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Home My WebLink AboutBhojani Final July 2021 CANDIDATE / OFFICEHOLDER FORM C/OH CAMPAIGN FINANCE REPORT COVER SHEET PG 1 1 Filer ID (Ethics Commission Filers) 2 Total pages filed: The C/OH Instruction Guide explains how to complete this form. 7 3 CANDIDATE/ MS/MRS/MR FIRST MI OFFICEHOLDER Mr. Salman OFFICE USE ONLY NAME Date Received NICKNAME LAST SUFFIX — Bhojani 4 CANDIDATE/ ADDRESS /PO BOX, APT/SUITE#; CITY; STATE; ZIP CODE • OFFICEHOLDER 1010 Lost Valley Dr. Euless TX 76039 JUL 15 2021 MAILING ADDRESS I I Change of Address 1 CITY OF EULESS 5 CANDIDATE/ AREA CODE PHONE NUMBER EXTENSION _Zam,,,..4 n,.r,,nr..n n,nn.r,oert...n,,,,i OFFICEHOLDER PHONE 469 774-0469 Receipt# Amount$ 6 CAMPAIGN MS/MRS/MR FIRST MI TREASURER Ms. Tiffany NAME Date Processed NICKNAME LAST SUFFIX Smith Date Imaged 7 CAMPAIGN STREET ADDRESS (NO PO BOX PLEASE); APT/SUITE#; CITY; STATE; ZIP CODE TREASURER 3932 Jasmine Fox Ln. Arlington TX 76005 ADDRESS (Residence or Business) 8 CAMPAIGN AREA CODE PHONE NUMBER EXTENSION TREASURER PHONE ( 806 ) 441-3895 9 REPORT TYPE I I January 15 I I 30th day before election IRunoff I 15th day after campaign treasurer appointment (Officeholder Only) I x I July 15 I 8th daybefore election- I i exceeded Modified I x Final Report(Attach C/OH-FR) Reporting Limit 10 PERIOD Month Day Year Month Day Year COVERED • 1 / I -'/- 2021 THROUGH 6 / 30 / 2021 11 ELECTION ELECTION DATE x >^ LEGTION TYPE Month Day Year n Primary n Runoff I I Other Description / / 7 General Li 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 OFFICEHOLDERS 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 I I 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 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 $ CONTRIBUTIONS MADE ELECTRONICALLY) 2. TOTAL POLITICAL CONTRIBUTIONS $ (OTHER THAN PLEDGES, LOANS, OR GUARANTEES OF LOANS) EXPAENDITURE 3. TOTAL UNITEMIZED POLITICAL EXPENDITURE.TOT $ 4. TOTAL POLITICAL EXPENDITURES $ 1,539.92 CONTRIBUTION 5. TOTAL POLITICAL CONTRIBUTIONS MAINTAINED AS OF THE LAST DAY BALANCE OF REPORTING PERIOD $ 0 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 Please complete either option below: .1pRY@ ""' JULEISA HINOJOS PG �i _j' 6:Notary Public, State of Texas (1)Affidavit S •, ' Comm.Expires 03-23-2025 ',• o 0 ,,,,f,,��% Notary ID 132991002 • NOTARY STAMP/SEAL (� Sworn to and subscribed before me by ( (\Ice ij'f\ \ \\ this the \ day of 2/• , to c ify which,w tness my hand and seal of office. r. r ktUk 01\\t) i• •ture of officer administering ath Printed name of officer administering oath Title ofbfficer administering oath OR (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. SCHEDULE Al: MONETARY POLITICAL CONTRIBUTIONS $ 2. SCHEDULEA2: NON-MONETARY(IN-KIND)POLITICAL CONTRIBUTIONS $ 3. SCHEDULE B: PLEDGED CONTRIBUTIONS $ 4. SCHEDULE E: LOANS $ 5. x SCHEDULE F1: POLITICAL EXPENDITURES MADE FROM POLITICAL CONTRIBUTIONS $ 1,539.92 6. SCHEDULE F2: UNPAID INCURRED OBLIGATIONS $ II SCHEDULE F3: PURCHASE OF INVESTMENTS MADE FROM POLITICAL CONTRIBUTIONS $ 8. 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 I: 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 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 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 Ft: 2 FILER NAME 3 Filer ID (Ethics Commission Filers) 1/3 Salman Bhojani 4 Date 5 Payee name 1/7/2021 Google Email Account 6 Amount ($) 7 Payee address; City; State; Zip Code $6.40 1600 Ampitheatre Pkwy Mountain View CA 94043 a (a) Category (See Categories listed at the top of this schedule) (b) Description PURPOSE Other Email service OF EXPENDITURE (c) n Check if travel outside of Texas.Complete Schedule T. I I Check if Austin,TX,officeholder living expense 9 Complete ONLY if direct Candidate/Officeholder name Office sought Office held expenditure to benefit C/OH Date Payee name 2/8/2021 Google Email Account Amount ($) Payee address; City; State; Zip Code $6.40 1600 Ampitheatre Pkwy Mountain View CA 94043 Category (See Categories listed at the top of this schedule) Description PURPOSE Other Email service OF EXPENDITURE Check if travel outside of Texas.Complete Schedule T. n Check if Austin,TX,officeholder living expense Complete ONLY if direct Candidate/Officeholder name Office sought Office held expenditure to benefit C/OH Date Payee name 3/8/2021 Google Email Account Amount ($) Payee address; City; State; Zip Code $6.40 1600 Ampitheatre Pkwy Mountain View CA 94043 Category (See Categories listed at the top of this schedule) Description PURPOSE Other Email service OF EXPENDITURE II Check if travel outside of Texas.Complete Schedule T. 7 Check if Austin.TX, officeholder living expense Complete ONLY if direct Candidate/Officeholder name Office sought Office held expenditure to benefit C/OH ATTACH ADDITIONAL COPIES OF THIS SCHEDULE AS NEEDED Forms provided by Texas Ethics Commission www.ethics.state.tx.us Revised 8/17/2020 POLITICAL EXPENDITURES MADE FROM POLITICAL CONTRIBUTIONS SCHEDULE F1 If the requested information is not applicable. DO NOT include this page in the report. EXPENDITURE CATEGORIES FOR BOX 8(a) Advertising Expense Event Expense Loan Repayment/Reimbursement Solicitation/Fundraising Expense Accounting/Banking Fees Office Overhead/Rental Expense Transportation Equipment&Related Expense Consulting Expense Food/Beverage Expense Polling Expense Travel In District Contributions/Donations Made By Gift/Awards/Memorials Expense Printing Expense Travel Out Of District Candidate/Officeholder/Political Committee Legal Services SalariesNVages/Contract Labor Other(enter a category not listed above) Credit Card Payment The Instruction Guide explains how to complete this form. 1 Total pages Schedule F1: 2 FILER NAME 3 Filer ID (Ethics Commission Filers) 2/3 Selman Bhojani 4 Date 5 Payee name 4/5/2021 Google Email Account 6 Amount ($) 7 Payee address; City; State; Zip Code S6.40 1600 Ampitheatre Pkwy Mountain View CA 94043 8 (a) Category (See Categories listed at the top of this schedule) (b)Description PURPOSE Other Email service OF EXPENDITURE (c) I Check if travel outside of Texas.Complete ScheduleT. I I 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 5/6/2021 Google Email Account Amount ($) Payee address; City; State; Zip Code $6.40 1600 Ampitheatre Pkwy Mountain View CA 94043 Category(See Categories listed at the top of this schedule) Description PURPOSE Other Email service OF EXPENDITURE Check if travel outside of Texas.Complete Schedule T. pi Check if Austin,TX,officeholder living expense Complete ONLY if direct Candidate/Officeholder name Office sought Office held expenditure to benefit C/OH Date Payee name 5/25/2021 Bhojani for Texas Amount ($) Payee address; City; State; Zip Code $1,500.00 6301 Campus Circle Dr East,Suite 100 Irving TX 75063 Category (See Categories listed at the top of this schedule) Description PURPOSE Contribution made by officeholder OF EXPENDITURE I Check if travel outside of Texas.Complete ScheduleT. I-7 Check if Austin,TX,officeholder living expense Complete ONLY if direct Candidate/Officeholder name Office sought Office held expenditure to benefit C/OH ATTACH ADDITIONAL COPIES OF THIS SCHEDULE AS NEEDED Forms provided by Texas Ethics Commission www.ethics.state.tx.us Revised 8/17/2020 POLITICAL EXPENDITURES MADE SCHEDULE F1 FROM POLITICAL CONTRIBUTIONS If the requested information is not applicable, DO NOT include this page in the report. EXPENDITURE CATEGORIES FOR BOX 8(a) Advertising Expense Event Expense Loan Repayment/Reimbursement Solicitation/Fundraising Expense Accounting/Banking Fees Office Overhead/Rental Expense Transportation Equipment&Related Expense Consulting Expense Food/Beverage Expense PollingExpense p ense Travel In District Contributions/Donations Made By Gift/Awards/Memorials Expense Printing Expense Travel Out Of District Candidate/Officeholder/Political Committee Legal Services Salaries/Wages/Contract Labor Other(enter a category not listed above) Credit Card Payment The Instruction Guide explains how to complete this form. 1 Total pages Schedule Fl: 2 FILER NAME 3 Filer ID (Ethics Commission Filers) 3/3 Salman Bhojani 4 Date 5 Payee name 6/7/2021 Google Email Account 6 Amount ($) 7 Payee address; City; State; Zip Code S6.40 1600 Ampitheatre Pkwy Mountain View CA 94043 8 (a) Category (See Categories listed at the top of this schedule) (b) Description PURPOSE Other Email service OF EXPENDITURE (c) I I Check if travel outside of Texas.Complete ScheduleT. I I 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 6/30/2021 Bhojani for Texas Amount ($) Payee address; City; State; Zip Code $1.52 6301 Campus Circle Dr East,Suite 100 Irving TX 75063 Category (See Categories listed at the top of this schedule) Description PURPOSE Contribution made by officeholder OF EXPENDITURE ICheck if travel outside of Texas.Complete Schedule T I Check if Austin.TX, officeholder living expense Complete ONLY if direct Candidate/Officeholder name Office sought Office held expenditure to benefit C/OH Date Payee name Amount ($) Payee address; City; State; Zip Code Category (See Categories listed at the top of this schedule) Description PURPOSE OF EXPENDITURE II Check if travel outside of Texas.Complete Schedule T. I I 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 CANDIDATE / OFFICEHOLDER REPORT: DESIGNATION OF FINAL REPORT FORM C/OH - FR The Instruction Guide explains how to complete this form. •• Complete only if "Report Type" on page 1 is marked "Final Report" •• 1 C/OH NAME 2 Filer ID (Ethics Commission Filers) Selman Bhojani 3 SIGNATURE 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. Signature o andidate/Officeholder 4 FILER WHO IS NOT AN OFFICEHOLDER •• Complete A & B below only if you are not an officeholder. -- A. CAMPAIGN FUNDS Check only one: x I I do not have unexpended contributions or unexpended interest or income earned from political contributions. I I 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: I x I I do not retain assets purchased with political contributions or interest or other income from political contributions. I I 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. • Signat e of Candidate 5 OFFICEHOLDER •• Complete this section only if you are an officeholder •• I I 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. Signature of Officeholder Forms provided by Texas Ethics Commission www.ethics.state.tx.us Revised 8/17/2020