HomeMy WebLinkAbout2016 Price 30 day CANDIDATE / OFFICEHOLDER FORM C/OH
CAMPAIGN FINANCE REPORT COVER SHEET PG 1
1 Filer IC)(Ethics Commission Flers) 2 Total pages filed:
The C/OH Instruction Guide explains how to complete this form. r
3 CANDIDATE/ Ms MR 'MR FIRST MI
NAMEOFFICEHOLDER E ci 3.`
OFFICE USE ONLY
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NICKNAME LAST SUFFIX � n � D
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4 CANDIDATE/ ADDRESS +PO BOX; APT SUITE A: CITY: STATE; ZIP CODE APR OS 2016 f�
OFFICEHOLDER , �11 pA `"� 7 r
MAILING 140� `a.9 j r k C1 r, u s5 •tom 16 C' '�
ADDRESS ` CITY OF EULESS
❑ Change o1 Address
-
5 CANDIDATE/ AREA CODE PHONE NUMBER EXTENSION Q R r•4QQ-2cC-,&
PHONE l fOFFICEHOLDER ( 0 ) zv(._, r 5 7 S? Dale Hand delivered or Date Paslmarked
6 CAMPAIGN MS MRS MR FIRST MI Receipt V Amount $
TREASURER
NAME F(c 7I. t Date Processed
NICKNAME LAST SUFFIX
�] ti Date Imaged
C 8.-1
7 CAMPAIGN STREET ADDRESS (NO PO BOX PLEASE); APT 1 SUITE p; CITY; STATE; ZIP CODE
TREASURER ADDRESS �+ WOO
OO r;I*r ,S C r, - cs l�T'-
d
b �-
(Residence or Business) a
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8 CAMPAIGN AREAr !COOD }CODE PHONE NUMBER EXTENSION
PHONE TREASURER o ( Z 5 757
9 REPORT TYPE
❑ January 15 IX1 30th day before election ❑ Runalf 15th day after campaign
treasurer appointment
(Officeholder Only)
July 15 n 8th day before election Exceeded$500limit n Final Report(Attach C+OH-FRI
10 PERIOD Month Day Year Month Day Year
COVERED 2 q /`
k�
0 1 LO THROUGH / L
11 ELECTION ELECTION DATE ELECTION TYPE
Month Day Year ❑ Primary ❑ Runoff ❑ Other
Description
05/01 / 1IL ® General ❑ Special
12 OFFICE OFFICE HELD (il any) 13 OFFICE SOUGHT (if known) ,
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Forms provided by Texas Ethics Commission] www.ethics.state.tx.us Revised 9.18.'2015
CANDIDATE / OFFICEHOLDER FORM C/OH
CAMPAIGN FINANCE REPORT COVER SHEET PG 2
14 C/OH NAME 15 Filer ID (Ethics Commission Filers)
as KEY lice,
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 HAY HAVE BEEN MADE WITHOUT THE CANDIDATES OR OFFICEHOLDERS
COMMITTEE(S) KNOWLEDGE OR CONSENT. CANDIDATES AND OFFICEHOLDERS ARE REQUIRED TO REPORT THIS INFORMATION ONLY IF THEY RECEIVE NOTICE
OF SUCH EXPENDITURES.
COMM•1 TEE TYPE COMMITTEE NAME
▪GENERAL
COMMITTEE ADDRESS
▪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 Q `
2. TOTAL POLITICAL CONTRIBUTIONS �*]
(OTHER THAN PLEDGES, LOANS, OR GUARANTEES OF LOANS) $ J G, 00
•
7 �
TOTALS ENDITURE 3. TOTAL POLITICAL EXPENDITURES OF $100 OR LESS,
UNLESS ITEMIZED --
4. TOTAL POLITICAL EXPENDITURES $ - - 0
CONTRIBUTION 5 TOTAL POLITICAL CONTRIBUTIONS MAINTAINED AS OF THE LAST DAY $ J 5 00
BALANCOF REPORTING PERIOD
OUTSTANDING 6. TOTAL PRINCIPAL AMOUNT OF ALL OUTSTANDING LOANS AS OF THE
LOAN TOTALS LAST DAY OF THE REPORTING PERIOD
18 AFFIDAVIT
I swear,or affirm,under penalty of perjury,that the accompanying report is
I true and correct and includes all information required to be reported by me
p.,�'.,,• MOLLIE SNAPP under Title 15,Election Code.
fr• 4=Notary Public,Stale of Texas
y' of tii+ts Comm.Expires O .05 2019 7
Nataly ID 130321757 t
Signature of Candidate or Officeholder
AFFIX NOTARY STAMP I SEAL ABOVE
Sworn to and subscribed before me,by the said dd.l.0 PA e. ,this the
day of Prp1f11 ,20 (L r ,to certify which,witness my hand and seal of office.
oll,►_.c. S Q Par►►►►tnEtrectIVc-�
Signature of officer 'staring 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
SUBTOTALS - C/OH FORM C/OH
COVER SHEET PG 3
19 FILER NAME 20 Filer ID(Ethics Commission Filers)
21 SCHEDULE SUBTOTALS SUBTOTAL
NAME OF SCHEDULE AMOUNT
1. P17 SCHEDULE Al: MONETARY POLITICAL CONTRIBUTIONS $ 7 5, OD
2. ❑ SCHEDULE A2: NON-MONETARY(IN-KIND)POLITICAL CONTRIBUTIONS $
3. ❑ SCHEDULE B: PLEDGED CONTRIBUTIONS $
4. ❑ SCHEDULE E: LOANS $
5• 0 SCHEDULE F1: POLITICAL EXPENDIT URES MADE FROM POLITICAL CONTRIBUTIONS $
6. 0 SCHEDULE F2: UNPAID INCURRED OBLIGATIONS $
7• SCHEDULE F3: PURCHASE OF INVESTMENTS MADE FROM POLITICAL CONTRIBUTIONS $
0. SCHEDULE F4: EXPENDITURES MADE BY CREDIT CARD $
9. 0 SCHEDULE G: POLITICAL EXPENDITURES MADE FROM PERSONAL FUNDS $
10. 0 SCHEDULE H: PAYMENT MADE FROM POLITICAL CONTRIBUTIONS TO A BUSINESS OF C/OH $
11. 0 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 918/2015
MONETARY POLITICAL CONTRIBUTIONS SCHEDULE Al
i
The Instruction Guide explains how to complete this form. 7 Total pages Schedule Al:
2 FILER NAME 3 Filer ID (Ethics Commission Filers}
die u 1Prime
4 Date 5 Full name of contributor 0 aui-of-state PAC(IDLY: 5 7 Amount of contribution ($)
Gt reci, r R n e►NI 7 5. 0❑
6 Contribu ad ress; City; State; Zip Code
Z010 Cu i r'✓1(u Cr655 to
N)C 7 5 zza -Z 31 a
8 Principal occupation/Job title(See Instructions) 9 Employer (See lnstrtftions)
'rekfle Covtin At\t A-11QC6 .. D'15054�
Date Full name of contributor ❑out•of-stale PAC(al: Amount of contribution ($)
Contributor address; City; State; Zip Code
Principal occupation/Job title(See Instructions) Employer(See Instructions)
Date Full name of contributor 0 out-at-stale PAC(IBC _ 1 Amount of contribution ($)
Contributor address; City; State; Zip Code
Principal occupation 1 Job title(See Instructions) Employer (See Instructions)
Dale Full name of contributor 0 out-of-state PAC(IDS: Amount of contribution ($)
Contributor address; City; State; Zip Code
Principal occupation 1 Job title(See Instructions) Employer (See Instructions)
ATTACH ADDITIONAL COPIES OF THIS SCHEDULE AS NEEDED
If contributor 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