2017 08-25 george c. fuller - correction-amendment affidavit for dandidate-officeholder redacted
1. CORRECTION/ AMENDMENT AFFIDAVIT
FOR CAN FORM COR- C/ OH
1 Filer ID( Ethics Commission Filers) 2 Total pages filed:
11
OFFICE USE ONLY
3 CANDIDATE/ MS/ MRS/ MRFIRST MI Date Received
OFFICEHOLDER
n'
NAME RECEIVED
NICKNAME LAST SUFFIX
ke'c
AUG
205
2017
4 ORIGINAL REPORT
January 15 Runoff other( specify) CITY SECRETARYTYPE
July 15 Exceeded$ 500 limit
30th day before election
15th day after treasurer Date Hand- delivered or Date Postmarked
appointment( officeholder only)
8th day before election Final report
Receipt# Amount $
5 ORIGINAL PERIOD Month Day Year Month Day Year
Date Processed
COVERED 1
THROUGH
6 3v /, W1β7 Date Imaged
6 EXPLANATION OF CORRECTION 1..
M
W4h
1 ni't
V1
cL0_C. & C>' 0LJ-;cJn-,
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,
or affirm, that any error or omission in the report as originally filed
was made in good faith.
R.
JANA CONDREN
MY COMMISSION EXPIRES
i' F;'; β’
Apd13, 2018
AFFIX NOTARY STAMP / SEAL ABOVE 9nature of Candidate or Officeholder
Sworn to and subscribed before me, by the said this the f day of
20 - 7 , to certify which, witness my hand and seal of office.
n_'& A_", 71ff/U'L
Sig to of officer
administering oath Printed name of officer
administering oath
Title of offic r administering oath
Remember 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
2. MONETARY POLITICAL CONTRIBUTIONS SCHEDULE Al
The Instruction Guide explains how to complete this form.
1 Total pages Schedule Al:
2 FILER NAME 3 Filer ID ( Ethics Commission Filers)
4 Date 5 Full name of contributor out- of- state PAC( ID#: 7 Amount of contribution ($)
3y17
ID,
COO
6 Cont ributor address; City; State; Zip Code
J 3 OGt,a,Ic. r L . ( su dfe fTX - 1,5Qi
8 Principal occupation/ Job title( See Instructions) g Employer( See Instructions)
Date Full name of contributor out- of- state PAC( ID#:
Amount of contribution ($)
Contributor address; City; State; Zip Code
Principal occupation/ Job title( See Instructions) Employer ( See Instructions)
Date Full name of contributor out- of- state PAC( ID#: t Amount of contribution ($)
Contributor address; City; State; Zip Code
Principal occupation/ Job title( See Instructions) Employer( See Instructions)
Date Full name of contributor
out- of- state PAC( ID#: Amount of contribution ($)
Contributor address; City; State; Zip Code
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 for additional reporting requirements.
Forms provided by Texas Ethics Commission www,ethics.state. tx. us Revised 9/8/ 2015
3. MONETARY POLITICAL CONTRIBUTIONS SCHEDULE Al
The Instruction Guide explains how to complete this form.
1 Total pages Schedule Al:
Ili
2 FILER NAME 3 Filer ID ( Ethics Commission Filers)
f 1
4 Date 5 Full name of contributor out- of- state PAC( IDC__- ._ J 7 Amount of contribution ($)
i . j - 7 6 Contributor address; City; State; Zip Code
r' Sv ;;I
8 Principal occupation/ Job title ( See Instructions) 9 Employer( See Instructions)
L i 4;
Date Full name of contributor our- ol- state PAC IIDu:_
Amount of contribution ($)
t^. . . . . . . . . . . . .
Contributor address; City; State; Zip Code
Principal occupation/ Job title ( See Instructions) Employer ( See Instructions)
Date Full name of contributor
I
out- of- state PAC( IDp: Amount of contribution ($)
Contributor address; City; State; Zip Code
I
Principal occupation/ Job title( See Instructions) Employer( See Instructio s)
Date Full name/ of contributor out- of- slate PAC( IDs Amount of contribution ($)
Ay' L.- 0'l
Contributor address; City; State; Zip Code
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 for additional reporting requirements.
Forms provided by Texas Ethics Commission www. ethics. state. tx. us Revised 9; 8'2015