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Texas Ethics Commission P.O Box 12070 Austin,Texas 78711-2070 (512)463-5800 (TDD 1-800-735-2989)
CANDIDATE / OFFICEHOLDER FORM C/OH
CAMPAIGN FINANCE REPORT COVER SHEET PG 1
1 ACCOUNT# 2 Total pages filed
The CIOH Instruction Guide explains how to complete this form. (Ethics Commission Filers) 3
3 CANDIDATE / Ms/MRsrMR FIRST MI
OFFICEHOLDERM �{ OFFICE USE ONLY
NAME "if. lcrC►tfY A o••rl--
NICKNAME LA,'-T SUFFIX
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4 CANDIDATE / ADDRESS IPOBOX; APT I SUITE AI. CITY; STATE. ZIP CODE -. L1 f}N 3 0
apt
OFFICEHOLDER AN
MAILING
ADDRESS
'6 b �t ateH`nd-deelllyeeredorPostmamee
change of address 7 Sipe?'
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5 CANDIDATE/ AREA CODE PHONE NUMBER EXTENSION
OFFICEHOLDER NE L U 7 xessee
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6 CAMPAIGN MS/MRSIMR FIRST MI Date Imaged
TREASURER NAME i `/jJ
fs ' Gar; A
NICKNAME LAST SUFFIX
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7 CAMPAIGN STREET ADDRESS(NO PO BOX PLEASE), APT I SUITE OP. CITY, STATE, ZIP CODE
TREASURER
ADDRESS
(residence or business) /IP 07 51 y 4 e f A-` ,leo. - , 740 Y0
H CAMPAIGN AREA CODE PHONE NUMBER EXTENSION
TREASURER PHONE ( p O'7} 3 3- 5,c7(
9 REPORT TYPE Li January 15 ❑ 30th day before election ❑ Runoff Y campaign 15th da after cam ai
treasurer appointment
{officeholder only)
gJuly 15 ❑ Blh day before election ❑ Exceeded 5500 n Final report(Attar,UCH•FR)
limit
10 PERIOD Month Day war Morin Day Year
COVEREDDS— / p + / 2 oiy THROUGH
° 6 / 3 D/ zaiy
11 ELECTION ELECTION DATE ELECTION TYPE
Montl'r [>ap' Year El Primary I Ru•nR General XI E SFecal
t T/ i /VDrY I 1
12 OFFICE OFFICE HELD(deny) 13 OFFICE SOUGHT (if known}
t.f let.J C i4 Cat t.:I ?/a . 2
GO TO PAGE 2
www,ethics.state.tx.us Revised 04/19/2013
Texas Ethics Commission P.O-Box 12070 Austin,Texas 78711-2070 (512)463-5800 (TDO 1-800-735-2989)
1
CANDIDATE / OFFICEHOLDER REPORT: FORM C/OH
SUPPORT & TOTALS COVER SHEET PG 2
14 C/OH NAME �» 15 ACCOUNT# (Ethos Commission Filers)
.SPf y err
15 NOTICE FROM THIS BOX IS FOR NOTICE OF POLITICAL CONTRIBUTIONS ACCEPTED OR POLJTICAL EXPENDITURES MADE BY POLITICAL COMMITTEES To SUPPORT THE
POLITICAL CANDIDATE I OFFICEHOLDER. THESE E7(PENDITURES MAY HAVE BEEN MADE VATNOUT THE CANDIDATES OR OFFICEHOLDERS KNOWLEDGE OR
COMMITTEE(S) CONSENT:CANDIDATES AND OFFICEHOLDERS ARE REQUIRED TEl REPORT THIS INFORMATION ONLY IF THEY RECEIVE NOTICE OF SUCH EXPENDITURES.
COMMITTEE NAME
COMMITTEE TYPE
0 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)
EXPENDITURE — --TOTALS 3. TOTAL POLITICAL EXPENDITURES OF$100 OR LESS, UNLESS ITEMIZED $
4. TOTAL POLITICAL EXPENDITURES $ ?7.7 SY
CONTRIBUTION 5 TOTAL POLITICAL CONTRIBUTIONS MAINTAINED AS OF THE LAST DAY BALANCE OF REPORTING PERIOD $ 4 ? p �]Q I 1
I ���PPPP
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 co ct and includes all information required to be reported by
•r r�,,.S. UNDSAY WELLS me un itl 15,Election Code.
}� =s , Notary FuEliC
STATE OF 2
sr g e;Commission Exp'irrTOOS1p411016
Signature of Candidate or Officeholder
AFFIX NOTARY STAMP I SEAL ABOVE
Sworn to and subscribed before me, by the said —11pLlf\ , this the
day of , 20 1 I , to ce�rtifydhich, witness my hand and seal of office.
Signature o inistering oath Printed name of offi r administering oath Title of officer administenng oath
www.ethics.state.tx.us Revised 04/19/2013
Texas Ethics Commission P.O.Box 12070 Austin,Texas 78711-2070 (512)463-5800 (TDD 1-800-735-2989)
POLITICAL EXPENDITURES SCHEDULE G
MADE FROM PERSONAL FUNDS
EXPENDITURE CATEGORIES FOR BOX s(a)
Advertising Expense Gift/Awards/Memorials Expense SeleriesNVages/Contract Labor Loan Repayment/Reimbursement
Accounting/Banking Legal Services Solicitation/Fundraising Expense Transportation Equipment&Related Expense
Consulting Expense Food/Beverage Expense Travel In District Contributions/Donations Made By
Event Expense Polfing Expense Travel Out Of District Candidate/Officeholder/Political Committee
Fees Printing Expense Office Overhead/Rental Expense OTHER (enter a category not listed above)
The Instruction Guide explains how to complete this form.
1 Total pages Schedule G: 2 FILER NAME 3 ACCOUNT# (Ethics Commission Filers)
4 Data 5 Payee name
slag 46/K Home 2p Veit
B Amount (S) 7 Payee address; City; State; Zip Code
r—/mbursement from 75-1 5'. ,Cy,��os , !iC 7a 0yD
political contributions r�
intended
H PURPOSE (a) Category (See categories listed ai the top of this schedule) (b) Description (If travel outside of Texas.complete Schedule T)
OF �/ �1 f�fa c�a
EXPENDITURE dv N sr 47 fy/,)eid I 7 1f vacIm 7a' iltcil'Otr
Date Payee name �/
Amount ($) Payee address; City; State; Zip Cade
Reimbursement hem
1 political contributions
intended
PURPOSE Category (See categories fisted at the top or this schedule) Description of travel outside of Texas.complete Schedule Tj
OF
EXPENDITURE
Date Payee name
Amount (S) Payee address; City; State; Zip Cade
Reimbursement from
1 politicalcontnbuuons
mended
PURPOSE Category (See categories listed at Inc top of this schedule) Descnption {If travel outside of Texas,complete ScheduleT)
OF
EXPENDITURE
Date Payee name
Amount ($) Payee address; City; State; Zip Code
Reimbursement
1 political contributionfroms
intended
PURPOSE Category (See categories listed at the top of this schedule) Description (if travel outside of Texas.complete Schedule Ti
OF
EXPENDITURE
ATTACH ADDITIONAL COPIES OF THIS SCHEDULE AS NEEDED
www.ethics.state.tx.us Revised 04/19/2013