Smith Semi July 2020CANDIDATE / OFFICEHOLDER
FORM C/OH
CAMPAIGN FINANCE REPORT COVER SHEET PG I
1 Filer ID (Ethics Commission Filers)
2 Total pages filed:
The C/OH Instruction Guide explains how to complete this form.
3 CANDIDATE/
MS MRJ:!!D FIRST Ml
OFFICE USE ONLY-
OFFICEHOLDER
NAME
. . . . . . . . . . . . . . . . * . . . . . .
Date Received
NICKNAME LAST SUFFIX
z5yv�_ -, +-L,
J U L 5 2020
4 CANDIDATE/
ADDRESS / PO BOX; APT / SUITE #; CITY; STATE; ZIP CODE
OFFICEHOLDER
MAILING
P. rb c)-r— -I Co L4
ADDRESS
C
Co Ll "11 c 4
V
FFICE OF CITY SECRETARY
F-1 Change of Address
5 CANDIDATE/
AREA CODE PHONE NUMBER EXTENSION
OFFICEHOLDER
PHONE
`�O� 0CA-1-
(Fl )
Date Hand-delivered or Date Postmarked
6 CAMPAIGN
Ms (g�-1 MR FIRST MI
Receipt #
Amount $
TREASURER
NAME
R-acke- L . . . . . . .
Date Processed
NICKNAME LAST SUFFIX
Date Imaged
7 CAMPAIGN
STREET ADDRESS (NO PO BOX PLEASE); APT / SUITE #; CITY; STATE;
ZIP CODE
TREASURER
ADDRESS
(Residence or Business)
tit l t e1 -2-
8 CAMPAIGN
AREA CODE PHONE NUMBER EXTENSION
TREASURER
Lt "IL
PHONE
9 REPORT TYPE
El January 15 F-1 30th day before election F-1 Runoff
15th day after campaign
treasurer appointment
(Officeholder Only)
X1 July 15 F-1 8th day before election Exceeded $500 limit
Final Report (Attach C/OH - FR)
10 PERIOD
Month Day Year Month
Day Year
COVERED
C)-j /(to / c;,- of /15
-
-
THROUGH
11 ELECTION
ELECTION DATE
ELECTION TYPE
Month Day Year
❑ Primary 1-1 Runoff F-1 Other
Description
OTfm
F-1 General 1:1 Special
12 OFFICE
OFFICE/HELD (if any)
13 OFFICE SOUGHT (if known)
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GO TO PAGE 2
Forms provided by Texas Ethics Commission www. ethics. state.tx. us Revised 9/8/2015
DocuSign Envelope ID: 6843E972-50DE-4984-AF4B-4E61C539DD7A
CANDIDATE 1 OFFICEHOLDER
FORM C/OH
CAMPAIGN I ANC COVER SHEET PG 2
14 CJOH NAME
15 Filer ID (Ethics Commission Filers)
i
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
D GENERAL
COMMITTEE ADDRESS
[]SPECIFIC
COMMITTEE CAMPAIGN TREASURER NAME
Additional Pages
I
COMMITTEE CAMPAIGN TREASURER ADDRESS
17 CONTRIBUTION 1. TOTAL UNITEMIZED POLITICAL CONTRIBUTIONS (OTHER THAN
TOTALS PLEDGES, LOANS, OR GUARANTEES OF LOANS, OR $ N/a
CONTRIBUTIONS MADE ELECTRONICALLY) (
2. TOTAL POLITICAL CONTRIBUTIONS
$ N/A
(OTHER THAN PLEDGES, LOANS, OR GUARANTEES OF LOANS)
EXPENDITURE 3 TOTAL UNITEMIZED POLITICAL EXPENDITURE,
TOTAL N/A
4. TOTAL POLITICAL EXPENDITURES $ 0.00
CONTRIBUTION 5. TOTAL POLITICAL CONTRIBUTIONS MAINTAINED AS OF THE LAST DAY
BALANCE
OF REPORTING PERIOD $1,525.57
OUTSTANDING 6. TOTAL PRINCIPAL AMOUNT OF ALL OUTSTANDING LOANS AS OF THE
LOAN TOTALS LAST DAY OF THE REPORTING PERIOD
i
18 AFFIDAVIT
I swear, or affirm, under penalty -of -perjury; -that theaccompanyingreport is --
_ true and correct and includes all information required to be reported by me
`" IIr' AMY SHELLEY under Title 15, Election Code.
��RY PUr/,.s
g
Notary Public, State of Texas Doc Signed by:
Comm. Expires 12-02-2023
rV rv�
OF � `�� r fiti
Notary ID 12.476110-5
FB01C�y6M..of Candidate or Officeholder
AFFIX NOTARY STAMP! SEALABOVE
Sworn to and subscribed before me, by the said ► ` C ell, ii. , this the
1 , 20 c�b to certify which, witness my hand and seal of office.
Aof
Sig re of officer imstering oath Printed 4rne of officer administering oath Title of ifficer administe in oath
Forms provided by Texas Ethics Commission www.ethics.state.tx.us Revised 1%1/2020
Amy Shelley
From: DocuSiqn System <dse_na2@docusign.net> on behalf of/one| smith via DocuSign
<dse_na2@docusignoet>
Sent: Wednesday, July 15'2U20 1:36 PM
To: Amy Shelley
Subject: Here is your signed RONELL - CFR - July 15
Do "
none|[smith
"Hi/\D7y.
Please let me kDQVV if I did this correctly,
Thanks for all of your help.
Select VIEW DOCUMENT to seCUrely view and download your documents.
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