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McCaskill Semi Jan 2021CANDIDATE / OFFICEHOLDER FORM C/OH CAMPAIGN FINANCE REPORT COVER SHEET PG 1 The Cl Instruction Guide explains ho Commission _ 1 Filer I® (Ethics Commission Filers} 2 Total pages filed: to complete this form. 3 CANDIDATE/ MS 1 MR. ! hfR FIRST MI OFFICE USE ONLY OFFICEHOLDER NAME ..t ....... .. .....,.. ate Received NICKNAME LAST SUFFIX CANDIDATE/ ADDRESS ( PO 60X; APT I SUITE #; CITY; STATE, ZIP CODE OFFICEHOLDER MAILING q Q c ILL ADDRESS Change of Address 4 5 CANDIDATE/ AREA CODE PHONE NUMBER EXTENSION Date Hand -delivered or Dake Postmarked OFFICEHOLDER PHONE1 l M......_: .�._._ Receipt # Amount $ CAMPAIGN MS! RS 0S .FIRST MI TREASURER w.. u.. NAME Date Processed ...... r ................ ... ..... NICKNAME LAST SUFFIX ILDate Im ® C 1 L -V 7 CAMPAIGN STREETADDRESS (NO PO BOX PLEASE); APT / SUITE #, CITY; STATE„ ZIP CODE TREASURER ADDRESS } (Residence or Business) CAMPAIGN AREA CODE PHONE NUMBER EXTENSION TREASURER PHONE 8 REPORT TYPE January 15 301[h day before election Runoff 15th day after campaign El 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 THROUGH ® // H- / 1 11 ELECTION ELECTION DATE ELECTION TYPE Month Day Year ❑ Primary ❑ Runoff ❑ Other Description General Special 12 OFFICE OFFICE HELD (If any)1 OFFICE SOUGHT (if known) 14 NOTICE FROM THIS BOX IS FOR NOTICE OF POLITICAL CONTRIBUTIONS ACCEPTED OR POLITICAL EXPENDITURES MADE BY POLITICAL COMMITTEES TO SUPPORT POLITICAL THE CANDIDATE J OFFICEHOLDER. THESE EXPENDITURES MAY HAVE BEEN RADE WITHOUT THE CANDIDATE'S OR OFFICEHOLDER'S KNOWLEDGE OR CONSENT. CANDIDATES AND OFFICEHOLDERS ARE REQUIRED TO REPORT THIS INFORMATION ONLY IF THEY RECEIVE NOTICE OF SUCH EXPENDITURES, COMMITTEE(S) COMMITTEE TYPE COMMITTEE NAME GENERAL COMMITTEE ADDRESS Additional Pages SPECIFIC COMMITTEE CAMPAIGN TREASURER NAME COMMITTEE CAMPAIGN TREASURER ADDRESS GO TO PAGE 2 Forms provided by Texas Ethics Commission www.ethics.state.N.us Revised 8/1712020 CANDIDATE / OFFICEHOLDER FORM C/OH t 15 C/O(Ethics Commission Filers) m 1 Filer ID Em u 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 3. TOTAL UNITEMIZED POLITICAL EXPENDITURE. TOTALS $ . 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 1 18 SIGNATURE 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. 6A)\— Signature of Candidate or Officeholder Please complete i r option below: THEKSA K. HOWARD (1) Affidavit Notary Texas Noxy ID 121663-2 My caffillirissim . 07-314021 NOTARY STAMP/ SEAL y M thisthe day of ` Sworn to and subscribed before me by ' t a ) " 20 to certify which witness my hand and seal of office. �-A: ..rx�'" Signature of s r officer administering oath Printed name of officer administering oath Title of officer administering oath a� () Unsworn Declaration My name is and my date of birth is My address is , (street) (city) (state) (Zip code) (country) Executed in County, State of on the day of ,20_. (month) (year) Signature of Candidate/Officeholder (Declarant) Forms provided by Texas Ethics Commission .ethics.state.tx.us Revised 8/17/2020 SUBTOTALS - C/OH FORM C/OH COVER SHEET PG 3 19 FILER NAME 20 Filer ID (Ethics Commission Filers) T.A 21 SCHEDULE SUBTOTALS SUBTOTAL NAME OF SCHEDULE AMOUNT SCHEDULE Al: MONETARY POLITICAL CONTRIBUTIONS $ 2. El SCHEDULEA2: NON -MONETARY (IN-KIND) POLITICAL CONTRIBUTIONS $ 3. SCHEDULE B: PLEDGED CONTRIBUTIONS $ El 4. SCHEDULE E:LOANS 5, El SCHEDULE Fl: POLITICAL EXPENDITURES MADE FROM POLITICAL CONTRIBUTIONS $ 6, L ] SCHEDULE F2: UNPAID INCURRED OBLIGATIONS $ 7, ❑ SCHEDULE F3: PURCHASE OF INVESTMENTS MADE FROM POLITICAL CONTRIBUTIONS $ 8, SCHEDULE F4: EXPENDITURES MADE BY CREDIT CARD $ 9. El SCHEDULE G: POLITICAL EXPENDITURES MADE FROM PERSONAL FUNDS $ 10. SCHEDULE H: PAYMENT MADE FROM POLITICAL CONTRIBUTIONS TO A BUSINESS OF CION $ 11, ❑ SCHEDULE 1: NON-POLITICAL EXPENDITURES MADE FROM POLITICAL CONTRIBUTIONS $ 12.SCHEDULE K: INTEREST, CREDITS, GAINS, REFUNDS, AND CONTRIBUTIONS RETURNED $ 0 TO FILER Forms provided by Texas Ethics Commission www.ethics,state.tx.us Revised 8117/2020 MONETARY POLITICAL CONTRIBUTIONS SCHEDULE Al If the requested information is not applicable, DO NOT include this page in the report. 1 Total pages Schedule At The Instruction Guide explains how to complete this form. 2 FILER NAME 3 Filer ID (Ethics Commission Filers) tW FJ c t Date 6 Full name of contributor ❑ out -®f -state PAC (ID# p 7 Amount of contribution ($) Contributor address; City+,;; State; Zip Code Principal occupation / Job title (See Instructions) 9 Employer (See Instructions) Date Full name of contributor ❑ out-of-state PAC (ID#_ ) Amount of contribution ($) Contributor address; . City;{ * State; Zip Code Principal occupation / Job title (See Instructions) Employer (See Instructions) Date Full name of contributor ❑ out-of-state PAC (Mk L Amount of contribution ($) Contributor address; City, State; Zip Code Principal occupation / Job title (See Instructions) :rE7mplayer(See Instructions) Date Full name of contributor out-of-state PAC<(ID#; }- Amount of contribution ($) Contributor address, *City 4State; Y Zip Code Principal occupation / Job title (See Instructions) Employer (See Instructions) ATTACH ADDITIONAL COPIES OFT IS 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 8/17/2020 NON -MONETARY (IN-KIND) POLITICAL SCHEDULE A2 CONTRIBUTIONS If the requested information is not applicable, DO NOT include this page in the report. The Instruction Guide explains how to complete this form. 1 Total pages Schedule A2: 2 FILER NAME 3 Filer ID (Ethics Commission Filers) 1 TOTAL OF UNITE IZ IN-KIND POLITICAL CONTRIBUTIONS 6 m Date 6 Full name of contributor ❑ out-of-state PAC (10#' I8 Amount of 19 In-kind contribution Contribution $ h description i 7 Contributor address; City; State; Zip Code j( ❑ 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-state PAC (IDW--) I Amountof In-kind contribution Contribution $ description j Contributor address, City State; Zip Code I; 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) ATTACHITI L COPIES 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 .ethics.state.tx.us Revised 8/17/2020 PLEDGED CONTRIBUTIONS SCHEDULE B If the requested information is not applicable, DO NOT include this page in the report. I Total pages Schedule B: The Instruction Guide explains how to complete this form. 2 FILER NAME 3 Filer ID (Ethics Commission Filers) C- C /_Vs; V_ - 4 TOTAL OF UNITEMIZED PLEDGES $ 6 Date 6 Full name of pledgor ❑ out-of-state PAC (rp* 8 Amount I 9 In-kind contribution of Pledge $ description ................. ...... 7 Pledger address; City; State; Zip Code I. 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 I In-kind contribution of Pledge $ I 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 -slate PAC (ID#-.-) Amount of In-kind contribution Pledge $ I description Pledgor address; CityState; Zip Code ❑ Check if travel outside of Texas. Complete Schedule T Principal occupation / Job title (See Instructions) Employer (See Instructions) Date Full name of pledger E] out -of -stale PAC (WA i Amount of I In-kind contribution Pledge $ I. 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) ATTACH ADDITIONAL COPIES OF THIS SCHEDULE AS NEEDED If contributor Is out-of-state PAC, please see Instruction guide for additional reporting reclulrements. Forms provided by Texas Ethics Commission www.ethics.state,tx.us Revised 8/17/2020 LOANS SCHEDULE E If the requested information is not applicable, DO NOT include this page in the report. .m The Instruction Guide explains how to complete this form. 1 Total pages Schedule E 2 FILER NAME Filer ID (Ethics Commission Filers) 1 1 4 TOTAL OF UNITE IZED LOANS Date of loan 7 Name of lender out-of-state PAC (ID#' 9 Loan Amount {$) — „ .,nx..... ..:. ................ .. ..ew, .,.,.,,,..,..,.;� ,,.. ,:,, ...,e,., rate Is lender Lender address; City; State; Zip Code 1 Interest a financial Institution? 11 Maturity date Y 12 Principal occupation / Job title (See Instructions) 13 Employer (See Instructions) 14 Description of Collateral 15 Check if personal funds were deposited into politica! El none (See Instructions) none El 16 GUARANTOR 17 Name of guarantor 19 Amount Guaranteed ($) INFORMATION 18 Guarantor addressl City' State; Zip Code ❑ not applicable 20 Principal Occupation (See Instructions) 21 Employer (See Instructions) Date of loan Name of lender ❑out-of-state PACltD#-_... i Loan Amount ($) .. ...... ...... B teres4ra8e,..... Is lender Lender address; City; State; Zip Code n a financial Institution? Maturity date Y N Principal occupation ! Job title (See Instructions) Employer (See Instructions) Description of Collateral Check if personal funds were deposited into political account (See Instructions) ❑ none GUARANTOR Name of guarantor Amount Guaranteed ($) INFORMATION Guarantor address, City; State, 54Zip Code El 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 .ethics,state,tx.us Revised 8/17/2020 POLITICAL EXPENDITURES MADE SCHEDULE F1 FROM POLITICAL CONTRIBUTIONS If the requested information is not applicable, DO NOT include this page in the report. - - ------ EXPENDITURE CATEGORIES FOR BOX 8(a) Advertising Expense Event Expense Loan RepayrnenVReimbursement Solicitation/Fund raising 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 GifDowards/Memorials Expense Printing Expense Travel Out Of District Candidate/Officeholder/Political Committee Legal Services Salades/Wages/Contract Labor Other (enter a category not listed above) Credit Card Payment The Instruction Guide explains how to complete this form. I Total pages Schedule Fl, wiry 2 FILER NAME 3 Miller ID (Ethics Commission Filers) L - "Date 5 Payee name 4 Amount 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) E-1 Check if travel outside of Texas. Complete Schedule I ❑ Check if Austin, TX, officeholder living expense 9 Complete QLU-Y if direct Candidate / Officeholder name Office sought office held expenditure to benefit C10H Date Payee name Amount Payee address; City; State; Zip Code Category (See Categories listed M the top of this schedule) Description PURPOSE OF EXPENDITURE Check 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 C/OH 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 of-rexas. Complete ScheduloT. Check if Austin, TX, officeholder living expense Complete QNLY if direct Candidate / Officeholder name Office sought Office held expenditure to benefit C10H ATTACH ADDITIONAL COPIES OF THIS SCHEDULE AS NEEDED Forms provided by Texas Ethics Commission www.ethics,state,tx.us Revised 8/17/2020 UNPAID INCURRED OBLIGATIONS SCHEDULE F2 If the requested information is not applicable, DO NOT include this page in the report. EXPENDITURE CATEGORIES FOR BOX 10( ) Advertising Expense Event Expense Loan Repay ment/ReirubUrsement 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 Gifi/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, I Total pages Schedule F2: 2 FILER NAME 3 Filer ID (Ethics Commission Filers) IA C C P,5 lh< I t__ 4 TOTAL OF UNITEZED UNPAID INCURRED OBLIGATIONS $ Date 6 Payee name 7 Amount 8 Payee address City; State; Zip Code 9 TYPE OF PoliticalEl 1:1 Non -Political EXPENDITURE 10 (a) Category (See Categories listed at the top of this schedule) (b) Description PURPOSE OF EXPENDITURE (c) Cheek if travel outside of Texas, Cornplele SchadUle T. Check if Austin, TX, officeholder living expense 11 Complete PNLY if direct Candidate / Officeholder name Office Sought Office held expenditure to benefit C/OH Date Payee name Amount Payee address; City; Statew Zip Code TYPE OF EXPENDITURE Political Non -Political Category (See Categories listed at the top of this schedule) Description PURPOSE OF EXPENDITURE Check if travel outside ofTexas, Complete Schedule T. El Check if Austin, TX, officeholder living expense Complete QNLY if direct Candidate / Officeholder name Office sought Office held expenditure to benefit C10H ATTACH ADDITIONAL COPIES OFT I SCHEDULE AS NEEDED Forms provided by Texas Ethics Commission www.ethics.state.tx.us Revised 8/1712020 PURCHASE OF INVESTMENTS MADE SCHEDULE F3 FROM POLITICAL CONTRIBUTIONS If the requested information is not applicable, DO NOT include this page in the report. 1 Total pages Schedule F3: The Instruction Guide explains how to complete this form. FILER NAME 3 Filer IC (Ethics Commission Filers) I _ c 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 {$) Date Name of person from whom investment is purchased Address of person from whom investment is purchased, City; State Zip Code Description of investment Amount of investment {$) ATTACH ADDITIONAL COPIES OF THIS SCHEDULE AS NEEDED Forms provided by Texas Ethics Commission www.ethics.state.tx.us Revised 8/1712020 EXPENDITURES MADE BY CREDIT CARD SCHEDULE F4 If the requested information is not applicable, DO NOT include this page in the report. EXPENDITURE CATEGORIES FOR BOX I 0(a) Advertising Expense Event Expense Loan Repayment/ReirnbUrsement Solicitation/Fundralsing Expense Accounflng/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) The Instruction Guide explains how to complete this form. I Total pages Schedule F4FILER NAME 3 Filer ID (Ethics Commission Filers) 4 TOTAL OF UNITEMIZED EXPENDITURES CHARGED TOACREDIT CARD $ 5 Date 6 Payee name 7 Amount 8 Payee address; City; State; Zip Code 9 TYPE OF EXPENDITURE El Political El Non -Political 10 (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 EJ Check if Austin, TX, officeholder living expense 11 Candidate / Officeholder name Office sought Office held Complete gM if direct expenditure to benefit C/OH Date Payee name Amount ($) Payee address, City; State; Zip Code TYPE OF EXPENDITURE Political Non -Political El Category (see Categories listed at the top of this schedule) Description PURPOSE OF EXPENDITURE Check iftravei outside olTexas, Complete ScheduleT. ❑ Check if Austin, TX, officeholder living expense Candidate / Officeholder name Office sought Office held Complete Q= if direct expenditure to benefit C/OH ATTACH ADDITIONALC I OF THIS SCHEDULE AS NEEDED Forms provided by Texas Ethics Commission www.ethics.state,tx.us Revised 8/17/2020 POLITICAL EXPENDITURES MADE FROM SCHEDULE G PERSONAL FUNDS If the requested information is not applicable, DO NOT include this page in the report. EXPENDITURE CATEGORIES FOR BOX 8(a) Advertising Expense Event Expense Loan Repayment/Relmloursement 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 CandidatelOfflosholder/Political Committee Legal Services SaladesMages/Contract Labor Other (enter a category not listed above) Credit Card Payment The Instruction Guide explains how to complete this form. 1 -Totapages --- I Schedule G: 2 FILER NAME -ID"Etl lea Commission Filers) r3FII-r C 4 Date 5 Payee name 6 Amount 7 Payee address: City; State; Zip Code Reimbursement from 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 QLLLY if direct expenditure to benefit C1OH Date Payee name Amount Payee address; City; State; Zip Code Reirdfo,psement from PoRicalcontribulone k1tonded Category (see categories listed at the top of this schedule) Description PURPOSE OF EXPENDITURE Check if travel outside of Texas. Complete Schedule T. [J Check if Austin, TX, officeholder living expense Candidate / Officeholder name Office sought Office held Complete QhLy if direct expenditure to benefit C/01-1 Date Payee name Amount Payee address; City; State; Zip Code Reimbursement from EJpoliVeAWcontributions intended Category (See Categories listed at the top ofthis schedule) Description PURPOSE OF EXPENDITURE Check if travel outside of Taxes. Complete Schedule T. El Check if Austin, TX, officeholder living expense Candidate I Officeholder name Office sought Office held Complete 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 8/17/2020 PAYMENT MADE FROM POLITICAL CONTRIBUTIONS SCHEDULE H TO A BUSINESS OF C/OH If the requested information is not applicable, DO NOT Include this page in the report. EXPENDITURE CATEGORIES FOR BOX 8(a) Advertising Expense Event Expense Loan Repayment/Rembursement 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 Giff/Awardsiesemorials Expense Printing Expense Travel Out Of District Candidate/Officeholder/Political Committee Legal Services SalariesAAfages/Contract Labor Other (enter a category not listed above) Credit Card Payment The Instruction Guide explains how to complete this form. Total pages Schedule H: 2 FILER NAME 3 Filer ID (Ethics Commission Filers) C— iid:if-� V— ( %-A— Data Business name -"mount 7 Business address; City: State; Zip Code 8 (a) Category (See Categories listed at the top of this schedule) (b) Description PURPOSE OF EXPENDITURE (c) El Check if travel outside of Texas. Complete Schedule T. Check if Austin, TX, officeholder living expense 9 Complete QhLy 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 OF EXPENDITURE Check if travel outside of Texas. Complete Schedule T. ❑ Check if Austin, TX, officeholder living expense Complete Q= if direct Candidate / Officeholder name Office sought Office held expenditure to benefit CIOH Date Business name Amount ($) Business address; City; State; Zip Code Category (See Categories listed at the top of this schedule) Description PURPOSE OF EXPENDITURE Check If travel outside of Texas. Complete Schedule T. El Check if Austin, TX, officeholder living expense Complete Q= if direct Candidate / Officeholder name Office sought Office held expenditure to benefit C/01-1 ATTACH ADDITIONAL COPIES OFT IS SCHEDULE AS NEEDED Forms provided by Texas Ethics Commission www,ethics.state.tx.us Revised 8/17/2020 NON-POLITICAL EXPENDITURES SCHEDULEI MADE FROM POLITICAL CONTRIBUTIONS If the requested information is not applicable, DO NOT Include this page in the report. The Instruction Guide explains how to complete this form. I Total pages Schedule I. 2 FILER NAME 3 Filer ID (Ethics Commission Filers) - 4 Date 5 Payee name 6 Amount 7 Payee aciclress, City State Zip Code 8 (a) Category (See insfruclions 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.) 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,) 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.) OF EXPENDITURE ATTACH ADDITIONAL COPIES OF THIS SCHEDULE AS NEEDED Forms provided by Texas Ethics Commission www.ethics.state.tx.us Revised 8/17/2020 INTEREST, CREDITS, GAINS, REFUNDS, AND SCHEDULE K CONTRIBUTIONS RETURNED TO FILER If the requested information is not applicable, DO NOT include this page in the report. I Total pages Schedule K: The Instruction Guide explains how to complete this form. 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 E] Check if political contribution returned to filer Date Name of person from whore amount is received Amount Address of person from whom amount is received; City; F 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 ATTACH ADDITIONAL COPIES OFT I LEAS NEEDED Pnrmq nmvirled by TF-xn.s Ethics Commission www.ethics.state.tx.us Revised 8/17/2020 IN-KIND CONTRIBUTIONS OR POLITICAL EXPENDITURES SCHEDULE T FOR TRAVEL OUTSIDE OF TEXAS If the requested information is not applicable, DO NOT include I in the report. 1 Total pages Schedule T: The Instruction Guide explains how to complete this form. 2 FILER NAME 3 Filer ID (Ethics Corrimission Filers) 4 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 6 Dates of travel 7 Name of person(s) traveling Departure city or name of departure location 9 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: ❑ Schedule A2 ❑ Schedule B ❑ Schedule B(J) ❑ Schedule 02 ❑ 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) 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) ATTACH ADDITIONAL COPIES OF THISSCHEDULE Forms provided by Texas Ethics Commission .ethics.state.tx.us Revised 8/17/2020 CANDIDATE/ OFFICEHOLDER REPORT. DESIGNATION OF FINAL REPORT FORM C/OH - FR The Instruction Guide explains how to complete is form. •• Complete only If " e o e" on page 1 is marked "Final Report' •• I C/OH NAME Filer Ip (Ethics Commission Filers) 3 SIGNATURE I do not expect any further political contributions or political expenditures in connection with my candidacy. I understand that designating 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 S Check only one: I do not have unexpended contributions or unexpended interest or income earned from political contributions. have unexpended contributions or unexpended interest or income earned from political contributions. I understand that 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: E:] I do not retain assets purchased with political contributions or interest or other income from political contributions. 0 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. -- _,_---I',------ —----- — ,.. ---- Signature of Candidate 5 OFFICEHOLDER •• Complete this section only If you are an officeholder •• fes' 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 political contributions or interest or other income from political contributions. Signature of Officeholder Forms provided by Texas Ethics Commission www.ethics.state.tx.us Revised 9/17/2020"