Talley Semi Jan 2021CANDIDATE / OFFICEHOLDER
FORM C/OH
CAMPAIGN FINANCE REPORT
COVER SHEET PG 1
1 Filer ID (Ethics Commission Fsers)
2 Total pages filed:
The C/OH Instruction Guide explains how to complete this form.
3 CANDIDATE/
MS / MRS / MR FIRST MI
OFFICE USE ONLY
OFFICEHOLDER
Kathleen, B.
to R calved
NAME................................................................................
NICKNAME LAST SUFFIX
Kathy Talley
RECEIVED
4 CANDIDATE/
ADDRESS / PO BOX; APT / SUITE 61 CITY; STATE; ZIP CODE
OFFICEHOLDER
MAILING
JAN 1 5 2021
ADDRESS
Change of Address
5 CANDIDATE/
AREA CODE PHONE NUMBER EXTENSION
atp�pellvetatlror�� ppggggrjust( ,
OFFICEHOLDER
(
'
PHONE
ecelpt #
Amount $
6 CAMPAIGN
MS / MRS l MR FIRST MI
TREASURER
Michael
Date Process
if
NAME..............................................................................
NICKNAME LAST SUFFIX
D
ate Imaged
Mike Talley
7 CAMPAIGN
STREET ADDRESS (NO PO BOX PLEASE); APT / SUITE V CRY;
STATE; ZIP CODE
TREASURER
ADDRESS
(Residence or Business)
8 CAMPAIGN
AREA CODE PHONE NUMBER EXTENSION
TREASURER
PHONE
(
9 REPORT TYPE
® January 15 30th day before election F-1 Runoff
15th day after campaign
treasurer appointment
(Officeholder Only)
❑ July 15 ❑ Sth day before eleollon ❑ Exceeded Modified
FInal Report (Attach C/OH - FR)
Reporting Limn
10 PERIOD
Month Day Year Month
Day Year
COVERED
10 /`25 /'2020 THROUGH 12 ,/`31 /2020
11 ELECTION
ELECTION DATE
ELECTION TYPE
❑ Primary ❑ Runoff ❑ Other
Month Day Year
OwApoon
11,/ 03 ;'2020
®General ❑ Special
12 OFFICE
OFFICE HELD (Ir any)
13 OFFICE SOUGHT (If known)
Southlake City Council,
Place 1
14 NOTICE FROM
THIS BOX IS FOR NOTICE OF POLITICAL CONTRIBUTIONS ACCEPTED OR POL.mGU. EXPENDITURES MME BY POLITICAL COMMITTEES TO SUPPORT
POLITICAL
THE CANDIDATE I OFFICEHOL DER. THESE EXPENDITCRES MAY HAVE BEEN MADE WITHOUT THE CANDWATEW OR OFRCEHOLDER KNOMAM OR
COMMITTEE(S)
CONSENT.. CANDIDATES AND OFFICEHOLDERS ARE REQUIRED TO REPORT THIS INFORMATION ONLYIFTHEYRECEIVENOTICEOFSUCHEXPENDITURES.
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.tx.us Revised 8/17/2020
CANDIDATE I OFFICEHOLDER FORM C/OH
CAMPAIGN FINANCE REPORT COVER SHEET PG 2
15 C/OH NAME Kathleen B Talley
16 Filer ID (Ethics Commission Filers)
17 CONTRIBUTION
1. TOTAL UNITEMIZED POLITICAL CONTRIBUTIONS (OTHER THAN
TOTALS
PLEDGES, LOANS, OR GUARANTEES OF LOANS, OR
$
CONTRIBUTIONS MADE ELECTRONICALLY)
50.00
2. TOTAL POLITICAL CONTRIBUTIONS
(OTHER THAN PLEDGES, LOANS, OR GUARANTEES OF LOANS)
$150.00
...................
EXPENDITURE
TOTALS
3. TOTAL UNITEMIZED POLITICAL EXPENDITURE.
$
..................
4. TOTAL POLITICAL EXPENDITURES
$ 2,310.59
5. TOTAL POLITICAL CONTRIBUTIONS MAINTAINED AS OF THE LAST DAY
$
CONTRIBUTION
ALANCE
..................
OF REPORTING PERIOD
3,502.63
OUTSTANDING
6. TOTAL PRINCIPAL AMOUNT OF ALL OUTSTANDING LOANS AS OF THE
LOAN TOTALS
LAST DAY OF THE REPORTING PERIOD
$
16 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.
Signature of Candidate or OfflQ11der
Please complete either option below:
(1) Affidavit �Y�P,VERONICA LOMAS
Notary Public, State of Texas
Expires 06-27-2024
p
Comm.
NOTARY STAMP/SEAL �'�;rFOF �`o` Notary Ib 129013126
Swom to and subscribed before me by Q I, 41,�lle�, this the Z / day ofl
'ZP___,to
20 certify which, witness my hand and seal gf office.
`cc, Lln')C'k
� AAO l Ci
nir'1D� lV&'o rr, r
Signature of officer administering oath Printed name of officer administering oath Title of officer administering oath
•
(2) 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 (Dedarant)
Forms provided by Texas Ethics Commission wwmethics.staterAx.us Revised 8/17/2020
Forms provided by Texas Ethics Commission www.ethics.state.tx.us Revised 8/17/2020
SUBTOTALS - C/OH FORM C/OH
COVER SHEET PG 3
19
FILER NAME
Kathleen B Talley
20 Filer ID (Ethics Commission Filers)
21
SCHEDULE SUBTOTALS
NAME OF SCHEDULE
SUBTOTAL
AMOUNT
1.
® SCHEDULEAi: MONETARY POLITICAL CONTRIBUTIONS
$100.00
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
$2,310.59
8-
F] SCHEDULE F2: UNPAID INCURRED OBLIGATIONS
$
7.
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.
El SCHEDULE H: PAYMENT MADE FROM POLITICAL CONTRIBUTIONS TO A BUSINESS OF C/OH
$
11.
SCHEDULE I: NON-POLITICAL EXPENDITURES MADE FROM POLITICAL CONTRIBUTIONS
$
12.
SCHEDULE K: INTEREST, CREDITS, GAINS, REFUNDS, AND CONTRIBUTIONS RETURNED
TO FILER
$
Forms provided by Texas Ethics Commission www.ethics.state.tx.us Revised 8/17/2020
MONETARY POLITICAL CONTRIBUTIONS SCHEDULE Al
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 Al:
1
2 FILER NAME
3 Filer ID (Ethics Commission Filers)
Kathleen B Talley
4 Date
5 Full name of contributor ❑ out-of-state PAC pts: t
7 Amount of contribution ($)
$100.00
Austin Mitchell Stacy
6 Contributor address; City; State; Zip Code
330 Shady Oaks Dr. Southlake/Texas/76092
8 Principal occupation / Job title (See Instructions)
9 Employer (See Instructions)
Delta
Full name of contributor ❑ out-of-state PAC poi t
Amount of contribution ($)
..................................................................................
Contributor address; City; State; Zip Code
Principal occupation / Job title (See Instructions)
Employer (See Instructions)
Date
Full name of contributor ❑ out-of-state PAC (IDar: t
Amount of contribution ($)
..................................................................................
Contributor address; City; State; Zip Code
Principal occupation / Job title (See Instructions)
Employer (See Instructions)
Date
Full name of contributor ❑ out-of-state PAC QDaR 1
Amount of contribution ($)
..................................................................................
Contributor address; City; State; Zip Code
Principal occupation / Job title (See Instructions)
T --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 8/17/2020
NON-MONETARY (IN-KIND) POLITICAL
A2
SCHEDULE
CONTRIBUTIONS
If the requested information is not applicable, DO NOT Include this page in the report.
1 Total pages Schedule A2:
The Instruction Guide explains how to complete this form.
2 FILER NAME
3 Filer ID (Ethics Commission Filers)
4 TOTAL OF UNITEMIZED IN-KIND POLITICAL CONTRIBUTIONS
$
S Dabs
6 Full name of contributor ❑ out-of-state PAC pDlf: t
8 Amount of 19 In-kind contribution
Contribution $ I description
I
.....................................................................
T Contributor address; City; State; Zip Code
1
1
l
[]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 Of any) (FOR JUDICIAL)
16 If contributor is a child, law firm of parent(s) (if any) (FOR JUDICIAL)
Full name of contributor [Iout-of-statePAC (IQ4 1
Amount of 1 In-kind contribution
Dabs
Contribution $ I description
I
........................................................................
Contributor address; City; State; Zip Code
I
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)
Contributors 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 SCHEDULEAS NEEDED
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 8/17/2020
PLEDGED CONTRIBUTIONS SCHEDULE B
If the requested information is not applicable, DO NOT Include this page in the report.
The Instruction Guide explains how to complete this forth.
1 Tota( pages Schedule B:
2 FILER NAME
3 Filer ID (Ethics Commission Filers)
4 TOTAL OF UNITEMIZED PLEDGES
$
5 Date
6 Full name of pledgor ❑ out-of-state PAC (ID#: I
8 Amount 1 9 In-kind contribution
of Pledge $ I description
I
7 Pledgor address; City; State; Mp Code
i
L
❑ Check H travel outside of Texas. Complete Schedule T.
10 Principal occupation / Job title (See Instructions)
11 Employer (See Instructions)
Date
Full name of pledgor C] out-of-state PAC (ID#: I
Amount 1 in-kind contribution
of Pledge $ I description
I
.......................................................................
Pledgor address; City; State; Zip Code
i
I
I
I.
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 (ID#: I
Amount of I In-kind contribution
Pledge $ I description
1
Pledgor add ress; City State Zip Code
1
1,
❑Check 8 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 (0#: I
I
Amount of In-kind contribution
Pledge $ I description
1
...................•...................................................
Pledgor address; City; State; Zip Code
I
I
1
❑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 8/17/2020
LOANS SCHEDULE E
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 E:
2 FILER NAME
3 Filer ID (Ethics Commission Filers)
4 TOTAL OF UNITEMIZED LOANS
$
5 Date of loan
7 Name of lender out -or -state PAC (KV.' )
........................................ ....................
6 Lender address; City; State; Zip Code
g LoanAmount ($)
6 Is lender
10 Interest rate
a financial
Institution?
11 Maturity date
Y N
12 Principal oocupatlon / Job title (See Instructions)
13 Employer (See instructions)
14 Description of Collateral
15
if personal funds were deposited Into political
El
El none
account
account (See instructions)
16 GUARANTOR
17 Nameofguarantor
19 Amount Guaranteed ($)
INFORMATION
..................................................................................
16 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 (M* )
..................................................................................
Lender address; City; State; Zip Code
Loan Amount ($)
Is lender
Interest rate
a financial
Institution?
Maturity date
Y N
Principal occupation / Job title (See Instructions)
Employer (See Instructions)
Description of Collateral
❑ Check If personal funds were deposited Into political
❑ none
account (See Instructions)
GUARANTOR
Nameofguarantor
Amount Guaranteed ($)
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 www ethics.state.bcus Revised 8/17/2020
POLITICAL EXPENDITURES MADE
FROM POLITICAL CONTRIBUTIONS SCHEDULE F1
If the requested information is not applicable, DO NOT Include this page In the report.
EXPENDrrURE CATEGORIES FOR BOX 8(s)
Advertising Expense Event Expense Loan RepaymatRelabirsement SoBdtatbn1l undralsingExpense
Arxxxmting/Banidng Fees OfIllceOverhead/Rental Expense Transportation Equipment& Related Expense
Consulting Expense FoodBeverage Expense Polling Expense Travel In District
Con%utions/Donatkms Made By GIB/Awards/Memodals Expense Printing Expense Travel Out Or District
Candidate/Olfloehok)er/Pollical Committee Legal Servs es Salaries/Wages/Contract Labor Other (enter a category notilated above)
Credt Card Payment
The Instruction Guide explains how to complete this form.
1 Total pages Schedule FI:
2 FILER NAME
3 Filer ID (Ethics Commission Filers)
4
Kathleen B Talley
4 Date
5 Payee name
10/25/2020
Surefire Promotions
6 Amount ($)
7 Payee address; City; State; Zip Code
$866.00
3225 Glenmore Ave. Northlake, TX 76247
8
(a) Category (see Categories listed at the top of this schedule)
(b) Description
Advertising expense
t -shirts
PURPOSE
OF
EXPENDITURE
(c) Check IftraveloufeideofTaxes.Complete SchedkleT. Check If Austin, TX, officeholder living expense
9 Complete ONLY If direct Candidate / Officeholder name Office sought Office held
expenditure to benefit C/OH
Date
Payee name
10/28/2020
Wix.com
Amount ($)
Payee address; City; State; Zip Code
$5.35
1691 Michigan Ave. Miami Beach, FL 33139
Category (Sae Categories listed at the top ofthis schedule)
Description
Advertising expense
Website fees
PURPOSE
OF
EXPENDITURE
ChedkBtraveioutsldeofTexes.Complete SchedulaT. Check IfAustin, TX, officeholder living expense
Complete ONLY If direct Candidate / Officeholder name Office sought Office held
expenditure to benefit C/OH
Date
Payee name
11/06/2020
Brandstorm Creative Inc.
Amount ($)
Payee address; City; State; Zip Code
$150.00
Southlake/Texas/76092
733 Ashleigh Lane
Category (see Categories listed atthe top of this schedule)
Description
PURPOSE
Advertising expense
Mailer design
OF
EXPENDITURE
Check sftraveloutside ofTexas.Complete SchaduleT. ❑ Check If Austin, Tx, officeholder living expense
Complete ONLY if direct Candidate / Officeholder name Office sought Office held
expenditure to benefit C/OH
ATTACH ADDrrioNAL COPIES OF THIS SCHEDULEAS NEEDED
Forms provided by Texas Ethics Commission www.ethics.state.tx.us Revised 8/17/2020
POLITICAL EXPENDITURES MADE
FROM POLITICAL CONTRIBUTIONS
SCHEDULE F1
If the requested information is not applicable, DO NOT Include this page In the report.
EXPENDITURE CATEGORIES FOR BOX S(a)
Advertising Expense
Event Expense Loan RepwflnentReIrnbureement
Sotctation/FundralsingExpense
Acooknflng/Banldng
Fear OmoeOverhead/RentalExpense Transportation Equipment& Related Expense
Consulting Expense
Food/Beverage Expense Polling Expense Travel In District
Contributions/Donations Made By GlIVAwards/MamodafsExpense Printing Expense Travel Out Of District
Candidate/ORloshoider/PditicalCommittee Legal Services Salades/Wages(ContractLabor Other (enter acats" not listed above)
Credit CardPaymert
The Instruction Guide explains how to complete this form.
1 Total pages Schedule FI:
2 FILER NAME
3 Filer ID (Ethics Commission Filers)
4
Kathleen B Talley
4 Date
5 Payee name
11/15/2020
Constant Contact
IS Amount ($)
7 Payee address;
City; State; Zip Code
$133.26
1601 Trapelo Rd., Ste. 329 Waltham, MA 02451
8
(a) Category (3eeCategories llstedetthetop ofthissehedule)
(b) Description
Advertising expense
Email service
PURPOSE
OF
EXPENDITURE
(c) ElCheck IftraveloutsldsofTexes.Complete ScheduleT.
1:3 Check NAustin, TX, officeholder living expense
9 Complete 0= If direct
Candidate / Officeholder name
Office sought Office held
expenditure to benefit C/OH
Data
Payee name
11/16/2020
1-800-Flowers.com
Amount ($)
Payee address;
City; State; Zip Code
$508.68
Category (See categories listed atthe top ofthis schedule)
Description
Gifts
Thank you gifts
PURPOSE
OF
EXPENDITURE
Check Ntraveloutside ofTexea.CompletsScxlduleT.
Check if Austin, TX, officeholder living expense
Complete ONLY If direct
Candidate / Officeholder name
Office sought Office held
expenditure to benefit C/OH
Date
Payee name
11/17/2020
1-800-Flowers.com
Amount ($)
Payee address;
City; State; Zip Code
$211.06
Category (See Categories listed at the top of this schedule)
Description
PURPOSE
Gifts
Thank you gifts
OF
EXPENDITURE
Check Iftraveioutside ofTeres.Complete Schedule T.
Check if Austin, TX, officeholder living expense
Complete ONLY If direct
Candidate / Officeholder name
Office sought Office held
expenditure to benefit C/OH
ATTACH ADDITIONAL COPIES OF THIS SCHEDULEAS NEEDED
Forms provided by Texas Ethics Commission wwmethics.state.U.us Revised 8/17/2020
POLITICAL EXPENDITURES MADE
FROM POLITICAL CONTRIBUTIONS SCHEDULE F1
If the requested information is not applicable, DO NOT Include this page In the report.
EXPENDITURE CATEGORIES FOR BOK 8(a)
Advertising Expense Event Expense Loan Repsymentneirnbursement Soidtabon/FtndrelsingExpense
Aomunting/BaMnil Fees Office OverheadfRentelExpense Transportation Equipment & Related Expense
Consulting Expense Food/Beverage Expense Polling Expense Travel In District
Contributbns/Donatbns Made By GIMAwarda/Memodals Expense Printing Expense Travel Out Of District
CandWffie101rloehokler/PdiloalConenittee Legal services SalarieslWages(CatUactLabor Oliver (enter acategory notlMWabove)
Crect Card payment The Instruction Guide explains how to complete this form.
1 Total pages Schedule Ft:
2 FILER NAME
3 Flier ID (Ethics Commission Filers)
4
Kathleen B Talley
4 Data
5 Payee name
11/25/2020
Wix.com
6 Amount ($)
7 Payee address; City; state; Zip Code
$5.35
1691 Michigan Ave. Miami Beach, FL 33139
8
(a) Category (see Categories listed at" top of this schedule)
(b) Description
Advertising expense
Website fees
PURPOSE
OF
EXPENDITURE
(C) Check KtreveloutWoOtTexas.Complete ScheduleT Q Check It Austin, TX, officeholder living expense
9 Complete ONLY If direct Candidate / Officeholder name Office sought Office held
expenditure to benefit C/OH
Data
Payee name
12/15/2020
Priority Signs
Amount ($)
Payee address; City; State; Zip Code
292.28
P.O. Box 32 Grapevine, TX 76051
Category (See Categories listed at the top ofthte schedule)
Description
Advertising expense
Additional signs
PURPOSE
OF
EXPENDITURE
ChedkBtroveloutside o Tma.CompleteScheduteT. Check if Austin, TX, cifloeholder living expense
Complete ONLY If direct Candidate / Officeholder name Office sought Office held
expenditure to benefit C/OH
Date
Payee name
12/16/2020
Constant Contact
Amount ($)
Payee address; City; State; Zip Code
$133.26
Waltham, MA 02451
1601 Trapelo Rd., Ste. 329
Category (See Categories listed atthe top ofthis schedule)
Description
Email service
Advertising expense
PURPOSE
OF
EXPENDITURE
0 Check tftraval outside ofTexas.Complete SchedWST. 171 Check If Austin, TX, officeholder living expense
Complete ONLY If direct Candidate / Officeholder name Office sought Office held
expenditure to benefit C/OH
ATTACH ADDITIONAL COPIES OF THIS SCHEDULE AS NEEDED
Forms provided by Texas Ethics Commission www.ethics.state.tx.us Revised B/17/2020
POLITICAL EXPENDITURES MADE
FROM POLITICAL CONTRIBUTIONS SCHEDULE F1
If the requested information is not applicable, DO NOT Include this page In the report.
EXPENDITURE CATEGORIES FOR BOX8(a)
Advertising Expense Event Expense Loan RepsyrneritiRsimbursement So9gtation/FundralsingExpense
Accotmting/Batddng Fees OfflceOverhead/ReMal Expense Transportation Equipment & Related Expense
Consulting Expense Food/BeverageExpense Polling Expense Travel In District
Contribudona/DonationsMade By GIR/AwardafMemorfatsExpense Printing Expense Travel OutO(Dlstrict
Candidata/ORlcehokler/PoliticalComnittee Legal Services Selmes/WagearAntrsdLabor Other (enter a category not listed above)
Cre;CardPayment The instruction Guide explains how to complete this form.
1 Total pages Schedule F7:
2 FILER NAME
3 Filer ID (Ethics Commission Filers)
4
Kathleen B Talley
4 Date
5 Payee name
12/28/2020
Wix.com
6 Amount ($)
7 Payee address; City; State; Zip Code
$5.35
1691 Michigan Ave. Miami Beach, FL 33139
$
(a) Category (See Categorleslisted atthe top ofWeschedule)
(b) Description
Advertising expense
Website fees
PURPOSE
OF
EXPENDITURE
(0) Check titraveloutsldsofTexas.complete SchedulsT. Check NAustin, TX, officeholder living expense
9 Complete ONLY if direct Candidate / Officeholder name Office sought Office held
expenditure to benefit C/OH
Dain
Payee name
Amount ($)
Payee address; City; State; Zip Code
Category (Bee Categories listed at the top ofthle schedule)
Description
PURPOSE
OF
EXPENDITURE
Che&lftraveloutsldeofTexes.CompletescmMeT. Check IfAustln, TX, officeholder living expense
Complete ONLY If direct Candidate / Officeholder name Office sought Office held
expenditure to benefit C/OH
Date
Payee name
Amount ($)
Payee address; City; State; Zip Code
Category (See Categories listed at the top of this schedule)
Description
PURPOSE
OF
EXPENDITURE
Check lfb vel outside ofTexas.Complete ScheduleT. Check if Austin, TX, officeholder living 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 wwwethics.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(a)
Advertising Expense Evert Expense L0691 Reps Soltdtation/Fundralshg Expense
se
Office eed/Rental ElpwEquipment & Related Expense
Consulting
ulg Expense Food/Beverage In
Cont ibutlons/Donadws Made By GiNAwards/Mematab Expense Printing Expense Travel Out Of District
Candidate/Otfioeholder/PoldcalComnittee Legal Services Selarles/Wagesir"ftradLabor Other (enter acategorynotlistedabove)
The Instruction Guide explains how to complete this form.
1 Total pages Schedule F2:
2 FILERNAME
3 Filer ID (Ethics Commission Filers)
4 TOTAL OF UNITEMIZED UNPAID INCURRED OBLIGATIONS
$
5 Date
6 Payee name
7 Amount ($)
8 Payee address; City; State; Zip Code
9 TYPE OF
EXPENDITURE
F-1 Political FINoll-Political
10
(a) Category (See Categories listed at the top ofWs schedule)
(b) Description
PURPOSE
OF
EXPENDITURE
(c) Check titraveladsWeofTexes.Complete SchedideT. F-1 Check If Austin, TX, officeholder living expense
?I Complete ONLY If direct Candldate / Officeholder name Office sought Office held
expenditure to benefit C/OH
Date
Payee name
Amount ($)
Payee address; City; State; Zip Code
TYPE OF
EXPENDITURE
D Political Non -Polio al
Category (See Categories listed at the top ofthis schedule)
Description
PURPOSE
OF
EXPENDITURE
Check dtraveloutsideofTe m. Complete BeheddeT. Check If Austin, TX, officeholder living 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.N.us Revised 8/17/2020
PURCHASE OF INVESTMENTS MADE SCHEDULE F3
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.
1 Total pages Schedule F3:
2 FILER NAME
3 Filer ID (Ethics Commission Filers)
4 Date 5 Name of person from whom Investment is purchased
................................................................................................................................
6 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.N.us Revised 8/17/2020
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 10(a)
Advertising Expense Event Expense Loan RepaymeoVRelonbursemard SoBdtetionlFundraisIng Expense
Accowli ng/Banldng Fees Office Overhead/Rental Expense Transportation Equipment& Related Expense
Consulting Expense Food/BeverageExipeise Polling Expense Travel In Distffat
Conlribudorns0onafbns Made By 0WAwards/Memodals Expense Printing Expense Travel Out Of District
Ca"date/OMosholder/PdiHoal Committee mr itte a Legal Servkres Sawasmages/Ca Labor Other (entera category not Rated above)
The Instruction Guide explains how to complete this form.
1 Total pages Schedule F4:
2 FILER NAME
3 Filer ID (Ethics Commission Filers)
4 TOTAL OF UNITEMIZED EXPENDITURES CHARGED TOACREDIT CARD
$
5 Date
0 Payee name
7 Amount ($)
8 Payee address; city. state; Zip Code
9 TYPE OF
EXPENDITURE
El Political ❑ Nott -Political
10
(S) Category(See Categories listed atthe top ofthis schedule)
(b) Description
PURPOSE
OF
EXPENDITURE
(C) F-1 Check tihaveloutsideofTexes.Complete schedule T. EJ Check If Austin, TX, officeholder living expense
Candidate / Officeholder name Office sought Office held
Complete ONLY If direct
expenditure to benefit C/01-1
Date
Payee name
Amount ($)
Payee address; City; State; Zip Code
TYPE OF
EXPENDITURE
1-1 Political Non -Political
Category (See Categories listed at the top ofthisschedule)
Description
PURPOSE
OF
EXPENDITURE
Check Iftraveloutside ofTexas.Complete SdsduleT. 0 Check If Austin, TX, officeholder living expense
Candidate / Officeholder name Office sought Office held
Complete ONLY If direct
expenditure to benefit C/OH
ATTACH ADDITIONAL COPIES OF THIS SCHEDULE AS NEEDED
Forms provided by Texas Ethics Commission www.ethics.state.N.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 BOX8(a)
Advertising Expense Event Expense Loan ReparnarrIlReirnbureement Soldtatlon/Fundraising Expense
AcxxwntingBarsdng Fees Olgoe Overhead/Rental Expense Transportation Equipment & Related Expense
Consulting Expense Food/Beverage Expense Poling Expense Travel In District
Contrlbutlorw/Danations Made By GWAwards/Mamodalls Expense Printing Expense Travel Out Of District
Candidata/Otrksholder/PollticallCommlt0ae Legal Services Selar"WagesINContractLabor Other(enterecategorynotiistedabove)
CreditCwdPaymeol The Instructlon Gulde explains how to complete this form.
1 Total pages Schedule G:
2 FILER NAME
3 Filer ID (Ethics Commission Filers)
4 Date
5 Payee name
6 Amount ($)
7 Payee address; City; State; Zip Code
ReNnbtrsementllnm
political contributions
Intended
8
(a) Category (see Categories gated at the top of this schedule)
(b) Description
PURPOSE
OF
EXPENDITURE
(C) Check tftrwetoutside ofTamComplete SdsduleT. E] Check if Austin, TX, officeholder IMng expanse
9 Candidate / Officeholder name Office sought Office held
Complete ONLY If direct
expenditure to benefit C/OH
Date
Payee name
Amount ($)
Payee address; City; State; Zip Code
ReirrWoemendfnom
polgcalcontribution
Intended
Category (See Categories listed at the top ofthis schedule)
Description
PURPOSE
OF
EXPENDITURE
Check Iftraveloutside ofTexas.Complete SdneduleT Check If Austin, TX, officeholder living expense
Candidate / Officeholder name Office sought Office held
Complete ONLY if direct
expenditure to benefit C/OH
Date
Payee name
Amount ($)
Payee address; City; State; Zip Code
ReknbugemenHrom
po®gcal contributions
rrbanded
Category (See Categories listed at the top of this schedule)
Description
PURPOSE
OF
EXPENDITURE
Check IftraveloutedeMTexas.Complete Scha"T. Check If Austin, TX, officeholder living expense
Candidate / Officeholder name Office sought Office held
Complete ONLY if direct
expenditure to benefit C/OH
ATTACH ADDITIONAL COPIES OF THIS SCHEDULE AS NEEDED
Forms provided by Texas Ethics Commission www.ethics.state.bws Revised 8/17/2020
PAYMENT MADE FROM POLITICAL CONTRIBUTIONS
TO A BUSINESS OF CIOH SCHEDULE H
If the requested information Is not applicable, DO NOT Include this page in the report.
EXPENDITURE CATEGORIES FOR BOX 8(a)
AdverdsingExpense Event Expense Loan RepayrnenMeirnbursement Sadtation/FundraisingExpense
Accaerthgfnanking Fees Ofrtca OverheadlRental Expense Transportation EqulpmentB RstaW Expense
Consu" Expense FoodBeverage Expense Polling Expense Travel In District
ConhSruuona/Donstlons Made By GUIVAwarda/Memodals Expense Printing Expense Travel Out Of District
Candidate/Onkx;holder/PditicalCommittee Legal Services SWdesANagas/ContradLabor Other (entera catVM notlisted above)
CrerkCardPapmerd
The instruction Guide explains how to complete this form.
1 Total pages Schedule H:
2 FILER NAME
3 Her ID (Ethics Commission Filers)
4 Date
5 Business name
6 Amount {$)
7 Business address; City; State; Zip Code
8
(a) Category (See Categories listed at the top of this schedule)
(b) Description
PURPOSE
OF
EXPENDITURE
(e) ❑ O*cktfUweioutsldeofTem.ComptetWSO*"T. ❑ Check If Austin, TX, officeholder living expense
9 Complete Q= if direct Candidate / Officeholder name Office sought Office held
expenditure to benefit C/OH
Date
Business name
Amount ($j
Business address; City; State; Zip Code
Category (See Categories fisted atthe top ofthis schedule)
Description
PURPOSE
OF
EXPENDITURE
❑ ChedcBtravelouW"ofTexes.CompideScheduleT. ❑ Check It Austin, TX, otfloehoider living expense
Complete QALY if direct Candidate / Officeholder name Office sought Office held
expenditure to benefit C/OH
Date
Business name
Amount ($)
Business address; City; State; Zip Code
Category (See Categories listed at the top ofthis schedule)
Description
PURPOSE
OF
EXPENDITURE
❑ ChedciftraveloufakieofTexes.CompideSd>eddeT. ❑ Check It Austin, TX, officeholder living expense
Complete D= 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 9/1712020
NON-POLITICAL EXPENDITURES
MADE FROM POLITICAL CONTRIBUTIONS SCHEDULE 1
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 I:
2 FILER NAME
$ Filer ID (Ethics Commission Filers)
4 Date
5 Payee name
6 Amount ($)
7 Payee address; city State Zip Code
8
(a)Category (See Instructions for examples of acceptable
(b) Description (See instructions regarding type or information
PURPOSE
categories.)
required.)
OF
EXPENDITURE
Date
Payee name
Amount ($)
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 ($j
Payee address; City State Zip Code
PURPOSE
Category (See Instructions for examples of acceptable
Description (See instructions regarding type of Information
OF
categories.)
required.)
EXPENDITURE
Date
Payee name
Amount ($)
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
CONTRIBUTIONS RETURNED TO FILER SCHEDULE K
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 K:
2 FILER NAME
3 Filer ID (Ethics Commission Filers)
4 Date
5 Name of person from whom amount Is received
........................................................................I.......................
6 Address of person from whom amount Is received; City; State; Zip Code
S Amount ($)
7 Purpose for which amount is received F --j Check If political contribution returned to filer
Date
Name of person from whom amount is received
................................................................................................
Address of person from whom amount Is received; City; State; Zip Code
Amount ($)
Purpose for which amount Is received E] Check if political contribution returned to flier
Date
Name of person from whom amount is received
................................................................................................
Address of person from whom amount Is received; City; State; Zip Code
Amount ($)
Purpose for which amount is received F --j Check If political contribution returned to filer
Date
Name of person from whom amount Is received
................................................................................................
Address of person from whom amount Is received; City; State; Zip Code
Amount ($)
Purpose for which amount Is received Check if political contribution returned to filer
ATTACH ADDITIONAL COPIES OF THIS SCHEDULE AS NEEDED
Forms provided by Texas Ethics Commission www.ethics.state.N.us Revised 8/77/2020
IN-KIND CONTRIBUTIONS OR POLITICAL EXPENDITURES SCHEDULE T
FOR TRAVEL OUTSIDE OF TEXAS
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 T:
2 FILER NAME
3 Flier ID (Ethics Commission Fliers)
4 Name of Contributor/ Corporation or Labor Organization / Pledgor /Payee
5 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
B 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
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 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)
ATTACH ADDITIONAL COPIES OF THIS SCHEDULE AS NEEDED
Forms provided by Texas Ethics Commission www.ethics.state.tx.us Revised 8/17/2020