HomeMy WebLinkAbout2022 Tompkins semi Jan 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.
3 CANDIDATE/ MS/MRS/MR /FIRST MI
''I
OFFICEHOLDER * /Jetl Sir /1 OFFICE USE ONLY
NAME
Date Received
NICKNAME „LAST SUFFIX
4 CANDIDATE/ ADDRESS /PO BOX; APT/SUITE#; CITY; STATE; ZIP CODE
OFFICEHOLDER
MAILING
ADDRESS r/� �(/ 71,6�/
Change of Address / 7 (,(/ir- d r. �u "5.5i 6 l v
5 CANDIDATE/ AREA CODE PHONE NUMBER EXTENSION
OFFICEHOLDER ! �/ Q/_ Dat Hand-delivered or Date Postmarked
PHONE ` CI/ ! 62 7(- V 6 � / `�3(2.o 0-2-- OS 2f
Receipt# Amount $
6 CAMPAIGN MS/MRS/MR FIRST MI
TREASURER I"N/ #?
NAME Date Processed
NICKNAME LAST SUFFIX
Date Imaged
DA/O4'Ai
7 CAMPAIGN STREET ADDRESS (NO PO BOX PLB'ASE); APT/SUITE#; CITY; STATE; ZIP CODE
TREASURER
ADDRESS _Ih�
(Residence or Business) ( v? /rJhe 12!'� (Nf f ' 16•a10
8 CAMPAIGN AREA CODE ` PHONE NUMBER EXTENSION
TREASURER
PHONE ( Of'1 ) 0233^ 557
eip
9 REPORT TYPE January 15 I I 30th day before election I I Runoff I I 15th day after campaign
treasurer appointment
(Officeholder Only)
July 15 8th day before election Exceeded Modified Final Report(Attach C/OH-FR)
Reporting Limit
10 PERIOD Month Day Year Month Day Year
COVERED 67 / °( / 2o2 / THROUGH /2 / 3 l / ZOO,/
11 ELECTION ELECTION DATE 1 ELECTION TYPE
Month Day Year I I Primary Runoff Other
Description
/ / I I General I Special
12 OFFICE OFFICE HELD (if any) 13 OFFICE SOUGHT (if known)
A (e5 (al 66 i {7//Ct 0/l
14 NOTICE FROM THIS BOX IS FOR NOICE 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
EI
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 $ 6'
CONTRIBUTIONS MADE ELECTRONICALLY) /t/
2. TOTAL POLITICAL CONTRIBUTIONS $
(OTHER THAN PLEDGES, LOANS, OR GUARANTEES OF LOANS) 0
TOTAL DITURE 3. TOTAL UNITEMIZED POLITICAL EXPENDITURE.
4. TOTAL POLITICAL EXPENDITURES $ Npl.
CONTRIBUTION 5. TOTAL POLITICAL CONTRIBUTIONS MAINTAINED AS OF THE LAST DAY $ / I-4,
BALANCE OF REPORTING PERIOD l0 3. S
OUTSTANDING 6. TOTAL PRINCIPAL AMOUNT OF ALL OUTSTANDING LOANS AS OF THE
LOAN TOTALS LAST DAY OF THE REPORTING PERIOD $ 8--
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:
�,�,„,no, KIM SUTTER
.1rr ..0
_2:• ��Notary Public, State of Texas
;,,; :'e Comm.Expires 08-25-2025
'"?. . !... Notary ID 10956806
(1)Affidavit '��,,,,,\o�`
NOTARY STAMP/SEAL In 3
Sworn to and subscribed before me by J IC,(K,S this the day o
20 Z to ce i which,witness my hand ands al f office. IeL.(7____ ___
k/67-MeV
igna a of officer ad roistering oath Printed name of officer administering oath Title of officer 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