HomeMy WebLinkAboutEilenfeldt semi Jan 2017 Texas Ethics Commission P.C.Box 12070 Austin,Texas 78711-2070 (512)483-5800 (TD01-800-735-2989)
CANDIDATE / OFFICEHOLDER FORM C/OH
CAMPAIGN FINANCE REPORT COVER SHEET PG 1
1 ACCOUNT# 2 Total pages filed:
The C/O1i Instruction Guide explains how to complete this form. (Ethics Commission Fliers)
3 CANDIDATE / MSIMRSI R FIRST MI
OFFICEHOLDER '�n da_, ❑FF{CE USE[ONLY
Dale Received
NICKNAME LAST SUFFIX
� ► I e n Jae I�� e/q /oI 7
4 CANDIDATE / ADDRESS IPOBOX; APTISUITE/0; CITY; STATE; ZIP CODE sr:300r r`
OFFICEHOLDER /�...�//...�,/�, �[
MAILING 4 1/ �e(A + 1 J C1 t►i C t de r.
ADDRESS gate Hand-delivered or Postmarked
11change of address 6£ I [e s .y TX 76 0 3 i Receipt# Amwn
5 CANDIDATE/ AREA CODE PHONE NUMBER EXTENSION
OFFICEHOLDER I Dale Processed
PHONE `91 n{ ) .5 7). 3 6 0L
6 CAMPAIGN MSfMRS MR FIRST MI Date Imaged
TREASURER lk 6b erg- CBc,f7)
NAME
NICKNAME LAST SUFFIX
7 CAMPAIGN STREET ADD RE SS(NO PO BOX PLEASE); APT/SUITE fF, CffY; STATE; ZIP CODE
TREASURER '�(�
ADDRESS '-a l Fo utt-1 a!n Y Id .
(residence or business)
E (es s T X 7 ( oj9
8 CAMPAIGN AREA CODE PHONE NUMBER EXTENSION
TREASURER (B[7 ) 5 71 074,9
PHONE 1
9 REPORT TYPE rEga,January 15 � 30th day before election � Run Off 15th day aRer campaign
treasurer appointment
Officeholder only)
❑ July 15 ❑ 8th day before election ❑ Exceeded $500 ❑ Final report(Attach CrOH-FR}
limit
10 PERIOD Moth Dal/ rt+ar snaxrOafyea
COVERED '7 ` i /-2 0,45. THROUGH fry /31 / 2 0/4
11 ELECTION ELECTION DATE ELECTION TYPE
Monti Day Year ❑ Poway ❑ Ruwff ❑ General ❑ SPo.„I
12 OFFICE OFFICE HELD Of any) 13 OFFICE SOUGHT {if known}
E u.f e s 5 o f 41 Ce c e. C
Race
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www.ethics,state.tx.us Revised 04/19/2013
Texas Ethics Commission P.O,Box 12070 Austin,Texas 78711-2070 (512)463-580❑ (TOD 1-800-735-2989)
CANDIDATE 1 OFFICEHOLDER REPORT: FORM C/OH
SUPPORT & TOTALS COVER SHEET PG 2
14 C/OH NAME 15 ACCOUNT# (Ethics Commission Filers)
L nd a E l e n fi e t d..-h-
I
16 NOTICE FROM THIS BOX IS FOR NOTICE OF POLITICAL CONTRIBUTIONS ACCEPTED OR POLITICAL EXPENDITURES MADE BY POLICAL COMMITTEES TO SUPPORT THE
POLITICAL CANDIDATE I OFFICEHOLDER. THESE EXPENDITURES MAY HAVE BEEN MADE IY1T7-fQUT THE CANDIDATES OR QFF/CEHQLDER S KM,bit EDGE OR
COMMITTEE(S) CONSENT CANDIDATES AND OFFICEHOLDERS ARE REQUIRED TO REPORT THIS INFORMATION ONLY IF THEY RECEIVE NOTICE OF SUCH EXPENDITURES.
COMMITTEE NAME
COMMITTEE TYPE
EJ GENERAL
COMMITTEE ADDRESS
LD SPECIFIC
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 $ — d -...
2. TOTAL POLITICAL CONTRIBUTIONS
(OTHER THAN PLEDGES,LOANS,OR GUARANTEES OF LOANS) $ — 0
EXPENDITURE
TOTALS 3. TOTAL POLITICAL EXPENDITURES OF$100 OR LESS, UNLESS ITEMIZED $ `C)y
4. TOTAL POLITICAL EXPENDITURES $ 0.__.
CONTRIBUTION 5 TOTAL POLITICAL CONTRIBUTIONS MAINTAINED AS OF THE LAST DAY BALANCE OF REPORTING PERIOD $ Log ryi.a q
OUTSTANDING 6. TOTAL PRINCIPAL AMOUNT OF ALL OUTSTANDING LOANS AS OF THE
LOAN TOTALS LAST DAY OF THE REPORTING PERIOD G
18 AFFIDAVIT
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
,,,""",„ KIM SIITiER me under Title 15,Election Code.
_:°:: `, Natafy Public.State of Texas
to,: . . Comm.Expires 48-25-201> 4.1.A.,-01-44,-' p'°'FOF,1*". NOtory I❑ 10956806L
�hrrrnH
Signature of Candidate orCfrceholder
AFFIX NOTARY STAMP/SEAL ABOVE I
Sworn to and subscribed before me, by the said tGI� I r*[ Q Pet.al , this the
4-• day ...of • 20 ( 7 , to certify which, witness my hand and seal of office.
t , .� �j if)1 r_ ( f 7"C.- IV O / 7//Z.t
igna re of officer administering oath 7A5
ted name of officer administering oath Title of officer administering oath
www.ethics.state.tx-us Revised 04/19/2013