10-31-2022CANDIDATE / OFFICEHOLDER
CAMPAIGN FINANCE REPORT
The C /OH Instruction Guide explains how to complete this form.
FORM C /OH
COVER SHEET PG 1
1 Filer ID (Ethics Commission Filers) 2 Total pages filed:
3 CANDIDATE / MS / MRS / MR FIRST MI OFFICE USE ONLY
OFFICEHOLDER ,
NAME I.......'" ;....... .... rP1/J. .% . .. � ..... Date Received
NICKNAME LAST SUFFIX /
4 CANDIDATE / ADDRESS / PO BOX; APT / SUITE #; _ CITY; STATE; ZIP CODE
OFFICEHOLDER .�.� a_, IL
MAILING
ADDRESS ! ' + ear ❑ Change of Address
5 CANDIDATE/ AREA CODE PHONE NUMBER EXTENSION Date Hand - delivered or Date Postmarked
OFFICEHOLDERar^
PHONE
_ Receipt # Amount $
B CAMPAIGN MS / MRS / MR FIRST MI
TREASURER f-A "e-4 Cc-r Data Processed
NAME : d!. ..... .... ....
NICKNAME LAST SUFFIX
ill � Dale Imaged
7 CAMPAIGN STREET ADDRESS (NO PO BOX PLEASE); APT / SUITE #; CITY; STATE; ZIP CODE
TREASURER
ADDRESS —Amommimm
(Residence or Business) _ ■t�l�_
8 CAMPAIGN AREA CODE PHONE NUMBER EXTENSION
TREASURER _
PHONE
(� 1
9 REPORT TYPE ❑ January 15 ❑ 30th day before election ❑ Runoff ❑ 15th day after campaign
treasurer appointment
(Officeholder Only)
❑ July 15 8Ih day before election ❑ Exceeded Modred ❑ Final Report (Attach C /OH - FR)
Reporting Limit
10 PERIOD Month Day Year Month Day Year
COVERED
% / I j /)1 -�j /1 2-)— THROUGH % /1 `'] / 2-
11 ELECTION ELECTION DATE f ELECTION JTYPE
/ ice'
Month Da Year ❑ Primary F-1 Runoff F] Other
Y Description
General ❑ Special
12 OFFICE OFFICE HELD If any) 13 OFFICE SOUGHT (if known)
V
14 NOTICE FROM THIS BOX IS FOR NOTICE OF POLITICAL CONTRIBUTIONS ACCEPTED OR POLITICAL EXPENDITURES MADE BY I-OLITICAL COMMITTEES TO SUPPORT
POLITICAL THE CANDIDATE / OFFICEHOLDER. THESE EXPENDITURES MAY HAVE BEEN MADE WITHOUT THE CANDIDATE'S 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 I COMMITTEE NAME
❑ GENERAL
❑ Additional Pages
❑ SPECIFIC
COMMITTEE ADDRESS
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
FORM C /OH
COVER SHEET PG 2
15 C /OH NAME 16 Filer ID (Ethics Commission Filers)
17 CONTRIBUTION L— 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)
EXPENDITURE 3 TOTAL UNITEMIZED POLITICAL EXPENDITURE.
TOTALS
4.
......... ..... . -
CONTRIBUTION 5
BALANCE
TOTAL POLITICAL EXPENDITURES
TOTAL POLITICAL CONTRIBUTIONS MAINTAINED AS OF THE LAST DAY
OF REPORTING PERIOD
$ o
$ 0
$ (f
$
$ O
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 accompanying report is true and correct and includes all information
required to be reported by me under Title 15, Election Code.
4..twe of Candidate or VOfficeholder
r
SHEILA M.EDMONDSJTEXAS Please complete either option below:
NOTARY PUBLIC •STATE OID 41249 22*1 ARy CE>� = Qil1
(1) Affidavit
NOTARY STAMP/ SEAL '
k�(W �Sworn to and subscribed before me by this the -'/~J a_ day of
20 Ao certify, whic wit ss hand and se I f offi . .
nh I scA
I
Signatu o deer d i is erin Printed name of off [car administering oath Tille or officer admi istering 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 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 20 Filer ID (Ethics Commission Filers)
21 SCHEDULE SUBTOTALS SUBTOTAL
NAME OF SCHEDULE AMOUNT
1. El SCHEDULEA1: MONETARY POLITICAL CONTRIBUTIONS — $ fro
2. SCHEDULEA2: NON - MONETARY (IN -KIND) POLITICAL CONTRIBUTIONS $
3. SCHEDULE B: PLEDGED CONTRIBUTIONS $ Q
4. SCHEDULE E: LOANS $
5• SCHEDULE F1: POLITICAL EXPENDITURES MADE FROM POLITICAL CONTRIBUTIONS
6. SCHEDULE F2: UNPAID INCURRED OBLIGATIONS $ O
7. El SCHEDULE F3: PURCHASE OF INVESTMENTS MADE FROM POLITICAL CONTRIBUTIONS $
8• 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. El SCHEDULE L NON- POLITICAL EXPENDITURES MADE FROM POLITICAL CONTRIBUTIONS $ Q
I
12. n SCHEDULE K: INTEREST, CREDITS, GAINS, REFUNDS, AND CONTRIBUTIONS RETURNED $
�J 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)
i
4 Date 5 Full name of contributor ❑ out -of -state PAC (ID#: ) 7 Amount of contribution ($)
6 1 Contributor address; City; State; Zip Code
8 Principal occupation / Job title (See Instructions) 9 Employer (See Instructions)
Full name of contributor ❑ out -of -state PAC
........................... ... ............ ...... ....
Contributor address; City; State; Zip Code
Amount of contribution ($)
Principal occupation / Job title (See Instructions) rmployeF to cc mm�ucuvuo/
Date Full name of contributor ❑ out -of -state PAC (ID #: ) Amount of contribution ($)
Contributor address; City; State; Zip Code
Principal occupation / Job title (See Instructions)
Date
Employer (See Instructions)
Full name of contributor ❑ out -of -slate PAC (ID#: ) Amount of contribution ($)
... ............. ......... .. ...... ..... ...
Contributor address; City; State; Zip Code
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 w Av.ethics.state.tx.us Revised 8117/2020
NON - MONETARY (IN -KIND) POLITICAL
CONTRIBUTIONS
SCHEDULE AZ
If the requested information is not applicable, DO NOT include this page in the report.
1 Total pages Schedule A2:
The Instruction Guide explains how to complete this form.
2 FILER NAME 3 Filer ID (Ethics Commission Filers)
4 TOTAL OF UNITEMIZED IN -KIND POLITICAL CONTRIBUTIONS 1$
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)
14 Contributor's employer /law firm (FOR JUDICIAL)
16 If contributor is a child, law firm of parent(s) (if any) (FOR JUDICIAL)
13 Contributor's job title (FOR JUDICIAL) (See Instructions)
15 Law firm of contributor's spouse (if any) (FOR JUDICIAL)
Date Full name of contributor ❑ out -of -state PAC (ID#: ) I
Amount of !n -kind contribution
Contribution $ I description
I
.. ............1.......... ... . ........ ........
Contributor address; City; State; Zip Code I
❑Check 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 8117/2020
PLEDGED CONTRIBUTIONS
If the requested information is not applicable, DO NOT include this page in the report.
The Instruction Guide explains how to complete this form.
2 FILER NAME
SCHEDULE B
1 Total pages Schedule B:
3 Filer ID (Ethics Commission Filers)
4 TOTAL OF UNITEMIZED PLEDGES — $
5 Date 6 Full name of pledgor ❑ out -of -state PAC (ID #: _ ) 8 Amount I 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) 111 Employer (See Instructions)
Date Full name of pledgor ❑ out -ot -state PAC (ID#:_
Pledgor address; City; State;
Principal occupation / Job title (See Instructions)
Date Full name of pledgor ❑ out -of -state PAC (ID #:�
......
Pledgor address; City; State;
Principal occupation / Job title (See Instructions)
Date
Amount I In -kind contribution
of Pledge $ I description
...............
Zip Code
I I
❑ Check 0 travel outside of Texas. Complete Schedule T
Employer (See Instructions)
Amount of I In -kind contribution
Pledge $ I description
I
Zip Code
I
❑Check if travel outside of Texas. Complete Schedule T
Employer (See Instructions)
Full name of pledgor ❑ out -of -state PAC (IN : Amount of I In -kind contribution
Pledge $ I description
I
Pledgor address; City; State; Zip Code
Principal occupation / Job title (See Instructions)
I
Y❑ Check ff travel outside of Texas. Complete Schedule T.
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 8/1712020
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)
4 TOTAL OF UNITEMIZED LOANS $
5 Date of loan 7 Name of lender ❑ out -of -state PAC (ID#: ) 9 Loan Amount ($)
6 Is lender I 8 Lender address; City; State; Zip Code
10 Interest rate
a financial
Institution?
ri�—Maturity date
Y N
12 Principal occupation / Job title (See Instructions)
13 Employer (See Instructions)
14 Description of Collateral 15
El account if personal funds were deposited into political
account (See Instructions)
El none
16 GUARANTOR 17 Name ofguarantor 19 Amount Guaranteed ($)
INFORMATION
18 Guarantor address; City; State; Zip Code
❑ not applicable
20 Principal Occupation (See Instructions)
Date of loan
Is lender
a financial
Institution?
Y N
Principal occupation / Job title (See Instructions)
21 Employer (See Instructions)
Name of lender ❑ out -of -state PAC (ID#: )
.. ... ......... ..... ...... ......
Lender address; City; State; Zip Code
Description of Collateral
❑ none
GUARANTOR Name ofguarantor
INFORMATION
.. ......................
Guarantor address;
TEmployer (See Instructions)
Loan Amount ($)
Interest rate
Maturity date
❑ Check if personal funds were deposited into political
account (See Instructions)
Amount Guaranteed ($)
....... ..........
City; State; Zip Code
❑ not applicable I 1
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 6117/2020
POLITICAL EXPENDITURES MADE
F1
FROM POLITICAL CONTRIBUTIONS
SCHEDULE
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 RepaymenVReimbursement
Solicitation /FundraisingExpense
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
Candidata/Officeholder /Political Committee Legal Services SalariesNVages/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 F1: 2 FILER NAME +f�Jj�� .
3 Filer ID (Ethics Commission Filers)
4 Date
5 Payee name
6 Amount ($}
7 Payee address; City;
State; Zip Code
s (a) Category (See Categories listed at the top of this schedule) I (b) Description
PURPOSE
OF
EXPENDITURE
(c) F-1 Check Itravel outside of Texas. Complete Schedule T.
9 Complete ONLY if direct Candidate/ Officeholder name
expenditure to benefit C /OH
Date I Payee name
7 Check if Austin, TX, officeholder living expense
Office sought
Office held
Amount ($) Payee address; City; State;, Zip Code
Category (See Categories listed at the top of this schedule) Description
PURPOSE
OF
EXPENDITURE
Check if travel outside ofTexas. Complete Schedule T. 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 ($) 4 Payee address;
Category (See Categories listed at the top of this schedule)
PURPOSE
OF
EXPENDITURE
Check if travel outside of Texas. Complete Schedule T.
Complete ONLY if direct Candidate I Officeholder name
expenditure to benefit C /OH
City; State; Zip Code
Description
Check if Austin, TX, officeholder living expense
Office held
Office sought
ATTACH ADDITIONAL COPIES OF THIS SCHEDULE AS NEEDED
Forms provided by Texas Ethics Commission v, rww.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/Memodals Expense Printing Expense
Travel Out Of District
Candidate /Officeholder /Political Committee Legal Services Salaries/Wages /Contract Labor
Other (enter a 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)
4 TOTAL OF UNITEMIZED UNPAID INCURRED OBLIGATIONS
$
3 Date 6 Payee name
7 Amount ($) 8 Payee address; City;
i
State; Zip Code
9 TYPE OF
EXPENDITURE
10
PURPOSE
OF
EXPENDITURE
11 Complete ONLY if direct
expenditure to benefit C /OH
El Political r_1 Non - Political
(a) Category (See Categories listed at the lop of this schedule) (b) Description
(c) F7 Check it travel outside of Texas. Complete Schedule D Check if Austin. TX, officeholder living expense
Candidate / Officeholder name Office sought Office held
Date Payee name
Amount ($) Payee address;
TYPE OF ❑ ❑
EXPENDITURE Political Non-Political
Category (See Categories listed at the top of this schedule)
PURPOSE
OF
EXPENDITURE
F7Check if travel outside of Texas- Complete Schedule T.
Complete ONLY if direct Candidate / Officeholder name
expenditure to benefit C /OH
City; State; Zip Code
❑ Check if 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 8/17/2020
PURCHASE OF INVESTMENTS MADE SCHEDULE F3
FROM POLITICAL CONTRIBUTIONS
If the requested information is not applicable, DO NOT include this page in the report. — —
1 Total pages Schedule F3:
The Instruction Guide explains how to complete this form.
2 FILER NAME 3 Filer ID (Ethics Commission Filers)
ki�l V L T -I/- -- -- -- --
4 Date 5 Name of person from whom investment is purchased
.................... ............................... .
6 Address of person from whom investment is purchased; C* ity: State; Zip Code
! Description of investment
8 Amount of investment ($)
Date Name of person from whom investment is purchased
.. .............. .. .............. .. ..............P ....... ...
Address of erson from whom investment is purchased; City; State; Zip Code
3escription of investment
Amount of investment ($)
Forms provided by Texas Ethics Commission www.ethics.state.tx.us Revised 8/1712020
EXPENDITURES MADE BY CREDIT CARD
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
Accounting /Banking Fees Office Overhead /Rental Expense
Consulting Expense Food /Beverage Expense Polling Expense
Contributions/Donations Made By Gift/Awards/Memodals Expense Printing Expense
Candidate/Officeholder/Political Committee Legal Services Selaries/Wages/Contract Labor
The Instruction Guide explains how to complete this form.
1 Total pages Schedule F4: 2 FILER NAME _.
– J
4 TOTAL OF UNITEMIZED EXPENDITURES CHARGED TOA CREDIT CARD
5 Date
7 Amount ($)
6 Payee name
8 Payee address;
SCHEDULE F4
Solicitation/Fundraising Expense
Transportation Equipment & Related Exper
Travel In District
Travel Out Of District
Other (enter a category not listed above)
3 Filer ID (Ethics Commission Filers)
S
City; State; Zip Code
9 TYPE OF
EXPENDITURE Political ❑ NOn- P01111Ca1
10 (a) Category (See Categories listed at the top of this schedule) (b) Description
PURPOSE
OF
EXPENDITURE —
(C) F-1 Check if travel outside ofTexas, Complete Schedule T, Check If Austin, TX, officeholder living expense
11 Candidate / Officeholder name Office sought Office held
Complete ONLY if direct
expenditure to benefit C /OH
Date
Payee name
Amount ($) Payee address;
TYPE OF
EXPENDITURE
PURPOSE
OF
EXPENDITURE
Complete ONLY if direct
expenditure to benefit C /OH
C ity;
Political F-1 Non- Political
Category (See Categories listed at the lop of this schedule) Description
Check if travel outside of Texas. Complete Schedule T.
Candidate / Officeholder name
State; Zip Code
L1 Check if 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 8117/2020
6 Amount ($)
❑Reimbursement from
political contributions
intended
8
PURPOSE
OF
EXPENDITURE
7 Payee address; City;
(a) Category (See Categories listed at the top of this schedule) 1 (01 Uescrlpilon
(c) Check if travel outside of Texas. Complete Schedule T.
g Candidate / Officeholder name
Complete ONLY if direct
expenditure to benefit C /OH
Date I Payee name
Amount ($)
Payee address;
POLITICAL EXPENDITURES MADE FROM
❑Reimbursement from
political contributions
intended
SCHEDULE G
PERSONAL FUNDS
Category (See Categories listed at the top of this schedule)
If the requested information is not applicable, DO NOT include this page in the report.
EXPENDITURE CATEGORIES FOR BOX 8(a)
OF
Advertising Expense Event Expense Loan Repsyment/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/Memonals Expense Printing Expense
Travel Out Of District
Candidate /Officeholder /Political Committee Legal Services SalariesAA/ages /Contract Labor
Other (entera 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)
Ak �/
CA Ir
Complete ONLY if direct
4 Date 5 Payee name
expenditure to benefit C /OH
6 Amount ($)
❑Reimbursement from
political contributions
intended
8
PURPOSE
OF
EXPENDITURE
7 Payee address; City;
(a) Category (See Categories listed at the top of this schedule) 1 (01 Uescrlpilon
(c) Check if travel outside of Texas. Complete Schedule T.
g Candidate / Officeholder name
Complete ONLY if direct
expenditure to benefit C /OH
Date I Payee name
Amount ($)
Payee address;
Payee address;
❑Reimbursement from
political contributions
intended
intended
Category (See Categories listed at the top of this schedule)
PURPOSE
OF
Category (See Categories listed et the top of this schedule)
PURPOSE
Check if travel outside of Texas. Complete Schedule T.
OF
Complete ONLY if direct
EXPENDITURE
Check if travel outside of Texas. Complete Schedule T.
Candidate / Officeholder name
Complete ONLY if direct
expenditure to benefit C /OH
Date
Payee name
Amount ($)
Payee address;
Reimbursement from
E-1 political contributions
intended
Category (See Categories listed at the top of this schedule)
PURPOSE
OF
EXPENDITURE
Check if travel outside of Texas. Complete Schedule T.
—
Candidate / Officeholder name
Complete ONLY if direct
expenditure to benefit CIOH
State; Zip Code
Check if Austin, TX, officeholder living expense
Office sought Office held
C ity;
Description
State; Zip Code
Check if Austin, TX, officeholder living expense
Office sought Office held
City; State; Zip Code
Description
0 Check if Austin, TX, officeholder living expense
Office sought Office held
ATTACH ADDITIONAL COPIES OF THIS SCHEDULE AS NEEDED
Forms provided by Texas Ethics Commission www.ethics.state.tx.us Revised 8117/2020
PAYMENT MADE FROM POLITICAL CONTRIBUTIONS
SCHEDULE H
TO A BUSINESS OF C /OH
If the requested information is not applicable, DO NOT include this page in the report.
EXPENDITURE CATEGORIES FOR BOX 8(a)
Advertising Expense Event Expense Loan Repayment/Reimbursement
Solicitation /Fundraising Expense
Accounting/Banking Fees Office Overhead /Rental Expense
Transportation Equipment & Related Expense
Consulting Expense Food /Beverage Expense Polling Expense
Travel In District
Contributions /Donations Made By Gift/Awards/Memorials Expense printing Expense
Travel Out Of District
Candidate /Ofrrceholder /Polifical Committee Legal Services Salaries/Wages/Contract Labor
Other (enter a category not listed above)
Credit Card Payment
The Instruction Guide explains how to complete this form.
1 Total pages Schedule H:
2 FILER NAME
3 Filer ID (Ethics Commission Filers)
4 Date
5 Business name
State; Zip Code
6 Amount ($)
7 Business address; City;
g (a) Category (See Categories listed at the top of this schedule) (b) Description
PURPOSE
OF
EXPENDITURE
(c) El Check if travel outside of Texas_ Complete Schedule T.
9 Complete ONLY if direct Candidate / Officeholder name
expenditure to benefit C /OH
Date Business name
Amount ($)
PURPOSE
OF
EXPENDITURE
Business address;
ElCheck if Austin, TX, officeholder living expense
Office sought Office held
City; State; Zip Code
Category (See Categories listed at the top of this schedule) Description
Check if travel outside of Texas. Complete Schedule T.
Complete ONLY if direct Ganolaaie t vmcenvraei nnnic
expenditure to benefit C /OH
Date
Amount ($)
Business name
Check if Austin. TX, officeholder living expense
Office sought Office held
Business address; City
Category (See Categories listed at the top of this schedule) Description
State; Zip Code
PURPOSE
OF
EXPENDITURE
Check 9 travel outside ofTexes. Complete Schedule 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
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 A/� 3 Filer ID (Ethics Commission Filers)
?,Okar4- /`4G�Y %� WJV%
4 Date 5 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 ($) Payee address; City State Zip Code
PURPOSE Category (See instructions for examples of acceptable Description (See instructions regarding type of information
categories.) required.)
OF
EXPENDITURE
Date
Payee name
Amount ($) 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
J
ATTACH ADDITIONAL COPIES OF THIS SCHEDULE AS NEEDED
Forms provided by Texas Ethics Commission www.ethics.state.ix.us Revised 8 /1 712 02 0
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 ($)
....................... I ...........................
..
6 Address of person from whom amount is received; City; State; Zip Code
7 Purpose for which amount is received F-� Check if political contribution returned to filer
Date Name of person from whom amount is received
Address of person from whom amount is received; City; State; Zip Code
Amount ($)
Purpose for which amount is received F Check if political contribution returned to filer
Date Name of person from whom amount is received Amount ($)
.. .................. ............................... .... . ..
Address of person from whom amount is received; City; State; Zip Code
I
Purpose for which amount is received F-1 Check if political contribution returned to filer
Date Name of person from whom amount is received
.................. ............................... .. . ...
Address of person from whom amount is received; City;
State; Zip Code
Amount ($)
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 8/17/2020
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.
1 Total pages Schedule T;
The Instruction Guide explains how to complete this form.
2 FILER NAME 3 Filer ID (Ethics Commission Filers)
i
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 Ft
❑ 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 B ❑ Schedule B(J) ❑ Schedule C2
❑ Schedule F2 ❑ Schedule F4 ❑ Schedule G ❑ Schedule H
Dates of travel Name of person(s) traveling
Departure city or name of departure location
Destination city or name of destination location
❑ Schedule D ❑ Schedule F1
❑ Schedule COH -UC ❑ Schedule B -SS
Means of transportation Purpose of travel (including name of conference, seminar, or other event)
ATTACH ADDITIONAL COPIES OF THIS SCHEDULEAS NEEDED
Forms provided by Texas Ethics Commission www.ethics.state.tx.us meviseu or i r,zua
CANDIDATE/ OFFICEHOLDER REPORT:
DESIGNATION OF FINAL REPORT
1 C /OH NAME
3 SIGNATURE
The Instruction Guide explains how to complete this form.
FORM C /OH - FR
•- Complete only if "Report Type" on page 1 is marked "Final Report" •-
2 Filer ID (Ethics Commission Filers)
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.
Agn(ature o f Candidate /Officeholder
4 FILER WHO IS NOTAN OFFICEHOLDER
•• Complete A & B below only if you are not an officeholder. ••
A. CAMPAIGN FUNDS
Check only one:
[r� I do not have unexpended contributions or unexpended interest or income earned from political contributions.
F7 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:
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 •-
0 1 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.
Forms provided by Texas Ethics Commission www.ethics.state.tx.us
Signature of Officeholder
Revised 6!1712020