Williamson Semi Jan 2018CANDIDATE / 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/
OFFICEHOLDER
NAME
MS / MlRjf!�R�> FIRST MI
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OFFICE USE ONLY
Date Received c C `,
RECEIVED
NICKNAME LAST SUFFIX
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JAN 1 1 v 2018
4 CANDIDATE/
OFFICEHOLDER
ADDRESS /PO X; APT / SUITE #; CITY; STATE; ZIP CODE
./
F-1Changeof Address
OFFICE OF CITY SECR
5 CANDIDATE/
AREA CODE PHONE NUMBER EXTENSION
OFFICEHOLDER//
PHONE
//
6 CAMPAIGN
MS / MRS / MR FI T MI
Receipt #
Amount $
TREASURER
NAME/'
Date Processed
NICKNAME LAST SUFFIX
Z/ i f,� J
/) /'
Date Imaged
7 CAMPAIGN
STREET ADDRESS (NO PO BOX PLEASE); APT / SUITE #; CITY; STATE;
ZIP CODE
TREASURER
` /
-
8 CAMPAIGN
AREA CODE PHONE NUMBER EXTENSION
TREASPHONE URER
( ?
9 REPORT TYPE
January 15 ❑ 30th 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
/
/ �//7 THROUGH / //-S- / /.r
7 �
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)
II
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GO TO PAGE 2
t-orms provided by texas Ethics Commission www.ethics.state.tx.us Revised 9/8/2015
'ARY
CANDIDATE / OFFICEHOLDER
FORM C/OH
CAMPAIGN FINANCE REPORT COVER SHEET PG 2
14 C/OH NAME A,,-*
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15 Filer ID (Ethics Commission Filers)
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16 NOTICE FROM
THIS BOX IS FOR NOTICE OF POLITICAL COdTRIR1ITIONS 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
COMM ITTEE(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
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
r/
2. TOTAL POLITICAL CONTRIBUTIONS
(OTHER THAN PLEDGES, LOANS, OR GUARANTEES OF LOANS)
a
EXPENDITURE
TOTALS
3. 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
$ y
OF REPORTING PERIOD
OUTSTANDING
6. TOTAL PRINCIPAL AMOUNT OF ALL OUTSTANDING LOANS AS OF THE
t' d b
$ /? D
LOAN TOTALS
LAST DAY OF THE REPORTING PERIOD
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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
CAROL ANN BORGES under Title 15,�lectio Code.
;Notary Public, State of Texas ;
°i�'•Wx 'i Comm. Expires 11-12-2021
„IF Notary ID 128100482
Signature of Candidate or Officeholder
AFFIX NOTARY STAMP/SEALABOVE
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Sworn to/ and subscribed before me, by the said this the
hand
day 2019 to certify which, witness my and seal of office.
ry
I-11Vi✓&)XCC- 4 'Tn
Signature of officer administering oath Printed name of officer administering oath Title of officer adminis9bring oath
Forms provided by Texas Ethics Commission www. ethics. state. tx.us Revised 9/8/201 b