HomeMy WebLinkAbout2015 Tompkins semi July CANDIDATE / OFFICEHOLDER FORM C/OH
CAMPAIGN FINANCE REPORT COVER SHEET PG 1
I Filer ID(Ethics Commission Filers) 2 Total pages filed
The C/OH Instruction Guide explains how to complete this form.
1
3 CANDIDATE/ 1 MS/MRS/MR FIRST MI
OFFICEHOLDER OFFICE USE ONLY
NAME ITr• J tfeAi i /4 ZI.L�� f .,i.Gtl _
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NICKNAME LAST SUFFIX ! E c E [i w
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4 CANDIDATE/ ADDRESS !PO BOX; APT 1 SUITE# CITY, STATE, ZIP CODE J+t
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ADD SS /6,07 5�kr L�!'r'�+rC Fvc(�55 �iC 1 ��
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1 I Change of Address CITY OF EULESS
5 CANDIDATE/ AREA CODE PHONE NUMBER EXTENSION
OFFICEHOLDER ! Date Rand-delivered or Dale Postmarked
PHONE ( ��� �� o�.�ry
6 CAMPAIGN MS 1 MRS 1 MR FIRST MI Receipt# Amount 5
TREASURER �Yl�] /y,r,�
NAME ��/� W , , , Date Processed
NICKNAME LAST SUFFIX
Date imaged
;Aipr.44s
7 CAMPAIGN STREET ADDRESS (NO PO BOX PLEASE), APT 1 SUITE#. CITY. STATE. DP CODE
TREASURER
ADDRESS(Residence or Business) /(Q.* �7v ! S'9yCr '/e s rx 7(pOy6
8 CAMPAIGN AREA CODE PHONE NUMBER EXTENSION
TREASURER PHONE ( %r7 ) a3 3 - 5-574
9 REPORT TYPE
n January 15 n 30th day before election Runoff n 15th day after campaign
treasurer appointment
(Orficerolder Only)
Xi' July 15 ❑ 8111 day before election n Exceeded MOD limit 0 Final Report(Attach C/OH-FR)
la PERIOD Month Day Year MMonth/ Day Year
COVERED / / / pis THROUGH v / 3°/ �lr
/
YI ELECTION ELECTION DATE I ELECTION TYPE
Month Day Year ID primaryI Runoff ❑ Other
Description
/ / ❑ General ❑ Special
12 OFFICE OFFICE HELD (if any) I
13 OFFICE SOUGHT fit known)
144 6r7
/ess Cvkilur r T p/4Ca 2.
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Forms provided by Texas Ethics Commission www.ethics.state.tx.us Revised 02/27/2015
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CANDIDATE 1 OFFICEHOLDER
FORM cJOH
CAMPAIGN FINANCE REPORT COVER SHEET PG 2
- - - .. _ --- --_..___ .. 'l
14 C/OH NAME 15 Filer ID (Ethics Commission Filers)
Se/e d ' 7 m04;ors
16 NOTICE FROM THIS BOX IS FOR NOTICE OF POLITICAL CONTRIBUTIONS ACCEPTED OR POLITICAL EXPENDITURES MADE BY POLITICAL COMMITTEES TO
POLITICAL SUPPORT THE CANDIDATE I OFFICEHOLDER. THESE EXPENDITURES MAY HAVE BEEN MADE WITHOUT THE CANDIDATE'S OR OFFICEHOLDERS
COMMITTEE(S) KNOWLEDGE OR CONSENT. CANLSOATES 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
n 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 $ lef
2. TOTAL POLITICAL CONTRIBUTIONS $
(OTHER THAN PLEDGES, LOANS, OR GUARANTEES OF LOANS)
TOTALSEXPENDITURE 3 TOTAL POLITICAL EXPENDITURES OF $100 OR LESS.
$
UNLESS ITEMIZED y
4. TOTAL POLITICAL EXPENDITURES $
re
CONTRIBUTION 5 TOTAL POLITICAL CONTRIBUTIONS MAINTAINED AS OF THE LAST DAY 17
BALANCE OF REPORTING PERIOD 7O.
OUTSTANDING 6. TOTAL PRINCIPAL AMOUNT OF ALL OUTSTANDING LOANS AS OF THE
LOAN TOTALS LAST ❑AY OF THE REPORTING PERIOD $ pr
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 15, kection Code.
•
,,,,
SG...Caw LINDSAY WELLS
_ • _ Notary Public.Slate or Texas
My Commission Expires%
May02, 2019.,.� ..0-$ Si nature of Candidate or Officeholder
AFFIX NOTARY STAM P I SEAL ABOVE
Sworn to and subscribed before me, by the said J-e,_ --caf15 ,this the •0
y of '}t.)1 ,20 15 ,to certify which, witness and and seal of office.
al\\ tAl c,r61.3
ti,-.0151,
_,,,A _ N. 4&,_ ()Qui C..,
Signatu off. r administerng oath Printed nam of fflcer administering oath Title of co ce administering oath
Forms provided by Texas Ethics Commission www.ethics.state.tx.us Revised 02/27/2015 •