Williamson Semi July 2022CANDIDATE ! OFFICEHOLDER
FORM C/OH
CAMPAIGNFINANCE T
COVER SHEEP PG 1
The CIOH Instruction Guide explains haw to complete this farm.
1 Filer ID (Ethics Commission Filers)
2 Total pages filed:
3 CANDIDATE /
MS r MRS FIRST MI
OFFICEHOLDER
"NAME...:...........:.......:..._..,.........:...,.....
Date Reserved
N AME LAST SUFFIX
JUL ¢ 0 22
4 CANDIDATE /
OFFICEHOLDER
MAILING
ADDRESS t P0ifIOX, APT % SUITE #; CITY; STATE. ZIP CODE
/� {' }%,,
5 CANDIDATE/
OFFICEHOLDER
AREA CODE PHONE NUMBER EXTENSION
Date .�hd UelFvered or Date Postmarked
PHONE
6 CAMPAIGN
_..
MS J MRS F MR IRST MI
Receipt #
Amounf S
TREASURER
Date Processed
NAME
........:: .,.....:........ ......:.,....-.::...,..............:.:. ......:.
NICKNAME LAST SUFFIX
Date Imaged
j) I
W /W 'm% 1
7 CAMPAIGN
TREASURER
STREET ADDRESS (NO PO BOX PLEA `; APT t SUIT- #, CITY;
(Residence or Business)
8 CAMPAIGN
AREA CODE PHONE NUMBER EXTENSION
TREASURER
PHONE
9 REPORT TYPE
El January 15 30th day before election Runoff
15th day after campaign
treasurer appointment
(Officeholder Only)
July 15 8th day before election El Exceeded Modified
Final Report (Attach"C/OH - FR)
Reporting Limit
10 PERIOD
Month Day Year Month
Day Year
COVERED
/ j l 2^ ,% 7.4i"�-Z-- THROUGH % /1"
/�/' // )
11 ELECTION
ELECTION DATE
ELECTION TYPE
Month Day Year
❑ Primary Runoff El Other
Description
❑ General Special
12 OFFICE
OFFICE HE D (if any)
,�
13 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
P L
THE CANDIDATE I OFFICEHOLDER, THESE EXPENDITURES MAY HAVE SEEN MADE WITHOUT THE CANDIDATE'S OR OFFICEHOLDER'S KNOWLEDGE OR
COMMITT
CONSENT. CANDIDATES AND OFFICEHOLDERS ARE REQUIRED TO REPORT THIS INFORMATION ONLY IF THEY
RECEIVE NOTICE OF SUCH EXPENDITURES.
_
ITTEE TYPE
-
COMMITTEE NAME
GENERAL
ITTEE ADDRESS
Additional Pages
SPECIFIC
EE CAMPAIGN SURER 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 / OFFICEHOLDER FORM C/OH
COVER SHEET PIG 2
CAMPAIGN
i y. FINANCE REPORT
15 C/OH NAME Filer ID (Ethics Commission Filers)
/11, W/ i &eq J 0 /L-
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
CONTRIBUTION
BALANCE
1 TOTAL UNITEMIZED POLITICAL EXPENDITURE.
4. TOTAL POLITICAL EXPENDITURES $
5. TOTAL POLITICAL CONTRIBUTIONS MAINTAINED AS OF THE LAST DAY C/
OF REPORTING PERIOD J• /
OUTSTANDING 6, TOTAL PRINCIPAL AMOUNT OF ALL OUTSTANDING LOANS AS OF THE r+�
LOAN TOTALS LAST DAY OF THE REPORTING PERIOD �$
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.
Q,,--...,
Signature of Candidate or Officeholder
Please complete either option below:
AMY SHELLEY PLC ��
(1}Affidavit =r a=Notary Public, State of Texas
Q: Comm. Expires 12-02-2023"
Notary ID 12476110-5
NOTARY STAMP/SEAL
Sworn to and subscribed before me by _ �,�� 4t ° __ this the " day of _ -
c., r? to certify which, witness my hand and seal of office.
Signatu of officer d_, inistering oath Printed ame of officer administering oath Ti e of officer administe ing 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 (Declarant)
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
20 Filer ID (Ethics Commission Filers)
21
SCHEDULE SUBTOTALS
NAME OF SCHEDULE
SUBTOTAL
AMOUNT
1.
❑
SCHEDULEA1:
MONETARY POLITICAL CONTRIBUTIONS
$
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
$
LL
6.
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.
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
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 8(a)
Advertising Expense Event Expense Loan Repayment/Reimbursement 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
Candidate/Officeholder/Political Committee Legal Services Salaries/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 F1:
2 FILER NAME
V. , 1 % j � /
3 Filer ID (Ethics Commission Filers)
,,
4 Date
2-/1l'2—
$ Payee name (���
U Gb
6 Amount ($)
7 Payee address, City; State; Zip Code
8
(a) Category (See Categories listed at the top of this schedule)
(b) Description
PURPOSE
#0_�
OF
a)c;
EXPENDITURE
(c) ❑ Check if travel outside of Texas.CompleteScheduleT. Check if Austin, TX, officeholder living expense
9 Complete ONLY if direct Candidate / Officeholder name Office sought Office held
expenditure to benefit C/OH
Date
Payee name
Amount ($)
Payee address; City; State, Zip Code
Category (See Categories listed at the top of this schedule)
Description
PURPOSE
OF
EXPENDITURE
❑ Check iflraveloutside ofTexas.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
Date
Payee name
Amount ($)
Payee address; City; State, Zip Code
Category (See Categories listed at the top of this schedule)
Description
PURPOSE
OF
EXPENDITURE
Check if travel outside of Texas.CompleteScheduleT. Check if Austin, TX, officeholder living expense
Complete ONLY if direct Candidate / Officeholder name Office sought Office held
expenditure to benefit C/OH
ATTACH ADDITIONAL COPIES OF THIS SCHEDULE AS NEEDED
Forms provided by Texas Ethics Commission www.ethics.state.tx.us Revised 8/17/2020
INTEREST, CREDITS, GAINS, REFUNDS, AND
CONTRIBUTIONS RETURNED TO FILER SCHEDULE K
If the requested information is not applicable, DO NOT include this page in the report.
The Instruction Guide explains how to complete this form.
1 Total pages Schedule K:
2 FILER NAME k `��
uo4t 9 VV ��1 /
3 Filer ID (Ethics Commission Filers)
4 Date
5 Name of person from whom amount is received
8 Amount ($)
fi��I l I o
6 Address of from whom amount is received; City, State, Zip Code
person
0 /
7 Purpose for which amount is received Check if political contribution returned to filer
d
1A e-e-MA
Date
Name of person from whom amount is received
Amount ($)
................................................................................................
Address of person from whom amount is received; City; State; Zip Code
Purpose for which amount is received Check if political contribution returned to filer
Date
Name of person from whom amount is received
Amount ($)
........................................... ....................... I ..... ........................
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
ATTACH ADDITIONAL COPIES OF THIS SCHEDULE AS NEEDED
Forms provided by Texas Ethics Commission www.ethics.state.tx.us Revised 8/17/2020