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HomeMy WebLinkAbout2017 Tompkins semi Jan 1 • CANDIDATE / OFFICEHOLDER FORM C/OH CAMPAIGN FINANCE REPORT COVER SHEET PG 1 1 Filer ID ;E'hics Commission Filers' 2 Total pages tiled The C;OH Instruction Guide explains how to complete this form. 3 CANDIDATE, MS MRS•MA MI OFFICEHOLDER ' rEA OFFICE USE ONLY NAME '. Darn Aecffi•,ed NICKNAME SIJFFIii�. 4 4.01004.17 3 © [I V/ ,Iiiiiiiiiiiii 4 CANDIDATE' ADDRESS 'PO 50x APT'SUITE u CITY STATE. ZIP •' D . OFFICEHOLDER JAN 0 6 2017 MAILING �]� ADDRESS Ol ii Dr.'" ( ' 1 I change of Address �� ���G ale CC � CITY OF EUL 5 5 CANDIDATE: AREA CODE PHONE NUMBER EXTENSION PHONE OFFICEHOL DFR ��y } 7 r J b Dale Hard-dclwerad or Dale Posrrnarki d 6 CAMPAIGN (MS'MRS,MR FIRHT ul Receipt a Amount S TREASURER [.s r? M NAME�, . , . , . . Dale Processed NICKNAME -AST SUFFIX er4 Hs Date Imaged 7 CAMPAIGN STREET ADDRESS ;NO PO BOX PLEASE;: APT SUITE IS CITY, STATE ZIP CODE TREASURER ADDRESS I�57 5f'�+7C71 � c vt EA, 5; 2( f'o (Residence or Business) r 8 CAMPAIGN AREA CODE PHONE NUMBER EXTENSION TREASURER p PHONE `( r!r (r7 ) 3 7- r5-7 ' 9 REPORT TYPE 1,4 January 15 n 30th day beldre election u Runotl ❑ 15th day after campaign treasurer appointment Olticohokier Only; July 15 n Sth day Pelore election Exceeded$500 limit Final Report Attach CdOH FR1 10 PERIOD ulontn Day Year Montt' Day Year COVERED 0'7 / ❑ I f Zo I io THROUGH IZ/ 3 f/ ZO/b 11 ELECTION ELECTION DATE ELECT ON TYPE Month Day Year I Pr•mary I Ronal ❑ Other Description ` ` E Cannel E Special 12 OFFICE OFFICE/HELD [rf any) 13 OFFICE SOUGHT ;lf Ivrownl 1 & e Oki towed ?/4 Z I GO TO PAGE 2 Forms provided by Texas Ethics Commission www.ethics.state.tx.t.s Revised 9'8 2015 • CANDIDATE / OFFICEHOLDER FORM C/OH CAMPAIGN FINANCE REPORT COVER SHEET PG 2 14 C.OH NAME 15 F lei ID Ethics Comm ssion Fliers) 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 MAY HAVE BEEN MADE WITHOUT THE CANDIDATES OR OFFICEHOLDERS COMMITTEE(S) KNOWLEDGE OR CONSENT. CANDIDATES ANC OFFICEHOLDERS ARE REQUIRED TO REPORT THIS INFORMATION ONLY IF THEY RECEIVE NOTICE OF SUCH EXPENDITURES. COMMITTEE TYPE COMMITTEE NAME GENERAL COMM TTEE ADDRESS SPECIFIC COMMITTEE CAMPAIGN TREASURER NAME n Add i oral Pages COMMITTEE CAMPAI CN TREASURER ADDRESS 17 CONTRIBUTION 1. TOTAL POLITICAL CONTRIBUTIONS OF $50 OR LESS (OTHER THAN �f TOTALS PLEDGES. LOANS. OR GUARANTEES OF LOANS). UNLESS ITEMIZED ^' 2. TOTAL POLITICAL CONTRIBUTIONS $ ty (OTHER THAN PLEDGES. LOANS. OR GUARANTEES OF LOANS K� TXOPAENDITURE LS 3 TOTAL POLITICAL EXPENDITURES OF S100 OR LESS, $ UNLESS ITEMIZED +`' 4. TOTAL POLITICAL EXPENDITURES $ ger BACONTRIBUTION 5. $ TOTAL POLITICAL CONTRIBUTIONS MAINTAINED AS OF THE LAST DAY I 7 r] OF REPORTING PERIOD {p �❑ I OUTSTANDING 6 TOTAL PRINCIPAL AMOUNT OF ALL OUTSTANDING LOANS AS OF THE LOAN TOTALS LAST DAY OF THE REPORTING PERIOD $ 18 AFFIDAVIT !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 LINDSAY WELLS under Title 15,E tion Code :ro`' r'jfi;:Notary public,Stare of :�, 7K• Comm.ExplteS 35.02•2019 Notdty 4f} 128603636 yig lure ❑f Candidate or Officeholder AFFIX NOTARY STAMP SEALABOVE Sworn to and subscribed before me,by the said this the day of t] 20 1 _,to certify which,witness and and seal of office. 1 � P1-) c Signature of nffi .r administering oath Printed na o officer administering oath Title of nffi ei administering oath Forms provided by Texas Ethics Commission www.ethics.state.tx.us Revised 9.8.2015