McCaskill Semi July 2019CANDIDATE / OFFICEHOLDER
FORM C/OH
CAMPAIGN FINANCE REPORT COVER SHEET PG I
1 Filer ID (Ethics Commission Filers)
2 Total pages tiled:
The C/01-1 Instruction
Guide explains how to complete this form.
3 CANDIDATE/
OFFICEHOLDER
11-4 I tota, MR FIRST M1
Vj t� 0
OFFICE USE ONLY
NAME
. . . . . .
NICKNAME LAST SUFFIX
Date Received
RECEIVED
C CA5 V- I, LL
4 CANDIDATE/
OFFICEHOLDER
J U L 1 5 20119
i ADDRESS i PO BOX; APT I SUITE #; CITY; s STATE; ZIP CODE
MAILING
i UQS
ADDRESS
C) t,.1k-T1r4 LA- U-6-
Change of Address
OFFICE
OF CITY SECRETAF
5 CANDIDATE/
AREA CODE PHONE NUMBER EXTENSION
OFFICEHOLDERDate
PHONE
5-7ko
Hand -deli ate Postmarked
6 CAMPAIGNFIRST
Ms(�91 MP MI
Amount, $
TREASURER
Date Processed
NAME
NICKNAME LAST SUFFIX
Imaged
VDate
7 CAMPAIGN
STREET ADDRESS (NO PO BOX PLEASE); APT 1 SUITE #; CITY; STATE; ZIP CODE
TREASURER
ADDRESS
6001. e0 TO VA IV --
(Residence or Business)
(-A-T-V4L-AV-I`F- it'44v7 c)
8 CAMPAIGN
TREASURER
PHONE
1,
AREA CODE PHONE NUMBER EXTENSION
9 REPORT TYPE
F7 January 15 30th day before election Runoff 17 15th day after campaign F
treasurer appointment
(officeholder Only)
-u,-K July 15
Sin day before election Exceeded $500 limit � Final Report (Attach CIOH - FR)
10 PERIOD
Month Day Year Month Day Year
COVERED
THROUGH
11 ELECTION
ELECTION DATE ELECTION TYPE
Month Day Year 011 Pnmary Runoff F7 Other
C(fil" Description
/General Special
12 OFFICE
OFFICE HELD (if any) 13 OFFICE SOUGHT (it known)
C j T--( C Q i,,.N
-----------------------
GO TO PAGE 2
rUTITIS provuea Dy iexas tinics uornmisslon www,ethics.stateJx.us Revised 9/8/2015
CANDIDATE / OFFICEHOLDER
CAMPAIGN FINANCE REPORT
14 C/OH NAME
16 NOTICE FROM
POLITICAL
COMMITTEE(S)
❑ Additional Pages
17 CONTRIBUTION
TOTALS
EXPENDITURE
TOTALS
CONTRIBUTION
BALANCE
OUTSTANDING
LOAN TOTALS
18 AFFIDAVIT
FORM C/OH
COVER SHEET PG 2
15 Filer ID (Ethics Commission Filers)
THIS BOX IS FOR NOTICE OF POLITICAL CONTRIBUTIONS ACCEPTED OR POLITICAL EXPENDITURES MADE BY POLITICAL COMMITTEES TO
SUPPORT THE CANDIDATE / OFFICEHOLDER. THESE EXPENDITURES MAY HAVE BEEN MADE WITHOUT THE CANDIDATES OR OFFICEHOLDER'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
SPECIFIC
COMMITTEE ADDRESS
COMMITTEE CAMPAIGN TREASURER NAME
r"T THERESA K. HOWARD
Notary Public, State of Texas
tary
NoID 121663-2
My Collnmission Exp. 07-31-2021
AFFIX NOTARY STAMP/ SEAL ABOVE
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, Election Code.
v LKyU---'U
—
Signature of Candidate or Officeholder
Sworn to and subscribed before me, by the said NAC this the
day of , 20%, to certify which, witness my hand and seal of office.
K. Kc,,LvA �,) o"to-c PIC `� c_
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 9/8/2015
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)
3.
TOTAL POLITICAL EXPENDITURES OF $100 OR LESS,
UNLESS ITEMIZED
$
4. TOTAL POLITICAL EXPENDITURES
5.
TOTAL POLITICAL CONTRIBUTIONS MAINTAINED AS OF THE LAST DAY
OF REPORTING PERIOD
6.
TOTAL PRINCIPAL AMOUNT OF ALL OUTSTANDING LOANS AS OF THE
$
LAST DAY OF THE REPORTING PERIOD
I
r"T THERESA K. HOWARD
Notary Public, State of Texas
tary
NoID 121663-2
My Collnmission Exp. 07-31-2021
AFFIX NOTARY STAMP/ SEAL ABOVE
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, Election Code.
v LKyU---'U
—
Signature of Candidate or Officeholder
Sworn to and subscribed before me, by the said NAC this the
day of , 20%, to certify which, witness my hand and seal of office.
K. Kc,,LvA �,) o"to-c PIC `� c_
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 9/8/2015
SUBTOTALS - C/OH
FORM C/OH
COVER SHEET PG 3
19 FILER NAME 20 Filer ID (Ethics Commission Filers)
SUBTOTAL
AMOUNT
$
$
$
Forms provided by Texas Ethics Commission www. ethics. state.tx.us Revised 9/8/2015
s1 -I �,- u•r � � � C ,�. S ►�C c L �.-
21
SCHEDULE SUBTOTALS
NAME OF
SCHEDULE
1.
❑
SCHEDULEAI: MONETARY POLITICAL CONTRIBUTIONS
2.
SCHEDULE A2: NON -MONETARY (IN-KIND) POLITICAL CONTRIBUTIONS
3.
SCHEDULE B: PLEDGED CONTRIBUTIONS
4.
SCHEDULE E: LOANS
5.
SCHEDULE F1: POLITICAL EXPENDITURES MADE FROM POLITICAL CONTRIBUTIONS
6.
SCHEDULE F2: UNPAID INCURRED OBLIGATIONS
f •
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.
F1
SCHEDULE H: PAYMENT MADE FROM POLITICAL CONTRIBUTIONS TO A BUSINESS OF C/OH
11,
El
SCHEDULE I: NON-POLITICAL EXPENDITURES MADE FROM POLITICAL CONTRIBUTIONS
12.
�'-1
SCHEDULE K: INTEREST, CREDITS, GAINS, REFUNDS, AND CONTRIBUTIONS
LJ
RETURNED TO FILER
SUBTOTAL
AMOUNT
$
$
$
Forms provided by Texas Ethics Commission www. ethics. state.tx.us Revised 9/8/2015
MONETARY POLITICAL CONTRIBUTIONS SCHEDULE Al
The Instruction Guide explains how to complete this form.
1 Total pages Schedule At: I
3 Filer ID (Ethics Commission Filers)
2 FILER NAME
AWP -I �A C CA5V%%- %--
7 Amount of contribution ($)
4 Date 5 Full name of contributor ❑ out-of-state PAC (ID#: )
6 Contributor address; City; State; Zip Code
8 Principal occupation / Job title (See Instructions) 9 Employer (See Instructions)
Date
Full name of contributor ❑ out-of-state PAC {ION: _ I
Amount of contribution ($)
Contributor address; City; State; Zip Code
Principal occupation / Job title (See Instructions)
Employer (See Instructions)
Date Full name of contributor ❑ out-of-state PAC IiD#: I Amount of contribution ($)
Contributor address; City; State; Zip Code
Principal occupation / Job title (See Instructions) Employer (See Instructions)
Date Full name of contributor ❑ out-of-state PAC (ID#: ) Amount of contribution ($)
Contributor address; City; State; Zip Code
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 9/8/2015
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)
SH A w C11, S u
4 TOTAL OF UNITEMIZED IN-KIND POLITICAL CONTRIBUTIONS
$
5 Date 6 Full name of contributor ❑ out-of-state PAC (ID#:
)
8 Amount of g 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)
16 If contributor is a child, law firm of parent(s) (if any) (FOR JUDICIAL)
Date
Full name of contributor ❑ out-of-stale PAC (ID#:
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 9/8/2015
PLEDGED CONTRIBUTIONS SCHEDULE B
1 Total pages Schedule B:
Instruction Guide explains how to complete this form.
IThe
2 FILER NAME
3 Filer ID (Ethics Commission Filers)
S►-Id wfJ 0C CA-5V iLL
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) 11 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 Amount of In-klnd contribution
Full name of pledgor El out-of-state PAC (ID#: )
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-or-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.ethics.state.tx.us Revised 9/8/2015
LOANS SCHEDULE E
1 Total pages Schedule E:
The Instruction Guide explains how to complete this form.
2 FILER NAME 3 Filer ID (Ethics Commission Filers)
SM iii NA V- I, L-L
4 TOTAL OF UNITEMIZED LOANS
$
5 Date of loan
7 Name of lender ❑ out-of-state PAC (IDN:_ )
9 Loan Amount ($)
6 Is lender
g10
Lender address; City; State; Zip Code
Interest rate
a financial
Institution?
--
11 Maturity date
Y N
12 Principal occupation / Job title (See Instructions)
" 13 Employer (See Instructions)
14 Description of Collateral 15 Check if personal funds were deposited into political
account (See Instructions)
❑ none j ❑ _.
16 GUARANTOR 17 Name of guarantor 19 Amount Guaranteed ($)
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 (IDN ) Loan Amount ($)
Is lender Lender address; City; State; Zip Code Interest rate
a financial
Institution?
Maturity data
Y N
Principal occupation / Job title (See Instructions) Employer (See Instructions)
Description of Collateral
Check if personal funds were deposited into political
account (See Instructions)
❑ none
❑
GUARANTOR
Name of guarantor
Amount Guaranteed ($)
INFORMATION
Guarantor address; City; State; Zip Cade
❑ 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.ethics.state.tx.us Revised 9/8/2015
POLITICAL EXPENDITURES MADE
FROM POLITICAL CONTRIBUTIONS SCHEDULE F1
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 SaladesANages/Contract Labor Other (enter a category not listed above)
Credit Card Payment
The Instruction Guide explains how to complete this form.
Y Total pages Schedule F1: 2 FILER NAME 3 Filer ID (Ethics Commission Filers)
J 5 Hv3i, r/\ e CA :5 V, k V-
4
4 Date
5 Payee name
6 Amount ($)
7 Payee address; City; State; Zip Code
(a) Category (See Categories listed at the top of this schedule) (b) Description
$
❑ Check If travel outside of Texas. Complete Schedule T.
PURPOSE
OF
❑ Check if Austin. TX, officeholder living expense
EXPENDITURE
9 Complete ONLY if direct Candidate / Officeholder name Office sought Office held
expenditure to benefit C/OH
Date
Payee name
Amount ($)
Payee address; City; State; Zip Code
Category (See Categories listed at the top of this schedule) Description
❑ Check if travel outside of Texas. Complete Schedule T.
PURPOSE
OF ❑ Check if Austin, TX, officeholder living expense
EXPENDITURE
Complete ONLY if direct Candidate / Officeholder name Office sought Office held
expenditure to benefit C/OH
Date
Payee name
Amount ($)
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
❑ living
EXPENDITURE
Check If Austin, TX, officeholder 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 Revised 9/6/2015
Forms provided by Texas Ethics Commission www.ethics.state.tx.us Revised 9/8/2015
UNPAID INCURRED OBLIGATIONS SCHEDULE F2
EXPENDITURE CATEGORIES FOR BOX 10(a)
Advenising 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 SalariesMages/Contract Labor 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)
S H II L'i r.l r!1 c C /� S IVB I_ L
4
TOTAL OF UNITEMIZED UNPAID INCURRED OBLIGATIONS $y
5
Date 6
Payee name
7
Amount ($)
a
(a)
Payee address; City; State; Zip Code
Political Non -Political
_....... ___ -
Category (See Categories listed at the top of this schedule) (b) Description
9 TYPE OF
EXPENDITURE
10
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 ($)
Payee address; City; State; Zip Code
TYPE OF
EXPENDITURE
❑ Political ❑ Non -Political
Category (See Categories listed at the top of this schedule) Description
❑ Check if travel outside of Texas. Complete Schedule T.
PURPOSE
OF
❑ Check It Austin, TX, olllceholder living expense
EXPENDITURE
Complete ONLY if direct
Candidate / Officeholder name Office sought Office held
expenditure to benefit C/OH
ATTACH ADDITIONAL COPIES OF THIS SCHEDULE AS NEEDED
Forms provided by Texas Ethics Commission www.ethics.state.tx.us Revised 9/8/2015
PURCHASE OF INVESTMENTS MADE
FROM POLITICAL CONTRIBUTIONS
The Instruction Guide explains how to complete this form.
2 FILER NAME
4 Date 5 Name of person from whom investment is purchased
SCHEDULE F3
1 Total pages Schedule F3:
3 Filer ID (Ethics Commission Filers)
6 Address of person from whom investment is purchased; City; State; Zip Code
7 Description of investment
8 Amount of investment ($)
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 Revised 9/8/2015
EXPENDITURES MADE BY CREDIT CARD SCHEDULE F4
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 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)
The Instruction Guide explains how to complete this form.
1 Total pages Schedule F4:
2 FILER NAME
3 Filer ID (Ethics Commission Filers)
I
6'Hfiiil 0cCk0,,sL,%L-L-
4 TOTAL OF UNITEMIZED EXPENDITURES CHARGED TO A CREDIT CARD
$
5 Date
6 Payee name
8 Payee address; City; State; Zip Code
7 Amount ($)
9 TYPE OF
EXPENDITURE
10
PURPOSE
OF
EXPENDITURE
11 Complete ONLY if direct
expenditure to benefit C/OH
J Political Non -Political
(a) Category (See Categories listed at the top of this schedule) (b) Description
❑ Check if travel outside of Texas. Complete Schedule T.
❑Check If Austin, TX, officeholder living expense
Candidate / Officeholder name Office sought Office held
Date I Payee name
Amount ($)
TYPE OF
EXPENDITURE
PURPOSE
OF
EXPENDITURE
Complete ONLY if direct
expenditure to benefit C/OH
u Political
Non -Political
Category (See Categories listed at the top of this schedule) Description
Check if travel outside of Texas. Complete Schedule T.
❑'t Check II Austin, TX, officeholder living expense
Candidate / Officeholder name Office sought
ATTACH ADDITIONAL COPIES OF THIS SCHEDULE AS NEEDED
Office held
Forms provided by Texas Ethics Commission www.ethics.state.tx.us Hevlsed 9/8/2015
POLITICAL EXPENDITURES
MADE FROM PERSONAL FUNDS
EXPENDITURE CATEGORIES FOR BOX 8(a)
SCHEDULE G
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 GlfVAWards/Memorlals 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 G;
2 FILER NAME
3 Filer ID (Ethics Commission Filers)
o. w,J Nl `
eves k �-`-
4 Date
5 Payee name
6 Amount ($) 17 Payee address; City; State; Zip Code
EI Reimbursement from
L.� political contributions
intended _
8 (a) Category (See Categories listed at the top of this schedule) (b) Description
PURPOSE
OF Check If travel outside of Texas Complete Schedule T.
EXPENDITURE ❑ Check if Austin. TX, officeholder living expense
9 Complete ONLY if direct Candidate / Officeholder name Office sought Office held
expenditure to benefit C/OH
Amount ($)
Reimbursement from
political contributions
intended
PURPOSE
OF
EXPENDITURE
Complete ONLY if direct
expenditure to benefit C/OH
Date
Amount ($)
❑Reimbursementfrom
political contributions
PURPOSE
OF
EXPENDITURE
Complete ONLY if direct
expenditure to benefit C/OH
Payee name
Payee address; City; State; Zip Code
Category (See Categories listed at the top of this schedule) (b) Description
❑ Check if travel outside of Texas Complete Schedule T.
❑ Check If Austin, TX, officeholder living expense
Candidate / Officeholder name Office sought Office held
Payee name
Payee address; City; State; Zip Code
Category (See Categories listed at the top of this schedule) (b) Description
❑. Check if travel outside of Texas. Complete Schedule T.
❑ Check if Austin, TX, officeholder living expense
Candidate / Officeholder name Office sought Office held
ATTACH ADDITIONAL COPIES OF THIS SCHEDULE AS NEEDED
Forms provided by Texas Ethics Commission www.ethics.state.tx.us hevisea wb/eui o
PAYMENT MADE FROM POLITICAL
CONTRIBUTIONS TO A BUSINESS OF C/OH SCHEDULE H
EXPENDITURE CATEGORIES FOR BOX 8(a)
Advertising Expense Event Expense Loan Repayment/Reimbursement Solicitation/Fundraising Expense
Accounting/Banking Fees Office Overhead/Rental Expense Transportation Equipment & Related Expense
Consulting Expense Food/Beverage Expense Polling Expense Travel In District
Contributions/Donations Made By Gift/Awards/Memorials Expense Printing Expense Travel Out Of District
Candidate/Officeholder/Political Committee Legal Services SalariesANages/Contract Labor Other (enter a category not listed above)
Credit Card Payment
The Instruction Guide explains how to complete this form.
1 Total pages Schedule H: 2 FILER NAME 3 Filer ID (Ethics Commission Filers)
SHIlaw "I
4 Date
5 Business name
6 Amount ($)
7 Business address; City; State; Zip Code
8
(a) Category (See Categories listed at the top of this echedule)
(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 II 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 Revised 9/8/2015
NON-POLITICAL EXPENDITURES
MADE FROM POLITICAL CONTRIBUTIONS
The Instruction Guide explains how to complete this form.
1 Total pages Schedule l; 2 FILER NAME
(-%, w ,J N` C CA -5 V, t
4 Date 5 Payee name
6 Amount ($) 1 7 Payee address; City; State; Zip Code
SCHEDULE
3 Filer ID (Ethics Commission Filers)
8 (a)Category (See instructions for examples of acceptable (b)Description (See Instructions regarding type of inlormation
PURPOSE I categories.) I required.)
OF
EXPENDITURE
Date Payee name
Amount ($) Payee address;
City; State; Zip Code
PURPOSE Category (See instructions for examples of acceptable Description (See instructions regarding type of information
categories.) I required.)
OF
EXPENDITURE
Date Payee name
Amount ($) Payee address;
PURPOSE
OF
EXPENDITURE
Date
Amount ($)
PURPOSE
OF
EXPENDITURE
City; State; ap coae
Category (See instructions for examples of acceptable Description (See Instructions regarding type of information
categories.) required.)
Payee name
Payee address; City; State; Zip Code
Category (See Instructions for examples of acceptable Description (See instructions regarding type of Information
categories.) I required.)
ATTACH ADDITIONAL COPIES OF THIS SCHEDULE AS NEEDED
Forms provided by Texas Ethics Commission www.ethics.state.tx.us Hevlsed 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 8 Amount ($)
6 Address of person from whom amount is received; City; State; Zip Code
7 Purpose for which amount is received ❑ Check if political contribution returned to filer
Date
Name of person from whom amount is received Amount ($)
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 ($)
Address of person from whom amount is received; City; State; Zip Code
Purpose for which amount is received
Name of person from whom amount is received
U Check if political contribution returned to filer
Address of person from whom amount is received; City; State; Zip Code
Purpose for which amount is received
Amount ($)
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
The Instruction Guide explains how to complete this form.
2 FILER NAME
+ i�anC ui vunuiuuui vu,Nu, auun u�au�i viya,�auv,, ,o.+yv, , ny ��
5 Contribution / Expenditure reported on:
❑ Schedule A2 ❑ Schedule B ❑Schedule B(J) ❑Schedule C2
❑ Schedule F2 ❑ Schedule F4 ❑ Schedule G ❑ Schedule H
..-......—
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
SCHEDULE
i l Total pages Schedule I: t
3 Filer ID (Ethics Commission Filers)
❑ Schedule D ❑ Schedule F1
❑ Schedule COH-UC ❑ Schedule E3 -SS
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 F2 ❑ Schedule F4 ❑ Schedule G ❑ Schedule H
Dates of travel 1 -Name of person(s) traveling
Departure city or name of departure location
❑ Schedule D ❑ Schedule F1
❑ Schedule COWLIC ❑ Schedule B -SS
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 F2 ❑ Schedule F4 ❑ Schedule G ❑ Schedule H
Dates of travel Name of person(s) traveling
Departure city or name of departure location
❑ Schedule D ❑ Schedule F1
❑ Schedule COH-UC ❑ Schedule B -SS
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