July 15, 2017 Campaign Finance ReportCANDIDATE / OFFICEHOLDER
FORM C/OH
CAMPAIGN FINANCE PORT COVER SHEET PG 1
1 Filer ID (Ethics Commission Filers)
2 Total pages filed:
The C /OH Instruction Guide
explains how to complete this form.
3 CANDIDATE/
MS / MRS / MR FIRST MI
OFFICE USE ONLY
OFFICEHOLDER
NAME
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Date Received
NICKNAME LAST SUFFIX
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CITY; STATE; ZIP CODE
4 CANDIDATE/
ADDRESS / PO BOX; APT I SUITE #;
OFFICEHOLDER
MAILING
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ADDRESS
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4 L �)
❑ Change of Address
5 CANDIDATE/
AREA CODE PHONE NUMBER EXTENSION
Date Hand - delivered or Date Postmarked
OFFICEHOLDER
Ga (-D t 4
�3 �
PHONE
6 CAMPAIGN
MS I MRS /(M:N FIRST MI
Receipt #
Amount $
TREASURER
NAME
Date Processed
NICKNAME LAST SUFFIX
Date Imaged
7 CAMPAIGN
STREET ADDRESS (NO PO BOX PLEASE); APT / SUITE &; CITY; STATE;
ZIP CODE
TREASURER
11�cv�S� L7 4 zi iY 257S" iY
kr5
(Residence or Business)
8 CAMPAIGN
AREA CODE PHONE NUMBER EXTENSION
TREASURER
1"
PHONE
9 REPORT TYPE
El January 15 ❑ 30th day before election El Runoff
❑ 15th day after cam
t
treasurer appointment
(Officeholder Only)
July 15 ❑ 8th day before election ❑ Exceeded $500 limit
`f
❑ Final Report (Attach CIOH - FR)
10 PERIOD
Month Day Year Month
Day Year
COVERED
�"Z /IL7
THROUGH
11 ELECTION
ELECTION DATE
ELECTION TYPE
Month Day Year
❑ Primary ❑ Runoff ❑ Other -
Description
General ❑ Special
12 OFFICE
OFFICE HELD (If any)
13 OFFICE SOUGHT (If known)
GO TO PAGE 2
Forms provided by Texas Ethics Commission www.ethics,state.tx.us Hevlsea umrI uI o
CANDIDATE / OFFICEHOLDER FORM C/OH
CAMPAIGN FINANCE REPORT COVER SHEET PG 2
14 C /OH NAM
15 Filer ID (Ethics Commission Filers)
16 NOTICE FROM
THIS BOX IS FOR NOTICE OF POLITICAL CONTRIBUTIONS ACCEPTED OR POLITICAL EXPENDITURES MADE BY POLITICAL COMMITTEES TO
POLITICAL
SUPPORT THE CANDIDATE / OFFICEHOLDER. THESE EXPENDITURES AIAY HAVE BEEN MADE WITHOLIr THE CANDIDATES OR OFFwEHOLDER s
COMMITTEE(S)
KNOWLEDGE OR CONSENT. CANDIDATES AND OFFICEHOLDERS ARE REQUIRED TO REPORT THIS INFORMATION ONLY IF THEY RECEIVE NOTICE
OF SUCH EXPENDITURES.
•
COMMITTEE TYPE
COMMITTEE NAME
D GENERAL
COMMITTEE ADDRESS
SPECIFIC
COMMITTEE CAMPAIGN TREASURER NAME
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)
�� b6
EXPENDITURE
TOTALS
3. TOTAL POLITICAL EXPENDITURES OF $100 OR LESS,
$ C)
UNLESS ITEMIZED
4, TOTAL POLITICAL EXPENDITURES
CONTRIBUTION TION
5. TOTAL POLITICAL CONTRIBUTIONS MAINTAINED AS OF THE LAST DAY
OF REPORTING PERIOD
121
OUTSTANDING
6, TOTAL PRINCIPAL AMOUNT OF ALL OUTSTANDING LOANS AS OF THE
LOAN TOTALS
LAST DAY OF THE REPORTING PERIOD
IS 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.
DONNA R. SCHMOREL
NOTARY
PUBLIC�.� --
S
My COM SS OR Signature of Candidate or Officeholder
Sp1
pT S p019
C � ka",
AFFIX NOTARY STAMP / S EALABOVE
Sworn to and subscribed before me, by the said 0 A,, this the
r`
day of U _ 20 C to certify which, witness my hand and seal of office.
t � t �
I
Signature of officer administering oath Printed name of officer administering oath Ti le of Officer aclminisfering oath
Forms provided by Texas Ethics Commission www.ethics.state.tx.us HeVised 9/8 /2015
.MONETARY" POLITICAL CONTRIBUTIONS SCHEDULE Al
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 ❑ oul -of -stale PAC (ID #: I
7 Amount of contribution ($)
�v,Q, s
�:R�C �\-� C�- L ......................
INu'G �
2 C�' C?
6 Contributor address; City; State; Zip Code
L-) V.
S�•�Z
8 Principal occupation / Job title (See Instructions)
9 Employer (See Instructions)
Date
Full name of contributor ❑ out -of -state PAC (ID #: I
Amount of contribution ($)
Contributor address; City; State; Zip Code
Principal occupation / Job title (See Instructions)
Employer (See Instructions)
Date
Full name of contributor ❑ out -of -state PAC (ID #: t
Amount of contribution ($)
............... ......................
Contributor address; City; State; Zip Code
Principal occupation / Job title (See Instructions)
Employer (See Instructions)
Date
Full name of contributor ❑ out -of -state PAC (ID #: 1
Amount of contribution ($)
Contributor address; City; State; Zip Code
Principal occupation / Job title (See Instructions)
Employer (See Instructions)
ATTACH ADDITIONAL COPIES Or THIS SCHEDULE AS NEEDED
It 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 9/8/2015
SUBTOTAL /O # 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
I VSCHEDULEAI: MONETARY POLITICAL CONTRIBUTIONS
$
2,
SCHEDULE A2: NON-MONETARY (IN-KIND) POLITICAL CONTRIBUTIONS
$
3.
SCHEDULES: PLEDGED CONTRIBUTIONS
$
4.
SCHEDULE E: LOANS
$
5.
SCHEDULE Fl: POLITICAL EXPENDITURES MADE FROM POLITICAL CONTRIBUTIONS
$
6.
El SCHEDULE F2: UNPAID INCURRED OBLIGATIONS
$
7.
0 SCHEDULE F3: PURCHASE OF INVESTMENTS MADE FROM POLITICAL CONTRIBUTIONS
$
8.
r_1 SCHEDULE F4: EXPENDITURES MADE BY CREDIT CARD
$
9•
El SCHEDULE G: POLITICAL EXPENDITURES MADE FROM PERSONAL FUNDS
$
10.
El 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 bvTexas Ethics Commission www.ethlcs.state.tx.us
II
Revised 9/8/2015