Williamson Semi Jan 2017CANDIDATE / OFFICEHOLDER
CAMPAIGN FINANCE REPORT
FORM C/OH
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.
15th day after campaign
3 CANDIDATE/
MS / MRS FIRST MI
OFFICEHOLDER
NAME
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C` r /.......
.......... .
NAME LAST SUFFIX
NICK}
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4 CANDIDATE/
OFFICEHOLDER
ADDRESS / PO Bdx; APT / SUITE #; CITY; STATE; ZIP CODE
F-1Changeof Address
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5 CANDIDATE/
AREA CODE PHONE NUMBER EXTENSION
PHONE HOLDER
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6 CAMPAIGN
MSe IG / MR FIR(,SMI
TREASURER
NAME............../................
NICKNAME LAST SUFFIX
wall►�sa�
7 CAMPAIGN
TREASURER
STREET ADDRESS (NO PO BOX PLEASE); APT / SUITE #; CITY; STATE;
�- /
-
8 CAMPAIGN
AREA CODE PHONE NUMBER EXTENSION
TREASURER
-%
PHONE
9 REPORT TYPE
January 15 El 30th day before election El Runoff
❑ July 15 ❑ 8th day before election ❑ Exceeded $500 limit
10 PERIOD Month Day Year
COVERED S /
11 ELECTION ELECTION DATE
Month Day Year ❑ Primary
❑ General
12 OFFICE OFFICE HELD (if any)
OFFICE USE ONLY
Date Received
RECEIVED
JAN 1 2 2017
101OF CIT°,' Sr --C WETARY
Date Hand -delivered or Date Postmarked
Receipt # Amount $
Date Processed
Date Imaged
ZIP CODE
Month Day Year
THROUGH / / / z/ /
ELECTION TYPE
❑ Runoff ❑ Other
Description
❑ Special
13 OFFICE SOUGHT (if known)
GO TO PAGE 2
Forms provided by Texas Ethics Commission www.ethics.state.tx.us
Revised 9/8/2015
15th day after campaign
treasurer appointment
(Officeholder Only)
Final Report (Attach C/OH - FR)
Month Day Year
THROUGH / / / z/ /
ELECTION TYPE
❑ Runoff ❑ Other
Description
❑ Special
13 OFFICE SOUGHT (if known)
GO TO PAGE 2
Forms provided by Texas Ethics Commission www.ethics.state.tx.us
Revised 9/8/2015
CANDIDATE / OFFICEHOLDER FORM C/OH
CAMPAIGN FINANCE REPORT COVER SHEET PG 2
14 C/01-1 NAME
15 Filer ID (Ethics Commission Filers)
16 NOTICE FROM
THIS BOX IS FOR NOTICE OF POLITICAL CONTRIBUTIONS ACCEPTED OR POLITICAL EXPENDITURES MADE BY POLITICAL COMMITTEES TO
POLITICAL
SUPPORT THE CANDIDATE/ OFFICEHOLDER. THESE EXPENDITURES MAY HAVE BEEN MADE WITHOUT THE CANDIDATES OR OFFICEHOLDER S
COMMITTEE(S)
KNOWLEDGE OR CONSENT. CANDIDATES AND OFFICEHOLDERS ARE REQUIRED TO REPORT THIS INFORMATION ONLY IF THEY RECEIVE NOTICE
OF SUCH EXPENDITURES.
COMMITTEE TYPE COMMITTEE NAME
❑ Additional Pages
17 CONTRIBUTION
TOTALS
EXPENDITURE
TOTALS
CONTRIBUTION
BALANCE
OUTSTANDING
LOAN TOTALS
18 AFFIDAVIT
GENERAL
COMMITTEE ADDRESS
SPECIFIC
COMMITTEE CAMPAIGN TREASURER NAME
COMMITTEE CAMPAIGN TREASURER ADDRESS
1. TOTAL POLITICAL CONTRIBUTIONS OF $50 OR LESS (OTHER THAN
PLEDGES, LOANS, OR GUARANTEES OF LOANS), UNLESS ITEMIZED
2. TOTAL POLITICAL CONTRIBUTIONS
(OTHER THAN PLEDGES, LOANS, OR GUARANTEES OF LOANS) fJ
3. TOTAL POLITICAL EXPENDITURES OF $100 OR LESS, $ !1
UNLESS ITEMIZED (�
4. TOTAL POLITICAL EXPENDITURES $ D
5. TOTAL POLITICAL CONTRIBUTIONS MAINTAINED AS OF THE LAST DAY
OF REPORTING PERIOD 1
6. TOTAL PRINCIPAL AMOUNT OF ALL OUTSTANDING LOANS AS OF THE
LAST DAY OF THE REPORTING PERIOD $ / 70. O�
uu ,
,�.".... -, Lori Payne
?.' 161 Notary Public, State of Texas
"' • Comm
Expires
,�,F •••����,- 10-27-2017
Notary ID 11019863
AFFIX NOTARY STAMP / SEALABOV E
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
under Title 15, El e tion C de./
Signature of Candidate or Officeholder
Sworn to and subscribed before me, by the said (C�� W (, 11(`Q RVLS IqA
day o `GlV1LXU`{ 20 7 to certify which, witness my hand and seal of office.
41ni I - pa4y.11-� Lov-C Pe4c,�-le-
Signature of officer adm -tering oath Printed name of off er administering oath
this the t
CL ky Sof-�k�
Title of officer administering Ath
Forms provided by Texas Ethics Commission www.ethics.state.tx.us Revised 9/8/2015