HomeMy WebLinkAbout2023 Tompkins semi JulyCANDIDATE / OFFICEHOLDER
CAMPAIGN FINANCE REPORT
FORM C/OH
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:
3 CANDIDATE / MS / MRS / MR FIRST MI
OFFICE USE ONLY
OFFICEHOLDER
NAME...................... v./.ea,� f Y..................................... Date Received
NICKNAME LAST StIFFIX
4 CANDIDATE /
OFFICEHOLDER
MAILING
ADDRESS
❑ Change of Address
5 CANDIDATE/
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
1 volA M1"'Ijr
ADDRESS / PO BOX; APT / SUITE #; CITY; STATE; ZIP CO � L IIL7 `/ L=1 U U L M
t
/bO � /9" �fr , �x ` JUL 0 7 2023 [Di
AREA CODE PHONE NUMBER EXTENSION CITY OF EULESSDate Hand -delivered or Date Postmarked
(1-7
Receipt # Amount $
MS / MRS / MR FIRST
MI
Date Processed
NICKNAME LAST SUFFIX
Date Imaged
STREET ADDRESS (NO PO BOX PLEASE); APT / SUITE #; CITY; STATE; ZIP CODE
1467
AREA CODE
( `? 17 )
❑ January 15
5�yhc f P/. �14 leff, 6 4 o Ya
PHONE NUMBER EXTENSION
?33 - .-�—/(-
❑ 30th day before election
July 15 ❑ 8th day before election
Month Day Year
o//o//Z0.23
ELECTION DATE
Month Day Year ❑ Primary
❑ General
❑
Runoff
15th day after campaign
treasurer appointment
(Officeholder Only)
❑
Exceeded Modified
Final Report (Attach C/OH - FR)
Reporting Limit
-
Month
Day
Year
THROUGH
I% 6O
/ 3 O
/ ZD 2-
ELECTION TYPE
❑ Runoff ❑ Other
Description
❑ Special
12 OFFICE OFFICE HELD (if any) 13 OFFICE SOUGHT (if known)
Qtsf (f4( `4e6%I N,ta 2
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 I 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 11/15/2022
CANDIDATE / OFFICEHOLDER
FORM C/OH
CAMPAIGN FINANCE REPORT
COVER SHEET PG 2
15 C/OH NAME
/ /l
rc; K I
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)
..................
TOTALS EXPENDITURE
3. TOTAL UNITEMIZED POLITICAL EXPENDITURE.
$
(x
Y
...................
4. TOTAL POLITICAL EXPENDITURES
$
CONTRIBUTION
5. TOTAL POLITICAL CONTRIBUTIONS MAINTAINED AS OF THE LAST
DAY S 4
$
BALANCE
..................
OF REPORTING PERIOD
3
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.
-� Sidnature of andidate
or Officeholder
Please complete either option below:
JACOUELINE ROSS
'0 Notary Public, State of Texas
Comm. Expires 01-18-2028
(1)Affidavit ''';���� Notary ID 133638881
NOTARY STAMP/SEAL
Sworn to and subscribed before me by II- of eA-"
20 '2 to certify which witness my hand and seal of —lice.
n6le P � J 6�- crel ( .0 -
Signature of &)car administering oath Printed name of officer administering oath
(2) Unsworn Declaration
My name is
My address is
Executed in
(street)
County, State of
Forms provided by Texas Ethics Commission
this the -11+11 day of ,) ut V
�YJy
Title of officer administer ng Bath
and my date of birth is
(city) (state) (zip code) (country)
on the day of 20
(month) (year)
Signature of Candidate/Officeholder (Declarant)
www.ethics.state.tx.us Revised 11/15/2022