HomeMy WebLinkAbout2016 Martin semi January ,
CANDIDATE / OFFICEHOLDER FORM C/OH
CAMPAIGN FINANCE REPORT COVER SHEET PG 1
-
1 Filer ID(Ethics Comml.aan Films) 2 Total pages filed
The CIOH Instruction Guide explains how to complete this form.
3 CANDIDATE/ &I ORS J MR FIRST MI
OFFICEHOLDER OFFICE USE ONLY
NAME I. i1.410A L.
Date Received
NICKNAME LAST SUFFIX
1 ?Pik° fir
4 CANDIDATE/ ADDRESS %PO BOX. APT!SUITE 4: CITY; STATE: ZIP CODE
OFFICEHOLDER
MAILING
ADDRESS Ix 1y'ri,3�
.30 Ln�K �.��� t et) `� ,
❑ Change of Address
5 CANDIDATE/ AREA CODE PHONE NUMBER EXTENSION
OFFICEHOLDER oat.
d vaned or
DM*Postmarked
PHONE 1 7 3 - ` O3 , f ' SU r]
6 CAMPAIGN MS'MRS/MR FIRST Mt Recaipl Or Amount I
TREASURER
NAME 50N oJ14 'r -
Dale Processed
NICKNAME LAST SUFFIX —
Dele Imaged
RAN
7 CAMPAIGN STREET ADDRESS NO PO BOX PLEASE}; APT/SURE it; CITY; STATE; ZIP CURE
TREASURER �y
ADDRESS Z}i -Ira),1 j]W E Laa-55 r �y '7 v3 9
(Residence or Business)
8 CAMPAIGN AREA CODE PHONE NUMBER EXTENSION
TREASURER ( Oil ) e3Z- 11/ Z
9 REPORT TYPE
64 January 1s ❑ 30th day before election ❑ Rona ❑ 151h day der camper
Irossurer a0poinlmenl
101ticeholder Only}
❑ July 15 ❑ 8Ih day before election n Exceeded$50.0 limit ❑ Find Rayon(Aced,C/OH I-A)
10 PERIOD Month Day Year Month Day Yew
COVERED , . /
C 3Q 0 1.5 THROUGH I Z� 3+ / 15
f'
11 ELECTION ELECTION DATE ELECTION TYPE
Month Day Year ❑ Primary ❑ Runolt ❑ Other
Descnplion
b / 1 0 rw 1 4 El GeneralEl Special
12 OFFICE OFFICE HELD {1f miry) I 13 OFFICE SOUGHT (Ir known)
AN/p6
GO TO PAGE 2
Forms provided by Texas Ethics Commission www•ethics.state.Ix.us Revised 918i2015
CANDIDATE I OFFICEHOLDER FORM C/OH
CAMPAIGN FINANCE REPORT COVER SHEET PG 2
14 C/OH NAME 15 Filer ID (Ethics Commission Filers)
16 NOTICE FROM THIS SOX IS FOR NOTICE OF POLITICAL CONrnlst mo*s ACCEPTEO OR POLITICAL EXPENDITURES MADE EY POLITICAL COMMITTEES TO
POLITICAL SUPPORT THE CANDIDATE 1 OFFICEHOLDER. THESE EXFEMC TUBES MAY NAVE SEEN MADE VTrHOUT THE CANDIDATES OR OfFWCENOLOER'
COMMITTEE(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
❑SP ECIFIC
COMMITTEE CAMPAIGN TREASURER NAME
Additional Pages
COMMITTEE CAMPAIGN TREASURER ADDRESS
17 CONTRIBUTION 1, TOTAL POLITICAL CONTRIBUTIONS OF S50 OR LESS (OTHER THAN
TOTALS PLEDGES, LOANS,OR GUARANTEES OF LOANS). UNLESS ITEMIZED $ �f-]
2. TOTAL POLITICAL CONTRIBUTIONS
(OTHER THAN PLEDGES, LOANS,OR GUARANTEES OF LOANS)
I7
TOTALS EXPENDITURE 3. TOTAL POLITICAL EXPENDITURES OF$100 OR LESS, $
UNLESS ITEMIZED /]l]
4. TOTAL POLITICAL EXPENDITURES $ /]�}
9A❑CONTRIBUTION 5. TOTAL POLITICAL CONTRIBUTIONS MAINTAINED AS OF THE LAST DAY $
OF REPORTING PERIOD 21O3. 170
OUTSTANDING 6, TOTAL PRINCIPAL AMOUNT OF ALL OUTSTANDING LOANS AS OF THE V
LOAN TOTALS LAST DAY OF THE REPORTING PERIOD $
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 me
under Title 15.Election Code.
,�....0e .
z :`n� KW SUMP
Notary Public, State of Texas
";• *r=Comm.Expires O8-25.201 7 Signature al Candidstefficehoider
Notary ID 10956806
f �`f
Sworn to and subscribed before me,by the said /ir'GIGL ! " [ Qrlp7 this the
day of . 20 /�' ,to certify which,witness my hand and seal of office.
l?"-A217-722 '4/1'4 AU 7L(-61/ N (rr fe
nature of off r administering oath Printed name of officer administering oath Title of officer administering oath
Forms provided by Texas Ethics Commission www.ethics.state.tx.us Revised 9/8/2015