10-31-2022CANDIDATE / OFFICEHOLDER FORM C /OH
CAMPAIGN FINANCE REPORT COVER SHEET PG 1
POLITICAL
1 Filer ID (Ethics Commission Filers)
2 Total pages filed:
The C /OH Instruction Guide explains how to complete this form.
1
i-
3 CANDIDATE/
MS / MRS MR FIRST MI
OFFICE USE ONLY
OFFICEHOLDER
D
//�
❑GENERAL
NAME
............ r!� Q. .... .............
Daie Received
❑ January 15
NICKNAME LA AT SUFFIX
6 if
wYU V
4 CANDIDATE /
ADDRESS / PO BOX; APT /SUITE #; CITY; STATE; ZIP CODE
OFFICEHOLDER
� �
MAILING
ADDRESS
(Officeholder Only)
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qrl
❑ Change of Address
_
Final Report (Attach C /OH - FR)
5 CANDIDATE /
AREA CODE PHONE NUMBER EXTENSION
Date Hand - delivered ar Date Pos marked
OFFICEHOLDER
PHONE
6 CAMPAIGN
TREASURER
NAME
7 CAMPAIGN
TREASURER
ADDRESS
(Residence or Business)
8 CAMPAIGN
TREASURER
PHONE
9 REPORT TYPE
10 PERIOD
COVERED
11 ELECTION
r - - Receipt # Amount S
MS / MRS l2 FIRST MI
/ /6eef.
Date Processed
NICKNAME LAST SUFFIX
® Date Imaged
Aa
, , teZ --
STREET ADDRESS (NO PO BOX PLEASE); APT / SUITE #; CITY; STATE; ZIP CODE
Month Day Year
THROUGH
ELECTION DATE
Month Day Year �❑l Primary El Runoff
!f /09 17p General ❑ Special
OFFICE HELD (if any)
1/
Month Day Year
ELECTION TYPE
❑ Other
Description
13 OFFICE SOUGHT (H known)
14 NOTICE FROM
THIS BOX IS FOR NOTICE OF POLITICAL CONTRIBUTIONS ACCEPTED OR POLITICAL EXPENDITURES MADE BY POLITICAL COMMITTEES TO SUPPORT
POLITICAL
THE CANDIDATE / OFFICEHOLDER THESE EXPENDITURES MAY HAVE BEEN MADE WITHOUT THE CANDIDATE'S OR OFFICEHOLDER'S KNOWLEDGE OR
AREA CODE
PHONE NUMBER
EXTENSION
COMMITTEE TYPE
COMMITTEE NAME
❑GENERAL
COMMITTEE ADDRESS
❑ Additional Pages
❑ January 15
301h day before election
❑ Run9ff��
❑
15th day after campaign;
treasurer appointment
(Officeholder Only)
❑ July 15
8th day before election
❑ Exceeded Modified
❑
Final Report (Attach C /OH - FR)
Reporting Limit
Month Day Year
THROUGH
ELECTION DATE
Month Day Year �❑l Primary El Runoff
!f /09 17p General ❑ Special
OFFICE HELD (if any)
1/
Month Day Year
ELECTION TYPE
❑ Other
Description
13 OFFICE SOUGHT (H known)
14 NOTICE FROM
THIS BOX IS FOR NOTICE OF POLITICAL CONTRIBUTIONS ACCEPTED OR POLITICAL EXPENDITURES MADE BY POLITICAL 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
COMMITTEE NAME
❑GENERAL
COMMITTEE ADDRESS
❑ Additional Pages
❑SPECIFIC
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 CONTRIBL°JTION
TOTALS
2.
EXPENDITURE 3
TOTALS
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.
FORM C /OH
COVER SHEET PG 2
16 Filer ID (Ethics Commission Filers)
13 s/0
4. TOTAL POLITICAL EXPENDITURES
CONTRIBUTION 5. TOTAL POLITICAL CONTRIBUTIONS MAINTAINED AS OF THE LAST DAY $ yo� / �f
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 accompanying report is true and correct and includes all information
required to be reported by me under Title 15, Election Code.
Sig t re of Candidate or Officeholder
Please complete either option below:
M. EDMONDSON
NOTARY SHEILA
- RAE OF TEXAS
101 12495213.1
N1r 00MMftttn E>r M 61/11/2029
(1) Affidavit
C
NOTARY STAMP/ SEAL
'L this the ' day of
Sworn and subscnbed before me by __ � Y
20 to i hi wit ss my hand a eal of office.
Sig ure of officer ed inistenng oath Printed name of officer administering oath Title of officer dministering oath
a
(2) Unsworn Declaration
My name is
My address is
Executed in
(street)
County, State of
on the
and my date of birth is
(city) (state) (zip code) (country)
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
SCHEDLIFLE SUBTOTALS
NAME OF SCHEDULE
$
SUBTOTAL
AMOUNT
1• SCHEDULEAI; MONETARY POLITICAL CONTRIBUTIONS
2•
3.
4.
5.
6.
7.
/ ❑�
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SCHEDULEA2:
SCHEDULE B:
SCHEDULE E:
SCHEDULE F1:
SCHEDULE F2:
SCHEDULE F3:
NON - MONETARY (IN -KIND) POLITICAL CONTRIBUTIONS
PLEDGED CONTRIBUTIONS
LOANS
POLITICAL EXPENDITURES MADE FROM POLITICAL CONTRIBUTIONS
UNPAID INCURRED OBLIGATIONS
PURCHASE OF INVESTMENTS MADE FROM POLITICAL CONTRIBUTIONS
$
"1 3
$
$
/
$
$
$•
❑
SCHEDULE F4:
EXPENDITURES MADE BY CREDIT CARD
$
9.
10.
11.
12.
El
F-1
El
❑
SCHEDULE G: POLITICAL EXPENDITURES MADE FROM PERSONAL FUNDS
SCHEDULE H: PAYMENT MADE FROM POLITICAL CONTRIBUTIONS TO A BUSINESS OF C /OH
SCHEDULE I: NON - POLITICAL EXPENDITURES MADE FROM POLITICAL CONTRIBUTIONS
SCHEDULE K: INTEREST, CREDITS, GAINS, REFUNDS, AND CONTRIBUTIONS RETURNED
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)
4 Date $ Full name of contributor ❑ out -of -state PAC (ID #: ) 7 Amount of contribution ($)
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6 Contributor address; City; State; Zip Code Al e z-
8 Principal occupation / Job title (See Instructions) 9 Employer (See Instructions) 4j" 3 , 5-
Date Full name of contributor ❑ out -of -state PAC
. ............. .. ..I................. .. .
Contributor address; City; State; Zip Code
Principal occupation / Job title (See Instructions)
Date
Full name of contributor ❑ out -of -state PAC (I
Employer (See Instructions)
............... I ............ .... ... .....
Contributor address; City; State; Zip Code
Principal occupation / Job title (See Instructions) Employer (See Instructions)
Date Full name of contributor ❑ out -of -state PAC (ID #: )
.. ........ .. ...... ... .. ..
Contributor address; City; State; Zip Code
Principal occupation / Job title (See Instructions) Employer (See Instructions)
Amount of contribution ($)
Amount of contribution ($)
Amount of contribution ($)
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 811712020
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NON- MONETARY (IN -KIND) POLITICAL
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
_,A&,oil- -
SCHEDULE A2
1 Total pages Schedule A2:
3 Filer ID (Ethics Commission Filers)
4 TOTAL OF UNITEMIZED IN -KIND POLITICAL CONTRIBUTIONS I $ At Od
5 Date 6 Full name of contributor ❑ out -of -state PAC
Sip f .. WA# . ..... ...........
/ 7 Contributor address; City;
y60
8 Amount of I g In -kind contribution
Contribution $ I description
I
y6o
State; Zip Code I /�Af4ee
�❑ 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)
Date
Full name of contributor ❑ out -of -state PAC (ID#
13 Contributor's job title (FOR JUDICIAL) (See Instructions)
15 Law firm of contributor's spouse (if any) (FOR JUDICIAL)
I Amount of In -kind contribution
Contribution $ I description
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Contributor address; City; State; Zip Code J OD
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Contributor's principal occupation (FOR JUDICIAL) Contributor's jA title 40fOR JUDICIAL) (See Instructions)
Contributor's employer /law firm (FOR JUDICIAL)
If contributor is a child, law firm of parent(s) (if any) (FOR JUDICIAL)
Law firm of contributor's spouse (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 8/1 712 02 0
NON - MONETARY (IN -KIND) POLITICAL
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 A2
1 Total pages Schedule A2:
i
7—
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 (MM ) 8 Amount of 1 g In -kind contribution
Contribution $ 1 description
Oc� ..... t7a z e.... Aor -;ot. s .... .................. 5 11 ; A /���
�tr� 7 Contributor address; City; State; Zip Code /3
7L/9,7Z .4 �� � � Check ff 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)
Date Full name of contributor ❑ out -of -state PAC (ID#:
13 Contributor's job title (FOR JUDICIAL) (See Instructions)
15 Law firm of contributor's spouse (if any) (FOR JUDICIAL)
— - I Amount of I In -kind contribution
Contribution $ description
............... ..........
.... ............................ .......... .. 1
Contributor address; City; State; Zip Code j
Principal occupation / Job title (FOR NON - JUDICIAL) (See Instructions)
Contributor's principal occupation (FOR JUDICIAL)
Contributor's employer /law firm (FOR JUDICIAL)
If contributor is a child, law firm of parent(s) (if any) (FOR JUDICIAL)
E] Check if travel outside of Texas. Complete Schedule T.
Employer (FOR NON- JUDICIAL)(See Instructions)
Contributor's job title (FOR JUDICIAL) (See Instructions)
Law firm of contributor's spouse (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 8/1712020
POLITICAL EXPENDITURES MADE
FROM POLITICAL CONTRIBUTIONS
If the requested information is not applicable, DO NOT include this
in the
SCHEDULE F1
Date
Amount ($)
PURPOSE
OF
EXPENDITURE
Complete ONLY if direct
expenditure to benefit C /OH
I
Payee name
Payee address;
Category (See Categories listed at the top of this schedule)
DCheck if travel outside of Texas. Complete Schedule T.
Candidate / Officeholder name
Date Payee name
Amount ($)
Payee address;
City; State; Zip Code
Description
Check if Austin, TX, officeholder living expense
Office sought
Office held
City; State; Zip Code
I Category (See Categories listed at the lop of this schedule) Description
PURPOSE
OF
EXPENDITURE
ElCheck iftravel outside ofTexas . Complete ScheduleT. E-1 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
EXPENDITURE CATEGORIES FOR BOX 8(a)
Advertising Expense
Event Expense Loan RepaymentlReimbursement
Solicitation/FundraisingExpense
Accounting/Banking
Fees Office Overhead /Rental Expense
Transportation Equipment & Related Expense
Consulting Expense
Food /Beverage Expense Polling Expense
Travel In District
Contributions/Donabons Made By Gift/Awards/Memorials Expense Printing Expense
Travel Out Of District
Candidate /Officeholder/Pofitical Committee Legal Services SalarieslWages/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 Fl:,
2 FILER NAME//
3 Filer ID (Ethics Commission Filers)
Z- - -
O
9m
4 Date
5 P�,e! I.,
SIC DzZ .7`f
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-
6 Amount (55
7 Payee address; City;
State; Zip Code
7 -0/' 'g/ G /d/yi
8
(a) Category (See Categories listed at the top of this schedule) (b) Description
PURPOSE
OF
EXPENDITURE
(c) Check iflravetoulsideofTexas .CompleleSeheduleT. Check if Austin, TX, officeholder living expense
9 Complete ONLY if direct
Candidate / Officeholder name Office sought
Office held
expenditure to benefit C /OH
Date
Amount ($)
PURPOSE
OF
EXPENDITURE
Complete ONLY if direct
expenditure to benefit C /OH
I
Payee name
Payee address;
Category (See Categories listed at the top of this schedule)
DCheck if travel outside of Texas. Complete Schedule T.
Candidate / Officeholder name
Date Payee name
Amount ($)
Payee address;
City; State; Zip Code
Description
Check if Austin, TX, officeholder living expense
Office sought
Office held
City; State; Zip Code
I Category (See Categories listed at the lop of this schedule) Description
PURPOSE
OF
EXPENDITURE
ElCheck iftravel outside ofTexas . Complete ScheduleT. E-1 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
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