McCaskill Semi July 2020CANDIDATE / OFFICEHOLDER
FORM C/OH
CAMPAIGN
FINANCE REPORT COVER SHEET PG 1
-- .....--
1 Filer ID (Ethics Commission Filers) f
p
al pages filed:
2 Total
The C/O Instruction Guide explains how to complete this form.
3 CANDIDATE/
MS /Mfg `R FIRST MI
OFFICE USE ONLY
OFFICEHOLDER
b
NAME
Date Received
NICKNAME LAST SUFFIX
. �.
4 CANDIDATE/
ADDRESS / PO BOX; APT / SUITE #; CITY; STATE; ZIP CODE
OFFICEHOLDER
MAILING
ADDRESS
❑ Change of Address
5 CANDIDATE/
AREA CODE PHONE NUMBER EXTENSION
OFFICEHOLDER``
h t t{
Date Hand -delivered or Date Postmarked
PHONE
/
6 CAMPAIGN
MS f RS % R FIRST MI
Receipt # Amount
TREASURER
NAME
. . . . .
Date Processed
NICKNAME LAST SUFFIX
-
"
Dale Imaged
7 CAMPAIGN
STREET AD�.....,.�,...rv..._.
DRESS (NO PO BOX PLEASE); APT / SUITE #; CITY;
STATE; ZIP CODE
TREASURER(&
-l-0 y
i
ADDRESS
(Residence or Business)
CAMPAIGN
AREA CODE PHONE NUMBER EXTENSION
TREASURER
M-1 f9 9 3S S6
PHONE
3 REPORT TYPE
❑ January 15 ❑ 30th day before election Runoff
f l 15th day after campaign
l—J
treasurer appointment
(Officeholder Only)
July 15 ❑ 8th day before election Exceeded Modified
Final Report (Attach C/OH - FR)
Reporting Limit
10 PERIOD
Month Day Year Month
Day Year
COVERED
zO THROUGH`
3 a.l
A
11 ELECTION
ELECTION DATE ELECTION TYPE
Month Day Year ❑ Primary ❑ Runoff Other
OV*,„� Description
7 1,` 157 General ❑ Special
12 OFFICE
OFFICE HELD litany) 13 OFFICE SOUGHT (if known)
CQ N;�
--------------
GO TO PAGE 2
Forms provided by Texas Ethics Commission w.ethics.state.tx.us
Revised 1/1/2020
CANDIDATE / OFFICEHOLDER FORM C/OH
CAMPAIGN FINANCE REPORT COVER SHEET PG 2
1 C(OH NAME
1 Filer ID (Ethics Commission Filers)
}�t{a
1 .
16 NOTICE FROM
THIS BOX Is FOR NOTICE OF POLITICAL CONTRIBUTIONS ACCEPTED OR POLITICAL EXPENDITURES MADE BY POLITICAL COMMITTEES TO
POLITICAL
SUPPORT THE CANDIDATE I OFFICEHOLDER. THESE EXPENDITURES MAY HAVE BEEN MADE WITHOUT THE CANDIDATE'S 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
GENERAL
COMMITTEE ADDRESS
❑SPECIFIC
COMMITTEE CAMPAIGN TREASURER NAME
Additional Pages
COMMITTEE CAMPAIGN TREASURER ADDRESS
17 CONTRIBUTION
1. TOTAL UNITEMIZED POLITICAL CONTRIBUTIONS (OTHER THAN
TOTALS
PLEDGES, LOANS, OR GUARANTEES OF LOANS, OR
CONTRIBUTIONS MADE ELECTRONICALLY)
2, TOTAL POLITICAL CONTRIBUTIONS $
(OTHER THAN PLEDGES, LOANS, OR GUARANTEES OF LOANS)
EXPENDITURE
TOTALS
3,_ TOTAL UNITEMIZED POLITICAL EXPENDITURE.
$
4. TOTAL POLITICAL EXPENDITURES
CONTRIBUTION
BALANCE
5, TOTAL POLITICAL CONTRIBUTIONS MAINTAINED AS OF THE LAST DAY
OF REPORTING PERIOD
OUTSTANDING
6,, TOTAL PRINCIPAL AMOUNT OF ALL OUTSTANDING LOANS AS OF THE
$ UQ
LOAN TOTALS
LAST DAY OF THE REPORTING PERIOD 1 4
i
18 AFFIDAVIT
I swear, or affirm, under penalty of perjury, that the accompanying report is
YTHERESA
K.ARD true and correct and includes all information required to be reported by me
Notary `° , State of Tax8s under Title 15, Election Code.
Notary ID 121663-2
07-31-2021
My CoIlimiaW Exp,
Signature of Candidate or Officeholder
AFFIX NOTARY STA MPISEALABOVE
Sworn to and subscribed before me, by the saild,.5'f s this the
day of v� q q
20 A0 , to certify which, witness my hand and seal of office.
Signature of officer administering oath Printed name of officer administering oath Title ofd Icer administering oath
Forms provided by Texas Ethics Commission www.ethics.state.tx.us Revised 1/1/2020
MONETARY POLITICAL CONTRIBUTIONS SCHEDULE Al
The Instruction Guide explains how to complete this form. 1 Total pages Schedule Al.
FILER NAME 8 Filer ID (Ethics Commission Filers)
Date Full name of contributor out-of-state PAC (ID# _;-) 7 Amount of contribution ($)
6 Contributor address; y City; State; Zip Code
Principal occupation / Job title (See Instructions) 9 Employer (See Instructions)
Date Full name of contributor ❑ out-of-state PAC (ID# m -) Amount of contribution ($)
Contributor address; City; State; Zip Code
Principal occupation / Job title (See Instructions) Employer (See Instructions)
:1::
Date Full name of contributor out-of-state PAC ()DO--) Amount of contribution ($)
Contributor address; City; State; Zip Code
Principal occupation P Job title (See Instructions) Employer (See Instructions)
Date Full name of contributor out-of-state PAC (ID#: _-rr) Amount of contribution ($)
Contributor address; City; State; Zip Code
Principal occupation f Job title (See Instructions) Employer (See Instructions)
ATTACH ITI AL COPIES OF THISSCHEDULE
If contributor Is out-of-state PAG, please see Instruction guide for additional reporting requirements.
Forms provided by Texas Ethics Commission www.ethics.state.tx.us Revised 1/1/2020
NON -MONETARY (IN-KIND) POLITICAL
SCHEDULE A2
CONTRIBUTIONS
The Instruction Guide explains how to complete this form. 1 Total pages Schedule A2:
2 FILER NAME Filer ID (Ethics Commission Filers)
�' S -
4 TOTAL OF UNITE IZE IN-KIND POLITICAL CONTRIBUTIONS
Date S Full name of contributor ❑ out-of-state PAC (10W 5 Amount of 9 In-kind contribution
Contribution $ description
7 Contributor address; City; State; Zlp 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)
1 IIf contributor is a child, law firm ofarent
p (s) (if any) (FOR JUDICIAL)
Date Full name of contributor ❑ out-of-state PAC (IDA: ---J j 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 employerllaw firm (FOR JUDICIAL) Law firm - _ L)
of contributor's spouse (if any) (FOR JUDICIAL)
If contributor is a child, law firm of parent(s) (if any) (FOR JUDICIAr
w
L)
ATTACH ADDITIONAL COPIES THIS C L
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 1/1/2020
PLEDGED CONTRIBUTIONS SCHEDULE B
f
The Instruction Guide explains how to complete this form. 1 Total pages Schedule 3:
2 FILER NAME Filer ID (Ethics Commission Filers)
-�
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 (10# y Amount In-kind contribution
- of Pledge $ description
Pledgor address; (City; State; Zip Code
jo Check if travel outside of Texas: Complete Schedule T
mH�
Employer (ee InstructioPrinos al occupation l Job title (See Instructions) ns)
Date Full name of pledgor out-of-state PAC (ID#, ) Amount of In-kind contribution
Pledge $ description
Pledger 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 ttt�# m ) 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 COPTS 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 wwwethics. state Ax. us Revised 1(1!2020
LOANS SCHEDULE E
The Instruction Guide explains .. 1 ^^ Total pages _ p ns how to complete this form. p 9 l Schedule E:
2 FILER NAME 3 Filer ID (Ethics Commission Filers)
4 TOTAL OF UITMIZED LOANS
5 Date of loan 7 Name of lender ❑ out-of-state PAC (IDX-) 9 Loan Amount{$)
. . . .-. , , .. ,
6 Is lender 6 Lender address. City; State; Zip Code 10 Interest rate
a financial
Institutions
11 Maturity date
Y N
72 Principal occupation / J _ ...
p p Job title (See instructions) 13 Employer (See Instructions)
14 Description of Collateral m 16
Check if personal funds were deposited into political
El account (See Instructions)
❑ none
16 GUARANTOR 17 Name ofguarantor 19 Amount Guaranteed ($)
INFORMATION
16 1 Guarantor address; City; State; Zip Code
❑ not applicable
20 Principal Occupation (See instructions) 21 Employer (See Instructions)
Date of loan Name of tender ❑ out-of-state PAGCz#, _., ) Loan Amount ($)
Is lender Lender address; .-r City; State; k #Zip Code Interest rate
a financial
Institution?
Maturity date
Y N
Principal occupation / Job title (See Instructions) Employer (See Instructions)
Description of Collateral
Check if personal funds were deposited into political
account (See Instructions)
none
GUARANTOR Name of guarantor Amount Guaranteed ($)
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 ww.ethics.state.tx.us Revised 1/1/2020
POLITICAL
EXPENDITURES MADE
SCHEDULE F1
FROM POLITICAL
CONTRIBUTIONS
EXPENDITURE CATEGORIES FOR BOX 8(a)
Advertisin g Expense
EventExpense Loan RepaymentIReimbumernent
Solicitation/Fundraising Expense
AccountinglBan king
Fees Office Overhead/Rental Expense
Transportation Equament& Related Expense
Consulting Expense
Food/Beverage Expense Polling Expense
Travel In District
r
_ontdbutions/Donations Made By
GIVAwards/Memorials Expense Printing Expense
Travel Out Of District
Candidate/Officeholder/Political
Committee Legal Services SaladesANages/Contract Labor
Other (enter a category not listed above)
CreditCard payment
The Instruction Guide explains how to complete this form.
1 Total pages Schedule Fl,
2 FILER NAME
3 Filer ID (Ethics Commission Filers)
4 Date
5 Payee name
�Amoun�t($)i
7 Payee address; City;
State; Zip Code
8
(a) Category (See Categories listed at the top of this schedule) (b) Description
PURPOSE
OF
EXPENDITURE
(c) Check iftravel outside ofTexas, Complete Schedule T. Check if Austin, TX, officeholder living expense
9 Complete QN if direct
Candidate / Officeholder name Office sought
Office held
expenditure to benefit CICH
Date
Payee name
Amount ($)
Payee address; City;
State; Zip Code
Category (See Categories listed at the top of this schedule) De cription
PURPOSE
OF
EXPENDITURE
Check iftravel outside ofTexas Complete Schedule T Check if Austln,
TX, officeholder living expense
Complete QULY if direct
Candidate / Officeholder name Office sought
Office held
expenditure to benefit C1OH
Date
Payee name
Amount ($)
Payee address; City;
State; Zip Code
Category (See Categories listed at the top of this schedule) Description
PURPOSE
OF
EXPENDITURE
Check if travel outside ofTexas Complete Schedule T Check if Austin, TX, officeholder living expense
Corroete QW If direct
Candidate / Officeholder name Office sought
Office held
expenditure to benefit C1OH
ATTACH ADDITIONAL COPIES OF THIS SCHEDULEAS NEEDED
Forms provided by Texas Ethics Commission www.ethics.state.tx.us
Revised 111/2020
UNPAID INCURRED OBLIGATIONS SCHEDULE F2
EXPENDITURE CATEGORIES FOR BOX 10(a)
Advertising Expense EventExpense Loan RepaymenVReimbursement Solicitation/Fundraising Expense
Accounting/Banking Fees Offlce Overhead/Rental Expense Transportation Equipment& Related Expense
Consulting Expense Food/Beverage Expense Polling Expense Travel In District
Contributions/Donations Made By GffVAwards/Memodals Expense Printing Expense Travel Out Of District
Candidate/Ofriceholder/Poildcal Committee Legal Services SaladesAfVages/Contract Labor Other (enter a category not listed above)
The Instruction Guide explains how to complete this form.
I Total pages Schedule F2: 2 FILER NAME 3 Filer ID (Ethics Commission Filers)
— I_- " I '5"H r3f� W �_ 0 C C 01-S (A I t,- \- --- ---
4 TOTAL OF UNITEMIZED UNPAID INCURRED OBLIGATIONS $
15 Data 6 Payee name
7 Amount 8 Payee address; Clty� State; Zip Code
9 TYPE OF Political Non -Political
EXPENDITURE
10 (a) Category (See Categories listed at the top of this schedule) (b) Description
PURPOSE
OF
EXPENDITURE
(c) E:1 Check if travel outside of Texas Complete Schedule T Check if Austin, TX, officeholder living expense
Complete QULY 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
PURPOSE
OF
EXPENDITURE
Check iftravel outside ofTexas. Complete Schedule T Check if Austin, TX, officeholder living expense
Complete QhLv, if direct Candidate Officeholder name Office sought Office held
expenditure to benefit C/OH
ATTACH ADDITIONAL COPIES OF THIS SCHEDULE AS NEEDED
Forms Drovided by Texas Ethics Commission www.ethics.state.tx.us Revised 1/1/2020
PURCHASE OF INVESTMENTS MADE
SCHEDULE F3
FROM POLITICAL CONTRIBUTIONS
Total pages Schedule F3
The Instructlon Guideexiallains. howto complete this form
2 FILER NAME 8 Filer ID (Ethics Commission Filers)
Date Name of person from whom investment is purchased
Address of person from whom investment is purchased; City; State; Zip Code
7 Description of investment
Amount of investment ($}
Date Name of person from whom investment is purchased
Address of person from whom investment Is purchased; Cityq State; Zip Code
Description of investment
Amount of investment ($)
ATTACH ADDITIONAL COPIES THIS SCHEDULE AS NEEDED
Revised 1!1(2020
Forms provided by Texas Ethics Commission www.ethics.state,tx.us
EXPENDITURES MADE BY CREDIT CARD SCHEDULE F4
EXPENDITURE CATEGORIES FOR BOX 10(a)
Advertising Expense EventExpense Loan RepaymenVReimburrement Solicitation/Fund raising Expense
Accounting/Banking Fees Office Overbead/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 SaladesNVages/Contract Labor Other (enter a category notlisted above)
The Instruction Guide explains how to complete this form.
I Total pages Schedule 74: 2 FILER NAME 3 Filer ID (Ethics Commission Filers)
I 5-kAjj,� INA'
4 TOTAL OF UNITEMIZED EXPENDITURES CHARGED TO A CREDIT CARD $
6 Date 6 Payee name
7 Amount Payee address; C lty� State; Zip Code
9 TYPE OF Political
EXPENDITURE Non -Political
r
10 (a) Category (See Categories listed at the top of this schedule) (b) Description
PURPOSE
OF
EXPENDITURE
(a) Check if travel outside ofTexas Complete Schedule T Check if Austin, TX, officeholder living expense
11 Candidate I Officeholder name Office sought Office held
Complete QbLy if direct
expenditure to benefit C/OH
Date Payee name
Amount Payee address; City; State; Zip Code
TYPE OF Political Non -Political
EXPENDITURE 0 0
Category (See Categories listed at the top of this schedule) Description
PURPOSE
OF
EXPENDITURE
Check if travel outside ofTexas Complete Schedule T. E-1 Check if Austin, TX, officeholder living expense
Candidate I Officeholder name Office sought Office held
Complete CM if direct
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 1/1/2020
POLITICAL EXPENDITURES
SCHEDULEG
MADE FROM
PERSONAL FUNDS
EXPENDITURE CATEGORIES FOR BOX 8(a)
Advertising Expense
EventExpense Loan Repayment/Reimbursement Solicitation/Fundralsing Expense
Accounting/Banking
Fees Office Overhead/Rental Expense Transportation EquipmentS, Related Expense
Consulting Expense
Food/Beverage Expense Polling Expense Travel In District
Con bibution a/Conations Made
By Gift/Awards/Memorials, Expense Printing Expense Travel Out Of District
Candiclate/Officeholder/Political Committee Legal Services SaladesNVages/Con tract Labor Other(entera category not listed above)
CrecitCandPayment
The Instruction Guide explains how to complete this form.
1 Total pages Schedule G:
2 FILER NAME 3 Filer ID (Ethics Cominnission Filers)
'5'HVA- V -j r� r4\ y- C' n.5 V,
4 Date
6 Payee name
Amount
7 Payee address; City; State; Zip Code
Reimbursernentfrom
political contributions
intended
8
(a) Category (See Categories listed at the top of this schedule) (b) Description
PURPOSE
OF
EXPENDITURE
(c) Check if travel outside of Texas, Complete Schedule T Check If Austin, TX, officeholder living expense
9
Candidate Officeholder name Office sought Office held
Complete QNLY if direct
expenditure to benefit CICH
Date
Payee name
Amount
Payee aciclress� City; State; Zip Code
Reimbursement from
E-1 political contributions
intended
Category (see Categories listed at the top of this schedule) Description
PURPOSE
OF
EXPENDITURE
Check If travel outside of Texas. Complete Schedule T. Check if Austin, TX, officeholder living expense
Candidate / Officeholder name Office sought Office held
Complete _Q= if direct
expenditure to benefit C/OH
Date
Payee name
Amount (s)
Payee address; City: State; Zip Code
Reimbursementfrom
El political contributions
intended
Category (See Categories listed at the top of this schedule) Description
PURPOSE
OF
EXPENDITURE
El Check if travel outside of Texas Complete Schedule T El Check if Austin, TX, officeholder living expense
Candidate / Officeholder name Office sought Office held
Complete QNLY if direct
expenditure to benefit CICH
ATTACH ADDITIONAL COPIES OF THIS SCHEDULE AS NEEDED
Forms provided by Texas Ethics Commission www.ethics.state.tx.us Revised 1/1/2020
PAYMENT MADE FROM POLITICAL
SCHEDULEH
CONTRIBUTIONS
TO A BUSINESS OF C/OH
EXPENDITURE CATEGORIES FOR BOX 8(a)
Advertising Expense
EventExpense Loan RepaymentlRemnoursement Solicitation/F u no raising Expense
Accounting/Ban king
Fees Office Overhead/Rental Expense Transportation Equament& 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 Salares/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
--F3 Her ID (Ethics Corrittolssion Filers)
FILER NAME
A J ca 'S V-
--,,
Data
Business name
6 Amount 7
Business address; City; State; Zip Code
8 (a) Category (See Categories listed at [he top of this schedule) (b) Description
PURPOSE
OF
EXPENDITURE
(c) EJ Check if [ravel outside ofTexas Complete Schedule T El Check if Austin, TX, officeholder living expense
9 Complete QNff if direct
Candidate / Officeholder name Office sought Office held
expenditure to benefit CIOH
Date
Business name
Amount
Business address; City; State; Zip Code
Category ($as Categories listed at the top of this schedule) Description
PURPOSE
OF
EXPENDITURE
ElCheck if travel outside ofTexas, Complete Schedule T Check if Austin, TX, officeholder living expense
Complete QNLY if direct
Candidate / Officeholder name Office sought Office held
expenditure to benefit VCH
Date
Business name
Amount
Business address; City� State; Zip Code
Category (See Categories listed at the top of this schedule) Description
PURPOSE
OF
EXPENDITURE
ED Check If travel outside ofTexas, Complete Schedule T. E] Check if Austin, TX, officeholder living expense
Complete _QLILY if direct
Candidate / Officeholder name Office sought Office �e
expenditure to benefit CIOH
ATTACH ADDITIONAL COPIES OF THIS SCHEDULE AS NEEDED
Forms provided by Texas Ethics Commission www.ethics.state.tx.us Revised 1/1/2020
NON-POLITICAL EXPENDITURES
SCHEDULE
MADE FROM POLITICAL CONTRIBUTIONS
The Instrindon Guide e.VaIns howto corroets, this form
1 Total pages Schedule I.
2 FILER NAME
3 Filer ID (Ethics Commission Filers)
1-I I k;.
Date
6 Payee name
ro Amount ($)
7 Payee address,
City State Zip Code
(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 ($)
Payee address;
City State Zip Code
Category (See Instructions for examples of acceptable
Description (See instructions regarding type of information
PURPOSE
categories:.)
required,}
F
EXPENDITURE
Date
Payee name
Amount ($)
Payee address;
City State Zip Code
PURPOSE
Category (See instructions for examples of acceptable
Description (See instructions regarding type of information
F
categories::}
requiredO.:)
EXPENDITURE
Date
Payee name
Amount ($)
Payee address;
City State Zip Code
Category (See instructions for examples of acceptable
Description (See instructions regarding type of information
PURPOSE
categories:.)
required.:)
OF
EXPENDITURE
ATTACH ITI AL COPIES OF THIS SCHEDULE AS NEEDED
Forms provided by Texas Ethics Commission www.ethics.state.tx.us
Revised 1/1/2020
AND
INTEREST, CREDITS, GAINS, REFUNDS,
SCHEDULE
CONTRIBUTIONS RETURNED TO FILER
..
The
Instruction Guide explains how to complete this fonrn. 1 Total pages Schedule K:
2 FILER NAME 3Filer ID (Ethics Conyrission Filers)
45�-� A ( t-
Date 6 Name of person from whom amount Is received 8Amount (�)
6 Address of person from whom amount is received; City; State; Zip Code
7 Purpose for which amount is received Check if political contribution returned to filer
Date Name of person from whom amount is received Amount ($)
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{$)
Address of person from whom amount Is received; City, State; Zip Code
Purpose for which amount is received ❑ Check if political contribution returned to filer
Date Name of person from whom amount is received Amount {$)
Address of person from nwhom {amount Is received; City; State; Zip Code
Purpose for which amount Is received ❑ Check if political contribution returned to filer
ATTACH ADDITIONALG I OFT IS SCHEDULEAS NEEDED
Forms provided by Texas Ethics Commission www.ethics.state.tx.us Revised 111/2020
IN-KIND CONTRIBUTIONS OR POLITICAL EXPENDITURES
SCHEDULE T
FOR TRAVEL OUTSIDE OF TEXAS
1 Total pages Schedule T:
The Instniction Guldleexplains how to complete this f
2 FILER NAMEm
-9l 7r Pt
$ Filer ID (Ethics Commission Filers)
Name of Contributor/ Corporation or Labor Organization/ Pledgor / Payee
Contribution / Expenditure reported on:
❑ Schedule A2 ❑ Schedule Schedule B(J) Schedule 02 Schedule D
Schedule F1
❑ Schedule F2 ❑ Schedule F4 Schedule G ❑ Schedule H Schedule COM -UC ❑ Schedule B -SS
6 Dates of travel
7 Name of person(s) traveling
Departure city or name of departure location
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:
El 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 trans ortationx P
p
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)
ADDITIONAL COPIES I
Forms provided by Texas Ethics Commission .ethics.state.tx.us
Revised 1/1/2020
CANDIDATE /OFFICEHOLDER REPORT,
DESIGNATION OF FINAL REPORT FORM C/OH - FR
The Instruction Guide explains how to complete this form.
Complete only If "Report Type" on page I 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:
r�:] I do not have unexpended contributions or unexpended interest or income earned from political contributions.
E::] 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 1 do not retain assets purchased with political contributions or interest or other income from political contributions.
E] 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
E] 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 111/2020