HomeMy WebLinkAbout2019 Martin semi January 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.
3 CANDIDATE / MS / MRS / MR FIRST MI
OFFICEHOLDER f , OFFICE USE ONLY
NAME L I Mad ^' pi°
Date Received
NICKNAME LAST SUFFIX
1:2 C [1W E mientoN
4 CANDIDATE / ADDRESS / PO BOX; APT / SUITE #; CITY; STATE; ZIP CODE D
OFFICEHOLDER 2 l ,, JAN u 8 2019
MAILING 305 La ' k t.e` '• 1 (,1. e s �?( rec39
ADDRESS
Change of Address CITY OF E U L E S
5 CANDIDATE/ AREA CODE PHONE NUMBER EXTENSION
OFFICEHOLDER // Date Hand-delivered or Date Postmarked
PHONE l 800 ) 2R.3 4- I0.3g
6 CAMPAIGN MS / MRS / MR FIRST MI Receipt # Amount $
TREASURER rTana ,.p -
NAME cc --1r Date Processed
NICKNAME LAST SUFFIX
nn` Date ImagedNACIP
7 CAMPAIGN STREET ADDRESS (NO PO BOX PLEASE); APT / SUITE #; CITY; STATE; ZIP CODE
TREASURER ' )Fi a%45 ' Z [o031
ADDRESS 0S Lz `I
( Residence or Business)
8 CAMPAIGN AREA CODE PHONE NUMBER EXTENSION
TREASURER PHONE ( Q Z� V1 ) 3 - 0.30
9 REPORT TYPE
January 15 ❑ 30th day before election Runoff I I 15th day after campaign
treasurer appointment
(Officeholder Only)
July 15 8th day before election ❑ Exceeded $500 limit ❑ Final Report (Attach C/OH - FR)
10 PERIOD Month Day Year Month Day Year
COVERED 01 / 0 i / nn? ,it � /
o i e THROUGH ' it / wig
11 ELECTION ELECTION DATE ELECTION TYPE
Month Day Year ❑ Primary ❑ Runoff ❑ Other
Description
/ / ❑ General ❑ Special
12 OFFICE OFFICE HELD (if any) 13 OFFICE SOUGHT (if known)
Major
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Forms provided by Texas Ethics Commission www.ethics.state.tx.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)
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 CANDIDATE'S OR OFFICEHOLDER 'S
COMMITTEE(S) KNOWLEDGE OR CONSENT, CANDIDATES 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
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 $
eib
(OTHER THAN PLEDGES , LOANS , OR GUARANTEES OF LOANS)
TOTALS EXPENDITURE 3 . TOTAL POLITICAL EXPENDITURES OF $100 OR LESS , $ pI�
UNLESS ITEMIZED ( �
4. TOTAL POLITICAL EXPENDITURES $ CP
CONTRIBUTION 5 TOTAL POLITICAL CONTRIBUTIONS MAINTAINED AS OF THE LAST DAY 2 3i 2 21
BALANCE OF REPORTING PERIOD
OUTSTANDING 6 . TOTAL PRINCIPAL AMOUNT OF ALL OUTSTANDING LOANS AS OF THE (�
LOAN TOTALS LAST DAY OF THE REPORTING PERIOD $ 2 31 2 1
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, Election Code.
" II''s°:pY PV�i
`� ��
° � Notary KIM Publi BUTTER
c, State of Texas
.�y. = Signature of Candi t 'ceholder
_
;;At. N Comm . Expires 08-254021
'�nnn�� Notary ID 10966806
Sworn • and subscribed before me, by the said �- I iwia 1 k 'ev2J , this the S
day o ,r RA / 20 / , to certify which, witness my hand and seal of office.
#-Cie._ N orp /l2Y pv 11 c
Sit ature of offcef 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