1. 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 ' I
1 ACCOUNT# 2 Total pages fifed:
The CIOH Instruction Guide explains how to complete this form. Ethics Commission Filers)
3 CANDIDATE ! MSIMRS yR) FIRST MI
OFFICE USE ONLY
OFFICEHOLDER
NAME JQ,,reryt 4 DataR
w
NICKNAME LAST SUFFIX
0 C
ii lr MAY 01 2015
4 CANDIDATE ! ADDRESS IPOBOX; APTISUITEk CITY. STATE: ZIP CODE
OFFICEHOLDER
CITY SECRETARYMAILING I]
Date Hand-delivered or Postmarked
ADDRESS
J OL iV
itchange of address
0 Receipt# Amount
5 CANDIDATE/ AREA CODE PHONE NUMBER EXTENSION
OFFICEHOLDER / Date Processed
PHONE
6 CAMPAIGN MRSIMR FIRST MI Date Imaged
TREASURER
01,C+NAME
NICKNAME LAST SUFFIX
Yl o ( I. S
7 CAMPAIGN STREETADORESS( NOPOBOXPLEASE)', APTISUiTE#, CITY, STATE; ZIP CODE
TREASURER
ADDRESS
1 ^
residence or business) Qt`-`
8 CAMPAIGN AREA CODE PHONE NUMBER EXTENSION
TREASURER l
n(
PHONE
y C] l^
DO
9 REPORT TYPE
January 15 301h day before election Runoff 15th day after campaign
treasurer appointment
officeholderonly)
July 15
CR 8th day before election Exceeded$ 500 Finat report( Attach CIOH- FR)
limit
10 PERIOD Month Dey Year Month Day Year
COVERED
L THROUGH
11 ELECTION ELECTION DATE
ELECTION TYPE
Month Day Year
Primary Runo
t
ff General Special
12 OFFICE OFFICE HELD( if any) 13 OFFICE SOUGHT ( if known)
GOTOPAGE2
www.ethics. state. tx. us
Revised 07/2812014
2. Texas E= thics Commission P.O. Box 12070 Austin, Texas 78711- 2070 512) 463- 5800 ( TDD 1- 800-735-2989)
CANDIDATE / OFFICEHOLDER REPORT: FORM C/ OH
SUPPORT & TOTALS COVER SHEET PG 2
14 C/ OH NAME 15 ACCOUNT# ( Ethics Commission Filers)
16 NOTICE FROM
THIS BOX IS FOR NOTICE OF POLITICAL CONTRIBUTIONS ACCEPTED OR POLITICAL EXPENDITURES MADE BY POLITICAL COMMITTEES TO SUPPORT THE
POLITICAL CANDIDATE I OFFICEHOLDER. THESE EXPENDITURES MAY HAVE BEEN MADE WITHOUT THE CANDIDATES OR OFFICEHOLDER' S KNOWLEDGE OR
COMMITTEE( S) CONSENT. CANDIDATES AND OFFICEHOLDERS ARE REQUIRED TO REPORT THIS INFORMATION ONLY IF THEY RECEIVE NOTICE OF SUCH EXPENDITURES.
COMMITTEE NAME
COMMITTEE TYPE
GENERAL
COMMITTEE ADDRESS
SPECIFIC
COMMITTEE CAMPAIGN TREASURER NAME
0 additional pages
COMMITTEE CAMPAIGN TREASURER ADDRESS
17 CONTRIBUTION
1 TOTAL POLITICAL CONTRIBUTIONS OF$ 50 OR LESS( OTHER THAN
Q@
TOTALS PLEDGES, LOANS, OR GUARANTEES OF LCANS), UNLESS ITEMIZED $
S
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 EXPENDITURE=S
C)
CONTRIBUTION
5 TOTAL POLITICAL CONTRIBUTIONS MAINTAINED AS OF THE LAST DAY
BALANCE
OF REPORTING PERIOD
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 p tty of perjury, that the accompanying report
is true and correct an
udes all information required to be reported by
AMM HA
me under Title 16 ction Code.
s NAY Public
STATE OF TEXASP
MyC un,
Bxp, lzRoy18. 2QI4
Signature of Candidate or Offceholder/
oc
AFFIX NOTARY STAMP I SEAL ABOVE t
Sworn to and subscribed before me, by the said this the
day of 20 certify which, witness my hand and seat of office.
Sig re of officer ad ministering oath Printed name of of r-eradrninisteringoath Titi fo
www. ethics. state. tx. us
Revised 0712812014
3. Texas Ethics Commission P.O. Box 12070 Austin, Texas 78711- 2070 512) 463- 5800 ( TDD 1- 800- 735- 2989)
POLITICAL CONTRIBUTIONS
SCHEDULE A
OTHER THAN PLEDGES OR LOANS
The Instruction Guide explains how to complete this form.
1 Total pages Schedule A:
2 FILER NAME
0
3 ACCOUNT# ( Ethics Commission Filers)
4 Date 5 Full name of contributor out- of-state PAC([ D#: i 7 Amount of 8 In- kind contribution
contribution ($)
I
description ( if applicable)
J 6 Contributor address; City; State; Zip Code
If travel outside of Texas, complete Schedule T)
Principal occupation / Job title ( See Instructions) 10 Employer( See Instructions)
Date Full name of contributor out- of-state PAC( to* S Amount of I In- kind contribution
1 Q
contribution ($)
I
description ( if applicable)
V
Contributoraddress; City; State; Zip Code I
If travel outside Of Texas, complete Schedule T)
Principal occupation!, lob title ( See Instructions) Employer ( See Instructions)
Date mull name of co tar out- of- state PAC( ID# 1 Amount of In- kind contribution
1 0 tr)Q
contribution ($} + description ( if applicable)
Contributor address; City; State; Zip Code
305 orb
r fN'x .1Sao
t
If travel outside of Texas, complete Schedule T)
Principal occupation / Job title ( See Instructions) Employer ( See Instructions)
Date Full name of contributor out- of- state PAC QD9- Amount of I In- kind contribution
contribution ($)
I
description ( if applicable)
L4 I
Contributor address; City; State; Zip Code
t'( avel outside If Texas complete Schedule
Principal occupation! Job title ( See Instructions) Employer ( See Instructions)
Date Full name of contributor out- of-state PAC p09 Amount of I In- kind contribution
contribution ($)
f description ( if applicable)
L/
Cantrib uttolr address; City`; State; Zip Code II
f travel outside of Texas, = plele Schedule
Principal occupation / Job title ( See Instructions) Employer ( See Instructions)
ATTACH ADDITIONAL COPIES OF THIS SCHEDULE AS NEEDED
If contributor is out-of-state PAC, please see instruction guide foradditional reporting requirements.
www. ethics. state. tx. us Revised 0 712 812 01 4
4. Texas Ethics Commission P.O. Box 12070 Austin Texas 78791- 2070 512) 463- 5800 ( TDD 1- 800-735-2989)
POLITICAL CONTRIBUTIONS
OTHER THAN PLEDGES OR LOANS
SCHEDULE A
The Instruction Guide explains how to complete this form.
1 Total pages Schedule A:
2 FILER NAME 3 ACCOUNT# ( Ethics Commission Filers)
4 Date 5 Full name of contributor nut- of- state PAC{ I#: 7 Amount of 8 In- kind contribution
contribution ($)
I
description ( if applicable)
6 Contributor address; City; State; Zip Code
Z t 3bIl
If travel outside of Texas, complete Schedule T)
9 Principal occupation / Job title ( See In ructions) 10 Employer( See Instructions)
Date Full name of contributor out- of- state PAC( 0* Amount of I In- kind contribution
j,
u
p _/] contribution ($)
I
description ( if applicable)
r Conptributor address';} City; State; Zip Code Aa
Lj
If travel outside of Texas, complete Schedule T
Principal occupation I Job title ( See Instructions) Employer( See Instructions)
Date Full name of contributor out-of-stale PAC( ID* Amount of
I In- kind contribution
fY t
Cl--d( A V—q S 5
contribution ($)
I
description ( if applicable)
t Contributor address; City; State; Zip Code
a QC. V_b_kf L'-
n S c_b ` 3
I
pIf travel outside of Texas, complete Schedule T
Principal occupation 1 Job title( See Instructions) Employer( See Instructions)
Date Full name of contributor out- of- statePAC( Oft: Amountof I In- kind contribution
i'..§fdd're_--i-
contributio n {$) description ( if applicable)
GontCity; State; Zip Code
If travel outside of Texas complete Schedule T)
P ' cipal occupation! Job title ( See instructions) Employer ( See Instructions)
13--
Date Full name of contributor out- of-state PAC( Idlt Amount of In- kind contribution
contribution ($)
I
description ( if applicable)
Contributor address; City; State; Zip Code
I
I
If travel cutslde of Texas com late Schedule T
Principal occupation ! Job title ( See Instructions) Employer ( See Instructions)
ATTACH ADDITIONAL COPIES OF THIS SCHEDULE AS NEEDED
If contributor is out-of-state PAC, please see instruction guide foradditional reporting requirements.
www,ethics. state. tx. us Revised 07128/ 2014
5. Texas Ethics Commission P.O. Box 12070 Austin, Texas 78711- 2070 512) 463- 5800 ( TDD 1- 800- 735- 2989)
POLITICAL EXPENDITURES SCHEDULE F
EXPENDITURE CATEGORIES FOR BOX Ill
Advertising Expense GiftiAwards/ Memorials Expense Sala ries! VVages; Contract Labor Loan Repayment Re mbursement
Accounting: Bankinc Legal Services SclicdationlFunaraising expense Transportation Equipme; t& Related Expense
Consulting Expense Food Beverage Expense Travel In District
Convibutions' Donatlons Made By
Event Expense Polling Expense Travel Out Of District CandidatelOfticeholder/ Political Committee
Fees Printing Expense Office OverheadrRental Expense OTHER ( enter a category not listed above)
The Instruction Guide explains how to complete this form.
1 Total pages Schedule F; 2 FILER NAME
i
3 ACCOUNT#( Ethics Commission Filers)
I i , ; ' vim V amom.
4 Date 5 Payee narne
6 Amount ($) 7 Payee address_ City; State, Zip Code
8 PURPOSE a) Category ( see categories listed at the top of this schedule) ( la) Description ( If travel outside of Texas, complete Schedule T}
OF
EXPENDITURE
Check ifAustin, TX, cffceholder living expense
9 Complete QNJ Y if direct Candidate! Officeholder name Office sought Office held
expenditure to benefit CIOH
Date Payee name
Lp G P-1
i I
In
Arnount ($) Payee address; City; State; Zip Code
PURPOSE Category (See categories listed at the top of this schedule) Description ( If travel outside of Texas, complete-Schedule T)
OF
EXPENDITURE
C `
1
ft-' Check ifAustin, TX, officeholder living expense
Complete ONLY it direct Candidate fficeholder name Office sought Office held
expenditure to oenefit CIOH
Date Paye ame
L,
1 I W,:) 7cz P-z
I L_
Amount ( S) Payee address; City; State; Zip Code
PURPOSE
Category ( See categories listed at the top of this schedule) Description ( If travel outside of Texas, complete Schedule T)
OF
EXPENDITURE. } f Q Check ifAustin, TX, otriceh older living expense
Complete ONLY if direct Candidate! iceholder name j Office sought Office held
expenditure to benefit C/ OH
Date Payee name
L
j a 14 oyv- I t r` I C
Amount ($} Payee address; City; State; p Code
S 9 a49,5
PURPOSE
Category ( See categories listed at the top of this schedule) Description ( If travel outside of Texas, complete Schedule T)
OF
c
EXPENDITURE Check ifAustin, TX, officeholder living expense
Complete ONLY if direct
111
Candidate/ O Iceholdername Office sought Office held
expenditure to benefit C/ OH
ATTACH ADDITIONAL COPIES OF THIS SCHEDULE AS NEEDED
www. ethics. state. tx. us Revised 07/ 2812014