Patton Semi July 2021CANDIDATE / OFFICEHOLDER
FORM C/OH
CAMPAIGN FINANCE REPORT
COVER SHEET PG 1
I Filer ID (Ethics Commission Filers)
2 Total pages filed:
The C/01-1 Instruction Guide explains how to complete this form,
3 CANDIDATE
CIS I MRS(�MR MI
OFFICEHOLDER
Nvck A-./
NAME
—1— ..... ... I ..... —1— ..... ...... .
Data R.1,FMrEI1VE1)
NICKNAME LAST SUFFIX
J U L - 9 2021
4 CANDIDATE
ADDRESS I PO BOX: APT / SUITE CITY: STATE: ZIP CODE
OFFICEHOLDER
I I ( LA
MAILING
It
ADDRESS
Change of Address
OFFICE OF CITY SECRETAR
Date Nand -delivered or Date Postmarked
5 CANDIDATE/
AREA CODE PHONE NUMBER EXTENSION
OFFICEHOLDER
PHONE
MI ) -7-33- -7ifl
Receipt #
Amount S
6 CAMPAIGN
MIS / MRSC
:�R> FIRST MI
TREASURER
61
NAME
...... — — ......
Date Processed
NICKNAME LAST SUFFIX
Date Imaged
W&6 1
7 CAMPAIGN
STREET ADDRESS (NO PO BOX PLEASE); APT / SUITE #; CITY;
STATE; ZIP CODE
TREASURER
I), V—� vv-e
ADDRESS
lzo
(Residence or Business)
8 CAMPAIGN
AREA CODE PHONE NUMBER EXTENSION
TREASURER
PHONE
9 REPORT TYPE
1:1 January 15 30th day before election Runoff
El
15th day after campaign
treasurer appointment
(Officeholder Only)
12/ July 15 M 8th day before election Exceeded Modified
F-1 Final Report (Attach GIOH - FR)
Reporting Limit
10 PERIOD
Month Day Year Month
Day Year
COVERED
THROUGH
11 ELECTION
ELECTION DATE
ELECTION TYPE
1:1 Primary F-1 Runoff Other
Month Day Year
Description
fl
General Special
12 OFFICE
OFFICE HELD (if any)
13 OFFICE SOUGHT (if known)
L-41 1i
14 NOTICE FROM
THIS BOX IS FOR NOTICE OF POLITICAL CONTRIBUTIONS ACCEPTED OR POLITICAL EXPENDITURES MADE BY POLITICAL COMMITTEES TO SUPPORT
POLITICAL
THE CANDIDATE I OFFICEHOLDER. THESE EXPENDITURES MAY HAVE BEEN MADE 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
DGENERAL
COMMITTEE ADDRESS
Additional Pages
OSPECIFIC
COMMITTEE CAMPAIGN TREASURER NAME
COMMITTEE CAMPAIGN TREASURER ADDRESS
GO TO PAGE 2
Forms provided by Texas Ethics Commission wwvv.ethics.state.tx.us Revised 8/1712020
CANDIDATE / OFFICEHOLDER FORM C/OH
CAMPAIGN FINANCE REPORT COVER SHEET PG 2
15 C/OH NAME
6 Filer ID (Ethics
I I Commission Filers)
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
$
LOAN TOTALS
LAST DAY OF THE REPORTING PERIOD
1
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,
Signature of ddate or C)fhcehol'd'er
Please complete either option below:
AMY SHELLEY
Notary Public, State of Texas
Affidavit Comm'
(1) Expires 12-02-2023
Notary ID 12476110-5
NOTARY STAMP/ SEAL
Sworn to and subscribed before me by —this the day of
to c which, witness my hand andffeal of office.
IkV'/A "6 WA
A
Sitnatlure�officer —MI)istering oath Pr'intedk_al)Ine of officer adminiltering oath Title V officer administers 0gath
(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 120
(month) (year)
Signature of Candidate/Officeholder (Declarant)
Forms provided by Texas Ethics Commission www,ethics,state.tX,LIS Revised 8117/2020