Loading...
Patton Semi July 2016 4 CANDIDATE / OFFICEHOLDER FORM C/OH CAMPAIGN FINANCE REPORT COVER SHEET PG 1 1 Filer ID(Ethics Commission Filers) 2 Total pages filed: The C/01­I Instruction Guide explains how to complete this form. 3 CANDIDATE/ MS/MRS/MR FIRST MI OFFICEHOLDER MCEHOLDER � ��� QFt=tCEUSEDtVLY 1`L1. Date Received NICKNAME LAST SUFFIX R E C is N E-D 4 CANDIDATE/ ADDRESS 1 PO BOX; r�APT 1 SUITE#; CITY; STATE; ZIP CODE MAILINGOFFICEHOLDER f j I tdL '" 0`'y�cc 1 �1i Io#Cr IY. JUL 2016 ADDRESS � a ❑ Change of Address OFFICE OF CITY $E:CRETA iY 5 CANDIDATE/ AREA CODE PHONE NUMBER EXTENSION 1-bs OFFICEHOLDER TDate Hand-delivered or Date Postmarked PHONE 6 CAMPAIGN MS I MRS/MR FIRST MI Receipt# Amount$ TREASURER 'y NAME . . . . . . . . . . . . ..1. . . . . . . . . . . . . . . . . . . . Date Processed NICKNAME LAST SUFFIX Date Imaged 7 CAMPAIGN STREET ADDRESS (NO PO BOX PLEASE); APT I SUITE#; CITY; STATE; ZIP CODE TREASURER ,Q j ADDRESS o-ao, Florence &"e, (Residence or Business) K 70vg2 8 CAMPAIGN AREA CODE PHONE NUMBER EXTENSION PHONE TREASURER r l �y ZD T, -7ggS`" I 9 REPORT TYPE ❑ January IS 301h day before election ❑ Runoff 15th day after campaign treasurer appointment (Officeholder Only) July 15 ❑ 8th day before election Exceeded$500 limit ❑ Final Report(Attach C/OH-FR) 10 PERIOD Month Day Year Month Day Year COVERED 0 /f /« THROUGH 11 ELECTION ELECTION DATE ELECTION-TYPE Month Day Year ❑ Primary ❑ Runoff Ix Other Description � r p ❑ General ❑ Special Ind,f° c n e `, C fC 3 i r.. fi�(e 12 OFFICE OFFICE HELD (ii any) 13 OFFICE SOUGHT (ii known) _.plat e 3 GO TOPAGE 2 Forms provided by Texas Ethics Commission wwmethics.state.N.us Revised 9/8/2015 i I CANDIDATE / OFFICEHOLDER FARM C/OH CAMPAIGN FINANCE REPORT COVER SHEET PG 2 E F 14 C/OH NAME 15 Filer ID (Ethics Commission Filers) 16 NOTICE FROM THIS BOX 15 FOR NOTICE OF POLITICAL CONTRIBUTIONS ACCEPTED OR POLITICAL EXPENDITURES MADE BY POLITICAL COMMITTEES TO POLITICAL SUPPORT THE CANDIDATE I OFFICEHOLDER. THESE ExPE=TuRES MAY HAVE BEEN MADE WITHOUT THE cANDiDATE+S 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 I ❑GENERAL 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 •/t/ (OTHER THAN PLEDGES, LOANS, OR GUARANTEES OF LOANS) EXPENDITURE TO3. TOTAL POLITICAL EXPENDITURES OF $100 OR LESS, UNLESS ITEMIZED 4. TOTAL POLITICAL EXPENDITURES CONTRIBUTION BALANCE 5. TOTAL POLITICAL CONTRIBUTIONS MAINTAINED AS OF THE LAST DAY OF REPORTING PERIOD OUTSTANDING 6. TOTAL PRINCIPAL AMOUNT OF ALL OUTSTANDING LOANS AS OF THE LOAN TOTALS LAST DAY OF THE REPORTING PERIOD 18 AFFIDAVIT swear,or affirm,under penalty of perjury,that the accompanying report is aBfFjg�gtlOCk true and correct and includes all information required to be reported by me utuNr �FKY fi4 _;; Notary Public.State of TOK0S under Title 15,Election Code. :u} Y Comm.Expires Da-10-2016 "���;� Notary ID 125©11618 a or + Signature of Candidate or Officeholder AFFIX NOTARY STAMP/SEALABOVE Sworn to and subscribed before me, by the said Ci)ya.I � this the b}� day of jt�.VM 20_1b to certify which,witness my hand and seal of office. Signature of officer administering oath Printed name of officer administering math Title of officer administering oath I Forms provided by Texas Ethics Commission www,ethics.state.tx,us Revised 9/8/2415 I I I SUBTOTALS - C/OH FORM C/OH COVER SHEET PG 3 19 FILER NAME 20 Filer ID(Ethics Commission Filers) 21 SCHEDULE SUBTOTALS SUBTOTAL NAME OF SCHEDULE AMOUNT 1. ❑ SCHEDULEAI: MONETARY POLITICAL CONTRIBUTIONS $ 2. SCHEDULEA2: NON-MONETARY(IN-KIND)POLITICAL CONTRIBUTIONS $ 3• SCHEDULE B: PLEDGED CONTRIBUTIONS $ 4. SCHEDULE E: LOANS $ � • S SCHEDULE F1: POLITICAL EXPENDITURES MADE FROM POLITICAL CONTRIBUTIONS $ 0- SCHEDULE 172: UNPAID INCURRED OBLIGATIONS $ � fx-- 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 $ _ � i 11. SCHEDULE I: NON-POLITICAL EXPENDITURES MADE FROM POLITICAL CONTRIBUTIONS i 12 ❑ SCHEDULE K: INTEREST,CREDITS,GAINS, REFUNDS,AND CONTRIBUTIONS RETURNED TO FILER $ I I I r Forms provided by Texas Ethics Commission www.ethics.state.tx.us Revised 9/8/2015 f + I MONETARY POLITICAL CONTRIBUTIONS SCHEDULE Al The Instruction Guide explains how to complete this form. 1 Total pages Schedule At: I 2 FILER NAME 3 Filer ID (Ethics Commission Filers) 4 Date 5 Full name of contributor ❑out-of-state PAC pD#:_ ) 7 Amount of contribution ($) 6 Contributor address; City; State; Zip Code 8 Principal occupation/Job title(See Instructions Employer Instructions ) gSee( ) Date Full name of contributor ❑out-of-state PAC(IDS: f Amount of contribution {$) Contributor address; City; State; Zip Code Principal occupation/Job title(See Instructions) Employer(See Instructions) Date Full name of contributor ❑out-of-state PAC(IDS: Amount of contribution $ Contributor address; City; State; Zip Code i Principal occupation/Job title (See Instructions) Employer(See Instructions) I Date Full name of contributor ❑out-of-state PAC(ID#: Amount of contribution ($) Contributor address; City; State; Zip Code L I I I r Principal 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.tx,us Revised 9/8/2415 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 Ip (Ethics Commission Filers) 14 &601 4 TOTAL OF UNITEMIZED IN-KIND POLITICAL CONTRIBUTIONS 5 Date 6 Full name of contributor ❑out-of-state PAC(10tt: } 8 Amount of 9 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) i 16 If contributor is a child,law firm of parent(s) (if any) (FOR JUDICIAL) Date Full name of contributor ❑out-of-state PAC(ID#: 1 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) 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 9/8/2415 PLEDGED CONTRIBUTIONS SCHEDULE B The Instruction Guide explains how to complete this form. Total pages Schedule B: 2 FILER NAME 3 Filer ID (Ethics Commission Filers) 4 TOTAL OF UNITEMIZED PLEDGES 5 Date is Full name of pledgor ❑out-of-state PAC(ID#: 7 g Amount 9 In-kind contribution of Pledge$ description 7 Pledgor address; City; State; Zip Code ❑Check if travel outside of Texas.Complete Schedule T 10 Principal occupation/Job title (See Instructions) 11 Employer(See Instructions) Date Full name of fed or Amount In-kind contribution p g El PAC pDa: l of 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-oT-state PAC(IDR: } 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-DF-state PAC(ID#: ) 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) i i i 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 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 5 Date of loan 7 Name of fender ❑out-of-state PAC(IDM ) 9 Loan Amount($) 6 Is lender $. Lender address; City; State; Zip Code 10 interest rate a financial Institution? 11 Maturitydato Y N 12 Principal occupation /Job title (See Instructions) 13 Employer (See Instructions) 14 Description of Collateral 15 Check if personal funds were deposited into political account (See Instructions) ❑ none ❑ 16 GUARANTOR 17 Name of guarantor 19 Amount Guaranteed($) INFORMATION . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 18 Guarantor address; City; State; Zip Code ❑ not applicable 20 Principal Occupation (See Instructions) 21 Employer (See Instructions) I I j Date of loan Name of lender El out-of-state PAC(ID#: ) Loan Amount($) Is lender Lender address; City; State; Zip Coda Interest rate a financial Institution? Maturity date Y N Principal occupation 1 Job title (See Instructions) Employer (See Instructions) Description of Collateral Check if personal funds were deposited into political account (See Instructions) ❑ none ❑ GUARANTOR Name of guarantor Amount Guaranteed($) INFORMATION Guarantor address; City; State; Zip Code ❑ not applicable Principal Occupation (See Instructions) Employer (See Instructions) ATTACH ADDITIONAL COPIES OF THIS SCHEDULE AS HEEDED 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 i . i POLITICAL EXPENDITURES MADE FROM POLITICAL CONTRIBUTIONS SCHEDULE F1 EXPENDITURE CATEGORIES FOR BOX 8(a) Advertising Expense Event Expense Loan Repayment/Reimbursement, SolicitatioNFundraisingExpense AccountingBanking Fees Office Overhead(Rental Expense Transportation Equipment&Related Expense Consulting Expense Food/Boverage Expense Polling Expense Travel In District Contributions/DDnations Made By GitUAwardsWemorials Expense Printing Expense Travel Out Ot District Candidate/OfficeholdeWolitioalCommittee Legal Services SalariG&Wages/ContractLabor Other(enter a category not listed above) Credt Card Payment The Instruction Guide explains haw to complete this form. 1 Total pages Schedule Fl: 2 FILER NAME 3 Filer ID (Ethics Commission Filers) 4 Date g Payee name 6 Amount ($) 7 Payee address; City; State; Zip Code f I $ (a) Category (See Categories listed at the top of this schedule) (b) Description PURPOSE ❑Check if travel outside of Texas.Complete Schedule I OF ❑Check If Austin,TX,officeholder living expense EXPENDITURE i 9 Complete ONLY if direct Candidate/Officeholder name Office sought Office held expenditure to benefit CIOH Date Payee name Amount ($) Payee address; City; State; Zip Code Category (See Categories listed at the top of this schedule) Description PURPOSE ❑Check if travel outside of Texas.Complete Schedule T. OF ❑Check if Austin,TX,officeholder living expense EXPENDITURE Complete ONLY if direct Candidate/Officeholder name Office sought Office held expenditure to benefit C/OH Date Payee name Amount ($) Payee address; City; State; Zip Code Category (See Categories listed at the top of this schedule) Description PURPOSE ❑Check if travel outside of Texas.Complete Schedule I OF ❑Check it 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 UNPAID INCURRED OBLIGATIONS SCHEDULE FZ EXPENDITURE CATEGORIES FOR BOX 10(a) Advertising Expense Event Expense Loan Repayment/Rdmbursement Solfcitation/FundralsingExpense Accounting/Banking Fees Office Overhead/Rental Expense Transportation Equipment&Related Expense Consulting Expense Food/BeverageExpense Polling Expense TravellnDistrict Contribubons/Donations Made By GIf1/Awards/Memarials Expense Printing Expense Travel Out Of District Candidate/Officeholder/Political Committee Legal Services SalariesMlages/ConlractLabor 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 $ 5 Date 6 Payee name { 7 Amount ($) 8 Payee address; City; State; Zip Cade i I R TYPE OF EXPENDITURE Political ❑ Non-Political I i 10 (a) Category (See Categories listed at the top of this schedule) (b) Description i PURPOSE ❑Check i1 travel outside of Texas.Complete Schedule T. OF EXPENDITURE ❑Check If Austin,TX,officeholder living expense 11 Complete ONLY if direct Candidate/Officeholder name Office sought Office held expenditure to benefit C/OH Date Payee name Amount ($) Payee address; City; State; Zip Code TYPE OF EXPENDITURE EJPolitical Non Political — I Category(See Categories listed at the top of this schedule) Description PURPOSE ❑Check it travel outside of Texas.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 GIOH ATTACH ADDITIONAL COPIES OF THIS SCHEDULE AS NEEDED Fortes provided by Texas Ethics Commission www.ethics.state.tx.us Revised 9/8/2015 i i - I PURCHASE OF INVESTMENTS MADE FROM POLITICAL CONTRIBUTIONS SCHEDULE F3 i 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 r 7 Description of investment i 8 Amount of investment($) Date Name of person from whom investment is purchased Address of person from whom investment is purchased; City; State; Zip Code Description of investment Amount of investment($) ATTACH ADDITIONAL COPIES OF THIS SCHEDULE AS NEEDED Forms provided by Texas Ethics Commission www.ethics.state,tx.us Revised 9/8/2015 EXPENDITURES MADE BY CREDIT CARD SCHEDULE F4 EXPENDITURE CATEGORIES FOR BOX 1D(a) Advertising Expense Event Expense Loan Repayment/Reimbursement Solicitation/FundralsingExpense Accounting/Banking Fees Office OverheadMonlalExpense Transportation Equipment&RelatedExpense Consulting Expense Food/Beverage,Expense Polling Expense Travel In District Contributions/Doneflons Made By Cift/Awards/MemorialsExpense Printing Expense Travel Out Of District Candidate/Officeholder/PolkicalCommittee LegalServicas Salaries/Wages/ContractLabor 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 ED (Ethics Commission Filers) 4 TOTAL OF UN ITEMIZED EXPENDITURES CHARGED TO ACREDIT CARD $ 5 Date 6 Payee name 1 7 Amount {$) 8 Payee address; City; State; Zip Code 9 TYPE OF EXPENDITURE Politica[ ❑ Non-Political 10 (a) Category (See Categories listed at the top of this schedule) (b) Description PURPOSE ❑Check if travel outside of Texas.Complete Schedule T. OF EXPENDITURE ❑Check if Austin,TX,officeholder living expense 1- 11 Complete ONLY if direct Candidate 1 Officeholder name Office sought Office held expenditure to honefit C/OH Date Payee name Amount ($) 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 oulsfde 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 I 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 PERSONAL FUNDS SCHEDULE G l EXPENDITURE CATEGORIES FOR BOX 8(a) f Advertising Expense Event Expense Loan Repayment/Reimbursement SolicitationlFundraisingExpense Accounting/Banking Fees Office Overhead/Rental Expense Transportation Equipment&Related Expense Consulting Expense Food/Beverage Expense Palling Expense Travel In District ContributionsrponationsMade By Gift/Awards/MemorialsExpense Printing Expense Travel Out Of District Candidate/Offioeholder/Politieal Committee Legal Services SalarleaWages/Contract Labor Other(enter acategory not listed above) Credit Card Payment i The Instruction Guide explains how to complete this form. 1 Total pages Schedule G: 2 FILER NAME 3 Filer ID (Ethics Commission Filers) I I i 4 Date 5 Payee name 6 Amount ($) 7 Payee address; City; State; Zip Code ❑ Reimbursementfm political contributions Intended 8 PURPOSE {a)Category (See Categories listed at the top of this schedule) (b) Description � OF ❑Check if travel outside of Texas.Complete Schedule T. EXPENDITURE ❑Check if Austin,TX,officeholder living expense 9 Complete ONLY if direct Candidate/Officeholder name Office sought Office held expenditure to beneiit C/OH Date Payee name F Amount ($) Payee address; City; State; Zip Code ❑ Reimbursementfrom political contributions intended Category (See Categories listed at the top of this schedule) (b) Description PURPOSE OF ❑Check if travel outside of Texas.Compfete Schedule T. EXPENDITURE ❑Check if Austin,TX,officeholder living expense Complete ONLY if direct Candidate/Officeholder name Office sought Office held expenditure to benefit CIOH Date Payee name Amount {$) Payee address; City; State; Zip Code i ❑ Reimbursementfrom political contributions intended Category (See Categories listed at the tap of this schedule) (b) Description PURPOSE OF ❑Check if travel outside of Texas.Complete Schedule T. EXPENDITURE ❑Check if Austin,TX,officeholder thing expense Complete ONLY If direct Candidate/Officeholder name Office sought Office held expenditure to benefit C/OH I i ATTACH ADDITIONAL COPIES OF THIS SCHEDULE AS NEEDED Forms provided by Texas Ethics Commission www.ethics.stateAx.us Revised 9/8/2015 PAYMENT MADE FROM POLITICAL CONTRIBUTIONS TO A BUSINESS OF C/OH SCHEDULE H k EXPENDITURE CATEGORIES FOR BOX 8(a) Advertising Expense Event Expense Loan RepaymentlReimbursement Solicitatfon/FundraisingExpense Accounting/Banking Fees Office Overhead/RentalExpense Transportation Equipment&Related Expense Consulting Expense Food/Beverage Expense Polling Expense Travel In Dfstrict Contributions/Donations Made By GitVAwards/Memorials Expense Printing Expense Travel Out Of District f Qandidate/Offioeholder/Political Committee Legal Services Safaries/Wages/Contract Labor Other(enter a category not listed above) Credit Card Payment The Instruction Guide explains how to complete this form. 1 Total pages Schedule H: 2 FILER NAME 3 Filer ID (Ethics Commission Filers) 4 Date 5 Business name 6 Amount ($) 7 Business address; City; State; Zip Code S II g (a) Category (see Categories listed at the top of this schedule) (b) Description PURUPOSE IJCheck if travel outsfdeofTexas.Complete Schedule T. i EXPENDITURE ❑Check if Austin,TX,officeholder living expense i i Candidate 1 Officeholder name Office sought Office held { 9 Complete ONLY if direct g i expenditure to benefit GfOH l Date Business name E i Amount ($) Business address; City; State; Zip Code Category See Categories listed at the to of this schedule g Y ( g P ) Description PURPOSE ❑Check if travel outside ofTexas.Complete Schedule T. OF EXPENDITURE ❑Check if Austin,TX,officeholder living expense Complete ONLY if direct Candidate!Officeholder name Office sought Office held expenditure to benefit CIOH Date Business name Amount ($} Business address; City; State; Zip Code 1 Category (See Categories listed at the top of this schedule) Description PURPOSE ❑CheckiftraveloutsideofTexas.Complete Schedule T OF ❑Check if Austin,TX,officeholder lidIng expense EXPENDITURE Complete ONLY If direct Candidate/Officeholder name Office sought Office held expenditure to benefit CION ATTACH ADDITIONAL COPIES OF THIS SCHEDULE AS NEEDED Forms provided by Texas Ethics Commission www.ethics.state.tx.us Revised 91$12015 NON-POLITICAL EXPENDITURES MADE FROM POLITICAL CONTRIBUTIONS SCHEDULE I i The Instruction Guide explains how to complete this form. 1 Total pages Schedule is 2 FILER NAME 3 Filer ID (Ethics Commission Filers) 4 Date 5 Payee name 6 Amount ($) T Payee address; City; State; Zip Code I 8 (a)Category (See instructions for examples of acceptable (b)Description (See instructions regarding type of information PURPOSE categories.) required.) C1 F EXPENDITURE Date Payee name Amount ($} Payee address; City; State; Zip Code PURPOSE Category (See instructions for examples of acceptable Description (See instructions regarding type of information F categories.) required.) O EXPENDITURE Date Payee name i Amount {$) Payee address; City; State; Zip Code I Category (See instructions for examples of acceptable Description (See instructions regarding type of information PURPOSE categories.) required.) OF q ) EXPENDITURE Date Payee name r. Amount {$) Payee address; City; State; Zip Code PURPOSE Category (See instructions for examples of acceptable Description (See instructions regarding type of information categories.) required.) OF EXPENDITURE ATTACH ADDITIONAL COPIES OF THIS SCHEDULE AS NEEDED Forms provided by Texas Ethics Commission www.ethics.state.N.us Revised 9/$/2015 I INTEREST, CREDITS, GAINS, REFUNDS, AND CONTRIBUTIONS RETURNED TO FILER SCHEDULE K The Instruction Guide explains how to complete this form. 7 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{$} i 6 Address of person from whom amount is received; City; State; Zip Code I 7 Purpose for which amount is received Check if political contribution returned to filer Date Name of person from whom amount is received Amount($) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 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 Date Name of person from whom amount is received Amount($) Address of person from whom amount is received; City; State; Zip Code Purpose for which amount is received Check if political contribution returned.to filer I Date Name of person from whom amount is received Amount($) L L Address of person from whom amount is received; City; State; Zip Code I Purpose for which amount is received ❑ Check if political contribution returned to filer ATTACH ADDITIONAL COPIES OF THIS SCHEDULE AS NEEDED Forms provided by Texas Ethics Commission www.ethics.state.tx.us Revised 9/8/2015 i IN-KIND CONTRIBUTIONS OR POLITICAL EXPENDITURES FOR TRAVEL OUTSIDE OF TEXAS SCHEDULE T i i 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 ❑ Schedule D ❑ Schedule F1 [-]Schedule F2 ❑ Schedule F4 ❑Schedule G ❑Schedule H ❑Schedule COH-UC ❑ Schedule B-SS i 6 Dates of travel 7 Name of person(s)traveling 8 Departure city or name of departure location i I 9 Destination city or name of destination location j l 10 Means of transportation 11 Purpose of travel(including name of conference,seminar,or other event) Name of Contributor I Corporation or Labor Organization/Pledgor I Payee Contribution/Expenditure reported on: ❑Schedule A2 ❑Schedule B ❑Schedule B(J) ❑Schedule C2 ❑ Schedule D ❑Schedule F1 ❑Schedule F2 ❑ Schedule F4 El Schedule G ❑Schedule H Schedule COH-UC ❑ Schedule 13-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 I Expenditure reported on: j ❑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 I Destination city or name of destination location i I Means of transportation Purpose of travel(including name of conference,seminar,or other event) j i ATTACH ADDITIONAL COPIES OF THIS SCHEDULE AS NEEDED Forms provided by Texas Ethics Commission wimmethies,state.N.us Revised 9/8/2015 i r l I CANDIDATE / OFFICEHOLDER REPORT-. DESIGNATION OF FINAL REPORT FORM C/OH - FR The Instruction Guide explains how to complete this form. •• Complete only if "Report Type" on page I is marked "Final Report" •� 11 C/OH NAME 2 Filer ID (Ethics Commission Filers) 3 SIGNATURE 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: E:D 1 do not have unexpended contributions or unexpended interest or income earned from political contributions. 0 I have unexpended contributions or unexpanded 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 orunexpended 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: � Q I do not retain assets purchased with political contributions or interest or other income from political contributions. Q 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 5 OFFICEHOLDER •• Complete this section only if you are an officeholder •• I [] 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 www,ethics.state.tx.us Revised 9/8/2015 � I i