Patton 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 / MRS / R FIRST MI
OFFICE USE ONLY
OFFICEHOLDER
//°° rrA� AA
M
Date Received
NAME
L/�
NICKNAME LAST SUFFIX
i n x t 1 t 2019
V I
4 CANDIDATE /
ADDRESS / PO BOX; APT / SUITE #; CITY; STATE; ZIP CODE
OFFICEHOLDER
MAILING
ADDRESS
U2vt,
t /9Z—
Change of Address
5 CANDIDATE/
AREA CODE PHONE NUMBER EXTENSION
Date Hand -delivered or Date Postmarked
OFFICEHOLDER
S�•% `
/ % I 'll
PHONE
6 CAMPAIGN
Ms / MRS /<D FIRST MI
Receipt #
Amount $
TREASURER
'bi XA_
Date Processed
NAME
. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
NICKNAME LAST SUFFIX
Date Imaged
We.10 /_
7 CAMPAIGN
STREET ADDRESS (NO PO BOX PLEASE); APT / SUITE #; CITY; STATE;
ZIP CODE
TREASURER
a a,-7 1 S.
G
ADDRESS
(Residence or Business)
5,420'& ,2()
tFHI T X (P D °1'Z-
8 CAMPAIGN
AREA CODE PHONE NUMBER EXTENSION
TREASURER
1 / 2-1LV 105 • -74Cls
PHONE
9 REPORT TYPE
yjJanuary 15 El 30Ih day before election ❑ Runoff
❑ 151h day after campaign
treasurer appointment
(Officeholder Only)
❑ July 15 ❑ 81h day before election ❑ Exceeded $500limit
Final Report (Attach C/OH - FR)
10 PERIOD
Month Day Year Month
Day Year
COVERED
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)
Gi�� CCU We-
GO TO PAGE 2
Forms provided by Texas Ethics Commission www.eth1cs.state.tx.us rsuvisuu yrotcv i o
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
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
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
$
(OTHER THAN PLEDGES, LOANS, OR GUARANTEES OF LOANS)
EXPENDITURE
3 TOTAL POLITICAL EXPENDITURES OF $100 OR LESS,
$
TOTALS
UNLESS ITEMIZED
4. TOTAL POLITICAL EXPENDITURES
$
CONTRIBUTION
5 TOTAL POLITICAL CONTRIBUTIONS MAINTAINED AS OF THE LAST DAY
$
BALANCE
OF REPORTING PERIOD
OUTSTANDING
g, 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 includes all information required to be reported by me
Amy Shelley under Title 15, Election Code.
ti�YP
Notary Public
* State of Texas—^
My Comm. Exp.12102/19 .
Notary ID# 12476110-5 Signature of Candidate or Officeholder
AFFIX NOTARY STAMP/ SEALABOVE
j
�� ` this the
Sworn to and subscribed before me, by the said
of 20 "I to certify which, witness my hand and seal of office.
Sig a*reof cer inistering oath Printe ame of officer Jinistering oath Title J off Od administering o
...a nIo inn�c
Forms provided by Texas Ethics Commission www.etmcs.s[ULU.LX.us ���