The URL can be used to link to this page

Home My WebLink About2021 Paudel 30 day CANDIDATE / OFFICEHOLDER FORM C/OH CAMPAIGN FINANCE REPORT COVER SHEET PG 1 The C/OH Instruction Guide explains how to complete this form. 1 Filer ID (Ethics Commission Filers) 2 Total pages filed: 19 3 CANDIDATE/ MS/MRS/MR FIRST MI OFFICEHOLDER MR. TI KA R OFFICE USE ONLY NAME ........................................... ................................. ..... Date Received NICKNAME LAST SUFFIX PAUDEL 4 CANDIDATE/ ADDRESS /PO BOX; APT/SUITE#; CITY; STATE; ZIP COD B OFFICEHOLDER MAILING EULESS TX 7604 APR 0 1 2021 ADDRESS 500 BRASHER LANE ❑ Change of Address 5 CANDIDATE/ AREA CODE PHONE NUMBER EXTENSION CITY F EULESS O Dale Hand-delivered or Date P st, OFFICEHOLDER PHONE ( 214 ) 277-1767 6CAMPAIGN MS/MRS MR FIRST MI Receipt# Amount S TREASURER BASU D NAME .................................... ..... ..................................... Date Processed NICKNAME LAST SUFFIX SHRESTHA Date Imaged 7 CAMPAIGN STREETADDRESS (NO PO BOX PLEASE); APT SUITE#; CITY; STATE. ZIP CODE TREASURER ADDRESS 409 LOIS LANE EULESS TX 76040 (Residence or Business) 8 CAMPAIGN AREA CODE PHONE NUMBER EXTENSION TREASURER PHONE ( 214) 718-8746 9 REPORT TYPE January 15 EN 30th day before election Runoff 15th day after campaign # treasurer appointment (Officeholder Only) ❑ July 15 ❑ 8th day before election Exceeded Modified Final Report(Attach C/OH-FIR) Reporting Limit 10 PERIOD Month Day Year Month,. Davy Year COVERED ... . >. 02 05 2021 THROUGH 03 22 2021 11 ELECTION ELECTION DATE ELECTION TYPE Month Day Year ❑ Primary ❑ Runoff ❑ Fthgr s escription '*"..r".,W,,.,,r,,...,L,"'- 05 01j" 2021 ® General ❑ Special 12 OFFICE OFFICE HELD (if any) 13 OFFICE SOUGHT (if 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 I 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 TIKA FOR EULESS ®GENERAL COMMITTEE ADDRESS Additional Pages 409 LOIS LANE, EULESS, TX, 76040 SPECIFIC COMMITTEE CAMPAIGN TREASURER NAME BASU DEV SHRESTHA COMMITTEE CAMPAIGN TREASURER ADDRESS 409 LOIS LANE, EULESS, TX, 76040 GO TO PAGE 2 Forms provided by Texas Ethics Commission www.ethics.state.tx.us Revised 8/17/2020 CANDIDATE / OFFICEHOLDER FORM C/OH CAMPAIGN FINANCE REPORT COVER SHEET PG 2 15 C/OH NAME 16 Filer ID (Ethics Commission Filers) 17 CONTRIBUTION 1. TOTAL UNITEMIZED POLITICAL CONTRIBUTIONS (OTHER THAN TOTALS PLEDGES, LOANS, OR GUARANTEES OF LOANS, OR $1 3,137.33 CONTRIBUTIONS MADE ELECTRONICALLY) 2. TOTAL POLITICAL CONTRIBUTIONS $13,137.33 (OTHER THAN PLEDGES, LOANS, OR GUARANTEES OF LOANS) . . . . . . . . . . . . . . . . . . . EXPENDITURE 3. TOTAL UNITEMIZED POLITICAL EXPENDITURE. TOTALS $217.26 4. TOTAL POLITICAL EXPENDITURES $217.26 . . . . . . . . . . . . . . . . . . . CONTRIBUTION 5. TOTAL POLITICAL CONTRIBUTIONS MAINTAINED AS OF THE LAST DAY BALANCE OF REPORTING PERIOD $12,920.07 . . . . . . . . . . . . . . . . . . _ OUTSTANDING 6. TOTAL PRINCIPAL AMOUNT OF ALL OUTSTANDING LOANS AS OF THE LOAN TOTALS LAST DAY OF THE REPORTING PERIOD $2,000.00 IS SIGNATURE I swear, or affirm, under penalty of perjury, that the accompanying report is true and correct and includes all information required to be reported by me under Title 15, Election Code. Signature of Candidate or Officeholder Please complete either option below: (1)A avl �raY°�B CURTIS ROBIN:Ee : r Notary ID#1252 y t MypeCommissions N ARC �4 P/Si?Tmber 23 7 Sworn to and subscribed before me by this the day of 20 to certify which,witness my hand and sea ffice. Signature o officer administering oath Printed name of officer administering oath Title of of icer administering oath (2) Una ybve� eclaration , My name is and my da is My address is (street) (city) (state) (zip code) (country) Executed in C. , late of on the day o 20 (month (year) Signature of Candidate/Officeholder (Declarant) Forms provided by Texas Ethics Commission www.ethics.state.tx.us Revised 8/17/2020 MONETARY POLITICAL_ CONTRIBUTIONS SCHEDULE Al If the requested information is not applicable, DO NOT Include this page In the report. The Instruction Guido explains how to complete this form. 1 Total pages Schedule At: 1/3 2 FILER NAME 4 a CaIJ �- 4�(� 3 Filer ID (Ethics Commission Filers) 4 (date 6 Full name of contributor � out-of.stale PAC(IUIt 7 Amount of contribution ($) Q4t,u(A, L................................... o 6 Contributor address; City; State; Zip Code C r 8 Principal occupation /Job title (See Instructions) 9 Employer(Sea Instructions) Date Full name of contributor cut-of-state PAC Amount of contribution ($) �� . ..........G.h►......�:............................... C I Contributor address; D - City; State; Zip Code L-t I a LnL�I�sS Principal occupation/Job title (See Instructions) Employer (See Instructions) Date Full name of contributor u cut-of-state PAC(ID#, ) Amount of contribution ($) 3� 31�� .hh ....,. 1�r ..CA....... Contributor address: City; State; Zip Code Fulc 7b0'-4 Principal occupation /Job title (See Instructions) Employer(See Instructions) Date Full name of contributor Elout-of-state PAC (IDx M Amount of contribution 3� , 21 �(-�.U......1- a c. .............................I......... 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. FcrTS Wowded by Texas EthiCs Commission www.ethics.state.tx.us Revised 8/1712020 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. FX I SCHEDULEAI: MONETARY POLITICAL CONTRIBUTIONS $ 11,137.33 2. SCHEDULE A2: NON-MONETARY(IN-KIND)POLITICAL CONTRIBUTIONS $ 3. SCHEDULES: PLEDGED CONTRIBUTIONS $ 4. X� SCHEDULE E: LOANS $ 2,000.00 A I SCHEDULE F1: POLITICAL EXPENDITURES MADE FROM POLITICAL CONTRIBUTIONS $ 217.26 6. El SCHEDULE F2: UNPAID INCURRED OBLIGATIONS $ 7. El SCHEDULE F3: PURCHASE OF INVESTMENTS MADE FROM POLITICAL CONTRIBUTIONS $ 8. 1-1 SCHEDULE F4: EXPENDITURES MADE BY CREDIT CARD $ 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 1: NON-POLITICAL EXPENDITURES MADE FROM POLITICAL CONTRIBUTIONS $ 12. 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 If the requested information is not applicable, DO NOT include this pago in the report. The instruction Guide explains how to complete this form.4 1 total pages schedule At: '2/3 2 FllErt NAME. _ (� �v— _- t ' Kvo 3 F ler ID (Ethics Commission Fllors) 4 Date 6 VFull narnO of contributorr 7 Amount of contribution g)out-of-tlAla PAC(IDN__-_-- aJr , tJcp �.Ic....................................... tom - 0b ,i 6 Contributor Ad(frosss; City; State; Zip Code 1 u CGDrm01-Ut U . 1),C 7 Qq_� _ 8 Principal occupation/sob titto(Son Instructions) y Employer (See Instructions) Date Full name of contributor ❑out-cf-state PAC (ID# Amount of contribution ('�) Contributor address; City; State; Zip Code 77 I Principal occupation/Job title (See Instructions) Employer (See Instructions) Date Full name of contributor ❑out-of-state PAC(ID# ) Amount of contribution (�) ! v Contributor address; City; State; Zip Code 1 101 Anchor TQ-vocQ t � rv , n `� 7S I, . Principal occupation/Job title(See Instructions) Ern loyer (See Instructions) Date Full name of contributor ❑out-ot-state PAC(10#: _ ) Amount of contribution (5) C ? D \ . ..,us? ..........; ..ksh....`................... ....... la Contributor address; City; State; Zip Code j t �3 �o�s lr� �I�ss Tn ` ! 040 Principal occupation/Job title(See Instructions) Employer(See Instructions) ATTACH ADDITIONAL COPIES OF THIS SCHEDULE AS NEEDED ` If contributor is out-of-state PAC,ploase see Instruction guide for additional reporting requirements. -Forms provided by Texas Ethics Commission www.ethics-state.tx.us Revised 8117r020 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: 3/3 2 FILER NAME BASHU SHRESTHA 3 Filer ID (Ethics Commission Filers) 4 Date 5 Full name of contributor ❑out-of-state PAC(IDrt. ) 7 Amount of contribution ($) Through .....onl.ine.and.cash.contri.nutions...........................I............... $8,332.33 March 22,2021 6 Contributor address; City; State; Zip Code 8 Principal occupation/Job title (See Instructions) g Employer (See Instructions) Date Full name of contributor ❑out-of-state PAC(IDtt: > Amount of contribution ($) .................................................................................. Contributor address; City; State; Zip Code Principal occupation/Job title(See Instructions) Employer (See Instructions) Date Full name of contributor ❑out-of-state PAC(IDk ) Amount of contribution (S) .................................................................................. Contributor address; City; State; Zip Code Principal occupation/Job title (See Instructions) Employer (See Instructions) Date Full name of contributor ❑out-of-state PAC(to# ) Amount of contribution ($) ...................................................I............................ .. 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 www.ethics.state.tx.us Revised 8/17/2020 NON-MONETARY (IN-KIND) POLITICAL CONTRIBUTIONS SCHEDULE A2 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 A2: ----- ------ - 2 FILER NAME 3 Filer ID (Ethics Commission Filers) 4 TOTAL OF UNITEMIZED IN-KIND POLITICAL CONTRIBUTIONS $ 5 Date 6 Full name of contributor ❑out-of-state PAC iiou: 1 8 Amount of I 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) 13 Contributor's job title (FOR JUDICIAL)(See Instructions) 14 Contributor's employer/law firm (FOR JUDICIAL) 15 Law firm of contributor's spouse (if any) (FOR JUDICIAL) 16 If contributor is a child, law firm of parent(s)(if any)(FOR JUDICIAL) Full name of contributor ❑out-of-state PAC(ID#: ) I Date Amount of In-kind contribution Contribution $ I description I ....................................................................... Contributor address; City; State; Zip Code 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 8/17/2020 PLEDGED CONTRIBUTIONS SCHEDULE B 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 B: 2 FILER NAME 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) 11 Employer (See Instructions) Date Full name of pledgor ❑out-of-state PAC (ID# ) Amount I In-kind contribution of Pledge$ I description ........................................................................... I Pledgor address; City; State; Zip Code I ❑Check if travel outside of Texas.Complete Schedule T. Principal occupation/Job title (See Instructions) Employer (See Instructions) Date Full name of pledgor ❑out-of-state PAC (ID# ) Amount of I In-kind contribution Pledge $ I description I Pledgor address; City; State; Zip Code I ❑Check if travel outside of Texas.Complete Schedule T. Principal occupation/Job title (See Instructions) Employer (See Instructions) Date Full name of pledgor Amount of I In-kind contribution P 9 out-of-state PAC (ID#. ) Pledge $ I description ........................................................................... I Pledgor address; City; State; Zip Code I ❑Check if travel outside of Texas.Complete Schedule T. 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 www.ethics.state.tx.us Revised 8/17/2020 LOANS SCHEDULE E 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 E. 2 FILER NAME 3 Filer ID (Ethics Commission Filers) BASHU SHRESTHA 4 TOTAL OF UNITEMIZED LOANS $ 2,000.00 5 Date of loan 7 Name of lender ❑ out-of-state PAC(ID#: ) 9 Loan Amount($) 02/12/2021 TIKA PAUDEL $2,000.00 ................................. ............................... 6 Is lender 8 Lender address; City. State; Zip Code 10 Interest rate a financial 0% Institution? 500 BRASHER LANE EULESS TX 76040 11 Maturity date Y 0 NONE 12 Principal occupation / Job title (See Instructions) 13 Employer (See Instructions) BUSINESS OWNER/MANAGER SELF 14 Description of Collateral 15 ❑ Check if personal funds were deposited into political EX none account (See Instructions) TOR 17 Nameofguarantor 19 Amount Guaranteed INFORMA 18 Guarantor address; it Sta ode ❑ not applicable 20 Principal Occupatioi s ructions) 21 Employer (See Instructions) Date of loan Name of lender Fj out-of-state PAC(ID# ) Loan Amount($) _ .................................................................................. --- Is lender Lender address; City; State; Zip Code Interest rate a financial Institution? Maturity date Y N Principal occupation / Job title (See Instructions) Employer (See Instructions) Description of Collateral ❑ Check if personal funds were deposited into political ❑ none account (See Instructions) GUARANTOR Name of guarantor Amount Guaranteed($) INFORMATION .................................................................................. Guarantor address; City; State; Zip Code ❑ not applicable Principal Occupation (See Instructions) Employer (See Instructions) ATTACH ADDITIONAL COPIES OF THIS SCHEDULE AS NEEDED If lender is out-of-state PAC, please see Instruction guide for additional reporting requirements. Forms provided by Texas Ethics Commission www.ethics.state.tx.us Revised 8/17/2020 POLITICAL EXPENDITURES MADE SCHEDULE F1 FROM POLITICAL CONTRIBUTIONS If the requested information is not applicable, DO NOT include this page in the report. EXPENDITURE CATEGORIES FOR BOX 8(a) Advertising Expense Event Expense Loan Repayment/Reimbursement Solicitation/Fundraising Expense Accounting/Banking Fees Office Overhead/Rental Expense Transportation Equipment&Related Expense Consulting Expense Food/Beverage Expense Polling Expense Travel In District Contributions/Donations Made By Gift/Awards/Memorials Expense Printing Expense Travel Out Of District Candidate/Officeholder/Political Committee Legal Services SalariesNVages/Contract Labor Other(enter a category not listed above) Credit Card Payment The Instruction Guide explains how to complete this form. 1 Total pages Schedule F1: 2 FILER NAME 3 Filer ID (Ethics Commission Filers) BASHU SHRESTHA 4 Date 5 Payee name 02/28/2021 The Gurkha Bar and Grill 6 Amount ($) 7 Payee address; City; State; Zip Code 78.23 1060 N Main St#118, Euless, TX 76039 8 (a) Category (See Categories listed at the top of this schedule) (b) Description PURPOSE FOOD OF MEETING EXPENDITURE (C) Check iftravel outside of Texas.Complete Schedule T. 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 Payee name 03/18/2021 Office Depot Amount ($) Payee address; City; State; Zip Code 41.22 201 S Industrial Blvd, Euless, TX 76040 Category (See Categories listed at the top of this schedule) Description PURPOSE OF SUPPLIES OFFICE EXPENDITURE ❑ Check if travel outside ofTexas.Complete Schedule T. Check if Austin,TX, officeholder living expense Complete ONLY if direct Candidate/Officeholder name Office sought Office held expenditure to benefit C/OH Date Payee name 03/20/2021 The Gurkha Bar and Grill Amount ($) Payee address; City; State; Zip Code 97.81 1060 N Main St#118, Euless, TX 76039 Category (See Categories listed at the top of this schedule) Description PURPOSE OF MEETING FOOD EXPENDITURE ❑ Check iftravel 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 ATTACH ADDITIONAL COPIES OF THIS SCHEDULE AS NEEDED Forms provided by Texas Ethics Commission www.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/Memorials 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 g 5 Date 6 Payee name 7 Amount ($) 8 Payee address; City; State; Zip Code 9 TYPE OF EXPENDITURE El Political ❑ Non-Political 10 (a) Category (See Categories listed at the top of this schedule) (b) Description PURPOSE OF EXPENDITURE (e) El Check iftravel outside ofTexas.Complete Schedule T. Check if Austin,TX, officeholder living expense 11 Complete QhLLY if direct Candidate / Officeholder name Office sought Office held expenditure to benefit C/OH Date Payee name Amount ($) Payee address; City; State; Zip Code TYPE OF EXPENDITURE El Political Non-Political Category (See Categories listed at the top of this schedule) Description PURPOSE OF EXPENDITURE Check if travel outside of Texas.Complete ScheduleT. El 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 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) 4 Date 5 Name of person from whom investment is purchased ................................................................................................................................ 6 Address of person from whom investment is purchased; City; State; Zip Code 7 Description of investment 8 Amount of investment($) Date Name of person from whom investment is purchased ................................................................................................................................ Address of person from whom investment is purchased; City; State; Zip Code Description of investment Amount of investment($) ATTACH ADDITIONAL COPIES OF THIS SCHEDULE AS NEEDED Forms provided by Texas Ethics Commission 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 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/Officeholder/Political Committee Legal Services Salaries/Wages/Contract Labor Other(entera category not listed above) The Instruction Guide explains how to complete this form. 1 Total pages Schedule F4: 2 FILER NAME 3 Filer ID (Ethics Commission Filers) 4 TOTAL OF UNITEMIZED EXPENDITURES CHARGED TO CREDIT CARD $ 5 Date 6 Payee name 7 Amount ($) 8 Payee address; City; State; Zip Code 9 TYPE OF EXPENDITURE Political Non-Political 10 (a) Category (See Categories listed at the top of this schedule) (b) Description PURPOSE OF EXPENDITURE (c) Check 9 travel outside of Texas.Complete Schedule T. Check if Austin,TX, officeholder living expense 11 Candidate / Officeholder name Office sought Office held Complete ONLY if direct expenditure to benefit C/OH Date Payee name Amount ($) Payee address; City; State; Zip Code TYPE OF EXPENDITURE El Political Non-Political Category (See Categories listed at the top of this schedule) Description PURPOSE OF EXPENDITURE ElCheck if travel outside of Texas.Complete Sched i ile T. ❑ Check if Austin, TX, officeholder living expense Candidate /Officeholder name Office sought Office held Complete ONLY if direct 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 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 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 Contribubons/Donations Made By Gift/Awards/Memorials Expense Printing Expense Travel Out Of District Candidate/Officeholder/Political 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 G: 2 FILER NAME 3 Filer ID (Ethics Commission Filers) 4 Date 5 Payee name 6 Amount ($) 7 Payee address; City; State; Zip Code Reimbursement from political contributions intended $ (a) Category (See Categories listed at the top of this schedule) (b) Description PURPOSE OF EXPENDITURE (c) Check if travel outside of Texas.Complete Schedule T. Check if Austin,TX, officeholder living expense 9 Candidate/ Officeholder name Office sought Office held Complete ONLY if direct expenditure to benefit C/OH Date Payee name Amount ($) Payee address; City; State; Zip Code Reimbursement from political contributions intended Category (See Categories listed at the top of this schedule) Description PURPOSE OF EXPENDITURE Check if travel outside of Texas.Complete Schedule T. Check if Austin,TX, officeholder living expense Complete ONLY if direct Candidate / Officeholder name Office sought Office held expenditure to benefit C/OH Date Payee name Amount ($) Payee address; City; State; Zip Code Reimbursement from❑ political contributions intended Category (See Categories listed at the top of this schedule) Description PURPOSE OF EXPENDITURE Check I travel Outside of Texas.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 PAYMENT MADE FROM POLITICAL CONTRIBUTIONS TO A BUSINESS OF C/OH SCHEDULE H 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/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/Officeholder/Political 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 6 Amount ($) 7 Business address; City; State; Zip Code 8 (a) Category (See Categories listed at the top of this schedule) (b) Description PURPOSE OF EXPENDITURE (C) Check V travel outside of Texas.Complete Sched ule T. ❑ Check if Austin,TX, officeholder living expense 9 Complete ONLY if direct Candidate / Officeholder name Office sought Office held expenditure to benefit C/OH Date Business name Amount ($) Business address; City; State; Zip Code Category (See Categories listed at the top of this schedule) Description PURPOSE OF EXPENDITURE Check if travel outside of Texas.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 Business name Amount ($) Business address; City; State; Zip Code Category (See Categories listed at the top of this schedule) Description PURPOSE OF EXPENDITURE Check if travel outside of Texas.Complete Schedule T. ❑ Check if Austin,TX, officeholder living expense Complete ONLY if direct Candidate/ Officeholder name Office sought Office held expenditure to benefit C/OH ATTACH ADDITIONAL COPIES OF THIS SCHEDULE AS NEEDED Forms provided by Texas Ethics Commission www.ethics.state.tx.us Revised 8/17/2020 NON-POLITICAL EXPENDITURES MADE FROM POLITICAL CONTRIBUTIONS SCHEDULE 1 If the requested information is not applicable, DO NOT include this page in the report. The Instruction Guide explains how to complete this form. 1 Total pages Schedule I: 2 FILER NAME 3 Filer ID (Ethics Commission Filers) 4 Date 5 Payee name 6 Amount ($) 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 ($) Payee address; City State Zip Code PURPOSE Category (See instructions for examples of acceptable Description (See instructions regarding type of information categores.) required.) OF EXPENDITURE Date Payee name Amount ($) Payee address; City State Zip Code PURPOSE Category (See instructions for examples of acceptable Description (See instructions regarding type of information OF categories.) required.) EXPENDITURE Date Payee name Amount ($) Payee address; City State Zip Code PURPOSE Category (See instructions for examples of acceptable Description (See instructions regarding type of information categories.) required.) OF EXPENDITURE ATTACH ADDITIONAL COPIES OF THIS SCHEDULE AS NEEDED Forms provided by Texas Ethics Commission www.ethics.state.tx.us Revised 8/17/2020 INTEREST, CREDITS, GAINS, REFUNDS, AND CONTRIBUTIONS RETURNED TO FILER SCHEDULE K If the requested information is not applicable, DO NOT include this page in the report. The Instruction Guide explains how to complete this form. 1 Total pages Schedule K: 2 FILER NAME 3 Filer ID (Ethics Commission Filers) 4 Date 5 Name of person from whom amount is received 8 Amount($) ........................................................................ .I...................... 6 Address of person from whom amount is received; City; State; Zip Code 7 Purpose for which amount is received Check if political contribution returned to filer Date Name of person from whom amount is received Amount($) ........................................................................ ...............I........ Address of person from whom amount is received; City; State; Zip Code Purpose for which amount is received Check if political contribution returned to filer Date Name of person from whom amount is received Amount($) ........................................................................ ........................ Address of person from whom amount is received; City; State; Zip Code Purpose for which amount is received Check if political contribution returned to filer Date Name of person from whom amount is received Amount ($) ........................................................................ ...........I........ .... Address of person from whom amount is received; City; State; Zip Code 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) 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 F1 ❑ Schedule F2 ❑ Schedule F4 ❑Schedule G ❑ Schedule H ❑ Schedule COH-Ur ❑ 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 narne 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 i 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 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) ATTACH ADDITIONAL COPIES OF THIS SCHEDULE AS NEEDED Forms provided by Texas Ethics Commission www.ethics.state.tx.us Revised 8/17/2020