HomeMy WebLinkAbout2017 Price semi January 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 MR 'MR FIRST MI
OFFICEHOLDER ti OFFICE USE ONLY
NAME
Dale Received
NICKNAME LAST SUFFIX
4 CANDIDATE/ ADDRESS /PO BOX; APT:SUITE E. CITY; STATE; ZIP CODE I.q] k
,a7
MAIL NG OFFICEHOLDER L � �. n _ , ^�' ' "--((
L �Q yq� r L�
ADDRESS �,r�
❑ Change of Address T.a 0 L 0
5 CANDIDATE/ AREA CODE PHONE NUMBER EXTENSION
PHONEOFFICE HOLDER (7 1 7 ) Zgz._ S7 r� Dale Hand-delivered or Date Postmarked
6 CAMPAIGN M i MR MR FIRST] µl Recetpl # Amounl $
TREASURER
NAME � I Dale Pracessed
NICKNAME LAST SUFFIX
Date Imaged
r1u-
7 CAMPAIGN STREET ADDRESS (NO PO BOX PLEASE): APT r SUITE 4; CITY; STATE; ZIP CODE
TREASURERDSS y i�
ADDRESS ll 1C7L�+1/181q� l •��j I �]� • �(o0
(Residence or Business) (]
8 CAMPAIGN AREA CODE PHONE NUMBER EXTENSION
TREASURER PHONE l` b{ 7 ) 2. 2_ -S 57 5 7
1 7
9 REPORT TYPE
[ January 15 3Rth day before election n Runoff n 15th day after campaign
�� treasurer appointment
(Officeholder Only)
July 15 ❑ Sib day before election ❑ Exceeded$5001imit n Final Report(Attach CIOH-FR)
10 PERIOD Month Day Year Month/ Day Year
COVERED 0-7/ L / t C THROUGH o� I S A 7
11 ELECTION ELECTION DATE ELECTION TYPE
Month Day Year ❑ Primary ❑ Runoff ❑ Other
5 Description
/ D-7/ } !� lg General ❑ Special
12 OFFICE OFFICE HELD lif any)f fYYY`����'"' 13 OFFICE SOUGHT lit known)
55 C-11 ("A 1 , \,
} Pia 3
I
,
GO TO PAGE 2
Forms provided by Texas Ethics Commission www.ethics.state.tx.us Revised 918/2U 5
•
CANDIDATE I OFFICEHOLDER FORM C/OH
CAMPAIGN FINANCE REPORT COVER SHEET PG 2
14 C/OH NAME 115
Filer ID {EthicsCommission Filers)----,ck,.i jy--k e--12...--
16 NOTICE FROM THIS BOX IS FOR Na77CE OF POLmCAL CONTRIBUTIONS ACCEPTED OR POLITICAL EXPENDITURES MADE BY POLITICAL COMMITTEES TO
POLITICAL SUPPORT THE CANDIDATE I OFFICEHOLDER. THESE EXPENDITURES MAY HAVE BEEN MADE WITHOUT THE CANDIDATES OR OFFICEHOLDER'S
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
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 $ -
2. TOTAL POLITICAL CONTRIBUTIONS
$
(OTHER THAN PLEDGES. LOANS, OR GUARANTEES OF LOANS) —___ 0
EXPENDITURE 3. TOTAL POLITICAL EXPENDITURES OF $100 OR LESS, $
TOTALS UNLESS ITEMIZED — U
_,
4. TOTAL POLITICAL EXPENDITURES $ !7
CONTRIBUTION 5. TOTAL POLITICAL CONTRIBUTIONS MAINTAINED AS OF THE LAST DAY V
BALANCE 4-2 30
OF REPORTING PERIOD r
OUTSTANDING 6. TOTAL PRINCIPAL AMOUNT OF ALL OUTSTANDING LOANS AS OF THE
LOAN TOTALS LAST DAY OF THE REPORTING PERIOD 0
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 Tit e
•"""',,,, KIM SUTTER SG'
5,Election C
e x ..S s Notary Public.Slate of Texas
r.%. 'T Comm.Expires 08-25-201 7
.(...-diLL:f 4-1—\"N.,
'a,,,;,,,,,.•• NOtaty ID 1 0956606
Signature of Candidate Gr ficeholder
AFFIX NOTARY STAMP;SEALABOVE
Sworn to and subscribed before me,by the said E.as 1- PC1 C.s_— ,this the /,,
day ofz:z ,to certify which,witness my hand and seal of office.
2
74f;141. 6C-7 7/71Cf- -
Si nature of officer 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 91812G15