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Home My WebLink AboutBhojani semi January 2018 • Al I . 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 OFFICEHOLDER Mr. Salman OFFICE USE ONLY NAME Date Received NICKNAME LAST SUFFIX• /�µ / Bhojani 1/rei (-,C 4 CANDIDATE / ADDRESS / PO BOX; APT / SUITE #; CITY; STATE ; ZIP CODE 1 O FFICEHOLDER a e Cc MAILING 1 01 0 Lost Valley Dr, Euless , TX 76039 ADDRESS Change of Address 5 CANDIDATE/ AREA CODE PHONE NUMBER EXTENSION O FFICEHOLDER 786- 6888 Date Hand-delivered or Date Postmarked P HONE ( 972 6 CAMPAIGN MS / MRS / MR FIRST MI Receipt # Amount $ TREASURER Ms . Tiffany A . NAME Date Processed NICKNAME LAST SUFFIX Smith Date Imaged 7 CAMPAIGN STREET ADDRESS (NO PO BOX PLEASE); APT / SUITE #; CITY; STATE; ZIP CODE TREASURER 2500 N Hwy 121 , # 1924 Euless TX , TX76039 ADDRESS ( Residence or Business) 8 CAMPAIGN AREA CODE PHONE NUMBER EXTENSION TREASURER 806 441 -3895 PHONE 9 REPORT TYPE X January 15 301h day before election ❑ Runoff 15th day after campaign treasurer appointment (Officeholder Only) ❑ July 15 8th day before election ❑ Exceeded $500 limit Final Report (Attach C/OH - FR) • 10 PERIOD Month Day Year Month Day Year COVERED 07 / 01 / 2017 THROUGH 12 / 31 / 2017 11 ELECTION ELECTION DATE ELECTION TYPE Month Day Year Primary ❑ Runoff ❑ Other Description . 05 / 05 / 2018 X General ❑ Special 12 OFFICE OFFICE HELD (if any) 13 OFFICE SOUGHT (if known) City Council GO TO PAGE 2 Forms provided by Texas Ethics Commission www.ethics .state .tx . us Revised 9/8/2015 CANDIDATE / OFFICEHOLDER FORM C /OH CAMPAIGN FINANCE REPORT COVER SHEET PG 2 14 C/OH NAME 15 Filer ID ( Ethics Commission Filers) Salman Bhojani 16 NOTICE FROM THIS BOX IS FOR NOTICE OF POLITICAL CONTRIBUTIONS ACCEPTED OR POLITICAL EXPENDITURES MADE BY POLITICAL COMMITTEES TO POLITICAL SUPPORT THE CANDIDATE / OFFICEHOLDER. THESE EXPENDITURES MAY HAVE BEEN MADE WITHOUT THE CANDIDATE'S OR OFFICEHOLDER 'S COMM ITTEE (S) KNOWLEDGE OR CONSENT. CANDIDATES AND OFFICEHOLDERS ARE REQUIRED TO REPORT THIS INFORMATION ONLY IF THEY RECEIVE NOTICE OF SUCH EXPENDITURES. COMMITTEE TYPE COMMITTEE NAME GENERAL COMMITTEE ADDRESS IISPECIFIC COMMITTEE CAMPAIGN TREASURER NAME Additional Pages COMMITTEE CAMPAIGN TREASURER ADDRESS 17 CONTRIBUTION 1 . TOTAL POLITICAL CONTRIBUTIONS OF $ 50 OR LESS (OTHER THAN TOTALS PLEDGES , LOANS , OR GUARANTEES OF LOANS ) , UNLESS ITEMIZED $ 2 . TOTAL POLITICAL CONTRIBUTIONS $ 0 . 00 ( OTHER THAN PLEDGES , LOANS , OR GUARANTEES OF LOANS) EXPAENS ITURE 3 . TOTAL POLITICAL EXPENDITURES OF $ 100 OR LESS ,TOT $ UNLESS ITEMIZED 4 . TOTAL POLITICAL EXPENDITURES $ 263 . 66 CONTRIBUTION 5 . TOTAL POLITICAL CONTRIBUTIONS MAINTAINED AS OF THE LAST DAY $ BALANCE OF REPORTING PERIOD OUTSTANDING 6 . TOTAL PRINCIPAL AMOUNT OF ALL OUTSTANDING LOANS AS OF THE LOAN TOTALS LAST DAY OF THE REPORTING PERIOD $ 1053 . 00 18 AFFIDAVIT I swear, or affirm , under penalty of perjury, that the accompanying report is ..)�Ppv P�I1y MADALYN ELIZABETH ADKINS true and correct and includes all information required to be reported by me Suk3 ' s% Notary Public , State of Texas under Title 15 , Election Code. ""- . t-' Comm . Expires 12 - 19-2021 %y,, , . . . �'} �Q rr '� ; °Lnr Notary ID 131385785 ` . Signatu-of Candidate or Officeholder AFFIX NOTARY STAMP / SEALABOVE '/� Y� y � Sworn to and subscribedc before me , by the said �11L�,C\� ✓ -) tt,RJ \ , this the 2 t Iday of c) RVJ `.r , 20 Ig to certify which , witness my hand and seal of office . • c-ViVa• Apn >hr0 Ae‘\(4LY-D Mal 4?)0 C Signature of • ficer administering oath Printed name of officer administering oath Title of officer administering oat9 :'e . . rf Forms provided by Texas Ethics Commission www.ethics .state .tx . us Revised 9/8/2015 SUBTOTALS - C /OH FORM C /OH COVER SHEET PG 3 19 FILER NAME 20 Filer ID ( Ethics Commission Filers) Salman Bhojani 21 SCHEDULE SUBTOTALS SUBTOTAL NAME OF SCHEDULE AMOUNT 1 . X SCHEDULEA1 : MONETARY POLITICAL CONTRIBUTIONS $ $ 0 . 00 2 . SCHEDULE A2 : NON -MONETARY (IN -KIND) POLITICAL CONTRIBUTIONS $ 3 . SCHEDULE B : PLEDGED CONTRIBUTIONS $ 4 . X SCHEDULE E : LOANS $ $ 1053 . 00 5 . x SCHEDULE F1 : POLITICAL EXPENDITURES MADE FROM POLITICAL CONTRIBUTIONS $ $263 . 66 6 . SCHEDULE F2 : UNPAID INCURRED OBLIGATIONS $ 7 • 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. J SCHEDULE H : PAYMENT MADE FROM POLITICAL CONTRIBUTIONS TO A BUSINESS OF C/OH $ 11 • I 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 9/8/2015 LOANS SCHEDULE E 1 Total pages Schedule E : The Instruction Guide explains how to complete this form . 1 of 1 2 FILER NAME 3 Filer ID ( Ethics Commission Filers) Salman Bhojani 4 TOTAL OF UNITEMIZED LOANS $ 5 Date of loan 7 Name of lender ❑ out-of-state PAC (ID#: ) 9 Loan Amount ($) 05/03/2017 Salman Bhojani $ 1053 . 00 6 Is lender 8 Lender address ; City ; State ; Zip Code 10 Interest rate a financial 0 Institution ? 1010 Lost Valley Dr , Euless , TX 76039 11 Maturity date Y N May 2018 12 Principal occupation / Job title (See Instructions) 13 Employer ( See Instructions) Attorney Bhojani & Nelson , PLLC 14 Description of Collateral 15 Check if personal funds were deposited into political account ( See Instructions ) [Xl none ❑ 16 GUARANTOR 17 Name of guarantor 19 Amount Guaranteed ($) INFORMATION 18 Guarantor address ; City ; State ; Zip Code IX not applicable 20 Principal Occupation ( See Instructions) 21 Employer (See Instructions) Date of loan Name of lender ❑ out-of-state PAC (ID#: ) Loan Amount ($) 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 account (See Instructions ) ❑ none ❑ GUARANTOR Name of guarantor Amount Guaranteed ($) INFORMATION Guarantor address ; City ; State ; Zip Code ❑ not applicable Principal Occupation (See Instructions) Employer (See Instructions) ATTACH ADDITIONAL COPIES OF THIS SCHEDULE AS NEEDED If lender is out -of-state PAC , please see instruction guide for additional reporting requirements . Forms provided by Texas Ethics Commission www. ethics . state .tx . us Revised 9/8/2015 POLITICAL EXPENDITURES MADE FROM POLITICAL CONTRIBUTIONS SCHEDULE F1 EXPENDITURE CATEGORIES FOR BOX 8(a) Advertising Expense Event Expense Loan Repayment/Reimbursement Solicitation/FundraisingExpense Accounting/Banking Fees Office Overhead/Rental Expense Transportation Equipment & Related Expense Consulting Expense Food/Beverage Expense Polling Expense Travel In District Contributions/Donations Made By Gift/Awards/Memorials Expense Printing Expense Travel Out Of District Candidate/Officeholder/Political Committee Legal Services Salaries/Wages/Contract Labor Other (enter a category not listed above) Credit Card Payment The Instruction Guide explains how to complete this form . 1 Total pages Schedule F1 : 2 FILER NAME 3 Filer ID ( Ethics Commission Filers ) 1 of 3 Selman Bhojani 4 Date 5 Payee name 07/06 - 12/06 2017 Google 6 Amount ($) 7 Payee address ; City ; State ; Zip Code $60 . 66 8 (a) Category (See Categories listed at the top of this schedule) (b) Description PURPOSE Check if travel outside of Texas. Complete Schedule T. O F Other- Email HostingCheck it Austin, TX , officeholder living expense EXPENDITURE 9 Complete ONLY if direct Candidate / Officeholder name Office sought Office held expenditure to benefit C/OH Date Payee name 07/23/2017 Campaign Partners Amount ($) Payee address ; City ; State ; Zip Code $ 29 . 00 Category (See Categories listed at the top of this schedule) Description PURPOSE Check if travel outside of Texas. Complete Schedule T. O F Check if Austin , TX, officeholder living expense EXPENDITURE Other- Website Complete ONLY if direct Candidate / Officeholder name Office sought Office held expenditure to benefit C/OH Date Payee name 08/23/2017 Campaign Partners Amount ($) Payee address ; City ; State ; Zip Code $ 29 . 00 Category (See Categories listed at the top of this schedule) Description PURPOSE ❑ Check if travel outside of Texas. Complete Schedule T. O F ❑ Check if Austin , TX, officeholder living expense EXPENDITURE Other-Website 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 9/8/2015 POLITICAL EXPENDITURES MADE FROM POLITICAL CONTRIBUTIONS SCHEDULE Fl EXPENDITURE CATEGORIES FOR BOX 8(a) Advertising Expense Event Expense Loan RepaymentReimbursement 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 F1 : 2 FILER NAME 3 Filer ID ( Ethics Commission Filers) 2 of 3 Salman Bhojani 4 Date 5 Payee name 9/23/2017 Campaign Partners 6 Amount ($) 7 Payee address ; City ; State ; Zip Code $ 29 . 00 8 (a) Category (See Categories listed at the top of this schedule) ( b) Description PURPOSE ❑ Check if travel outside of Texas. Complete Schedule T. O F Check if Austin, TX, officeholder living expense EXPENDITURE Other-Website 9 Complete ONLY if direct Candidate / Officeholder name Office sought Office held expenditure to benefit C/OH Date Payee name 10/23/2017 Campaign Partners Amount ($) Payee address ; City ; State ; Zip Code $ 29 . 00 Category (See Categories listed at the top of this schedule) Description PURPOSE ❑ Check if travel outside of Texas. Complete Schedule T. O F Other-Website ❑ Check if Austin , TX, officeholder living expense EXPENDITURE Complete ONLY if direct Candidate / Officeholder name Office sought Office held expenditure to benefit C/OH Date Payee name 11 /23/2017 Campaign Partners Amount ($) Payee address ; City ; State ; Zip Code $ 29 . 00 Category (See Categories listed at the top of this schedule) Description PURPOSE Check if travel outside of Texas. Complete Schedule T. O F Check if Austin , TX, officeholder living expense EXPENDITURE Other- Website 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 9/8/2015 POLITICAL EXPENDITURES MADE FROM POLITICAL CONTRIBUTIONS SCHEDULE Fl 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 F1 : 2 FILER NAME 3 Filer ID ( Ethics Commission Filers) 3 of 3 Salman Bhojani 1/4 4 Date 5 Payee name 12/23/2017 Campaign Partners 6 Amount ($) 7 Payee address ; City ; State ; Zip Code $29 . 00 8 (a) Category (See Categories listed at the top of this schedule) ( b) Description PURPOSE Check it travel outside of Texas. Complete Schedule T. OF Other-Website Check if Austin , TX , officeholder living expense EXPENDITURE 9 Complete ONLY if direct Candidate / Officeholder name Office sought Office held expenditure to benefit C/OH Date Payee name 06/23/2017 Campaign Partners Amount ($) Payee address ; City ; State ; Zip Code $ 29 . 00 Category (See Categories listed at the top of this schedule) Description PURPOSE I Check if travel outside of Texas. Complete Schedule T. OF Check II Austin , TX , officeholder living expense EXPENDITURE Other-Website 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 Check If travel outside of Texas. Complete Schedule T. OF Check if Austin , TX, officeholder living expense EXPENDITURE 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 9/8/2015