12-27-2022CANDIDATE / OFFICEHOLDER
FORM C/OH
CAMPAIGN FINANCE REPORT
COVER SHEET PG 1
1 Filer ID (Ethics Commission Filers)
2 Total pages filed:
The ClOH Inskruotion Guide explains how to complete this form.
3 CANDIDATE J
OFFICEHOLDER
NAME..................
MS / MRS / MR FIRST MI
�l..I....................................
NICKNAME LAST SUFFIX
OFFICE USE ONLY
Date Received
/ qqjg,
4 CANDIDATE /
OFFICEHOLDER
ADDRESS /iP0_B0= PT / SUITE It CITY, ` _STATE;' ZIP CODE
MAILING���--
ADDRESS
o
Change of Address
u ✓
[Date
6 CANDIDATE/
AREA CODE PHONE NUMBER EXTENSION
Han -delivered or Date Postmarked
OFFICEHOLDER
Aoi.d - - _— — _ _
�qWWW_
PHONE
I
Receipt #
Amount $
6 CAMPAIGN
TREASURER
NAME...I•v.>lr
MS / MRS / MR FIRST MI
�/� .............. !1.)t....................................
Date Processed
NICKNAME LAST SUFFIX
Date Imaged
7 CAMPAIGN
STREET ADDRESS (NO PO BOX PLEASE); APT / SUITE #; CITY;
STATE; ZIP CODE
TREASURER
ADDRESS�e
(Residence or Business)
—
8 CAMPAIGN
AREA CODE PHONE NUMBER EXTENSION
TREASURER
PHONE
8 REPORT TYPE
January 15 30th day before election Runoff
15th day after campaign
treasurer appointment
(Officeholder Only)
July 15 8th day before election Exceeded Modified
Reporting Limit
Final Report (Attach CIOH - FRI
10 PERIOD
Month Day Year Month
Day Year
COVERED
/ /i THROUGH 2T/6�d�
11 ELECTION
ELECTION DATE
ELECTION TYPE
Month Day Year
❑ Primary Sj Runoff ❑ Other
Description
b/ s
e✓
❑ General ❑ Special
12 OFFICE
OFFICE HELD If y) 13 OFFICE SOUGHT (R known)
IV
14 NOTICE FROM
POLITICAL
THIS BOX IS FOR NOTICE OF POLITICAL CONTRIBUTIONS ACCEPTED OR POLITICAL EkPiNDITURES MADE BY POLITICAL COMMITTEES TO SUPPORT
THE CANDIDATE I OFFICEHOLDER THESE EXPENDITURES MAY NINE BEEN MADE tMTN01R THE CANDIDATES OR OfACENOIDER'S KNOHREDRE OR
CONSENT. CANDIDATES AND OFFICEHOLDERS ARE REQUIRED TO REPORT THIS INFORMATION ONLY IF THEY RECEIVE NOTICE OF SUCH EXPENDITURES.
COMMITTEES)
COMMITTEE TYPE
COMMITTEE NAME
Additional Pages
GENERAL
COMMITTEE ADDRESS
COMMITTEE CAMPAIGN TREASURER NAME
SPECIFIC
COMMITTEE CAMPAIGN TREASURER ADDRESS
GO TO PAGE 2
Forms provided by Texas Ethics Commission www.ethics.state.tx.us Revised I W15,12022
CANDIDATE / OFFICEHOLDER
FORM C/OH
CAMPAIGN FINANCE REPORT
COVER SHEET PG 2
15 C/O NAME
1121
16 Filer ID (Ethics Commission Filers)
17 CO TRIBUTION
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)
$
TOTALS EXPENDITURE
3.
TOTAL UNITEMIZED POLITICAL EXPENDITURE.
4.
TOTAL POLITICAL EXPENDITURES
$
CONTRIBUTION
5.
TOTAL POLITICAL CONTRIBUTIONS MAINTAINED AS OF THE LAST DAY
$
/ T�
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.
Signature of Candidate or Officeholder
sllEllAr;�'ED�IIorr�solu Please complete either option below:
NOTA::LC
I• STATE OF TEASp pi 12496213-1MYW f'P"a 03/17M
(1) Affidavit
0
NOTARY STAMP / SEAL ' 7P", k/W
I A (va
Sworn to and subscribed before me by V this the ` day of v
20 : ,gyp lif�witch, witness my hand steel of office. n I
re of office+ administering oath
(2) Unsworn Declaration
My name is _
My address is
Executed in
Printed name of officer administering oath
, and my date of birth is
Title of officer actniifristering oath
(street) (city) (state) (zip code) (country)
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 11/15/2022
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 SCHEDULEAI: MONETARY POLITICAL CONTRIBUTIONS
$
2•
SCHEDULEA2: NON -MONETARY (IN -KIND) POLITICAL CONTRIBUTIONS
$
3.
SCHEDULE B: PLEDGED CONTRIBUTIONS
$
4.
SCHEDULE E: LOANS
$
V
5.
SCHEDULE F1: POLITICAL EXPENDITURES MADE FROM POLITICAL CONTRIBUTIONS
$_
6.
SCHEDULE F2: UNPAID INCURRED OBLIGATIONS
$
7.
SCHEDULE F3: PURCHASE OF INVESTMENTS MADE FROM POLITICAL CONTRIBUTIONS
$
8•
❑ SCHEDULE F4: EXPENDITURES MADE BY CREDIT CARD
$
l
9.
❑ SCHEDULE G: POLITICAL EXPENDITURES MADE FROM PERSONAL FUNDS
$
10.
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
$
VV
TO FILER
Forms provided by Texas Ethics Commission www.ethics.state.tx.us Revised 11/15/2022