Williamson Semi Jan 2016 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/MR M FIRST MI
OFFICEHOLDER 1`2 OFFICE USE ONLY
NAME . . . . . . . . . . . . . . . . . . . . . . . . . . . Date Received
NICKNAME LAST SUFFIX
��0Y (�.ge i��r� lo/j RECEIVED
4 CANDIDATE/ ADDRESS !PO BOX; APT I SUITE#; CITY; STATE; ZIP CODE
OFFICEHOLDER �+� - JAN 5 2015
MAIADDRESS
❑ Change of Address
OFFICE OF CITY SECRE''ARY
5 CANDIDATE/ AREA CODE PHONE NUMBER EXTENSION
OFFICEHOLDER �(� // Date Hand-delivered or Date Postmarked
PHONE
6 CAMPAIGN MS MR FIRST? MI Receipt# Amount$
TREASURER
NAME . . . . . . . . . . . . . .. . . . . . . . . . . Date Processed
NICKNAME LAST SUFFIX
0/��!�_6 %o Date Imaged
7 CAMPAIGN STREET ADDRESS (NO PO BOX PLEASE); APT 1 SUITE#; CITY; STATE; ZIP CODE
TREASURER
ADDRESS
/
8 CAMPAIGN AREA CODE PHONE NUMBER EXTENSION
TREASURER ! /
9 REPORT TYPE
January 15 ❑ 301h day before election ❑ Runoff ❑ 151h day atter campaign
treasurer appointment
(Officeholder Only)
❑ July 15 ❑ 8th day before election ❑ Exceeded$500 limit ❑ Final Report(Attach C10H-FR)
10 PERIOD Month Day Year Month Day Year
COVERED O ! THROUGH
11 ELECTION ELECTION DATE ELECTION TYPE
Month Day Year ❑ Primary ❑ Runoff ❑ Other
Description
❑ General ❑ Special
12 OFFICE OFFICE HELD (if any) 13 OFFICE SOUGHT (if known)
seo E- �,X
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Farms 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 NAMEl� a 15 Filer ID (Ethics Commission Filers)
A � fZ— � �p� Wali— t4ot-6sZ)
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 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
F-ISPECIFIC
COMMITTEE CAMPAIGN TREASURER NAME
❑ Additional Pages
COMMITTEE CAMPAIGN TREASURER ADDRESS
i
i
17 CONTRIBUTION 1. TOTAL POLITICAL CONTRIBUTIONS OF$50 OR LESS (OTHER THAN
TOTALS PLEDGES, LOANS, OR GUARANTEES OF LOANS), UNLESS ITEMIZED $ a
2. TOTAL POLITICAL CONTRIBUTIONS
(OTHER THAN PLEDGES, LOANS, OR GUARANTEES OF LOANS)
TOTALS
EXPENDITURE 3. TOTAL POLITICAL EXPENDITURES OF$100 OR LESS,
UNLESS ITEMIZED a
4. TOTAL POLITICAL EXPENDITURES
CONTRIBUTION
BALANCE 5. TOTAL POLITICAL CONTRIBUTIONS MAINTAINED AS OF THE LAST DAY ,u
OF REPORTING PERIOD s r
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 includ s all information required to be reported by me
under Title 15,Electi o e.
loll
I
sr Notary pt�btrc,Stato 01 Texas Signature of Candidate or Officeholder
'Comm,Expires 10-27-2017
AFFIX 61661
••,' o`'s``,•• ID i 1014863
� t ��CA k5
Sworn to and subscribed before me,by the said ,this the
day of 1Z 20, to certify which,witness my hand and seal of office.
Signature of officer adm istering oath Printed name of officer kd minister!ng oath Title of Acer administering o h
Forms provided by Texas Ethics Commission www.ethics.state.tx.us Revised 9/8/2015