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10-11-2022CANDIDATE / OFFICEHOLDER CAMPAIGN FINANCE REPORT FORM C /OH COVER SHEET PG 1 ❑ GENERAL Additional Pages ❑SPECIFIC COMMITTEE ADDRESS i COMMITTEE CAMPAIGN TREASURER NAME COMMITTEE CAMPAIGN TREASURER ADDRESS GO TO PAGE 2 Forms provided by Texas Ethics Commission www.ethics.state.tx.us Revised 8/17/2020 1 Filer ID (Ethics Commission Flers) 2 Total pages filed: The C /OH Instruction Guide explains how to complete this form. 3 CANDIDATE / OFFICEHOLDER M / MRS / MR FIRST OFFICE USE ONLY CNf�..�... NAME.. ... ........ Date F ad NICKNAME LAST H ADDRESS / P APT: $ E R CITY; FIx r STATE; ZIP CODE 4 CANDIDATE/ OFFICEHOLDER MAILING A Q ADDRESS E] Change of Address AREA CODE NUMBER EXTENSION Date Hand - delivered or Date Postmarked 5 CANDIDATE/ OFFICEHOLDER — _PHONE PHONE 1 / Receipt # Amount $ 6 CAMPAIGN TREASURER MS / MRS 4D FIRST M d MI r " "��L. n.1, Date Processed NAME ............. ��.... .............. .... ...... t . . NICKNAME LAST SUFFIX �y Date Imaged 7 CAMPAIGN TREASURER STREET ADDRESS (NO PO BOX PLEASE); APT / SUIT .# "A Est a ATE; ZIP CODE ADDRESS (Residence or Business) AREA CODE PHONE NUMBER EXTENSION 8 CAMPAIGN TREASURER PHONE AWN / 9 REPORT TYPE January 15 30th day before election Runoff 15th day after campaign treasurer appointment (Officeholder Only) July 15 El 8th day before election Exceeded Modified Final Report (Attach C /OH - FR) Month Day Year Reporting Limit Month Day Year 10 PERIOD COVERED THROUGH d' 11 ELECTION ELECTION DATE ELECTION TYPE ❑ Primary ❑ Runoff ❑ Other Month Day Year Description �7 I �., General El Special 7 `t 12 OFFICE OFFICE HE (if any) 13 OFF EI OUGHT (if known) 14 NOTICE FROM THIS BOX IS FOR NOTICE OF POLITICAL CONTRIBUTIONS ACCEPTED OR POLITICAL EX .NDITURES MADE BY POLITICAL COMMITTEES TO SUPPORT THE CANDIDATE 1 OFFICEHOLDER THESE EXPENDITURES MAY HAVE BEEN MADE WITHOUT THE CANDIDATE'S OR OFFICEHOLDER'S KNOWLEDGE OR POLITICAL 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 Additional Pages ❑SPECIFIC COMMITTEE ADDRESS i COMMITTEE CAMPAIGN TREASURER 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 CAMPAIGN FINANCE REPORT 15 C /OH NAME 17 CONTRIBUTION TOTALS EXPENDITURE TOTALS 1 2. 3. 4. TOTAL UNITEMIZED POLITICAL CONTRIBUTIONS (OTHER THAN PLEDGES, LOANS, OR GUARANTEES OF LOANS, OR CONTRIBUTIONS MADE ELECTRONICALLY) TOTAL POLITICAL CONTRIBUTIONS (OTHER THAN PLEDGES, LOANS, OR GUARANTEES OF LOANS) TOTAL UNITEMIZED POLITICAL EXPENDITURE. TOTAL POLITICAL EXPENDITURES FORM C /OH COVER SHEET PG 2 16 Filer ID (Ethics Commission Filers) $ ,o CONTRIBUTION 5. TOTAL POLITICAL CONTRIBUTIONS MAINTAINED AS OF THE LAST DAY $ BALANCE OF REPORTING PERIOD OUTSTANDING 6. TOTAL PRINCIPAL AMOUNT OF ALL OUTSTANDING LOANS AS OF THE LOAN TOTALS LAST DAY OF THE REPORTING PERIOD 18 SIGNATURE I swear, or affirm, under penalty of perjury, that the accompan report is true and correct and includes all information required to be reported by me under Title 15, Election Code. Signature of Cand or older (1) Affidavit Please complete either option below: SHEILA M. EDMONDSON NOTARY PUBLIC • STATE OF TEXAS ID 0 12495213.1 MY 1001710 on Expires 031174028 NOTARY STAMP/ SEAL Sworn to and subscribed before me by 20 to ce h, witness my han d sea of offs S ure of officer a inistering oath Printed name of officer administering oath (2) Unsworn Declaration this the day of 066K , %, of officer My name is and my date of birt h 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 FIL NAME 20 Filer ID (Ethics Commission Filers) 21 SCHEDULE SUBTOTALS SUBTOTAL AMOUNT NAME OF SCHEDULE 1 El SCHEDULEAI: MONETARY POLITICAL CONTRIBUTIONS— $ 2. SCHEDULEA2: NON - MONETARY (IN -KIND) POLITICAL CONTRIBUTIONS $ 3. SCHEDULE B: PLEDGED CONTRIBUTIONS $ $ 4. F1 SCHEDULE E: LOANS 5. SCHEDULE F1: POLITICAL EXPENDITURES MADE FROM POLITICAL CONTRIBUTIONS $ 6. El SCHEDULE F2; UNPAID INCURRED OBLIGATIONS $ �. 7. F-1 SCHEDULE F3: PURCHASE OF INVESTMENTS MADE FROM POLITICAL CONTRIBUTIONS $ 1� a- SCHEDULE F4: EXPENDITURES MADE BY CREDIT CARD $ / 1 9. 1 _ SCHEDULE G: POLITICAL EXPENDITURES MADE FROM PERSONAL FUNDS $ 10� SCHEDULE H: PAYMENT MADE FROM POLITICAL CONTRIBUTIONS TO A BUSINESS OF C /OH $ 11. D SCHEDULE I: NON - POLITICAL EXPENDITURES MADE FROM POLITICAL CONTRIBUTIONS $ 12. ❑ SCHEDULE K: INTEREST, CREDITS, GAINS, REFUNDS, AND CONTRIBUTIONS RETURNED $ TO FILER www.ethics.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 Office Overhead /Rental Expense Transportation Equipment & Related Expensi 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 SalariesM/ages /ConlractLabor Other (enter a category not listed above) The Instruction Guide explains how to complete this form. 1 Total pages Schedule 1`4: 2 FILER NAME 3 Filer ID (Ethics Commission Filers) 4 TOTAL OF UNITEMIZED EXPENDITURES CHARGED TOACREDIT CARD $ 5 Date 6 Payee name /.)a S f. f -k-.T _. - 7 Anni ($) 8 Payee address; ity; State; Zip Code u �r FNS m�� 9 TYPE OF Political 1-1 Non-Political EXPENDITURE 10 (a) Category (See Categories listed at the top of this schedule) (b) Description PURPOSE / P OF p EXPENDITURE /°t —Awl (c) Checkiftraveloutside exas.CompleteScheduleT. Check if Austin, TX, officeholder living expense 11 C d "d t / Officeholder name Office sought Office held Complete ONLY if direct expenditure to benefit C/011 Date Amount ($) TYPE OF EXPENDITURE PURPOSE OF EXPENDITURE Complete ONLY if direct expenditure to benefit C /OH antae Payee name Payee address; City; State; Zip Code Political Non - Political Category (See Categories listed at the top of this schedule) Description ElCheck if travel outside of Texas. Complete Schedule T. Candidate / Officeholder name U Check it Austin, TX, officeholder living expense Office sought Office held ATTACH ADDITIONAL COPIES OF THIS SCHEDULE AS NEEDED Forms provided by Texas Ethics Commission www.ethics.state.tx.us Revised 6/17/2020 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 BOX B(a) Advertising Expense Event Expense Loan Repayment/Reimbursemeni Solicitation /Fundraising Expense Accounting /Banking Fees Office Overhead /Rental Expense Transportation Equipment 8 Related Expense Consulting Expense Food/Beverage Expense Polling Expense Travel In District Contributions /Donations Made By Gift/Awards/Memonals Expense Printing Expense Travel Out Of District CandidatelOfficeholder /Political Committee Legal Services SalariesAA/ages /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 G: 2 F NAME 3 Filer ID (Ethics Commission Filers) Y _ 4 Date 5 Payee name / 6 Amou t ($ 7 Pa ee address; City; State; Zip Code s�90 0 s �v��.� %� Reimbursement from �� ) Elpolitical contributions intended $ (a) Category (See Categories listed at the top of this schedule) (b) Description PURPOSE r ' '�✓l < I OF (1, P EXPENDITURE [( 2 � (c) Check if travel outside of Texas .CompleteScheduleT. Check. if Au :in, TX, officeholder living expense g /11 Candidate / Officeholder name Office sough ///ttt�� n Office held expend Complete ONLY if fit C �i ¢ f- S � L) expenditure to benefit C/O v// Date J Pay name�J ILL 'tZ� -2- Amount $ Payee addre City; State; Zip Code Z��fr m Xd 0 ❑ political contributions intended PURPOSE OF EXPENDITURE Complete ONLY if direct expenditure to benefit C /OH Date Amount ($) Reimbursement from E-1 political contributions intended PURPOSE OF EXPENDITURE Complete ONLY if direct expenditure to benefit C /OH Category (See Categories listed at the lop of this schedule) I Description ❑ Check if travel outside of Texas. Complete Schedule T. F-1 Check if Austin, TX, officeholder living expense Candidate / Officeholder name Office sought Payee name Payee address; C ity; Category (See Categories listed at the top of this schedule) I Description State; Office held Zip Code 7 Check if travel outside of Texas. Complete Schedule T. 0 Check if Austin. TX, officeholder living expense Candidate / Officeholder name Office sought Office held ATTACH ADDITIONAL COPIES OF THIS SCHEDULE AS NEEDED Forms provided by Texas Ethics Commission wvvw.ethics.state.tx.us Revised 8 /17/2020