Loading...
McCaskill Semi Jan 2019CANDIDATE / 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 MR FIRST MI OFFICE USE ONLY OFFICEHOLDER NAME ' ^ ��I �"W rj � I Date Received . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . NICKNAME LAST SUFFIX x� 4 CANDIDATE / ADDRESS / PO BOX; APT / SUITE #; CITY; STATE; ZIP CODE OFFICEHOLDER Uu v eUT0A r).c. ?%�CF_ MAILING ADDRESS ❑ Change of Address C a ✓V�"� �'�� ( ���� �O `a 5 CANDIDATE/ AREA CODE PHONE NUMBER EXTENSION Date Hand -delivered or Date Postmarked OFFICEHOLDER PHONE / p 1 q!1 ) 41 � nn r —1 O i 6 CAMPAIGN MS / R MR FIRST MI Receipt # Amount $ TREASURER Date Processed NAME .' . . . . . NICKNAME LAST SUFFIX Date Imaged J� _ � � � ` �l 7 CAMPAIGN STREET ADDRESS (NO PO BOX PLEASE); APT / SUITE #; CITY; STATE; ZIP CODE TREASURER ADDRESS 6 U k P CjL (Residence or Business) 8 CAMPAIGN AREA CODE PHONE NUMBER EXTENSION PHONE TREASURER ! ,:n ` G a 9 REPORT TYPE El 30th day before election Runoff 15th day after campaign January 15 El treasurer appointment (Officeholder Only) ❑ July 15 ❑ 8th day before election Exceeded $500limit Final Report (Attach C/OH - FRI 10 PERIOD Month Day Year Month Day Year COVERED J� `...I / �� THROUGH 11 ELECTION ELECTION DATE ELECTION TYPE Month Day Year ❑ Primary ❑ Runoff ❑ Other YY�` / O�" Description General ❑ Special 12 OFFICE OFFICE HELD (if any) 13 OFFICE SOUGHT (if known) C \ T -`l or- sU t_-114 LA IAA CkT-1 Co %A.4 Ct L pl,vkcrp-. .-a GO TO PAGE 2 R�•1fo0.M t7 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/OH 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 OFFICEHOLDERS COMM ITTEE(S) KNOWLEDGE OR CONSENT. CANDIDATES AND OFFICEHOLDERS ARE REQUIRED TO REPORT THIS INFORMATION ONLY IF THEY RECEIVE NOTICE OF SUCH EXPENDITURES. N /► i�'T 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 (h 2. TOTAL POLITICAL CONTRIBUTIONS $ (OTHER THAN PLEDGES, LOANS, OR GUARANTEES OF LOANS) EXPENDITURE TOTALS 3. TOTAL POLITICAL EXPENDITURES OF $100 OR LESS, $ UNLESS ITEMIZED 4. TOTAL POLITICAL EXPENDITURES $ CONTRIBUTION 5. TOTAL POLITICAL CONTRIBUTIONS MAINTAINED AS OF THE LAST DAYBALANC $ OF REPORTING PERIOD OUTSTANDING 6. TOTAL PRINCIPAL AMOUNT OF ALL OUTSTANDING LOANS AS OF THE $ LOAN TOTALS LAST DAY OF THE REPORTING PERIOD 'Q t ya.' U Q 18 AFFIDAVIT 1 swear, or affirm, under penalty of perjury, that the accompanying report is ,ttllrrr. BRANDI GARLOCK true and correct and includes all information required to be reported by me �;�•• .Notary Public, State of Texas under Title 15, Election Code. 08-10-2020 ;r.zz Comm. Expires ) Notary ID 12501161-8 Signature of Candidate or Officeholder AFFIX NOTARY STAMP / SEAL ABOV E Sworn to and subscribed before me, by the said 5h�.� M�.<«S�. \\ this the \A day of20_to certify which, witness my hand and seal of office. Signature of officer administering oath Printed name of officer administering oath Title of officer administering oath Forms provided by Texas Ethics Commission www.ethics.state.tx.us Revised 9/8/201 b SUBTOTALS - C/OH FORM C/OH COVER SHEET PG 3 19 FILER NAME ` 20 Filer ID (Ethics Commission Filers) 21 SCHEDULE SUBTOTALS NAME OF SCHEDULE SUBTOTAL AMOUNT 1• El SCHEDULEAi: MONETARY POLITICAL CONTRIBUTIONS $ 2. SCHEDULEA2: NON-MONETARY(IN-KIND) POLITICAL CONTRIBUTIONS $ 3. SCHEDULE B: PLEDGED CONTRIBUTIONS $ 4. SCHEDULE E: LOANS $ 5. SCHEDULE F1: POLITICAL EXPENDITURES MADE FROM POLITICAL CONTRIBUTIONS $ (� �•Y 6. SCHEDULE F2: UNPAID INCURRED OBLIGATIONS $ 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 $ it. El SCHEDULE I: NON -POLITICAL EXPENDITURES MADE FROM POLITICAL CONTRIBUTIONS $ 12 ❑SCHEDULE K: INTEREST, CREDITS, GAINS, REFUNDS, AND CONTRIBUTIONS RETURNED TO FILER $ Forms provided by Texas Ethics Commission www. etn lcs. state.tx. us rluvlseu �/Ofcu I O 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 (ID#: ) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 6 Contributor address; City; State; Zip Code 7 Amount of contribution ($) 8 Principal occupation / Job title (See Instructions) 9 Employer (See Instructions) Date Full name of contributor ❑ out-of-state PAC (ID#: I . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Contributor address; City; State; Zip Code Amount of contribution ($) Principal occupation / Job title (See Instructions) Employer (See Instructions) Date Full name of contributor ❑ out-of-state PAC (ID#: ) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Contributor address; City; State; Zip Code Amount of contribution ($) Principal occupation / Job title (See Instructions) Employer (See Instructions) Date Full name of contributor ❑ out-of-state PAC (ID#: ) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Contributor address; City; State; Zip Code Amount of contribution ($) 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 tievisea t o 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 ID (Ethics Commission Filers) 4 TOTAL OF UNITEMIZED IN -KIND POLITICAL CONTRIBUTIONS $ 5 Date 6 Full name of contributor ❑ out-of-state PAC (ID#: . . . . . . . . . . . . 7 Contributor address; City; State; Zip Code . . . . 8 Amount of g In -kind contribution Contribution $ description ❑ 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) 16 If contributor is a child, law firm of parent(s) (if any) (FOR JUDICIAL) Date Full name of contributor ❑ out-of-state PAC (IDN: . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Contributor address; City; State; Zip Code . . . . Amount of In -kind contribution Contribution $ description 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 rmevlsea vitsizu i 5 PLEDGED CONTRIBUTIONS SCHEDULE B Total pages Schedule 13: The Instruction Guide explains how to complete this form. 1 2 FILER NAME 3 Filer ID (Ethics Commission Filers) / `n 4 TOTAL OF UNITEMIZED PLEDGES 5 Date 6 Full name of pledgor ❑ out-of-state PAC (ID#: ) 8 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) Employer (See Instructions) Date Full name of pledgor ❑out-of-state PAC (ID#: ) Amount In -kind contribution 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-of-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) Date Full name of pledgor ❑ out-of-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) 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.ethlcs.state.tx.us rtieviseu �ioicu i 1j LOANS SCHEDULE E 1 Total pages Schedule E: The Instruction Guide explains how to complete this form. 1 2 FILER NAME 3 Filer ID (Ethics Commission Filers) :S V--I A L-j N � ' 1`r C C (i� �j V— � �. �.► 4 TOTAL OF UNITEMIZED LOANS $ 5 Date of loan 7 Name of lender ❑ out-of-state PAC (lD#: I . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 8 Lender address; City; State; Zip Code 9 Loan Amount ($) 6 Is lender 10 Interest rate a financial Institution? 11 Maturity date Y N 12 Principal occupation / Job title (See Instructions) 13 Employer (See Instructions) 14 Description of Collateral 15 Check if personal funds were deposited into political account (See Instructions) ❑ none ❑ 16 GUARANTOR 17 Name of guarantor 19 Amount Guaranteed ($) INFORMATION . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 18 Guarantor address; City; State; Zip Code ❑ not applicable 20 Principal Occupation (See Instructions) 21 Employer (See Instructions) Date of loan Name of lender ❑ out-of-state PAC (ID#: I . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Lender address; City; State; Zip Code Loan Amount ($) Is lender Interest rate a financial Institution? Maturity date Y N Principal occupation / Job title (See Instructions) Employer (See Instructions) Description of Collateral Check if personal funds were deposited into political account (See Instructions) ❑ none ❑ GUARANTOR Name of guarantor Amount Guaranteed ($) INFORMATION . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Guarantor address; City; State; Zip Code ❑ not applicable Principal Occupation (See Instructions) Employer (See Instructions) ATTACH ADDITIONAL COPIES OF THIS SCHEDULE AS NEEDED If lender is out-of-state PAC, please see instruction guide for additional reporting requirements. Forms provided by Texas Ethics Commission www.etmcs.state.tx.us neviaGu U/O/GU 1 o POLITICAL EXPENDITURES MADE FROM POLITICAL CONTRIBUTIONS SCHEDULE F1 EXPENDITURE CATEGORIES FOR BOX 8(a) Advertising Expense Event Expense Loan Repayment/Reimbursement Solicitation/FundraisingExpense Accounting/Banking Fees Office Overhead/Rental Expense Transportation Equipment & Related Expense Consulting Expense FoodiBeverage 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 Salaries/wages/Contract tabor Other (enter a category not listed above) Credit Card Payment The Instruction Guide explains how to complete this form. 1 Total pages Schedule F1: 2 FILER NAME 3 Filer ID (Ethics Commission Filers) SH✓a-w(A- Cn 4 Date 5 Payee name 6 Amount ($) 7 Payee address; City; State; Zip Code 8 (a) Category (See Categories listed at the top of this schedule) (b) Description ❑ Check if travel outside of Texas. Complete Schedule PURPOSE OF ❑ Check if Austin, TX, officeholder living expense EXPENDITURE g Complete ONLY if direct Candidate / Officeholder name Office sought Office held expenditure to benefit C/OH Date Payee name Amount ($) Payee address; City; State; Zip Code Category (See Categories listed at the top of this schedule) Description ❑ Check if travel outside of Texas. Complete Schedule T. PURPOSE 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 ❑ Check if travel outside of Texas. Complete Schedule T. PURPOSE 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 ATTACH ADDITIONAL COPIES OF THIS SCHEDULE AS NEEDED Forms provided by Texas Ethics Commission www.etnlcs.state.tx.us ncviacu UNPAID INCURRED OBLIGATIONS SCHEDULE F2 EXPENDITURE CATEGORIES FOR BOX 10(a) Advertising Expense Event Expense Loan Repayment/Reimbursement Solicitation/Fundraising Expense Accounting/Banking Fees Office Overhead/Rental Expense Transportation Equipment & Related Expense Consulting Expense Food/Beverage Expense Polling Expense Travel In District Contributions/Donations Made By Giff/AWards/Memorials Expense Printing Expense Travel Out Of District Candidate/Officeholder/Political Committee Legal Services Salaries/Wages/Contract Labor Other (enter a category not listed above) The Instruction Guide explains how to complete this form. 1 Total pages Schedule F2: 2 FILLER NAME 3 Filer ID (Ethics Commission Filers) J '- Cr V_ I,L 4 TOTAL OF UNITEMIZED UNPAID INCURRED OBLIGATIONS $ 5 Date 6 Payee name 7 Amount ($) 8 Payee address; City; State; Zip Code 9 TYPE OF EXPENDITURE ❑ Political ❑ Non -Political 10 (a) Category (See Categories listed at the top of this schedule) (b) Description PURPOSE ❑ Check if travel outside of Texas. Complete Schedule T. OF EXPENDITURE ❑Check if Austin, TX, officeholder living expense 11 Complete ONLY if direct Candidate / Officeholder name Office sought Office held expenditure to benefit C/OH Date Payee name Amount ($) Payee address; City; State; Zip Code TYPE OF ❑ ElEXPENDITURE Political Non Political Category (See Categories listed at the top of this schedule) Description ❑ T. Check if travel outside of Texas. Complete Schedule PURPOSE 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 ATTACH ADDITIONAL COPIES OF THIS SCHEDULE AS NEEDED Forms provided by Texas Ethics Commission www.ethlcs.state.tx.us naviacu z7roi" PURCHASE OF INVESTMENTS MADE FROM POLITICAL CONTRIBUTIONS SCHEDULE F3 The Instruction Guide explains how to complete this form. 1 Total pages Schedule F3: ' 2 FILER NAME / + W ` C 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 7 Description of investment 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 neviseu aioleu i zi EXPENDITURES MADE BY CREDIT CARD SCHEDULE F4 EXPENDITURE CATEGORIES FOR BOX 10(a) Advertising Expense Event Expense Loan Repayment/Reimbursement SolicitatioNFundraising Expense Accounting/Banking Fees 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 Salades=ages/Contract Labor 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 ID (Ethics Commission Filers) `^ ! w S I— ✓N-of 1" ` ` �-I 1 L 4 TOTAL OF UN ITEMIZED EXPENDITURES CHARGED TOACREDIT CARD $ 5 Date 6 Payee name 7 Amount ($) 8 Payee address; City; State; Zip Code 9 TYPE OF EXPENDITURE Political Non -Political 10 (a) Category (See Categories listed at the top of this schedule) (b) Description PURPOSE ❑ Check if travel outside of Texas. Complete Schedule T. OF EXPENDITURE ❑Check if Austin, TX, officeholder living expense 11 Complete ONLY if direct Candidate / Officeholder name Office sought Office held expenditure to benefit C/OH Date Payee name Amount ($) Payee address; City; State; Zip Code TYPE OF ElEXPENDITURE Political Non -Political Category (See Categories listed at the top of this schedule) Description ❑ Check if travel outside of Texas. Complete Schedule T. PURPOSE OF 0 Check if 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 Fievlsea 9/8/4u 10 POLITICAL EXPENDITURES SCHEDULE G MADE FROM PERSONAL FUNDS EXPENDITURE CATEGORIES FOR BOX 8(a) Advertising Expense Event Expense Loan Repayment/Reimbursement Solicitation/Fundraising Expense Accounting/Banking Fees 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 SaladesWages/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 G: 2 FILER NAME 3 Filer ID (Ethics Commission Filers) I /� A N' J (" I A- w-,% N t • C Lin' S V— t 4 Date 5 Payee name 6 Amount ($) 7 Payee address; City; State; Zip Code ❑Reimbursement from political contributions intended 8 (a) Category (See Categories listed at the top of this schedule) (b) Description PURPOSE Check if travel outside of Texas. Complete Schedule T. OF EXPENDITURE ❑ Check if Austin, TX, officeholder living expense 9 Complete ONLY if direct Candidate / Officeholder name Office sought Office held expenditure to benefit C/OH Date Payee name Amount ($) Payee address; City; State; Zip Code ❑Reimbursement from political contributions intended Category (See Categories listed at the top of this schedule) (b) Description PURPOSE Check if travel outside of Texas. Complete Schedule T. OF EXPENDITURE ❑ Check if Austin, TX, officeholder living expense Complete ONLY it direct Candidate / Officeholder name Office sought Office held expenditure to benefit C/OH Date Payee name Amount ($) Payee address; City; State; Zip Code ElReimbursement from political contributions intended Category (See Categories listed at the top of this schedule) (b) Description PURPOSE Check if travel outside of Texas. Complete Schedule T. OF EXPENDITURE ❑ Check if Austin, TX, officeholder living expense Complete ONLY if direct Candidate / Officeholder name Office sought Office held expenditure to benefit C/OH ATTACH ADDITIONAL COPIES OF THIS SCHEDULE AS NEEDED Forms provided by Texas Ethics Commission www. ethics. state. tx. us nt:vlacu J/o/Lu 1 o PAYMENT MADE FROM POLITICAL CONTRIBUTIONS TO A BUSINESS OF C/OH SCHEDULE H EXPENDITURE CATEGORIES FOR BOX 8(a) Advertising Expense Event Expense Loan Repayment/Reimbursement Solicitation/Fundraising Expense Accounting/Banking Fees Office Overhead/Rental Expense Transportation Equipment & Related Expense Consulting Expense FoodBeverage Expense Polling Expense Travel In District Contributions/Donations Maxie By Gift/Awards/Memorials Expense Printing Expense Travel Out Of District Candidate/Officeholder/Political Committee Legal Services Salaries/Wages/Contract Labor Other (enter a category not listed above) Credit Card Payment The Instruction Guide explains how to complete this form. 1 Total pages Schedule H: 2 FILER NAME 3 Filer ID (Ethics Commission Filers) ^ - ^ 4 Date 5 Business name 6 Amount ($) 7 Business address; City; State; Zip Code 8 (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 9 Complete ONLY if direct Candidate / Officeholder name Office sought Office held expenditure to benefit C/OH Date Business name Amount ($) Business address; City; State; Zip Code Category (See Categories listed at the top of this schedule) Description ❑ PURPOSE Check if travel outside of Texas. Complete Schedule T. OF EXPENDITURE Check if Austin, TX, officeholder living expense Complete ONLY if direct Candidate / Officeholder name Office sought Office held expenditure to benefit C/OH Date Business name Amount ($) Business address; City; State; Zip Code Category (See Categories listed at the top of this schedule) Description ❑ Check if travel outside of Texas. Complete Schedule T. PURPOSE 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 ATTACH ADDITIONAL COPIES OF THIS SCHEDULE AS NEEDED Forms provided by Texas Ethics Commission www.ethics.state.tx.us rtevlseu y/oicu i o NON -POLITICAL EXPENDITURES MADE FROM POLITICAL CONTRIBUTIONS SCHEDULE 1 The Instruction Guide explains how to complete this form. 1 Total pages Schedule I: 2 FILER NAME 3 Filer ID (Ethics Commission Filers) S M vj J 0 . tA� C/a-S � ► 1►�- 4 Date 5 Payee name 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 PURPOSE Category (See instructions for examples of acceptable Description (See instructions regarding type of information OF categories.) required.) EXPENDITURE Date Payee name Amount ($) Payee address; City; State; Zip Code PURPOSE Category (See instructions for examples of acceptable Description (See instructions regarding type of information OF categories.) required.) EXPENDITURE Date Payee name Amount ($) Payee address; City; State; Zip Code Category (See instructions for examples of acceptable Description (See instructions regarding type of information PURPOSE 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 INTEREST, CREDITS, GAINS, REFUNDS, AND CONTRIBUTIONS RETURNED TO FILER SCHEDULE K The Instruction Guide explains how to complete this form. 1 Total pages Schedule K: 2 FILER NAME 3 Filer ID (Ethics Commission Filers) 4 Date 5 Name of person from whom amount is received . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 6 Address of person from whom amount is received; City; State; Zip Code 8 Amount ($) 7 Purpose for which amount is received Check if political contribution returned to filer Date Name of person from whom amount is received . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Address of person from whom amount is received; City; State; Zip Code Amount ($) Purpose for which amount is received Check if political contribution returned to filer Date Name of person from whom amount is received . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Address of person from whom amount is received; City; State; Zip Code Amount ($) Purpose for which amount is received ❑ Check if political contribution returned to filer Date Name of person from whom amount is received . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Address of person from whom amount is received; City; State; Zip Code Amount ($) 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 IN -KIND CONTRIBUTIONS OR POLITICAL EXPENDITURES FOR TRAVEL OUTSIDE OF TEXAS SCHEDULE T The Instruction Guide explains how to complete this form. 1 Total pages Schedule T: 2 FILER NAME w �J 1�1 C ✓a- S I L �- 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 COWLIC ❑ 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 10 Means of transportation 11 Purpose of travel (including name of conference, seminar, or other event) 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) 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 COWLIC ❑ 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) ATTACH ADDITIONAL COPIES OF THIS SCHEDULE AS NEEDED Forms provided by Texas Ethics Commission www.ethics.state.tx.us Revised 9/8/2015 CANDIDATE / OFFICEHOLDER REPORT: 1--� I A DESIGNATION OF FINAL REPORT FORM C/OH - FR The Instruction Guide explains how to complete this form. -• Complete only if "Report Type" on page 1 is marked "Final Report" •• 1 C/OH NAME 2 Filer ID (Ethics Commission Filers) 3 SIGNATURE 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. 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: I do not have unexpended contributions or unexpended interest or income earned from political contributions. 0 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 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 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. B. ASSETS Check only one: 0 I do not retain assets purchased with political contributions or interest or other income from political contributions. 0 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 •- 0 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