McCaskill Semi July 2022CANDIDATE
I OFFICEHOLDER FOR C/oH
CAMPAIGNI
COVER SHEET PG I
1 1 Filer ID (Ethics Commission Filers) 2 Total pages filed:
The C/OH Instruction Guide
explains how to complete this form. 1
3 CANDIDATE/
NIS I MRS MR FIRST MI OFFICE USE ONLY
"
OFFICEHOLDER
"'" ltJk
NAME
...,....`
NICKNAME LAST SUFFIX
C, rk-` V, tk
A, CANDIDATE /
ADDRESS / PO BOX; APT / SUITE #; CITY; STATE, ZIP CODE jj ){ 3 2022
0 2
OFFICEHOLDER
MAILING
JCJL C1 LU L
( (. J' ;»/fit 1 C.
ADDRESS
OFFICE O� CITY SECRETARY
Change at Address?G
5 CANDIDATE/
OFFICEHOLDER
AREA CODE PHONE NUMBER EXTENSION D to Hand delivered or Date Post k d
if
PHONE
_......,_.__
6 CAMPAIGN
��...._._._...w................_.: Receipt# Amounts
MS /60 MR FIRST MI
TREASURER
('+ Date Processed
NAME
NICKNAME LAST SUFFIX _
Date Imaged
1��,_ cc( -4 t i � � a V t ti e 4
7 CAMPAIGN
STREET ADDRESS (NO PO BOX PLEASE), APT / SUITE #; CITY, STATE; ZIP CODE
TREASURER
ADDRESS
0 Q,, O ." .,A,Fa_ C. 0
(Residence or Business)
8 . CAMPAIGN
AREA .CODE PHONE NUMBER EXTENSION
TREASURER
PHONE
9 REPORT TYPE
❑ January 15 30tfi day before election Runoff (� ISth day after campaign
L l
treasurer appointment
(Officeholder Only)
Exce&ited Modified Final Report (Attach C/OH - FR)
July 15 eth day before election
R-<pc Ctintj Limit
10 PERIOD
Month Day Year Month Day Year
COVERED
"0 THROUGH .1:::�.""�" �'K
-
11 ELECTION
ELECTION DATE ELECTION TYPE
"
❑ Primary ❑ Runoff ❑ Other
Month Dap Year Description '
r
I :taenerat Special
12 OFFICE
OFFICE HELD ((if any) (;/� LA 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
I OFFICEHOLDER. THESE EXPENDITURES MAY HAVE BEEN MADE WITHOUT THE CANDIDATE'S OR OFFICEHOLDER'S KNOWLEDGE OR
-
POLITICALTHE.CANDIDATE
CONSENT CANDIDATES AND OFFICEHOLDERS ARE REQUIRED TO REPORT THIS INFORMATION ONLY IF THEY RECEIVE NOTICE OF SUCH EXPENDITURES,
COMMITTEE(S)
COMMITTEE TYPE COMMITTEE NAME
COMMITTEE ADDRESS
@
GENERAL
Additional Pages
[:]SPECIFIC COMMITTEE CAMPAIGN TREASURER NAME
COMMITTEE CAMPAIGN TREASURER ADDRESS
_ -GO TO PAGE 2
Forms provided by Texas Ethics
Commission www.ethies.state.tx.us Revised 8/1712020
CANDIDATE / OFFICEHOLDER FOR /011
FINANCECAMPAIGN COVER SHEET PG 2
15 C/OH NAME 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)
2. TOTAL POLITICAL CONTRIBUTIONS
(OTHER THAN PLEDGES, LOANS, OR GUARANTEES OF LOANS)
TOTALS
EXPENDITURE 3. TOTAL UNITEMIZED POLITICAL EXPENDITURE,
4. TOTAL POLITICAL EXPENDITURES $
CONTRIBUTION 5. TOTAL POLITICAL CONTRIBUTIONS MAINTAINED AS OF THE LAST DAY
BALANCE OF REPORTING PERIOD $ J
OUTSTANDING 6, TOTAL PRINCIPAL AMOUNT OF ALL OUTSTANDING LOANS AS OF THE
LOAN TOTALS LAST DAY OF THE REPORTING PERIOD r
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 Candidate or Officeholder
Please complete either option below:
=(&T SA 1{HnWARDLIblll Stateof7ots(1) Affidavity121663-2
iolt r xplCes p7W31.2ti25
NOTARY STAMP/SEAL
Sworn to and subscribed before me by PA e C I t,—\- this the wl S day of s
20 f: to certify which, witness my hand and seal of office.
Signature of officer administering oath Printed name of officer administering oath Title of officer administering oath
s•
(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
V'j r'�
�r �v\�t��
20 Filer ID (Ethics Commission Filers)
21
SCHEDULE SUBTOTALS
NAME OF SCHEDULE
SUBTOTAL
AMOUNT
1
L_I SCHEDULEAI:
MONETARY POLITICAL CONTRIBUTIONS
$
2.
u SCHEDULE A2:
NON -MONETARY (IN -KIND) POLITICAL CONTRIBUTIONS
$
3.
SCHEDULE B:
PLEDGED CONTRIBUTIONS
$
4.
SCHEDULE E:
LOANS
$
5.
I� SCHEDULE F1:
POLITICAL EXPENDITURES MADE FROM POLITICAL CONTRIBUTIONS
$
6.
J SCHEDULE F2:
UNPAID INCURRED OBLIGATIONS
$
7
�I SCHEDULE F3:
PURCHASE OF INVESTMENTS MADE FROM POLITICAL CONTRIBUTIONS
$
$•
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 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
2 FILER NAME
3 Filer ID (Ethics Commission Filers)
4 Date
5 Full name of contributor ❑ out-of-state PAC (ID#: )
..................................................................................
6 Contributor address; City; State; Zip Code
7 Amount of contribution ($)
8 Principal occupation / Job title (See Instructions) (
9 Employer (See Instructions)
Date
Full name of contributor ❑ out-of-state PAC (ID# I
Contributor address; City; State; Zip Code
Amount of contribution ($)
Principal occupation / Job title (See Instructions)
Employer (See Instructions)
Date
Full name of contributor ❑ out -of -stale PAC (ION: i
..................................................................................
Contributor address; City; State; Zip Code
Amount of contribution ($)
Principal occupation / Job title (See Instructions)
Employer (See Instructions)
Date
Full name of contributor ❑ out-of-state PAC (IIMf I
......................... ..... .........
Contributor address; City; State; Zip Code
Amount of contribution ($)
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 Kevfsea 6/1 //zuzu
NON -MONETARY (IN -KIND) POLITICAL
CONTRIBUTIONS SCHEDULE A2
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)
4 TOTAL OF UNITEMIZED IN -KIND POLITICAL CONTRIBUTIONS
$
5 Date
6 Full name of contributor ❑ out-of-state PAC (ID#: )
8 Amount of ( g In -kind contribution
Contribution $ i description
I
7 Contributor address; City; State; Zip Code
❑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 -stale PAC (ID#: I
I
Amount of In -kind contribution
Contribution $ I description
I
............................................... .......
Contributor address; City; State; Zip Code
UCheck 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)
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 8/1712020
PLEDGED CONTRIBUTIONS SCHEDULE B
If the requested information is not applicable, DO NOT include this page in the report.
1 Total pages Schedule B.
The Instruction Guide explains how to complete this form.
f!
__
2 FILER NAME
3 Filer ID (Ethics Commission Filers)
5H V-_ C
4 TOTAL OF UNITEMIZED PLEDGES
$
5 Date
6 Full name of pledgor ❑ out-of-state PAC (ID# )
8 Amount ( 9 In -kind contribution
of Pledge $ I description
I
7 Pledgor 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 (IDH: )
Amount I In -kind contribution
of Pledge $ I description
I
_.._.... .....................
Pledgor address; City; State; Zip Code
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 -stale PAC (ID#: )
Amount of I In -kind contribution
Pledge $ I description
1
...........................................................................
Pledgor address; City; State; Zip Code
I
i
nCheck if travel outside of Texas. Complete Schedule T.
Principal occupation / Job title (See Instructions)
I Employer (See Instructions)
Date
Full name of pledgor ❑ out-of-state PAC (ID#: )
Amount of I In -kind contribution
Pledge $ I description
....................................... — ..... .........................
Pledgor address; City; State; Zip Code
I
F—I 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 811712020
LOANS
SCHEDULE E
If the requested information is not applicable,
DO NOT include this page in the report.
1 Total pages Schedule E.
The Instruction Guide explains how to complete this form.
2
FILER NAME
3 Filer ID (Ethics Commission Filers)
i
4
TOTAL OF UNITEMIZED LOANS
$
5
Date of loan
7 Name of lender
8 Lender address;
I] out -of --state PAC (I^.". )
...................................
City;State; Zip Code
9 LoanAmount ($)
6 Is lender
10 Interest rate
a financial
Institution?
-
11 Maturity date
Y N
12
Principal occupation ! Job title (See Instructions)
13 Employer (See Instructions)
14
Description of Collateral
15
Check if personal funds were deposited into political
❑ none
account (See Instructions)
16
GUARANTOR
17 Name of guarantor
19 Amount Guaranteed ($)
INFORMATION
18 Guarantor address;
............................ .....
City; State; Zip Code
❑ not applicable
'
20
Principal Occupation (See Instructions)
21 Employer (See Instructions)
Date of loan
Name of lender
Lender address;
❑ out-of-state PAC (16tr. )
.............. ......... ..................
City; State; Zip Code
Loan Amount ($)
Is lender
Interest rate
a financial
Institution?
Maturity date
Y N
Principal occupation ! Job title (See Instructions)
Employer (See Instructions)
Description of Collateral
❑ Check if personal funds were deposited into political
❑account
none
(See Instructions)
GUARANTOR
Name of guarantor
Amount Guaranteed ($)
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.tx.us Revised 8/1712020
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 Repayment/Reimbursement Solicitation/Fundraising Expense
Accounting/Banking Fees Office Overhead/Rental Expense Transportation Equipment S Related Expense
Consulting Expense Food/Beverage Expense Polling Expense Travel In District
Contributions/Donations Made By Gift/Awards/Memodals Expense Printing Expense Travel Out Of District
Candidate/Officeholder/Political Committee Legal Services Salaries/Wages/Contract Labor Other (entera category not listed above)
Credit Card Payment
The Instruction Guide explains haw to complete this form.
1 Total pages Schedule F1
2 FILER NAME
3 Filer ID (Ethics Commission Filers)
<f—t '/` f '. 5 (/L ( L l
4 Date
6 Payee name
6 Amount ($)
7 Payee address; City; State; Zip Code
8
(a) Category (See Categories listed at the top of this schedule)
(b) Description
PURPOSE
OF
EXPENDITURE
(C) Check if travel outside of Texas Complete Schedule T Check if Austin, TX, officeholder living expense
9 Complete ONLY if direct Candidate / Officeholder name Office sought Office held
expenditure to benefit C/OH
Date
Payee name
Amount ($)
^Payee address; City; State; Zip Code
Category (See Categories listed at the top of this schedule)
Description
PURPOSE
OF
EXPENDITURE
Checkiftraveloutside ofTexes.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
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, 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 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(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 SaleriesM/ages/Contract Labor Other (entera category not listed above)
The Instruction Guide explains how to complete this form,
1 Total pages Schedule F2:
2 FILER NAME
3 Filer ID (Ethics Commission Filers)
� (-I A � J jt/1 ` LkrS LAC i k-- L
4 TOTAL OF UNITEMIZED UNPAID INCURRED OBLIGATIONS
$
5 Date
6 Payee name
7 Amount ($)
a Payee address; City; State; Zip Code
9 TYPE OF
EXPENDITURE
n Political Non -Political
10
(a) Category (See Categories listed at the lop of this schedule)
(b) Description
PURPOSE
OF
EXPENDITURE
(c) Check if travel outside of Texas. Complete Schedule T. ❑ Check if Austin, TX, officeholder living expense
11 Complete ONLY if direct Candidate / Officeholder name Office sought Office held
expenditure to benefit C/OH
Date
Payee name
Amount ($)
Payee address; City; State; Zip Code
TYPE OF
EXPENDITURE
Political Non -Political
Category (See Categories listed at the top of this schedule)
Description
PURPOSE
OF
EXPENDITURE
Check if travel outside of Texas .CompleleSchedule 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 SCHEDULE AS NEEDED
Forms provided by Texas Ethics Commission www.ethics.state.tx.us Revised 8/17/2020
PURCHASE OF INVESTMENTS MADE
FROM POLITICAL CONTRIBUTIONS SCHEDULE F3
If the requested information is not applicable, DO NOT include this page in the report.
T
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
6 Name of person from whom investment is purchased
.........1...I...............II.... ......... ..... ............,........... ......... .......... ... ...... .. .....,........
6 Address of person from whom investment is purchased; City; State; Zip Code
7 Description of investment
8 Amount of investment ($)
Date
Name of person from whom investment is purchased
........... ................... ......... I.... .......... _......................_.............., ............... .... ........
Address of person from whom investment is purchased; City; State; Zip Code
Description of investment
Amount of investment ($)
ATTACH ADDITIONAL COPIES OF THIS SCHEDULE AS NEEDED
Forms provided by Texas Ethics Commission wwwethics. state. tx-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 Repayment/Reimbursement Solicitation/Fundraising Expense
Accounting/Banking Fees OfceOverhead/Rental Expense Transportation Equipmenl&Related Expense
Consulting Expense Food/Beverage Expense Polling Expense Travel In District
Contributions/Donations Made By GifVAwards/Memorials Expense Printing Expense Travel Out Of District
Candidate/Officeholder/Political Committee Legal Services SeladesANages/Contract Labor Other (enter a category not listed above)
The Instruction Guide explains how to complete this form.
1 Total pages Schedule F4:
2 FILER NAME
3 Filer ID (Ethics Commission Filers)
H lw 1/J 1XA C Cr-< IA. f L
4 TOTAL OF UNITEMIZED EXPENDITURES CHARGED TO A CREDIT CARD
$
5 Date
6 Payee name
7 Amount ($)
8 Payee address; City; State; Zip Code
9 TYPE OF
EXPENDITURE
I j
u Political Non -Political
10
(a) Category (See Categories listed at the top of this schedule)
(b) Description
PURPOSE
OF
EXPENDITURE
(c) ❑ Check if travel outside of Texas Complete Schedule T. El Check if Austin, TX, officeholder living expense
11 Candidate / Officeholder name Office sought Office held
Complete ONLY if direct
expenditure to benefit C/OH
Date
( Payee name
Amount ($)
Payee address; City; State; Zip Code
TYPE OF
EXPENDITURE
j�
u Political Non -Political
Category (See Categories listed at the top of this schedule)
Description
PURPOSE
OF
EXPENDITURE
_
❑ Check if travel outside of Texas. Complete Schedule T Check i1 Austin, TX, officeholder living expense
Candidate / Officeholder name Office sought Office held
Complete OILY if direct
expenditure to benefit C/OH
ATTACH ADDITIONAL COPIES OF THIS SCHEDULE AS NEEDED
Forms provided by Texas Ethics Commission vv w ,,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 BOX8(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
Conlributions/Donations Made By Gift/Awards/Memorials Expense Printing Expense Travel Out Of District
Candidate/Officeholder/Poliflcal Committee Legal Services SalariesANages/Conti act Labor Other (enters category not listed above)
Credit Card Payment
The Instruction Guide explains how to complete this Form.
1 Total pages Schedule G:
2 FILER NAME
3 Filer ID (Ethics Commission Filers)
I+
I r� w.�l jell r C
4 Date
5 Payee name
6 Amount ($)
7 Payee address; City; State; Zip Code
Reimbursement from
political contributions
intended
8
(a) Category (See Categories listed at the lop of this schedule)
(b) Description
PURPOSE
OF
EXPENDITURE
(c) Check if travel outside at Texas. Complete ScheduleT. Check if Austin, TX, officeholder living expense
9 Candidate / Officeholder name Office sought Office held
Complete ONLY if direct
expenditure to benefit C/OH
Date
Payee name
Amount ($)
Payee address; City; State; Zip Code
❑Reimbursement from
political contributions
intended
Category (See Categories listed at the lop of this schedule)
Description
PURPOSE
OF
EXPENDITURE
Check if(ravel outside ofTexas. Complete Schedule T. Check if Austin, TX, officeholder living expense
Candidate / Officeholder name Office sought Office held
LY
Complete ONif direct
expenditure to benefit C/OH
Date
Payee name
Amount ($)
Payee address; City, State; Zip Code
❑Reimbursement from
political contributions
intended
Category (See Categories listed at the top of this schedule)
Description
PURPOSE
OF
EXPENDITURE
❑ Check if travel outside of Texas. Complete Schedule Check if Austin, TX, officeholder living expense
Candidate / Officeholder name Office sought Office held
Complete QNLY if direct
expenditure to benefit C/OH
ATTACH ADDITIONAL COPIES OF THIS SCHEDULE AS NEEDED
Forms provided by Texas Ethics Commission www.ethics.state.tx.us Revised 8/17/2020
PAYMENT MADE FROM POLITICAL CONTRIBUTIONS
SCHEDULE H
TO A BUSINESS OF C/OH
If the requested information is not applicable, DO NOT include this page in the report.
EXPENDITURE CATEGORIES FOR BOX 8(a)
Advertising Expense Event Expense Loan Repayment/Reimbursement Solicitation/Fundraising Expense
AccountinglBanking Fees Office Overhead/Rental Expense Transportation Equipment & Related Expense
Consulting Expense Food/Beverage Expense Polling Expense Travel In District
Contributions/Donations Made By Gift/Awards/Memorials Expense Printing Expense Travel Out Of District
Candidate/Officeholder/Political Committee Legal Services Salaries/Wages/Contract Labor Other (enter a category not listed above)
Credit Card Payment
The Instruction Guide explains how to complete this form.
1 Total pages Schedule H
2 FILER NAME
3 Filer ID (Ethics Commission Filers)
5 v- ✓�- u1 .i \/\ �- ( ,- > Lk-. i L
4 Date
5 Business name
6 Amount ($)
7 Business address, City; State; Zip Code
8
(a) Category (See Categories listed at the top of this schedule)
(b) Description
PURPOSE
OF
EXPENDITURE
(c) ❑ Check if travel outside of Texas. Complete Schedule T. 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
Business name
Amount ($}
Business address; City; State; Zip Code
Category (See Categories listed at the top of this schedule)
Description
PURPOSE
OF
EXPENDITURE
Check if travel outside of Texas Complete ScheduleT. Check if Austin, TX, officeholder living expense
Complete ONLY if direct Candidate / Officeholder name Office sought Office held
expenditure to benefit C/OH
Date
Business name
Amount ($)
Business address; City; State; Zip Code
Category (See Categories listed al the top of this schedule)
Description
PURPOSE
OF
EXPENDITURE
Check if travel outside of Texas 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 vom.ethics.state.N.us Nevisea ts/T o2uzu
NON -POLITICAL EXPENDITURES
MADE FROM POLITICAL CONTRIBUTIONS SCHEDULE I
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
3 Filer ID (Ethics Commission Filers)
+
i i-I +`} w fJ )V1 ` C (�"S V_ I[
4 Date
_
$ Payee name
6 Amount ($)
7 Payee address; City State Zip Code
8
(a)Category (See instructions for examples of acceptable
(b) Description (See instructions regarding type of information
PURPOSE
categories.)
required.)
OF
EXPENDITURE
Date
Payee name
Amount ($)
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 ($)
Payee address; City State Zip Code
PURPOSE
Category (See instructions for examples of acceptable
Description (See instructions regarding type of information
OF
categories.)
required)
EXPENDITURE
Date
Payee name
Amount ($)
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
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 Check if political contribution returned to filer
Date
Name of person from whom amount is received
Amount ($)
.......................................................... . ........ .,...,..................
Address of person from whom amount is received; City; State; Zip Code
Purpose for which amount is received ❑ Check if political contribution returned to filer
Date
Name of person from whom amount is received
Amount ($)
... .... .
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 8/1712020
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 1 Schedule T:
2 FILER NAME
Srl (�rfJ N1 C C t -S V
3 Filer ID (Ethics Commission Filers)
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
6 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 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)
Name of Contributor / Corporation or Labor Organization / Pledgor / Payee
Contribution / Expenditure reported on:
❑ Schedule A2 ❑ Schedule 8 ❑ Schedule S(J) ❑ Schedule C2 ❑ Schedule D ❑ Schedule F1
❑ Schedule F2 ❑ Schedule F4 ❑ Schedule G ❑ Schedule H ❑ Schedule COWLIC ❑ 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
CANDIDATE / OFFICEHOLDER REPORT.
DESIGNATION OF FINAL REPORT FORM C/OH - FR
The Instruction Guide explains how to complete this form.
•- Complete only if "Report Type" on page 7 is marked "Final Report" ••
1 C/OH NAME
2 Filer ID (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 FUNDS
Check only one:
0 I do not have unexpended contributions or unexpended interest or income earned from political contributions.
F-1 I have unexpended contributions or unexpended interest or income earned from political contributions. I understand that I
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:
0 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.
Signature of Candidate
5 OFFICEHOLDER
•• Complete this section only If you are an officeholder ••
[] 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 8/1712020