HomeMy WebLinkAbout2016 Tompkins semi Jan CANDIDATE / OFFICEHOLDER FORM C/OH
CAMPAIGN FINANCE REPORT COVER SHEET PG 1
1 Filer ID tElhics Commission Filers) 2 Total pages tiled:
The CiOH Instruction Guide explains how to complete this form.
3 CANDIDATE! MS MRS.MR FIRST MI
OFFICEHOLDER 1� p OFFICE USE ONLY
NAME r• e�L Yit4 Date Received
NICKNAME LAST SUFFIX
�A(f(ce45 RD
JJ� CE UVI94 CANDIDATE I ADDRESS J PO SOX; APT J SUITE#; CITY; STATE. ZIP CODE
OFFICEHOLDER �+ 1MAILING !� �] [/ DEC 2 r3 TrylJADDRESS 'r4? 514G( L . fidef5 � ■ ! O }� 0
❑ Change of Address f!I I1 (�
5 CANDIDATE/ AREA CODE PHONE NUMBER EXTENSION CITY O f[
E U L t S
OFFICEHOLDER ddtivered or Date Postmarked l
PHONE ( �17 ) 27r' gWd
6 CAMPAIGN MS J MRS J MR FIRST MI Receipt # Amount $
TREASURER �/
NAME / [lf' Z-12r' Date Processed
NICKNAME LAST SUFFIX
- Date Imaged
Q11;17�
7 CAMPAIGN STREET ADDRESS (NO PO BOX PLEASEI; APT+SUITE U. CITY; STATE; ZIP CODE
TREASURER
ADDRESS �
(Residence or Business) !!t6 f�] ��`/e- ` 4
� x$ 1( 76oY6
8 CAMPAIGN AREA CODE PHONE NUMBER EXTENSION
TREASURER PHONE ( 9'7 ) a3 ?. j c7
1
9 REPORT TYPE /
pJanuary 15 El301h day before election n RunoH n 15th day alter Campaign
yam— treasurer appaimment
{Officeholder Only)
n July 15 ❑ 81h day belore election I I Exceeded$500 limit n Final Report{Attach CJOH•FR)
10 PERIOD Month Day Year Month Day Year
COVERED 7 / zQ/s- THROUGH / 2/ 3 / 2°/f
11 ELECTION ELECTION DATE ELECTION TYPE
Month Day Year ❑ Primary ❑ Runofl ❑ Other
Description
/ / I General ❑ Special
12 OFFICE OFFICE HELD ilf any) 13 OFFICE SOUGHT fd knownl
°,,Jerc 617 Gwnx4 /7ra Ga 2-
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Forms provided by Texas Ethics Commission www.ethics.state.lx.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)
5€Je iu y I� 1 rnt/cam
16 NOTICE FROM THIS BOX IS FOR NOTICE OF POLmCAL COPITRIBUTIONS ACCEPTED OR POLmCAL EXPENDITURES MADE BY POLITICAL COMMITTEES TO
POLITICAL SUPPORT THE CANDIDATE/OFFICEHOLDER. THESE EXPENDITURES MAY HAVE BEEN MADE WITHOUT THE CANDIDATES OR OFFICEHOLDER'S
COMMITTEE(S) KNOWLEDGE OR CONSENT. CANDIDATES AMU 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 ,QS
2. TOTAL POLITICAL CONTRIBUTIONS
(OTHER THAN PLEDGES, LOANS, OR GUARANTEES OF LOANS)
EXPAENDITURE 3. TOTAL POLITICAL EXPENDITURES OF $100 OR LESS,
TOT
UNLESS ITEMIZED
9. TOTAL POLITICAL EXPENDITURES
CO ANCE TRIBUTlON 5 TOTAL POLITICAL CONTRIBUTIONS MAINTAINED AS OF THE LAST DAY $ AA
OF REPORTING PERIOD
�u
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
true and correct and includes all information required to be reported by me
under Title 1 lection Code.
'''I`Iei„, KIM SUTTER //
Notary Public,State of Texas -- —
=�• •'r.Comm.Expires 08-25-201 7 Signature of Candidate or Officeholder
'r„11115,Laa i' Notary 1D 10956806
rfFf"y...Y.^YrY..�.,t. �,.W .1
Sworn to and subscribed before me,by the saki ere'fny ■ " 41I -5 ,this the 677 3
day of D.-C.-Le.,e .x,20 / 5 ...,to certify which,witness my hand and seal of office.
4 :;1
-11-1
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 9/8/2015