HomeMy WebLinkAboutBhojani 8 day 2018 amended CORRECTION/AMENDMENT AFFIDAVIT
FOR CANDIDATE/OFFICEHOLDER FORM COR-C/OH
1 Filer ID(Ethics Commission Filers) 2 ToIal pages fled;
cyJ( OFFICE USE ONLY
3 CANDIDATE I MS I MRS!MR FIRST MI Date Received
OFFICEHOLDER Mr. Salman
NAME � � J� [ ] � D
NICKNAME LAST SUFFIX
Bhojani JUN 2 6 2018 ,i
4 ORIGINAL REPORT n January 15 Runoff Other{specify) 11 '00 \
TYPE I CITY OF EULESS
nJuly 15 Exceeded$500 limit
n 30th day before election n
15th day after treasurer Date Hand-delivered or Date Past/larked
appointment(officeholder only)
XI 8th day before election n Final report Receipt# I Amount 5
5 ORIGINAL PERIOD Month Day Year Month bay Year Date Processed
COVERED
03/ 27
2018 THROUGH 04 25 / 2018 Date Imaged.
6 EXPLANATION OF CORRECTION
Please see attached.
7 AFFIDAVIT I swear,or affirm, under penalty of perjury,that this corrected
report is true and correct.
Check ONLY if applicable:
Semiannual reports: I swear,or affirm,that the original report was
made in good faith and without an intent to mislead or to misrepre-
sent the information contained in the report.
ther reports: I swear, or affirm, that I am filing this corrected
report not later than the 14th business day after the date I learned
that the report as originally filed is inaccurate or incomplete. I swear,
Ypbti+ LINDSAY WELLS or affirm, that any error or omission in the report as originally filed
' "' ya Notary Public.State or Texas was made in good faith.
1:,:51..M.14.ii Comm.Expires 05.32.2019
`H D`'� Notary ID 128603536
AFFIX NOTARY STAMP 1 SEAL ABOVE Signature o ndidate or Officeholder
Swam to and subscribed before me,by the said 5 fs\ y `'I .this the OIl.a day of ,....Tvf le,
01 , o certify which,witness my hand and seal of office.
�i aIL&L ��� \ mkt_ LrP\\E, N oT err F 1,11e,
' Ignatur• o r - , nistering oath Printed name of off er administering oath Title of officer ad inistering oath
emember To Attach Any Part Of The Campaign Finance Report Form
Needed To Report And Explain Corrections
Forms provided by Texas Ethics Commission www.ethics.state.tx.us Revised 04/27/2015
1 . The total amount on Candidate/ OfficeHolder Campaign Finance Report
Cover Sheet PG 2, Section 17 line item 2, Total Political Contributions
manintained as of the last day should be listed as $10,300.00.
2. The total amount on Candidate/ OfficeHolder Campaign Finance Report
Cover Sheet PG 2, Section 17 line item 4, Total Political Expenditures
should be listed as $5,980.58.
3.The total amount on Candidate/ OfficeHolder Campaign Finance Report
Cover Sheet PG 2, Section 17 line item 5, Total Political Contributions
manintained as of the last day should be listed as $8,344.33.
4.The total amount on Subtotals Form C/GH Cover Sheet PG 3, Section 21 line
item 1 , Schedule Al : Monetary Political Contributions, should be listed as
$10,300.00.
5.The total amount on Subtotals Form C/GH Cover Sheet PG 3, Section 21 line
item 5, Schedule Fl : Political Expenditures Made from Political Contributions,
should be listed as $5,980.58.
6.The total amount on Subtotals Form C/GH Cover Sheet PG 3, Section 21 line
item 12, Schedule K: Interests, Credits, Gains, Refund and Contributions
returned to filer, should be listed as $500.
7.Contributer listed on Schedule Al , Monetary Political Contributions as
Vincent Porter (Formerly reported as Painted Perfection), 1112 E.
Copeland Rd., Ste. 140, Arlington, TX 76011 , $500 00 contribution total
on 3/28/2018' should be removed. This contribution was already accounted
for on a report previously filed on April 5, 2018.
8. Contributer listed on Schedule Al , Monetary Political Contributions as
'Refunded to Aleem Dhanani, Suite 2212, 8561 8A Ave SE, Calgary Alberta,
Canada, -$500.00 contribution on 4/23/18' should be removed and instead
accounted for on the attached Schedule K.
9. 'Jay Boomareddy of 1003 High Hawk Trail, Euless, TX 76039, $50.00 total
contribution on 3/8/18' should be added as a contributer on Schedule Al ,
Monetary Political Contributions.
CANDIDATE / OFFICEHOLDER FORM C/OH
CAMPAIGN FINANCE REPORT COVER SHEET PG 2
14 C/OH NAME 15 Filer ID (Ethics Commission Filers)
Salman Bhojani
16 NOTICE FROM THIS BOX IS FUR 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 OFFICEHOLDER 5
COMMITTEE(S) KNOWLEDGE OR CONSENT_ CAP DATES AND OFFICEHOLDERS ARE REQUIRED TO REPORT THIS INFORMATION ONLY IF THEY RECEIVE NOTICE
OF SUCH EXPENDITURES.
COMMITTEE TYPE COMMITTEE NAME
D GENERAL
COMMITTEE ADDRESS
D 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 $
2. TOTAL POLITICAL CONTRIBUTIONS $ 10,300.00
(OTHER THAN PLEDGES, LOANS, OR GUARANTEES OF LOANS)
TOTALS EXPENDITURE 3. TOTAL POLITICAL EXPENDITURES OF $100 OR LESS, $
UNLESS ITEMIZED
4. TOTAL POLITICAL EXPENDITURES $ 5,980.58
CONTRIBUTION
BALANCE 5. TOTAL POLITICAL CONTRIBUTIONS MAINTAINED AS OF THE LAST DAY $ 8,344.33
OF REPORTING PERIOD
OUTSTANDING 6, TOTAL PRINCIPAL AMOUNT OF ALL OUTSTANDING LOANS AS OF THE
LOAN TOTALS LAST DAY OF THE REPORTING PERIOD $ 1,053.00
18 AFFIDAVIT
I swear,or affirm,under penalty of perjury,that the accompanying report is
true and correct and includes ail information required to be reported by me
under Title 15,Election Code.
Signature of Candidate or Officeholder
AFFIX NOTARY STAMP 1 SEALABOVE
Sworn to and subscribed before me, by the said this the
day of ,20 ,to certify which,witness my hand and seal of office.
Signature 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
SUBTOTALS - C/OH FORM C/OH
COVER SHEET PG 3
19 FILER NAME 20 Flier ID(Ethics Commission Filers)
Salman Bhojani
21 SCHEDULE SUBTOTALS SUBTOTAL
NAME OF SCHEDULE AMOUNT
1. SCHEDULE Al: MONETARY POLITICAL CONTRIBUTIONS $ 10 300.00
2. SCHEDULE A2: NON-MONETARY(IN-KIND)POLITICAL CONTRIBUTIONS
3. SCHEDULE B: PLEDGED CONTRIBUTIONS $
4. -g SCHEDULE E: LOANS $ 1,053.00
5. El SCHEDULE F1: POLITICAL EXPENDITURES MADE FROM POLITICAL CONTRIBUTIONS $ 5,980.58
6. SCHEDULE F2: UNPAID INCURRED OBLIGATIONS
7. SCHEDULE F3: PURCHASE OF INVESTMENTS MADE FROM POLITICAL CONTRIBUTIONS $
8. SCHEDULE F4: EXPENDITURES MADE BY CREDIT CARD
9• SCHEDULE G: POLITICAL EXPENDITURES MADE FROM PERSONAL FUNDS $
10. SCHEDULE H: PAYMENT MADE FROM POLITICAL CONTRIBUTIONS TO A BUSINESS OF C/OH $
11. El SCHEDULE I: NON-POLITICAL EXPENDITURES MADE FROM POLITICAL CONTRIBUTIONS
12. n SCHSCHEDULE K: FILER INTEREST, CREDITS,GAINS, REFUNDS,AND CONTRIBUTIONS $ SOo 00
TForms provided by Texas Ethics Commission www.ethics.state.tx.us Revised 9/8/2015
MONETARY POLITICAL CONTRIBUTIONS SCHEDULE Al
The Instruction Guide explains how to complete this form. 1 Total pages Schedule Al:
2 FILER NAME Salman Bhojani 3 Filer ID (Ethics Commission Filers)
4 Date 5 Full name of contributor out-ot-stale PAC OOP: 7 Amount of contribution ($)
6 Contributor address; City; State; Zip Code
8 Principal occupation/Job title (See Instructions) 9 Employer (See Instructions)
Date Full name of contributor ❑out of-slate PAC[Ipr. 1 Amount of contribution ($)
3/29/2018 Minhas Ladiwalla
$250.00
Contributor address; City; State; Zip Code
6572 Doonbeg Or, frisco, TX, 75035, US
Principal occupation/Job title (See Instructions) Employer(See Instructions)
Self Employed Ladiwalla Group
Date Full name of contributor ❑out-ol-slate PAC(De: I Amount of Contribution ($)
3/30/2018 Christopher Sandlin
$50.00
Contributor address; City; State; Zip Code
306 Park Crest Ave, Euless, TX, 76039, US
Principal occupation/Job title(See Instructions) Employer(See instructions)
Home Builder Christopher Sandlin Homes
Date Full name of contributor ❑out of state PAC One: ) Amount of contribution ($)
3/31/2018 Nadeem Virani
S500.00
Contributor address; City; State; Zip Code
PO BOX 630861 Irving, TX 75063
Principal occupation/Job title (See Instructions) Employer (See Instructions)
Sales Self Employed
ATTACH ADDITIONAL COPIES OF THIS SCHEDULE AS NEEDED
If contributor is out-of-state PAC,please see instruction guide far additional reporting requirements.
Farms provided by Texas Ethics Commission www.ethics.state.tx.us Revised 9/8/2015
MONETARY POLITICAL CONTRIBUTIONS SCHEDULE Al
The Instruction Guide explains how to complete this form. 1 Total pages Schedule Al:
2 FILER NAME Salman Bhojani 3 Filer ID (Ethics Commission Filers)
A Date 5 Full name of contributor 7 Amount of contribution $
0 out-vt-state PAC ItDp: I { }
4/20/2018 Al Karmali $100.00
6 Contributor address; City; State; Zip Code
10004 Broiles Lane, Fort Worth, TX, 76244, US
8 Principal occupation/Job title(See Instructions) g Employer(See Instructions)
Developer Karmali Holdings Inc
Date Full name of contributor ❑out-of-stale PAC SIDO. Amount of contribution ($)
Contributor address; City; State; Zip Code
Principal occupation/Job title(See Instructions) Employer (See Instructions)
Date Full name of contributor D out-of-state PAC lIDS: t Amount of contribution ($)
4/23/2018 James Goldie $25.00
Contributor address; City; State; Zip Code
506 Martha St, Euless, TX 76040
Principal occupation/Job title (See Instructions) Employer (See Instructions)
Customer Service Government
Date Full name of contributor ❑out of stale PAC IID# i Amount of contribution (5)
4/24/2018 Shahnawaz Hooda $500.00
Contributor address; City; State; Zip Code
105 N. Main St. Euless, TX 76040 •
Principal occupation/Job title (See Instructions) Employer(See Instructions)
Self Employed Hooda Ent Inc
ATTACH ADDITIONAL COPIES OF THIS SCHEDULE AS NEEDED
If contributor is out-of-state PAC,please see instruction guide for additional reporting requirements.
Farms provided by Texas Ethics Commission www.ethics.state.tx.us Revised 9/8/2015
INTEREST, CREDITS, GAINS, REFUNDS, AND
CONTRIBUTIONS RETURNED TO FILER SCHEDULE K
The Instruction Guide explains how to complete this form. I Total pages Schedule K: 1
2 FILER NAME 3 Filer ID (Ethics Commission Filers)
Salman Bhojani
4 Date 5 Name of person from whom amount is received 8 Amount($)
Aleem Dhanani
500.00
0412312018 6 Address of person from whom amount is received; City; State; Zip Code
Suite 2212, 8561 8A Ave SE, Calgary Alberta, Canada
7 Purpose for which amount is received 7j Check if political contribution returned to filer
Monetary Political Contribution
Date Name of person from whom amount is received Amount($)
Address of person from whom amount is received; City; State; Zip Code
Purpose for which amount is received ri Check if political contribution returned to filer
Date Name of person from whom amount is received Amount($)
Address of person from whom amount is received; City; State; Zip Code
Purpose for which amount is received ❑ Check if political contribution returned to filer
Date Name of person from whom amount is received Amount($)
Address of person from whom amount is received; City; State; Zip Code
Purpose for which amount is received ❑ Check if political contribution returned to filer
ATTACH ADDITIONAL COPIES OF THIS SCHEDULE AS NEEDED
Forms provided by Texas Ethics Commission www.ethics.state.tx.us Revised 9/1312 0 1 5
MONETARY POLITICAL CONTRIBUTIONS SCHEDULE Al
The Instruction Guide explains how to complete this form. 7 Total pages Schedule Al:
2 FILER NAME 3 Filer ID (Ethics Commission Filers(
Selman Bhojani
4 Date $ Full name of contributor lI out-of-state PAC(IDA: 7 Amount of contribution ($)
Jay Boomareddy
31281201 S 6 Contributor address: City; State; Zip Code 50.00
1003 High Hawk Trail, Euless, TX 76039
8 Principal occupation/Job title(See Instructions) g Employer (See Instructions)
Date Full name of contributor lI out-of-state PAC(ID*: Amount of contribution ($)
Contributor address; City; State; Zip Code
Principal occupation/Job title(See Instructions) Employer(See Instructions)
Date Full name of contributor out of state PAC LIDS: } Amount of contribution ($)
Contributor address; City; State: Zip Code
Principal occupation/Job title (See Instructions) Employer (See Instructions)
Date Full name of contributor out-ol-slate PAC(10e: t Amount of contribution ($)
Contributor address; City; State; Zip Code
Principal occupation 1 Job title(See Instructions) Employer (See Instructions)
ATTACH ADDITIONAL COPIES OF THIS SCHEDULE AS NEEDED
tf contributor Is out-of-state PAC,please see Instruction guide for additional reporting requirements.
Forms provided by Texas Ethics Commission www.ethics.state.tx.us Revised 9/8/2015