Williamson Semi Jan 2020r
APPOINTMENT OF A CAMPAIGN TREASURER FORM CTA
BY A CANDIDATE PG 1
See CTA Instruction Guide for detailed instructions.
3 Total pages fled:
2 CANDIDATE
NAME
MS IMRS/MR FIRST MI
OFFICE USE ONLY
r
RECEIVED
Date Received
NICKNAME-ASTl J%
9
SUFFIX
C\ lM 1f JAN 1 6 2020
3 CANDIDATE
MAILING
ADDRESS //PO BOX; APT/SUITE #; CITY; STATE; ZIP CODE
"
OFFICE OF CITY SECRETAR
a stmad/ce
1tl
J1
4 CANDIDATE AREA CODE PHONE NUMBER EXTENSION Receipt# Amcuni$
PHONE
Date Processed
5 OFFICE Date Imaged
HELD
if any)
8 OFFICE
SOUGHT UAI w
if known) UU
7 CAMPAIGN
TREASURER
MS/MRS/MR FIRST MI NICKNAME
Any
LAST SUFFIX
NAME urf.
8 CAMPAIGN STREET ADDRESS (NO PO BOX PLEASE); APT SUITE#; CITY; STATE; ZIP CODE
TREASURER
residence or business)
9 CAMPAIGN AREA CODE PHONE NUMBER EXTENSION
TREASURER
PHONE
to CANDIDATE
SIGNATURE I am aware of the Nepotism Law, Chapter 573 of the Texas Government Code.
I am aware of my responsibility to file timely reports as required by title 15 of
the Election Code.
I am aware of the restrictions in title 15 of the Election Code on contributions
from corporations and labor organizations.
lit
Signature of Candidate Date Signed
GO TO PAGE 2
Forms provided by Texas Ethics Commission www. ethics. state.tx. us Revised 12/6/2019
CANDIDATE / 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 explainslhow to complete this form.
3 CANDIDATE/ MS/MRYrMfi j FIRST MI
OFFICEHOLDER
OFFICE USE ONLY
NAME o-1 W 4
Date Received
NICKNAME LAST SUFFIX
6,4.6f tj Il it-AfzrO,.• RECEIVED
J
4 CANDIDATE/ ADDRESS /PO BOY APT/SUITE#; CITY; STATE; ZIP CODE
OFFICEHOLDER
MAILING
1
5 CANDIDATE/ AREA CODE PHONE NUMBER EXTENSION OFFICE OF CITY SECRETARY
OFFICEHOLDER ( /
7 ) / 0 L— /
Date an -
PHONE b3y
e(etvt / O
I
20?o
6 CAMPAIGN MS/MRS/MR F ST MI Receipt# Amount$
TREASURER
NAME Date Processed
NICKNAME LAST SUFFIX
tea .1O_
Date Imaged141)//k
7 CAMPAIGN STREET ADDRESS (NO PO BOX PLEASE); APT/SUITE#; CITY; STATE; ZIP CODE
TREASURER
ADDRESS
8 CAMPAIGN AREA CODE PHONE NUMBER EXTENSION
TREASURER
PHONE
9 REPORT TYPE
January 15 I 30th day before election I I Runoff I I ftcm
treasurer15thday
aappoerinatmentpaign
Officeholder Only)
I I July 15 8th day before election I Exceeded$500 limit I Final Report(Attach C/OH-FR)
10 PERIOD Month Day Year Month Day Year
COVERED
7 / /7 //fT //q THROUGH d /2v' -a
11 ELECTION ELECTION DATE ELECTION TYPE
Month Day Year Primary Runoff I Other
Description
General I I Special
12 OFFICE OFFICE HELD (if any) 13 OFFICE SOUGHT (if known)
V
tree./ C14-7 e6 ff, 44 Ilf
GO TO PAGE 2
Forms provided by Texas Ethics Commission www.ethics.state.tx.us Revised 9/26/2019
CANDIDATE / OFFICEHOLDER FORM C/OH
CAMPAIGN FINANCE REPORT COVER SHEET PG 2
14 C/OH NAME i/ ... 15 Filer ID (Ethics Commission Filers)
jIV/
II
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
0 GENERAL
COMMITTEE ADDRESS
D 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, OR DCONTRIBUTIONSMADEELECTRONICALLY), UNLESS ITEMIZED
2. TOTAL POLITICAL CONTRIBUTIONS
OTHER THAN PLEDGES, LOANS, OR GUARANTEES OF LOANS)
TOTAL
DITURE
3. TOTAL POLITICAL EXPENDITURES OF $100 OR LESS,
UNLESS ITEMIZED O
4. TOTAL POLITICAL EXPENDITURES
CONTRIBUTION
5. TOTAL POLITICAL CONTRIBUTIONS MAINTAINED AS OF THE LAST DAY $
BALANCE
OF REPORTING PERIOD
OUTSTANDING 6. TOTAL PRINCIPAL AMOUNT OF ALL OUTSTANDING LOANS AS OF THE
LOAN TOTALS LAST DAY OF THE REPORTING PERIOD 70 0 6 v
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
VERONICA LOMAS
under Title 15,Electi nCode.
Notary public State of Texas
Comm. Expires 06-27-20ZC+
Notary ID 12901312-$
Signature of Candidate or Officeholder
AFFIX NOTARY STAMP/SEALABOVE
Sworn to and subscribed before me, by the said S A)/r//,'
a J0 ,this the 10)41
day of (,14001 ,20 ZIO ,to certify which,witness my hand and seal of office.
u---119~ Q)rC4 h0/nac tl/(a
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 9/26/2019