Muller 30 Day 2015 Texas Ethics Commission P.O. Box 12070 Austin, Texas 78711 -2070 (512) 463 -5800 (TDD 1- 800 - 735 -2989)
CANDIDATE / OFFICEHOLDER FORM C /OH
CAMPAIGN FINANCE REPORT COVER SHEET PG 1
1 ACCOUNT # 2 Total pages filed:
The C /OH Instruction Guide explains how to complete this form. (Ethics Commission Filers)
3 CANDIDATE / MS /MRS /MR FIRST MI
OFFICEHOLDER OFFICE USE ONLY
NAME r� Date Received
RECLiVED
NICKNAME LAST SUFFIX
\V\ \ 5� \R
4 CANDIDATE / ADDRESS /PO BOX; APT /SUITE #, CITY; STATE; ZIP CODE APR - 9 2015
OFFICEHOLDER
MAILING
c
ADDRESS Z \"\ \7t > \ L "\C's S.' \\I V--- Date Hand - delivered or Postmarked
OFFICE OF CITY CrrC E — >t „
I I change of address '� U\_, \-- \ f - -- 5: 7 1 . , ' R eceipt # Amount
��/
5 CANDIDATE/ AREA CODE PHONE NUMBER EXTENSION
OFFICEHOLDER Date Processed
PHONE
Q. \V ) ‘-•\ - cj cj
6 CAMPAIGN MS /MRS /MR FIRST MI Date Imaged
TREASURER
NAME \ "V.,; ��\ -1\ \\
NICKNAME LAST SUFFIX
C._ \ C \\
7 CAMPAIGN STREET ADDRESS (NO PO BOX PLEASE); APT/ SUITE ft. CITY; STATE; ZIP CODE
TREASURER
ADDRESS 1 '-- 1
(residence or business) N' ,;: C k C.. \�'L��� <- .-ti\\ \ .\\\ -
8 CAMPAIGN AREA CODE PHONE NUMBER EXTENSION
PREASURER \ \�
PHONE ( �\ � t ^�,�'
9 REPORT TYPE I January 15 N. 30th day before election I Runoff 1 15th day after campaign
treasurer appointment
(officeholder only)
I I July 15 I I 8th day before election I Exceeded $500 I I Final report (Attach C /OH - FR)
limit
10 PERIOD Month Day Year Month Day Year
COVERED / / THROUGH / /
11 ELECTION ELECTION DATE ELECTION TYPE
Month Day Year
Primary Runoff I I General I Special
Q'S /o /?-_M
12 OFFICE OFFICE HELD (if any) 13 OFFICE SOUGHT (if known)
GO TO PAGE 2
www.ethics.state.tx.us Revised 04/19/2013
Texas Ethics Commission P.O. Box 12070 Austin, Texas 78711 -2070 (512) 463 -5800 (TDD 1- 800 - 735 -2989)
CANDIDATE / OFFICEHOLDER REPORT: FORM C /OH
SUPPORT & TOTALS COVER SHEET PG 2
14 C /OH NAME 15 ACCOUNT # (Ethics Commission Filers)
16 NOTICE FROM THIS BOX IS FOR NOTICE OF POLITICAL CONTRIBUTIONS ACCEPTED OR POLITICAL EXPENDITURES MADE BY POLITICAL COMMITTEES TO SUPPORT THE
POLITICAL CANDIDATE / OFFICEHOLDER. THESE EXPENDITURES MAY HAVE BEEN MADE WITHOUT THE CANDIDATE'S OR OFFICEHOLDERS KNOWLEDGE OR
COMMITTEE (S) CONSENT. CANDIDATES AND OFFICEHOLDERS ARE REQUIRED TO REPORT THIS INFORMATION ONLY IF THEY RECEIVE NOTICE OF SUCH EXPENDITURES.
COMMITTEE NAME
COMMITTEE TYPE
GENERAL
COMMITTEE ADDRESS
SPECIFIC
COMMITTEE CAMPAIGN TREASURER NAME
I additional pages
COMMITTEE CAMPAIGN TREASURER ADDRESS
17 CONTRIBUTION 1. TOTAL POLITICAL CONTRIBUTIONS OF $50 OR LESS (OTHER THAN
TOTALS PLEDGES, LOANS, OR GUARANTEES OF LOANS), UNLESS ITEMIZED $
2. TOTAL POLITICAL CONTRIBUTIONS
(OTHER THAN PLEDGES, LOANS, OR GUARANTEES OF LOANS)
EXPENDITURE
TOTALS 3. TOTAL POLITICAL EXPENDITURES OF $100 OR LESS, UNLESS ITEMIZED
4. TOTAL POLITICAL EXPENDITURES $ ,,,:::)
CONTRIBUTION 5. TOTAL POLITICAL CONTRIBUTIONS MAINTAINED AS OF THE LAST DAY Q
BALANCE OF REPORTING PERIOD `p
OUTSTANDING 6. TOTAL PRINCIPAL AMOUNT OF ALL OUTSTANDING LOANS AS OF THE Q / .�
LOAN TOTALS LAST DAY OF THE REPORTING PERIOD $
18 AFFIDAVIT
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.
°��p YVETTE M. RUIZ
Jie�r• • t,
z Notary Public, State of Texas
« My Commission Expires
- 4:411;,',, June 16, 2015
Signature of Candidate o fficeholder
AFFIX NOTARY STAMP / SEAL ABOVE yy�� 11 /�
Sworn to and subscribed before me, by the said le0.M.P\ Cl 'P_. 13%_L1...' C-r , this the
Crh day of I n Y T 1 20 \ to certify which, witness my hand and seal of office.
/A f Y 1- • ■ U Q eit,e,_ tA.. -= P-uCi - 2___
': - . e rf officer administering o. d P rinted name of officer administering oath Title of officer administerin oath
www.ethics.state.tx.us Revised 04/19/2013
Texas Ethics Commission P.O. Box 12070 Austin, Texas 78711 -2070 (512) 463 -5800 (TDD 1- 800 - 735 -2989)
POLITICAL CONTRIBUTIONS SCHEDULE A
OTHER THAN PLEDGES OR LOANS
The Instruction Guide explains how to complete this form. 1 Total pages Schedule A:
2 FILER NAME 3 ACCOUNT # (Ethics Commission Filers)
4 Date 5 Full name of contributor ❑ out - of - state PAC(QD# ) 7 Amount of I 8 In -kind contribution
contribution ($) description (if applicable)
6 Contributor address; City; State; Zip Code
(If travel outside of Texas, complete Schedule T)
9 Principal occupation / Job title (See Instructions) 10 Employer (See Instructions)
Date Full name of contributor ❑ out of state PAC (ID# ) Amount of I In -kind contribution
contribution ($) description (if applicable)
Contributor address; City; State; Zip Code
(If travel outside of Texas, complete Schedule T)
Principal occupation / Job title (See Instructions) Employer (See Instructions)
Date Full name of contributor ❑ out of state PAC (ID#: ) Amount of In -kind contribution
contribution ($) description (if applicable)
Contributor address; City; State; Zip Code
(If travel outside of Texas, complete Schedule T)
Principal occupation / Job title (See Instructions) Employer (See Instructions)
Date Full name of contributor ❑ out - of - state PAC (ID* ) Amount of 1 In -kind contribution
contribution ($) description (if applicable)
Contributor address; City; State; Zip Code
(If travel outside of Texas, complete Schedule T)
Principal occupation / Job title (See Instructions) Employer (See Instructions)
Date Full name of contributor ❑ out of state PAC (Olt ) Amount of I In -kind contribution
contribution ($) description (if applicable)
Contributor address; City; State; Zip Code
(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 foradditional reporting requirements.
www.ethics.state.tx.us Revised 04/19/2013
Texas Ethics Commission P.O. Box 12070 Austin, Texas 78711 -2070 (512) 463 -5800 (TDD 1- 800 - 735 -2989)
PLEDGED CONTRIBUTIONS SCHEDULE B
1 Total pages Schedule B:
The Instruction Guide explains how to complete this form.
2 FILER NAME 3 ACCOUNT # (Ethics Commission Filers)
4 TOTAL OF UNITEMIZED PLEDGES: * => c* b * b $
5 Date 6 Full name of pledgor ❑ out - of - state PAC (ID# ) 8 Amount of I g In -kind description
pledge ($) (if applicable)
7 Pledgor address; City; State; Zip Code 1
1
(If travel outside of Texas, complete Schedule T)
10 Principal occupation / Job title (See Instructions) 11 Employer (See Instructions)
Date Full name of pledgor ❑ out - of - state PAC(ID# ) Amount of ( In -kind description
pledge ($) (if applicable)
Pledgor address; City; State; Zip Code
(If travel outside of Texas, complete Schedule T)
Principal occupation / Job title (See Instructions) Employer (See Instructions)
Date Full name of pledgor ❑ out PAC (ID# ) Amount of 1 In -kind description
pledge ($) 1 (if applicable)
Pledgor address; City; State; Zip Code
i
1
(If travel outside of Texas, complete Schedule T)
Principal occupation / Job title (See Instructions) Employer (See Instructions)
Date Full name of pledgor ❑ out PAC (ID# ) Amount of 1 In -kind description
pledge ($) 1 (if applicable)
Pledgor address; City; State; Zip Code
1
t
(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#: ) Amount of 1 In -kind description
pledge ($) I (if applicable)
Pledgor address; City; State; Zip Code
(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.
www.ethics.state.tx.us Revised 04/19/2013
Texas Ethics Commission P.O. Box 12070 Austin, Texas 78711 -2070 (512) 463 -5800 (TDD 1- 800 - 735 -2989)
LOANS SCHEDULE E
1 Total pages Schedule E:
The Instruction Guide explains how to complete this form.
2 FILER NAME 3 ACCOUNT # (Ethics Commission Filers)
4
TOTAL OF UNITEMIZED LOANS: b b b b r=> b $
5 Date of loan 7 Name of lender 0 out - of - state PAC (ID#: ) 9 Loan Amount ($)
6 Is lender 8 Lender address; City; State; Zip Code 10 Interest rate
a financial
Institution?
11 Maturity date
Y N
12 Principal occupation / Job title (See Instructions) 13 Employer (See Instructions)
14 Description of Collateral 15 Check if personal funds were deposited into political account
❑ none ❑
16 GUARANTOR 17 Name of guarantor 19 Amount Guaranteed ($)
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 0 out - of - state PAC (ID #: ) Loan Amount ($)
Is lender Lender address; City; State; Zip Code Interest rate
a financial
Institution?
Maturity date
Y N
Principal occupation / Job title (See Instructions) Employer (See Instructions)
Description of Collateral Check if personal funds were deposited into political account
❑ none ❑
GUARANTOR Name of guarantor Amount Guaranteed ($)
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.
www.ethics.state.tx.us Revised 04/19/2013
Texas Ethics Commission P.O. Box 12070 Austin, Texas 78711 -2070 (512) 463 -5800 (TDD 1- 800 - 735 -2989)
POLITICAL EXPENDITURES SCHEDULE F
EXPENDITURE CATEGORIES FOR BOX 8(a)
Advertising Expense Gift /Awards /Memorials Expense Salaries/Wages /Contract Labor Loan Repayment/Reimbursement
Accounting /Banking Legal Services Solicitation /Fundraising Expense Transportation Equipment & Related Expense
Consulting Expense Food /Beverage Expense Travel In District Contributions /Donations Made By
Event Expense Polling Expense Travel Out Of District Candidate /Officeholder /Political Committee
Fees Printing Expense Office Overhead /Rental Expense OTHER (enter a category not listed above)
The Instruction Guide explains how to complete this form.
1 Total pages Schedule F: 2 FILER NAME 3 ACCOUNT # (Ethics Commission Filers)
4 Date 5 Payee name
6 Amount ($) 7 Payee address; City; State; Zip Code
8 PURPOSE (a) Category (See categories listed at the top of this schedule) (b) Description (If travel outside of Texas, complete Schedule T)
OF
EXPENDITURE
9 Complete ONLY if direct Candidate / Officeholder name Office sought Office held
expenditure to benefit C /OH
Date Payee name
Amount ($) Payee address; City; State; Zip Code
PURPOSE Category (See categories listed at the top of this schedule) Description (If travel outside of Texas, complete Schedule T)
OF
EXPENDITURE
Complete ONLY if direct Candidate / Officeholder name Office sought Office held
expenditure to benefit C /OH
Date Payee name
Amount ($) Payee address; City; State; Zip Code
PURPOSE Category (See categories listed at the top of this schedule) Description (If travel outside of Texas, complete Schedule T)
OF
EXPENDITURE
Complete ONLY if direct Candidate / Officeholder name Office sought Office held
expenditure to benefit C /OH
Date Payee name
Amount ($) Payee address; City; State; Zip Code
PURPOSE Category (See categories listed at the top of this schedule) Description (If travel outside of Texas, complete Schedule T)
OF
EXPENDITURE
Complete ONLY if direct Candidate / Officeholder name Office sought Office held
expenditure to benefit C /OH
ATTACH ADDITIONAL COPIES OF THIS SCHEDULE AS NEEDED
www.ethics.state.tx.us Revised 04/19/2013
Texas Ethics Commission P.O. Box 12070 Austin, Texas 78711 -2070 (512) 463 -5800 (TDD 1- 800 - 735 -2989)
POLITICAL EXPENDITURES SCHEDULE G
MADE FROM PERSONAL FUNDS
EXPENDITURE CATEGORIES FOR BOX 8(a)
Advertising Expense Gift/Awards /Memorials Expense Salaries /Wages /Contract Labor Loan Repayment/Reimbursement
Accounting /Banking Legal Services Solicitation /Fundraising Expense Transportation Equipment & Related Expense
Consulting Expense Food /Beverage Expense Travel In District Contributions /Donations Made By
Event Expense Polling Expense Travel Out Of District Candidate /Officeholder /Political Committee
Fees Printing Expense Office Overhead /Rental Expense OTHER (enter a category not listed above)
The Instruction Guide explains how to complete this form.
1 Total pages Schedule G: 2 FILER NAME 3 ACCOUNT # (Ethics Commission Filers)
4 Date 5 Payee name
6 Amount ($) 7 Payee address; City; State; Zip Code
Reimbursement from
political contributions
intended
8 PURPOSE (a) Category (See categories listed at the top of this schedule) (b) Description (If travel outside of Texas, complete Schedule T)
OF
EXPENDITURE
Date Payee name
Amount ($) Payee address; City; State; Zip Code
Reimbursement from
Political contributions
intended
PURPOSE Category (See categories listed at the top of this schedule) Description (If travel outside of Texas, complete Schedule T)
OF
EXPENDITURE
Date Payee name
Amount ($) Payee address; City; State; Zip Code
n Reimbursement from
political contributions
intended
PURPOSE Category (See categories listed at the top of this schedule) Description (If travel outside of Texas, complete Schedule T)
OF
EXPENDITURE
Date Payee name
Amount ($) Payee address; City; State; Zip Code
Reimbursement from
political contributions
intended
PURPOSE Category (See categories listed at the top of this schedule) Description (If travel outside of Texas, complete Schedule T)
OF
EXPENDITURE
ATTACH ADDITIONAL COPIES OF THIS SCHEDULE AS NEEDED
www.ethics.state.tx.us Revised 04/19/2013
Texas Ethics Commission P.O. Box 12070 Austin, Texas 78711 -2070 (512) 463 -5800 (TDD 1- 800 - 735 -2989)
PAYMENT FROM POLITICAL CONTRIBUTIONS SCHEDULE H
TO A BUSINESS OF C /OH
EXPENDITURE CATEGORIES FOR BOX 8(a)
Advertising Expense Gift /Awards /Memorials Expense Salaries/Wages /Contract Labor Loan Repayment/Reimbursement
Accounting /Banking Legal Services Solicitation /Fundraising Expense Transportation Equipment & Related Expense
Consulting Expense Food /Beverage Expense Travel In District Contributions /Donations Made By
Event Expense Polling Expense Travel Out Of District Candidate /Officeholder /Political Committee
Fees Printing Expense Office Overhead /Rental Expense OTHER (enter a category not listed above)
The Instruction Guide explains how to complete this form.
1 Total pages Schedule H: 2 FILER NAME 3 ACCOUNT # (Ethics Commission Filers)
4 Date 5 Business name
6 Amount ($) 7 Business address; City; State; Zip Code
8 PURPOSE (a) Category (See categories listed at the top of this schedule) (b) Description (If travel outside of Texas, complete Schedule T)
OF
EXPENDITURE
9 Complete ONLY if direct Candidate / Officeholder name Office sought Office held
expenditure to benefit C /OH
Date Business name
Amount ($) Business address; City; State; Zip Code
PURPOSE Category (See categories listed at the top of this schedule) Description (If travel outside of Texas, complete Schedule T)
OF
EXPENDITURE
Complete ONLY if direct Candidate / Officeholder name Office sought Office held
expenditure to benefit C /OH
Date Business name
Amount ($) Business address; City; State; Zip Code
PURPOSE Category (See categories listed at the top of this schedule) Description (If travel outside of Texas, complete Schedule T)
OF
EXPENDITURE
Complete ONLY if direct Candidate / Officeholder name Office sought Office held
expenditure to benefit C /OH
Date Business name
Amount ($) Business address; City; State; Zip Code
PURPOSE Category (See categories listed at the top of this schedule) Description (If travel outside of Texas, complete Schedule T)
OF
EXPENDITURE
Complete ONLY if direct Candidate / Officeholder name Office sought Office held
expenditure to benefit C /OH
ATTACH ADDITIONAL COPIES OF THIS SCHEDULE AS NEEDED
www.ethics.state.tx.us Revised 04/19/2013
Texas Ethics Commission P.O. Box 12070 Austin, Texas 78711 -2070 (512) 463 -5800 (TDD 1- 800 - 735 -2989)
NON - POLITICAL EXPENDITURES SCHEDULE 1
MADE FROM POLITICAL CONTRIBUTIONS
The Instruction Guide explains how to complete this form.
1 Total pages Schedule l: 2 FILER NAME 3 ACCOUNT # (Ethics Commission Filers)
4 Date 5 Payee name
6 Amount ($) 7 Payee address; City; State; Zip Code
8 PURPOSE (a)Category (See instructions for examples of acceptable ( b)Description (See instructions regarding type of information
OF categories) required.)
EXPENDITURE
Date Payee name
Amount ($) Payee address; City; State; Zip Code
PURPOSE (a) Category (See instructions for examples of acceptable (b)Description (See instructions regarding type of information
OF categories) required.)
EXPENDITURE
Date Payee name
Amount ($) Payee address; City; State; Zip Code
PURPOSE (a) Category (See instructions for examples of acceptable (b) Description (See instructions regarding type of information
OF categories) required.)
EXPENDITURE
Date Payee name
Amount ($) Payee address; City; State; Zip Code
PURPOSE (a) Category (See instructions for examples of acceptable (b) Description (See instructions regarding type of information
OF categories) required.)
EXPENDITURE
ATTACH ADDITIONAL COPIES OF THIS SCHEDULE AS NEEDED
www.ethics.state.tx.us Revised 04/19/2013
Texas Ethics Commission P.O. Box 12070 Austin, Texas 78711 -2070 (512) 463 -5800 (TDD 1- 800 - 735 -2989)
INTEREST EARNED, OTHER CREDITS /GAINS/
REFUNDS, AND PURCHASE OF INVESTMENTS SCHEDULE K
The Instruction Guide explains how to complete this form. 1 Total pages Schedule K:
2 FILER NAME 3 ACCOUNT # (Ethics Commission Filers)
4 Date 5 Name of person from whom amount is received 8 Amount
($)
6 Address of person from whom amount is received; City; State; Zip Code
7 Purpose for which amount is received
Date Name of person from whom amount is received Amount
($)
Address of person from whom amount is received; City; State; Zip Code
Purpose for which amount is received
Date Name of person from whom amount is received Amount
($)
Address of person from whom amount is received; City; State; Zip Code
Purpose for which amount is received
Date Name of person from whom amount is received Amount
($)
Address of person from whom amount is received; City; State; Zip Code
Purpose for which amount is received
ATTACH ADDITIONAL COPIES OF THIS SCHEDULE AS NEEDED
www.ethics.state.tx.us Revised 04/19/2013
Texas Ethics Commission P.O. Box 12070 Austin, Texas 78711 -2070 (512) 463 -5800 (TDD 1- 800 - 735 -2989)
IN -KIND CONTRIBUTION OR POLITICAL EXPENDITURE SCHEDULE T
FOR TRAVEL OUTSIDE OF TEXAS
The Instruction Guide explains how to complete this form. 1 Total pages Schedule T:
2 FILER NAME 3 ACCOUNT # (Ethics Commission Filers)
4 Name of Contributor / Corporation or Labor Organization / Pledgor / Payee
5 Contribution / Expenditure reported on:
Schedule A 1 I Schedule B Schedule C I Schedule D I Schedule F I I Schedule G
Schedule H I I Schedule N I I COH -UC COH -T 1 1 PAC -C I I PAC -E
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:
I Schedule A I Schedule B I I Schedule C I] Schedule D I I Schedule F I Schedule G
I Schedule H I Schedule N 1 I COH -UC 1 COH -T ( 1 PAC -C 1 PAC -E
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:
1 Schedule A 1 Schedule B 1 1 Schedule C I Schedule D Schedule F 7 Schedule G
I Schedule H I Schedule N I I COH -UC 1 I COH -T I I PAC -C PAC -E
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
www.ethics.state.tx.us Revised 04/19/2013
Texas Ethics Commission P.O. Box 12070 Austin, Texas 78711 -2070 (512) 463 -5800 (TDD 1- 800 - 735 -2989)
CANDIDATE / OFFICEHOLDER REPORT:
FORM C /OH - FR
DESIGNATION OF FINAL REPORT
The Instruction Guide explains how to complete this form.
•• Complete only if "Report Type" on page 1 is marked "Final Report" ••
1 C /OH NAME 2 ACCOUNT # (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:
I I do not have unexpended contributions or unexpended interest or income earned from political contributions.
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:
n 1 do not retain assets purchased with political contributions or interest or other income from political contributions.
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
www.ethics.state.tx.us Revised 04/19/2013