountinglBanking Fees Office Overhead/Rental Expense Transportation Equipment&Related Expense Consulting Expense FoodlBeverage Expense Pollinq Expense Travel In District Contributions/Donations Made By WifAwards/Memorials Ex ense p Printing Expense Travel Out Of District Cartdidate/Officeholder/Political Committee Lega!Services SafariesMlageslContract Labor Other(enter a category not listed above) Credit Card Payment ' The Instruction Guide explains how to complete this form. Y Total pages Schedule F1: 2 FILER NAME 3 Filer ID (Fttlics Commission Filers) f or— 4 S t-I va 1'6 I\ c C d, S LC I 1- 4 tate 5 Payee name 6 Amount ($) 7 Payee address; City; State; Zip Code a (a) Category (See Categories listed atihelepofthisschedule) (b) Description PURPOSE ❑Check if travel oulside otTexas.Complete Schedule T. OF ❑Check if Austin,TX,officeholder living expense EXPENDITURE 9 Complete ONLY if direct Candidate/Officeholder name Office sought Office held expenditure to benefit C/OH Date Payee name I Amount ($) Payee address; City; State; Zip Code Category (See Calegorles listed at the lop of this schedule) Description PURPOSE ❑Check it travel oulsideofTmas.Complete Schedule T. OF ❑ EXPENDITURE Check if Austin,TX,officeholder living expense I Complete ONLY if direct Candidate/Officeholder name Office sought Office held expenditure to benefit C/OH Date Payee dame Amount ($) Payee address; City; State; Zip Code Category (See Categories listed atIlia lop atthis schedtde) Description PURPOSE- ❑Check it travel oulside ofTexas.Complete Schedule T. ' OF ❑Check if Austin,TX,officeholder living expense EXPENDITURE Complete ONLY if direct Candidate/Officeholder name Office sought Office held expenditure to benefit UGH ATTACH ADDITIONAL COPIES OF THIS SCHEDULE AS NEEDED Forms provided by Texas Ethics Commission www.ethics.slate.tx.us Revised 9/W2015 UNPAID INCURRED OBLIGATIONS SCHEDULE F2 EXPENDITURE CATEGORIE=S FOR BOX I0(a) Advertising Expense Event Expense Loan Repayment/Reimbursement SolicitafionlFundra€sing Expense AccounfingfBanking Fees Office Overl rital Expense Transportation Equipment&Related Expense - Consulting Expense Food/Beverage Expense Polling Expense Travel In District Contributions/Donations Made By GI(UAwardslMemoriais Expense Printing Expense Travel Out Of District Candidate/Officeholder/Political Committee Legal Services Salaries/WageslContractLabor Other(enter acategory not listed above} The Instruction Guide explains how to complete this form. 7 Total pages Schedule F2: 2 FILER NAME 3 f=iler ID (Ethics Commission Filers) { CTF I S 1-f W 1✓, C Ci—,. S V- 4 4 TOTAL OF UNITEMIZED UNPAID INCURRED OBLIGATIONS $ ���� �o 5 Date 6 Payee name 'TrW • I . c;l 0 1('0 Z S cel U--, L.L C- 7 Amount ($) 8 Payee address; Clty; State; Zip Code Io S Col t-wfN d B S D ii 5u I TYPE OF (EXPENDITUREPolitical ❑ Non-Politica! i 10 (a) Category (SoeCategorieslisted atthe top ofthis schedule) (b) Description i; li PURPOSE OF n .! +{ ` ( 6 [:]Check Check travel outside orTexas.Complete Schedule T. EXPENDITURE [--]Check if Ausi€n,TX,officeholder living expense Complete ONLY if direct Candidate/Officeholder name Office sought Oftice held expenditure to benefit UGH I. Date Payee name Amount ($) Payee address; City; State; Zip Code TYPE OF (EXPENDITURE ❑ Political ❑ Nan-Political Category (See Categories listed at the tap of this schedule) Description PURPOSE ❑Gheck if travel outside of Texas.Complete Schedule T. OF EXPENDITURE ❑Check If Austin.TX,officeholder living expense i Complete ONLY if direct Candidate!Officeholder name _ Office sought Office held expenditure to benefit CIOH i ATTACH ADDITIONAL COPIES OF THIS SCHEDULE AS NEEDED Forms provided by Texas Ethics Commission www.ethics.state.tx.us Revised 9/8/2015 PURCHASE OF INVESTMENTS MADE FROM POLITICAL CONTRIBUTIONS SCHEDULE F3 The lnstructionGuridee ailishmto 1 Total pages Schedule F3: xpl conn�leYeYhisforrvr. Cr� 2 FILER NAME 3 Filer ID (Ethics Commission Filers) Sl�� J vis rJ 0 , C 4 pate 5 Name of person from whom investment is purchased 6 Address of person from whom investment is purchased; City; Slate; Zip Code 7 Description of investment F3 Amount of investment($} i Dale Name of person from whprll investment is purchased 4 Address of person from whom investment is purchased; City; Stale; Zip Code I i Description of investment i I Amount of investment($) I I I ATTACH ADDITIONAL COPIES OF THIS SCHEDULE AS DEEDED Forms provided by Texas Ethics Commission www.ethics.stale.Ix.us Revised 9/8/2015 EXPENDITURES MADE BY CREDIT CAR® SCHEDULEF4 EXPENDITURE_CATEGORIES FOR SOX 10(a) Advertising Expense Event Expense - Loan RepaymentiReimbursement Solicitation/Fundraising Expense Accounting/Banking Fees - Office CvertieadlRental Expense Transportation Equipment&Related Expense Consulting Expense Food/Beverage Expense hewing Expense Travel In District ContributionsMonations Made By Gift/Awards/Memorials Expense Printing Expense Travel Out Of District Candidate/Officeholder/Political Committee Legal Services SalariesMages/Contract Labor Other(enter a category not listed above} The Instruction Guide explains how to complete this form. 1 Total pages Schedule F4: I 2 FILER NAME 3 Filer ID (Ethics Commission Filers) of 5 IAI,.t N� ` CA's kI � L i 4 TOTAL OF UNITEMIZED EXPENDITURES CHARGED TO A CREDIT CARD $ 5 Date 6 Payee name 7 Amount ($) $ Payee address; City; State; Zip Code I 9 TYPE OF EXPENDITURE ❑ Political ❑ Non-Political 10 (a) Category tSee Categories listed at the tap of this schedule) (b) Description PURPOSE [:]Cheek If travel outside of Texas.Complete Schedule T. OF EXPENDITURE ❑Check if Austin,TX,oflicehelder living expense 11 Complete ONLY if direct Candidate/Officeholder name Office sought Office held expenditure to benefit C/OH i Date Payee name I Amount ($) Payee address; City; State; zip Code i i i TYPE OF EXPENDITURE ❑ Political ❑ Non-Political _ - Category (See Categories listed at the top of this scheduled Description PURPOSE ❑Check if travel outside of Texas.Complete Scheduler OF EXPENDITURE ❑Check if Austin,TX,officeholder living expense Complete ONLY if direct Candidate/Officeholder name Office sought Office held expenditure to benefit ClOH ATTACH ADDITIONAL COPIES OF THIS SCHEDULE AS NEEDED Forms provided by Texas Ethics Commission www.ethics.stato.tx.us Revised 9/8/2015 POLITICAL EXPENDITURES MACE FROM PERSONAL FUNDS SCHEDULE: G EXPENDITURE CATEGORIES FOR BOX 8(a) Advertising Expense Event Expense Loan RepaymentlAcimbursement SolicitatlonlFundralsing Expense Accounting/Banking Foes Office Overhead/Rental Expense Transportation Equipment&Related Expense Consulting Expense Food/Beverage Expense Polling Expense Travel In District Contributions/Donations Made By Gift/Awards/Memorials Expense Printing Expense Travel Out Of District Candidate/Officeholder/Political Committee Legal Services SalariesrWages/Contract Labor Other(enter a category not listed above) j Credit Card Payment The Instruction Guide explains how to complete this form, 1 Total pages Schedule G: 2 FILER NAME 3 Filer ID (Ethics Commission Filers) tilt Date 5 Payee name i I 6 Amount ($} 7 Payee address; City; State; Zip Code ❑ Reimbursement from . political contributions intended i 8 (a)Category (See Categories listed at the top of this schedule) (b) Description PURPOSE OF ❑Check if travel outside of Texas.Complete Scheduli EXPENDITURE ❑Check if Austin,TX,officeholder living expense I 9 Complete ONLY if direct Candidate/Officeholder name Office sought Office held expenditure to benefit C/OH Date Payee name Amount ($) Payee address; City; State; Zip Code ❑ Reimbursement from political contributions intended Category (See Categories listed at the top of this schedule) (b) Description PURPOSE OF ❑Check if travel outside of Texas.Complete Schedule T. EXPENDITURE ❑Check it Austin,TX,officeholder living expense Corn iele ONLY if direct Candidate!Officeholder name Office sought Office held expenditure to benefit C/OH Date Payee name I _ I Amount {$) Payee address; City; State; 'Zip Code ❑ Reimbursement from political contributions intended PURPOSE Category (See Categories listed at the top of this schedule) (b) Description OF - - ❑Check if travel outside of Texas.Complete Schedule T. EXPENDITURE ❑Check it Austin.TX,officeholder living expense Complete CNLY if direct Candidate/Officeholder name Office sought Office held expenditure to benefit GOH ATTACH ADDITIONAL COPIES OF THIS SCHEDULE AS NEEDED Forms provided by Texas Ethics Commission www.ethics.slate.tx.us Revised 9/8/2015 PAYMENT MADE FROM POLITICAL CONTRIBUTIONS TO A BUSINESS OF C/OH SCHEDULE H EXPENDITURE CATEGORIES FOR BOX 8(a) Advertising Expense Event Expense Loan Repayment/Helmbursement SolicitatlonlFundraising Expense Accountingi king Fees Office OverheadlHentalExpense Transportation Equipment&Related Expense Consulting Expense Food/Beverage Expense Polling Expense Travel In District ContributionslDonaiions Made By Gift/AwardslMernorlals Expense Printing Expense Travot Out Of District Candidate/Officeholder/Political Committee Legal Services SalariesMages/Contract Labor Other(enter a category not listed above) Credit Gard Payment The Instruction Guide explains how to complete this farm. 1 Total pages Schedule H: 2 FILER NAME 3 Filer ID (Ethics Commission Filers) 4 Date 5 Business name 6 Amount ($) 7 Business address; City; State; Zip Code 8 (a) Category (See Categories listed at the tap of this schedule) (b) Description PURPOSE ❑Check if travel outside of Texas.Complete Schedule T. OF EXPENDITURE ❑Check if Austin,TX,officeholder living expense 9 Complete OILY if direct Candidate/Officeholder name Office sought Office held expenditure to benefit C/OH Dale Business name I I Amount ($) Business address; City; State; Zip Code Category (See Categories listed at the top of this scheduie) Description PURPOSE ❑Check if travel outside oITexas.Complete Schedule L OP EXPENDITURE ❑Check it 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 ($) Business address; City; State; Zip Code Category (See Categories listed at the top of this scheduie) Description 13 U R POSE ll Check if travel outside of Texas.Complete Schedule T. OF !�1 Check if Austin,TX,officeholder living expense EXP-NDITURE Complete ONLY it direct Candidate/Officeholder name Office sought Office held expenditure to benefit ClOH ATTACH ADDITIONAL COPIES OF THIS SCHEDULE AS NEEDED Forms provided by Texas Ethics Commission wmr.ethics.state.tx.us �� Revised 9/8/21715 NON-POLITICAL EXPENDITURES MADE FROM POLITICAL. CONTRIBUTIONS SCHEDULE I 1 The Instnxtion Guide e3Iairts i conjAetethiSfonn j 1 Total pages Schedule r 2 FILER NAME 3 Filer ID (Ethics Commission Filers) ! to nl 4 ,Date S Payee name i 6 Amount ($} 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 ($) Payee address; City; State; Zip Code Category (Sea instructions for examples of acceptable Description (See instructions regarding type of information PURPOSE categories.) required.) OF EXPENDITURE Date Payee name Amount ($) Payee address; City; State; Zip Code PURPOSE Category (See instructions for examples of acceptable Description (See instructions regarding type of information ! or categories.) required.) EXPENDITURE Date Payee name Amount W 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 ATTACH ADDITIONAL COPIES OF THIS SCHEDULE AS NEEDED Forms provided by Texas Ethics Commission www.ethics.state.tx.us Revised 9/8/2015 1 I EREST, CREDITS, GAMS, REFUNDS, AND CONTRIBUTIONS RETURNED TO TER SCHEDULE K The Instruction Guide explains how to corrVAete this torrrL 1 Total pages Schedule K: 2 FILER NAME 3 Filer ID (Ethics Commission Filers) 5HAU'j CA-5 VC 4 Date 5 Name of person from whom amount is received $ Amount($} 6 Address of person from whom amount is received; City; State; Zip Code i 7 Purpose for which amount is received Check if political contribution returned to filer Date Name of person from whom amount is received Amount($} Address of person from whom amount is received; City; State; Zip Code Purpose for which amount is received ❑ Check if political contribution returned to filer i Date Name of person from whom amount is received Amount($} Address of person from whom amount is received; City; State; Zip Cade Purpose for which amount is received Check if political contribution returned to filer Date Name of person from whom amount is received Amount($} Address of person from whom amount is received; City; State; Zip Code r Purpose for which amount is received Check if political contribution returned to filer i ATTACH ADDITIONAL COPIES OF THIS SCHEDULE AS NEEDED i C=orms provided by Texas Ethics Commission www.ethics.state.tx.us Revised 9/8/2015 IN-KIND CONTRIBUTIONS OR POLITICAL EXPENDITURES FOR TRAVEL OUTSIDE OF TEXAS SCHEDULE T The Instruction Quid explains how to complete this form. 1 Total pages Schedule T: 2 FILER NAME3 Filer ID (Ethics Commission Filers) 51-1 A-w >j 0 C I& t l_`.— 4 Name of Contributor/Corporation or Labor Organization/Pledgor/Payee 5 Contribution/Expenditure reported on: ❑Schedule A2 ❑Schedule B ❑Schedu;e R(J) ❑Schedule C2 ❑ Schedule D ❑Schedule F1 ❑Schedule F2 ❑ Schedule F4 ❑Schedule G ❑Schedule H ❑Schedule COW-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 i 10 Means of transportation 11 Purpose of travel(including name of conference,seminar,or other event) Name of Contributor/Corporation or Labor Organization/Pledgor 1 Payee Contribution/Expenditure reported on: ❑Schedule A2 ❑Schedule B ❑Schedule B(J) ❑Schedule C2 ❑ Schedule D ❑Schedule F1 ❑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 cr name of destination location I Means of transportation Purpose of travel(including name of conference,seminar,or other event) I 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 F1 ❑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) I ATTACH ADDITIONAL COPIES OF THIS SCHEDULE AS NEEDED Forms provided by Texas Ethics Commission www.etNcs.state.tx.us Revised 9/8/2015 CANDIDATE / OFFICEHOLDER REPORT. DESIGNATION OF FINAL REPORT FORM C/®FI - FR The Instruction Guide w plains how to complete this form. .� Complete only if "Report Type" on page 1 is marked "f=inal Report" •• j i 1 C/OH NAME 2 Filer Ip (Ethics Ccmmission Filers) I i 3 SIGANATURE 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. l 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 it you are not an officeholder. F- A. CAMPAIGN FUNDS Check only one: 0 Ido not have unexpended contributions or unexpended interest or income earned from political contributions. i [] 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 politica# 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. R. ASSETS Check only one: I do not retain assets purchased with political contributions or interest or other income from political contributions. C] 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. F I Signature of Candidate 5 OFFICEHOLDER _ - -- Complete this section only if you are an officeholder •- -1 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 politi- cal contributions or interest or other income from political contributions. Signature of Officeholder Forms provided by Texas Ethics Commission wwmethics.state.N.us Revised 9/8/2015