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Patton Semi Jan 2023CANDIDATE / OFFICEHOLDER FORM C/OH CAMPAIGN FINANCE REPORT COVER SHEET PG I I Filer ID (Ethics Commission Filers) 2 Total pages filed: The C/01-1 Instruction Guide explains how to complete this form. 3 CANDIDATE/ MS,MRS'MR FIRST Ml E SE ONLY US OFFICEHOLDER NAME Chad M Date Recei VECEIVED NICKNAME LAST SUFFIX Patton 4 CANDIDATE/ ADDRESS / PO BOX, APT .' SUITE #: CITY; STATE; E; ZIP CODE OFFICEHOLDER J U L 2 5 20P-3 MAILING 1111 LaPaloma Ct. ADDRESS Southlake, TX 76092 D Change of Address Fr-lrE OF CITY SECRETAR' 5 CANDIDATE/ AREA CODE PHONE NUMBER EXTENSION L OFFICEHOLDER i 817 ) 733-7191 PHONE -- Receipt# Amount 6 CAMPAIGN MS i MRS,MR FIRST MI I TREASURER Date Processed NAME Bill NICKNAME LAST SUFFIX Date Imaged Webb 7 CAMPAIGN STREET ADDRESS (NO PO BOX PLEASE); APT! SUITE #; CITY;;;;; STATE; ZIP CODE TREASURER 566 N. Kimball Ave. Suite 120 ADDRESS (Residence or Business) Southlake, TX 76092 8 CAMPAIGN AREA CODE PHONE NUMBER EXTENSION TREASURER PHONE 214 ) 205-7495 9 REPORT TYPE January 15 F-1 30th day before election Runoff 15th day after campaigntreasurer appointment (Officeholder Only) July 15 F-1 8th day before election Exceeded Modified Final Report (Attach C/OH - FRI Reporting Limit 10 PERIOD Month Day Year Month Day Year COVERED 07 / 01 / 2022 THROUGH 12 31 / 2022 11 ELECTION ELECTION DATE ELECTION TYPE F-1 Primary F-1 Runoff 1:1 Other Month Day Year Description General Special 12 OFFICE OFFICE HELD (if any) � 13 OFFICE SOUGHT (if known} City Council, Place 3 14 NOTICE FROM THIS BOX IS FOR NOTICE OF POLITICAL CONTRIBUTIONS ACCEPTED OR POLITICAL EXPENDITURES MADE BY POLITICAL COMMITTEES TO SUPPORT POLITICAL THE CANDIDATE IOFFICEHOLDER, THESE EXPENDITURES MAY HAVE BEEN MADE WITHOUT THE CANDIDATES 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 F COMMITTEE CAMPAIGN TREASURER NAME ] COMMITTEE CAMPAIGN TREASURER ADDRESS GO TO PAGE 2 Forms provided by Texas Ethics Commission www.ethics.state.tx.us Revised '11/15/2022 CANDIDATE / OFFICEHOLDER FORM C/OH CAMPAIGN FINANCE REPORT 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) EXPTOTAENDITURE 3. TOTAL UNITEMIZED POLITICAL EXPENDITURE. ................... 4. TOTAL POLITICAL EXPENDITURES $ CONTRIBUTION BALANCE 5. TOTAL POLITICAL CONTRIBUTIONS MAINTAINED AS OF THE LAST DAY $ $436 .................. OF REPORTING PERIOD OUTSTANDING TOTALS 6. TOTAL PRINCIPAL AMOUNT OF ALL OUTSTANDING LOANS AS OF THE $ LOAN 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. - d /• � t�f N Signature of Candi ate or Officeholder Please complete either option below: .�1y AMY SHELLEY :1Y PV6 ��� (1) Affidavit =?_Notary Public, State of Texas Q� Comm. Expires 12-02-2023 NN Notary ID 12476110 5 lit NOTARY STAMP/SEAL Sworn to and subscribed before me by this the^Jday of 3 to certify which, witness my hand ands I of office. Sign lure ffic r dministering oath Printed nam o officer administering oath Title of fficer 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 120 (month) (year) Signature of Candidate/Officeholder (Declarant) Forms provided by Texas Ethics Commission www.ethics.state.tx.us Revised 11/15/2022