amarillo city commissioner madison scott 2008 ethics form
DESCRIPTION
Amarillo, Texas, City Commissioner Madison Scott's 2008 personal financial disclosure form, covering calendar year 2007. Posted by Texas Watchdog (www.texaswatchdog.org).TRANSCRIPT
Texas Ethics Commission P.O. Box 12070 Austin, Texas 78711-2070 (512)463-5800 1-800-325-8506
PERSONAL FINANCIAL STATEMENT FORM PFS
COVER SHEET
Filed in accordance with chapter 572 of the Government Code.For filings required in 2008, covering calendar year ending December31,2007.
Use FORM PFS--INSTRUCTION GUIDE when completing this form.
TOTAL NUMBER OF PAGES FILED:
ACCOUNT #
1 NAME
2 ADDRESS
Check If F liar's Home Address
3 TELEPHONENUMBER
TITLE; FIRST; Ml
Madison .E..
OFFICE USE ONLYDate Received
NICKNAME; LAST; SUFFIX
ScottADDRESS / PO BOX; APT / SDITE #; CITY; STATE; ZIP CODE
720 S. Tyler, Suite 100Amarillo, TX 79101
Receipt #
HD/PMAREA CODE PHONE NUMBER; EXTENSION
Date Processed
(806 ) 467-2600 Date Imaged
REASONFOR FILINGSTATEMENT
D CANDIDATE
D ELECTED OFFICER City Commissioner, Place 1
D APPOINTED OFFICER
I EXECUTIVE HEAD
D FORMER OR RETIRED JUDGE SITTING BY ASSIGNMENT
I STATE PARTY CHAIR
OTHER
(INDICATE OFFICE)
(INDICATE OFFICE)
(INDICATE AGENCY)
(INDICATE AGENCY)
_ (INDICATE PARTY)
(INDICATE POSITION)
Family members whose financial activity you are reporting (filer must report information about the financial activity of the filer's spouse ordependent children if the filer had actual control over that activity):
SPOUSE D'Nan Scott
DEPENDENT CHILD 1
2.
3.
In Parts 1 through 18, you will disclose your financial activity during the preceding calendar year. In Parts 1 through 14, you arerequired to disclose not only your own financial activity, but also that of your spouse or a dependent child if you had actual controlover that person's financial activitv.
COPY AND ATTACH ADDITIONAL PAGES AS NECESSARY
Texas Ethics Commission P.O. Box12070 Austin, Texas 78711-2O7O (512) 463-5800 1 -800-325-8506
SOURCES OF OCCUPATIONAL INCOME PART 1A
NOT APPLICABLE
When reporting information about a dependent child's activity, indicate the child about whom you are reporting byproviding the number under which the child is listed on the Cover Sheet.
INFORMATION RELATES TO, FILER D SPOUSE D DEPENDENT CHILD
EMPLOYMENT
D EMPLOYED BYANOTHER
NAME AND ADDRESS OF EMPLOYER/ POSITION HELD
[] (Check If Filer's Home Address)
Gallagher Benefit Services, Inc.1900 W. Loop S.r Suite 1600Houston, TX 77027
Senior Benefits Consultant
D SELF-EMPLOYED
INFORMATION RELATES TO
NATURE OF OCCUPATION
Employee Benefits
FILER D SPOUSE D DEPENDENT CHILD
EMPLOYMENTNAME AND ADDRESS OF EMPLOYER / POSITION HELD
Q (Check If Piter's Home Address)
D EMPLOYED BY ANOTHER
D SELF-EMPLOYED
INFORMATION RELATES TO
EMPLOYMENT
D EMPLOYED BY ANOTHER
D SELF-EMPLOYED
COPY Al
city or AmarilloAmarillo, TX 79101
City Commissioner Place 1NATURE OF OCCUPATION
D FII FR n SPOUSE D DFPFNDFNT P.HII n
NAME AND ADDRESS OF EMPLOYER / POSITION HELD
fJJ (Check If Filer's Home Address)
NATURE OF OCCUPATION
>JD ATTACH ADDITIONAL PAGES AS NECESSARY
Texas Ethics Commission P.O. Box 12070 Austin, Texas 78711-2070 (512) 463-5800 1 -800-325-8506
RETAINERS
NOT APPLICABLE
PART 1B
This section concerns fees received as a retainer by you, your spouse, or a dependent child (or by a business in which you,your spouse, or a dependent child have a "substantial interest") for a claim on future services in case of need, rather than forservices on a matter specified at the time of contracting for or receiving the fee. Report information here only if the value ofthe work actually performed during the calendar year did not equal or exceed the value of the retainer. For more information,see FORM PFS-INSTRUCTION GUIDE.
When reporting information about a dependent child's activity, indicate the child about whom you are reporting byproviding the number under which the child ts listed on the Cover Sheet.
FEE RECEIVED FROMNAME AND ADDRESS
FEE RECEIVED BYNAME OF BUSINESS
D FILEROR FILER'S BUSINESS
D SPOUSEOR SPOUSE'S BUSINESS
D DEPENDENT CHILDOR CHILD'S BUSINESS
FEE AMOUNT D LESS THAN $5,000 D $5,000-$9,999 D $10,000-$24,999 D $25,000-OR MORE
FEE RECEIVED FROMNAME AND ADDRESS
FEE RECEIVED BYNAME OF BUSINESS
D FILEROR FILER'S BUSINESS
D SPOUSEOR SPOUSE'S BUSINESS
D DEPENDENT CHILDOR CHILD'S BUSINESS
FEE AMOUNT D LESS THAN $5.000 D $5,000~$9,999 D $10,000-$24,999 D $25,000-OR MORE
COPY AND ATTACH ADDITIONAL PAGES AS NECESSARY
Texas Ethics Commission P.O. Box12070 Austin, Texas 78711-2070 (512)463-5800 1-800-325-8506
STOCK PART 2
NOT APPLICABLE
List each business entity in which you, your spouse, or a dependent child held or acquired stock during the calendar yearand indicate the category of the number of shares held or acquired. If some or all of the stock was sold, also indicate thecategory of the amount of the net gain or loss realized from the sale. For more information, see FORM PFS—INSTRUCTION GUIDE.
When reporting information about a dependent child's activity, indicate the child about whom you are reporting byproviding the number under which the child is listed on the Cover Sheet.
BUSINESS ENTITY NAME
Amarillo Incredible Pizza Co., Ltd2 STOCK HELD OR ACQUIRED BY DSPOUSE D DEPENDENT CHILD
3 NUMBER OF SHARES Kl LESS THAN 1 00 D 1 00 TO 499 D 500 TO 999
D 5,000 TO 9,999 D 10,000 OR MORE
D 1 ,000 TO 4,999
IF SOLD D NET GAIN
D NET LOSS
D LESS THAN $5,000 D S5,000-$9,999 D $10,000-324,999 D S25.000-OR MORE
BUSINESS ENTITY NAME
Two Way TV Inc.STOCK HELD OR ACQUIRED BY FILER SPOUSE DEPENDENT CHILD
NUMBER OF SHARES D LESS THAN 100
D 5,000 TO 9,999
D 100 TO 499 £
D 10,000 OR MORE
500 TO 999 D 1,000 TO 4,999
IF SOLD D NET GAIN
D NET LOSS"O LESS THAN $5,000 D $5,000-$9,999 D $10,000-$24,999 D $25,000-OR MORE
BUSINESS ENTITY NAME
Wade Cook Financial CorpSTOCK HELD OR ACQUIRED BY 7J FILER SPOUSE D DEPENDENT CHILD
NUMBER OF SHARES D LESS THAN 100 M\00 TO 499 D 500 TO 999
D 5,000 TO 9,999
Q 1,000 TO 4,999
D 10,000 OR MORE
IF SOLD D NET GAIN
JD NET LOSS
G3 LESS THAN $5,000 D $5,000-$9,999 D $10,000-$24,999 D $25,000~OR MORE
BUSINESS ENTITY NAME
Arthur J. Gallagher, Inc.STOCK HELD OR ACQUIRED BY D FILER D SPOUSE D DEPENDENT CHILD
NUMBER OF SHARES D LESS THAN 100 D 100 TO 499 D 500 TO 999
5,000 TO 9,999 D 1 0,000 OR MORE
D 1,000 TO 4,999
IF SOLD Q NET GAIN
D NET LOSS
D LESS THAN $5,000 D $5,000-$9,999 D $10,000-$24,999 C3 $25,000-OR MORE
BUSINESS ENTITY NAME
STOCK HELD OR ACQUIRED BY D FILER n D DEPENDENT CHILD
NUMBER OF SHARES D LESS THAN 100 D 100 TO 499 D 500 TO 999
5,000 TO 9,999 D 10,000 OR MORE
1,000 TO 4,999
IF SOLD D NET GAIN
D NET LOSS
Q LESS THAN $5,000 D 55,000-$9,999 D $10,000-324,999 D $25,000-OR MORE
COPY AND ATTACH ADDITIONAL PAGES AS NECESSARY
Texas Ethics Commission P.O. Box 12070 Austin, Texas 78711-2070 (512)463-5800 1-800-325-8506
BONDS, NOTES & OTHER COMMERCIAL PAPER PARTS
NOT APPLICABLE
List all bonds, notes, and other commercial paper held or acquired by you, your spouse, or a dependent child during thecalendar year. If sold, indicate the category of the amount of the net gain or loss realized from the sale. For moreinformation, see FORM PFS-INSTRUCTION GUIDE.
When reporting information about a dependent child's activity, indicate the child about whom you are reporting byproviding the number under which the child is listed on the Cover Sheet.
DESCRIPTIONOF INSTRUMENT
HELD OR ACQUIRED BYD FILER D SPOUSE D DEPENDENT CHILD
IF SOLD
D NET GAIN
D NET LOSS
D LESS THAN $5,000 D $5,000-$9,999 D $10,000-$24,999 D $25,000-OR MORE
DESCRIPTIONOF INSTRUMENT
HELD OR ACQUIRED BYD FILER D SPOUSE D DEPENDENT CHILD
IF SOLD
D NET GAIN
D NET LOSS
D LESS THAN $5,000 D $5,000-$9,999 D $10,000-524,999 D $25,000-OR MORE
DESCRIPTIONOF INSTRUMENT
HELD OR ACQUIRED BYD FILER I SPOUSE D DEPENDENT CHILD
IF SOLD
D NET GAIN
D NET LOSS
D LESS THAN $5.000 D $5,000~$9,999 D $10,000-$24,999 D $25,000-OR MORE
COPY AND ATTACH ADDITIONAL PAGES AS NECESSARY
Dauici,,j t-ttenitnn-r
Texas Ethics Commission P.O. Box 12070 Austin, Texas 78711-2070 (512) 463-5800 1 -800-325-8506
MUTUAL FUNDS
fj NOT APPLICABLE
PART 4
List each mutual fund and the number of shares in that mutual fund that you, your spouse, or a dependent child held oracquired during the calendar year and indicate the category of the number of shares of mutual funds held or acquired. Ifsome or all of the shares of a mutual fund were sold, also indicate the category of the amount of the net gain or loss realizedfrom the sale. For more information, see FORM PFS-INSTRUCTION GUIDE.
When reporting information about a dependent child's activity, indicate the child about whom you are reporting byproviding the number under which the child is listed on the Cover Sheet.
1 MUTUAL FUND
2 SHARES OF MUTUAL FUNDHELD OR ACQUIRED BY
3 NUMBER OF SHARESOF MUTUAL FUND
* IF SOLD D NET GAIN
D NET LOSS
MUTUAL FUND
SHARES OF MUTUAL FUNDHELD OR ACQUIRED BY
NUMBER OF SHARESOF MUTUAL FUND
IF SOLD D NET GAIN
D NET LOSS
NAME
Schwab S&P 500 Inv. Shs.
OS, Fll FR fj RPDI IRF fj nFPFWDFMT CHM D
D LESS THAN 100 ^100TO499 D500TO999 D 1 ,000 TO 4,999
D 5,000 TO 9,999 D 10,000 OR MORE
D LESS THAN $5,000 Q $5,000-$9,999 fj $10,000-$24,999 fj S25.000-OR MORE
NAME
Wachovia SecuritiesHartford Cap Apprec FD C
| FILER I"] SPOUSF G DEPFWDPNT f^HII D
Z) LESS THAN 100 £§ 100 TO 499 D 500 TO 999 fj 1,000 TO 4,999
D 5,000 TO 9,999 D 10,000 OR MORE
J LESS THAN $5,000 Q $5,000-$9,999 Q $10,000-524,999 fj S25.000-OR MOREII- S>ULU LJ NET GAIN
D NET LOSS
MUTUAL FUND
SHARES OF MUTUAL FUNDHELD OR ACQUIRED BY
NUMBER OF SHARESOF MUTUAL FUND
IF SOLD D NET GAIN
D NET LOSS
D LESS THAN $5,000 D S5,000-$9,999 Q $10,000-524,999 fj S25.000-OR MORE
NAME
|~] FILER f~l SPOUSF (""I DFPENDFNT HHII D
D LESS THAN 100 D 1 00 TO 499 D 500 TO 999 Q 1 ,000 TO 4,999
D 5,000 TO 9,999 D 10,000 OR MORE
fj LESS THAN $5,000 Q S5,OOO-09,999 fj $10,000-$24,999 f~| $25,OOO-OR MORE
COPY AND ATTACH ADDITIONAL PAGES AS NECESSARY
Texas Ethics Commission P.O. Box 12070 Austin, Texas 78711-2070 (512)463-5800 1-800-325-8506
MUTUAL FUNDS PART 4
fj NOTAPPLICABLE
List each mutual fund and the number of shares in that mutual fund that you, your spouse, or a dependent child held oracquired during the calendar year and indicate the category of the number of shares of mutual funds held or acquired. Ifsome or all of the shares of a mutual fund were sold, also indicate the category of the amount of the net gain or loss realizedfrom the sale. For more information, see FORM PFS-INSTRUCTION GUIDE.
When reporting information about a dependent child's activity, indicate the child about whom you are reporting byproviding the number under which the child is listed on the Cover Sheet.
1 MUTUAL FUND
2 SHARES OF MUTUAL FUNDHELD OR ACQUIRED BY
3 NUMBER OF SHARESOF MUTUAL FUND
* IF SOLD D NET GAIN
D NET LOSS
NAME
. TWC Galileo Fds Inc. Select Equities FD CL N
f$ FILER n SPOUSE I") DEPENDENT CHII D
D LESS THAN 100 $ 100 TO 499 D 500 TO 999 Q 1,000 TO 4,999
D 5,000 TO 9,999 D 10,000 OR MORE
D LESS THAN $5,000 D $5,000-$9,999 Q $10,000-424,999 Q $25,000-OR MORE
MUTUAL FUND NAME
SHARES OF MUTUAL FUNDHELD OR ACQUIRED BY
NUMBER OF SHARESOF MUTUAL FUND
IF SOLD D NET GAIN
D NET LOSS
MUTUAL FUND
SHARES OF MUTUAL FUNDHELD OR ACQUIRED BY
NUMBER OF SHARESOF MUTUAL FUND
IF SOLD Q-NETGAIN
D NET LOSS
TWC Galileo Fds Inc. Small Cap Growth FD CL N
[/TFILER PI SPOUSE n DEPENDENT r.HII D
D LESS THAN 1 00 l L.1 00 TO 499 D 500 TO 999 fj 1 ,000 TO 4,999
D 5,000 TO 9,999 D 10,000 OR MORE
D LESS THAN $5,000 D $5,000-$9,999 Q $10,000-$24,999 fj $25,000-OR MORE
NAME
Target SMall Cap Value Port
^FILER (~I SPOUSE G DEPENDENT HHII D
U LESS THAN 100 £30°° TO 499 D 500 TO 999 n 1.000 TO 4,999
H 5,000 TO 9,999 D 10,000 OR MORE
p, LESS THAN $3,000 Q $5,OOO-$9,999 Q * 1O,OOO-*24,S93 Q $25,OOO-OR MOKb
COPY AND ATTACH ADDITIONAL PAGES AS NECESSARY
Texas Ethics Commission P.O. Box 12070 Austin, Texas 78711-2070 (512) 463-5800 1 -800-325-8506
MUTUAL FUNDS PART 4
NOT APPLICABLE
List each mutual fund and the number of shares in that mutual fund that you, your spouse, or a dependent child held oracquired during the calendar year and indicate the category of the number of shares of mutual funds held or acquired. Ifsome or all of the shares of a mutual fund were sold, also indicate the category of the amount of the net gain or loss realizedfrom the sale. For more information, see FORM PFS-INSTRUCTION GUIDE.
When reporting information about a dependent child's activity, indicate the child about whom you are reporting byproviding the number under which the child is listed on the Cover Sheet.
1 MUTUAL FUND
2 SHARES OF MUTUAL FUNDHELD OR ACQUIRED BY
3 NUMBER OF SHARESOF MUTUAL FUND
* IF SOLD D NET GAIN
D NET LOSS
MUTUAL FUND
NAME
The Growth Fund of America
Q^FIIER GSPOUSF n DFPFNnFNT CHII D
fa LESS THAN 100 Q100TO499 Q 500 TO 999 Q 1,000 TO 4,999
D 5,000 TO 9,999 D 10,000 OR MORE
Q LESS THAN $5,000 D $5,000-$9,999 D $10,000-$24,999 Q $25,000-OR MORE
NAME
Davis New York Venture Fund CL A
SHARES OF MUTUAL FUNDHELD OR ACQUIRED BY
NUMBER OF SHARESOF MUTUAL FUND
IF SOLD Q NET GAIN
D NET LOSS
MUTUAL FUND
SHARES OF MUTUAL FUNDHELDORACQUIREDBY
NUMBER OF SHARESOF MUTUAL FUND
IF SOLD NET GAIN
D NET LOSS
^ FILER
D LESS THAN 100
D 5,000 TO 9,999
D LESS THAN $5,000
Putnam Int
[ FILER
n LESS THAN 100
D 5,000 TO 9,999
LESS THAN 65,000
D SPOUSE D DEPENDENT CHILD
W 100 TO 499 D 500 TO 999 C•/H.
D 10,000 OR MORE
$5,000-$9,999 D $10,000-$24,999 Q
NAME
1 1 Equity Fund CL A
L~H SPOUSE D DEPENDENT CHILD
M 100 TO 499 D 500 TO 999 C
D 10,000 OR MORE
l~l $5,000 $0,OOO fj (510,000-824,888 |~~]
] 1,000 TO 4,999
$25,000-OR MORE
1,000 TO 4,999
02O,OOO— OR MORE
COPY AND ATTACH ADDITIONAL PAGES AS NECESSARY
Revised 11/01/2007
Texas Ethics Commission P.O. Box 12O7O Austin, Texas 78711-2070 (512)463-5800 1-800-325-8506
INCOME FROM INTEREST, DIVIDENDS, ROYALTIES & RENTS PART 5
NOTAPPLICABLE
List each source of income you, your spouse, or a dependent child received in excess of $500 that was derived frominterest, dividends, royalties, and rents during the calendar year and indicate the category of the amount of the income. Formore information, see FORM PFS-INSTRUCTION GUIDE.
When reporting information about a dependent child's activity, indicate the child about whom you are reporting byproviding the number under which the child is listed on the Cover Sheet.
SOURCE OF INCOMENAME AND ADDRESS
Hillside & Soncy Associates, Ltd,P. O. Box 9313Amarillo, TX 79105
RECEIVED BY
[& FILER SPOUSE D DEPENDENT CHILD
AMOUNT
SOURCE OF INCOME
D $500-$4,999 D $5,000~$9,999 D $10,000-$24,999 D $25,000-OR MORE
NAME AND ADDRESS
Wachovia Securities, LLCP. O. Box 50016Roanoke, VA 24040-7300
RECEIVED BYFILER D SPOUSE D DEPENDENT CHILD
AMOUNT $500-$4,999 D $5,000-$9,999 D $10,000-$24,999 D $25,000~OR MORE
SOURCE OF INCOMENAME AND ADDRESS
Antlers At Vail Condomimiums & Conference Ctr,
RECEIVED BYFILER D SPOUSE D DEPENDENT CHILD
AMOUNT D $500-84,999 D $5,000-$9,999 D $10,000~$24,999 D $25,000-OR MORE
COPY AND ATTACH ADDITIONAL PAGES AS NECESSARY
Texas Ethics Commission P.O. Box 12070 Austin, Texas 78711-2070 (512)463-5800 1-800-325-8506
PERSONAL NOTES AND LEASE AGREEMENTS PART 6
rj NOT APPLICABLE
Identify each guarantor of a loan and each person or financial institution to whom you, your spouse, ora dependent child had a total financial liability of more than $1,000 in the form of a personal note or notes or leaseagreement at any time during the calendar year and indicate the category of the amount of the liability. For more informa-tion, see FORM PFS-INSTRUCTION GUIDE.
When reporting information about a dependent child's activity, indicate the child about whom you are reporting byproviding the number under which the child is listed on the Cover Sheet.
1 PERSON OR INSTITUTIONHOLDING NOTE ORLEASE AGREEMENT
2 LIABILITY OF
GUARANTOR
4AMOUNT
PERSON OR INSTITUTIONHOLDING NOTE ORLEASE AGREEMENT
LIABILITY OF
GUARANTOR
AMOUNT
PERSON OR INSTITUTIONHOLDING NOTE ORLEASE AGREEMENT
LIABILITY OF
GUARANTOR
AMOUNT
IndyMac Bank
^J Fll FR M SPOIIRF fj nFPFNDFNT rH|| n
Jointly held
D $1,000-$4,999 D $5,000-$9,999 D $10,000-$24,999 | $25,000-OR MORE
Contrywide Home Loans
» r ~rj
HFIIFR jJ SPOUSE LJ DEPENDENT CHILD
Jointly held
.D $1,000-$4,999 D $5,000-39,999 D $10,000-$24,999 |?1$25,000-OR MORE
Amarillo National Bank
^Ry^pll FR (~] SPOIJSF PJ DFPFNnFNT f.HII n
Jointly held with Edward R. Scott, Jr.
D $1,000-$4,999 D $5,000-$9,999 D $10,000-$24,999 Q^$25,000-OR MORE
COPY AND ATTACH ADDITIONAL PAGES AS NECESSARY
Texas Ethics Commission P.O. BOX12070 Austin, Texas 78711-2070 (512)463-5800 1-800-325-8506
PERSONAL NOTES AND LEASE AGREEMENTS PART 6
Q NOT APPLICABLE
Identify each guarantor of a loan and each person or financial institution to whom you, your spouse, ora dependent child had a total financial liability of more than $1,000 in the form of a personal note or notes or leaseagreement at any time during the calendar year and indicate the category of the amount of the liability. For more informa-tion, see FORM PFS-INSTRUCTION GUIDE.
When reporting information about a dependent child's activity, indicate the child about whom you are reporting byproviding the number under which the child is listed on the Cover Sheet.
1 PERSON OR INSTITUTIONHOLDING NOTE ORLEASE AGREEMENT
2 LIABILITY OF
GUARANTOR
AMOUNT
PERSON OR INSTITUTIONHOLDING NOTE ORLEASE AGREEMENT
LIABILITY OF
GUARANTOR
AMOUNT
PERSON OR INSTITUTIONHOLDING NOTE ORLEASE AGREEMENT
LIABILITY OF
GUARANTOR
AMOUNT
Amarillo National Bank
(2l Fit FR d SPOl ISF d DFPFNDFNT OHM D
Jointly held with Mike Beller
D $1,000-$4,999 D $5,000-$9,999 D $10,000-$24,999 03 $25,000-OR MORE
America's Servicing Company
(XI FILER HI SPOUSE [jj DFPFNDFNT CHI1 D
D $1,000-$4,999 D $5,000-39,999 D $10,000-$24,999 El $25,000-OR MORE
Ocwen
[2 Fll FR FJ SPODSF d] nFPFNDFNT T.HII D
D $1,000-$4,999 D $5,000-$9,999 D $10,000-$24,999 M $25,000-OR MORE
COPY AND ATTACH ADDITIONAL PAGES AS NECESSARY
Texas Ethics Commission P.O. Box12070 Austin, Texas 78711-2070 (512)463-5800 1-800-325-8506
INTERESTS IN REAL PROPERTY PART 7A
NOTAPPLICABLE
Describe all beneficial interests in real property held or acquired by you, your spouse, or a dependent child during thecalendar year. If the interest was sold, also indicate the category of the amount of the net gain or loss realized from the sale.For an explanation of "beneficial interest" and other specific directions for completing this section, see FORM PFS--INSTRUCTION GUIDE.
When reporting information about a dependent child's activity, indicate the child about whom you are reporting byproviding the number under which the child is listed on the Cover Sheet.
HELD OR ACQUIRED BY FILER I SPOUSE D DEPENDENT CHILD
2 STREETADDRESSfj NOT AVAILABLE
[~| CHECK IF FILER'S HOME ADDRESS
STREET ADDRESS, INCLUDING CITY. COUNTY, AND STATE7409 Park RidgeAmarillo, TX 79119 Randall County
3 DESCRIPTIONM LOTS
I ACRES
NUMBER OF LOTS OR ACRES AND NAME OF COUNTY WHERE LOCATED
1 lot - principal residenceRandall County
NAMES OF PERSONSRETAINING AN INTEREST
Qfl NOTAPPLICABLE/\(SEVERED MINERAL INTEREST)
IF SOLD[3 NET GAIN
D NETLOSS
D LESS THAN $5,000 D S5,000-$9,999 D $10,000-$24,999 U $25,000-OR MORE
HELD OR ACQUIRED BY FILER .SPOUSE D DEPENDENT CHILD
STREETADDRESSn NOT AVAILABLE
CHECK IF FILER'S HOME ADDRESS
STREET ADDRESS, INCLUDING CITY, COUNTY, AND STATE
61 Aspen TrailCuchara, CO 81055 Huerfano County
DESCRIPTION"Ltj LOTS
FJ ACRES
NUMBER OF LOTS OR ACRES AND NAME OF COUNTY WHERE LOCATED
1 lot - secondary residenceHuerfano County, CO
NAMES OF PERSONSRETAINING AN INTEREST
NOTAPPLICABLE(SEVERED MINERAL INTEREST)
IF SOLDQ NET GAIN
n NETLOSS
D LESS THAN $5,000 D $5,000-$9,999 D $10,000-$24,999 Q! $25,000-OR MORE
COPY AND ATTACH ADDITIONAL PAGES AS NECESSARY
Revised 11/01/2007
Texas Ethics Commission P.O. Box 12070 Austin, Texas 78711-2070 (512)463-5800 1-800-325-8506
INTERESTS IN REAL PROPERTY
fj NOTAPPLICABLE
PART 7 A
Describe all beneficial interests in real property held or acquired by you, your spouse, or a dependent child during thecalendar year. If the interest was sold, also indicate the category of the amount of the net gain or loss realized from the sale.For an explanation of "beneficial interest" and other specific directions for completing this section, see FORM PFS--INSTRUCTION GUIDE.
When reporting information about a dependent child's activity, indicate the child about whom you are reporting byproviding the number under which the child is listed on the Cover Sheet.
HELD OR ACQUIRED BY FILER SPOUSE D DEPENDENT CHILD
2 STREET ADDRESSfj NOT AVAILABLE
CHECK IF FILER'S HOME ADDRESS
STREET ADDRESS, INCLUDING CITY, COUNTY, AND STATE
1205 High Altitude Ave.N. Las Vegas, NV 89032
3 DESCRIPTION
D LOTS
n ACRES
NUMBER OF LOTS OR ACRES AND NAME OF COUNTY WHERE LOCATED
rental property
NAMES OF PERSONSRETAINING AN INTERESTn NOTAPPLICABLE
(SEVERED MINERAL INTEREST)
IF SOLDQ NET GAIN
D NETLOSS
LESS THAN $5,000 D S5,000-$9,999 D $10,000-$24,999 D $25,000-OR MORE
HELD OR ACQUIRED BY FILER D SPOUSE D DEPENDENT CHILD
STREETADDRESSLU NOT AVAILABLE
n CHECK IF FILER'S HOME ADDRESS
STREET ADDRESS, INCLUDING CITY, COUNTY, AND STATE
680 W. Lionshead PlaceVail, CO 81657
DESCRIPTION
n LOTS
n ACRES
NUMBER OF LOTS OR ACRES AND NAME OF COUNTY WHERE LOCATED
Condominium
NAMES OF PERSONSRETAINING AN INTERESTn NOTAPPLICABLE
(SEVERED MINERAL INTEREST)
IF SOLDtl NET GAIN
O NET LOSS
LESS THAN $5,000 D $5,000-$9,999 D $10,000-$24,999 D $25,000-OR MORE
COPY AND ATTACH ADDITIONAL PAGES AS NECESSARY
Revised 11/01/2007
Texas Ethics Commission P.O. BOX12070 Austin, Texas 78711-2070 (512) 463-5800 1 -800-325-8506
INTERESTS IN REAL PROPERTY PART 7A
NOTAPPLICABLE
Describe all beneficial interests in real property held or acquired by you, your spouse, or a dependent child during thecalendar year. If the interest was sold, also indicate the category of the amount of the net gain or loss realized from the sale.For an explanation of "beneficial interest" and other specific directions for completing this section, see FORM PFS--INSTRUCTION GUIDE.
When reporting information about a dependent child's activity, indicate the child about whom you are reporting byproviding the number under which the child is listed on the Cover Sheet.
HELD OR ACQUIRED BY Jointly-, held with Mike BellerFILER if] SPOUSE U DEPENDENT CRILD
2 STREETADDRESSfj NOT AVAILABLE
r~l CHECK IF FILER'S HOME ADDRESS
STREET ADDRESS, INCLUDES CITY, COUNTY, AND STATE
3225 Turtle Creek Blvd.Dallas, TX 75215 Dallas County
3 DESCRIPTIOND LOTS
D ACRES
NUMBER OF LOTS OR ACRES AND NAME OF COUNTY WHERE LOCATED
Condominium
NAMES OF PERSONSRETAINING AN INTERESTfj NOTAPPLICABLE
(SEVERED MINERAL INTEREST)
IF SOLDO NET GAIN
[U NET LOSS
D LESS THAN $5,000 D $5,000-$9,999 D $10,000-$24,999 D $25,000-OR MORE
HELD OR ACQUIRED BY FILER U SPOUSEhp>1 H wi
D DEPENDENT CHILD
STREETADDRESSfj NOT AVAILABLE
r~| CHECK IF FILER'S HOME ADDRESS
STREET ADDRESS. INCLUDING CITY, COUNTY, AND STATE
Armstrong County, Texas
DESCRIPTIONNUMBER OF LOTS OR ACRES AND NAME OF COUNTY WHERE LOCATED
2,100 acres - Armstrong County, TXCattle Ranch
ACRES
NAMES OF PERSONSRETAINING AN INTERESTfj NOTAPPLICABLE
(SEVERED MINERAL INTEREST)
IF SOLD0 NET GAIN
n NET LOSS
D LESS THAN $5,000 D $5,000-$9,999 D $10,000-$24,999 D $25,000-OR MORE
COPY AND ATTACH ADDITIONAL PAGES AS NECESSARY
Revised 11/01/2007
Texas Ethics Commission P.O. Box 12070 Austin, Texas 78711-2070 (512)463-5800 1-800-325-8506
INTERESTS IN BUSINESS ENTITIES
fj NOTAPPUCABLE
PART 7B
Describe all beneficial interests in business entities held or acquired by you, your spouse, or a dependent child during thecalendar year. If the interest was sold, also indicate the category of the amount of the net gain or loss realized from the sale.For an explanation of "beneficial interest" and other specific directions for completing this section, see FORM PFS-INSTRUCTION GUIDE.
When reporting information about a dependent child's activity, indicate the child about whom you are reporting byproviding the number under which the child is listed on the Cover Sheet
HELD OR ACQUIRED BY FILER D SPOUSE D DEPENDENT CHILD
DESCRIPTION""~ AND ADDRESS
' Piter's Home Address)
Amarillo Incredible Pizza Mgmt. LLC720 S. Tyler, Suite 100Amarillo, TX 79101
IF SOLDNET GAIN
Q NET LOSS
LESS THAN $5,000 D $5,000-$9,999 D $10,000-$24,999 Q S25.000-OR MORE
HELD OR ACQUIRED BY [FILER SPOUSE D DEPENDENT CHILD
DESCRIPTIONNAME AND ADDRESS
AIP Management, LLC ^HomeAddress>720 S. Tyler, Suite 100Amarillo, TX 79101
IF SOLD
NET GAIN
D NET LOSS
LESS THAN $5,000 D $5,000-$9,999 D $10.000-$24,999 D $25.000-OR MORE
HELD OR ACQUIRED BY FILER D SPOUSE D DEPENDENT CHILD
DESCRIPTIONNAME AND ADDRESS
f~] (Check If Piter's Home Address)
Token Time, LLC720 *S. Tyler, Suite 100Amarillo, TX 79101
IF SOLDNET GAIN
D NET LOSS
D LESS THAN $5,000 D $5,000-$9,999 D $10,000-$24,999 v $25,000-OR MORE
COPY AND ATTACH ADDITIONAL PAGES AS NECESSARY
Texas Ethics Commission P.O. Box 12070 Austin, Texas 78711-2070 (512)463-5800 1-800-325-8506
INTERESTS IN BUSINESS ENTITIES
fj NOTAPPLICABLE
PART 7B
Describe all beneficial interests in business entities held or acquired by you, your spouse, or a dependent child during thecalendar year. If the interest was sold, also indicate the category of the amount of the net gain or loss realized from the sale.For an explanation of "beneficial interest" and other specific directions for completing this section, see FORM PFS—INSTRUCTION GUIDE.
When reporting information about a dependent child's activity, indicate the child about whom you are reporting byproviding the number under which the child is listed on the Cover Sheet.
HELD OR ACQUIRED BY FILER D SPOUSE DEPENDENT CHILD
DESCRIPTIONNAME AND ADDRESS
FJ (Check If Bier's Home Address)
Hillside & Soncy Development, LLCP. O. Box 9313Amarillo, TX 79105
IF SOLDQ NET GAIN
D NET LOSS
O LESS THAN $5,000 D $5,000-$9,999 D $10,000-$24,999 D $25,000-OR MORE
HELD OR ACQUIRED BY . FILER D SPOUSE D DEPENDENT CHILD
DESCRIPTIONNAME AND ADDRESS
fj (Check If Filer's Home Address)
Hillside & Associates, Ltd.P. O. Box 9313Amarillo, TX 79105
IF SOLDNET GAIN
D NET LOSS
D LESS THAN $5,000 D $5,000-$9,999 D $10,000-$24,999 $25,000-OR MORE
HELD OR ACQUIRED BY FILER D SPOUSE D DEPENDENT CHILD
DESCRIPTIONNAME AND ADDRESS
fj (Check If Filer's Home Address)
Wired For Fun, Ltd.720 S. Tyler, Suite 100Amarillo, TX 79101
IF SOLDNET GAIN
D NET LOSS
D LESS THAN $5,000 D $5,000-$9,999 D $10,000-$24,999 $25,000-OR MORE
COPY AND ATTACH ADDITIONAL PAGES AS NECESSARY
Revised 11/01/2007
, Texas Ethics Commission P.O. Box 12070 Austin, Texas 78711-2070 (512)463-5800 1-800-325-8506
INTERESTS IN BUSINESS ENTITIES
fj NOTAPPUCABLE
PART 7B
Describe all beneficial interests in business entities held or acquired by you, your spouse, or a dependent child during thecalendaryear. If the interest was sold, also indicate the category of the amount of the net gain or loss realized from the sale.For an explanation of "beneficial interest" and other specific directions for completing this section, see FORM PFS—INSTRUCTION GUIDE.
When reporting information about a dependent child's activity, indicate the child about whom you are reporting byproviding the number under which the child is listed on the Cover Sheet . .
HELD OR ACQUIRED BY FILER D SPOUSE D DEPENDENT CHILD
DESCRIPTION:AND ADDRESS' Piter's Home Address)
Amarillo Incredible Pizza Company, Ltd.720 S. Tyler, Suite TOOAmarillo, TX 79101
IF SOLDNET GAIN
D NET LOSS
D LESS THAN $5,000 D $5,000-$9.999 Q $10,000-$24,999 ,S25,000-OR MORE
HELD OR ACQUIRED BY [FILER D SPOUSE D DEPENDENT CHILD
DESCRIPTIONNAME AND ADDRESS
Tor's Home Address)
Renaissance Laser, L.P.720 S. Tyler, Suite 100Amarillo, TX 79101
IF SOLDD NET GAIN
D NET LOSS
Cf 4-ESS THAN $5,000 D $5,000-$9,999 D $10.000-$24,999 Q $25,000-OR MORE
HELD OR ACQUIRED BY FILER D SPOUSE D DEPENDENT CHILD
DESCRIPTIONNAME AND ADDRESS
I""] (Check If Filer's Home Address)
Madison Scott Enterprises, LLC720 S. Tyler, Suite 100Amarillo, TX 79101
IF SOLDD NET GAIN
D NET LOSS
D LESS THAN $5.000 D $5,000-$9,999 D $10,000-$24,999 D $25,OOf>-OR MORE
COPY AND ATTACH ADDITIONAL PAGES AS NECESSARY
Revised 11/01/M(T7
Texas Ethics Commission P.O. Box 12070 Austin, Texas 78711-2070 (512) 463-5800 1 -800-325-8506
INTERESTS IN BUSINESS ENTITIES PART 7B
NOTAPPLICABLE
Describe all beneficial interests in business entities held or acquired by you, your spouse, or a dependent child during thecalendar year. If the interest was sold, also indicate the category of the amount of the net gain or loss realized from the sale.For an explanation of "beneficial interest" and other specific directions for completing this section, see FORM PFS-INSTRUCTION GUIDE.
When reporting information about a dependent child's activity, indicate the child about whom you are reporting byproviding the number under which the child is listed on the Cover Sheet.
HELD OR ACQUIRED BY FILER D SPOUSE D DEPENDENT CHILD
DESCRIPTION-AND ADDRESS' Rtef's Home Address)
BC Pizza LP720 S. Tyler, Suite TOOAmarillo, TX 79101
IF SOLDD NET GAIN
NET LOSS
D LESS THAN $5,000 D S5,000-$9,999 Q $10.000-$24,999 \ S25.000-OR MORE
HELD OR ACQUIRED BY 'FILER D SPOUSE D DEPENDENT CHILD
DESCRIPTION S Glass LLC720 S. Tyler, Suite 100Amarillo, TX 79101
NAME AND ADDRESS^s Home Address)
IF SOLD
D NET GAIN
D NET LOSS
D LESS THAN $5,000 D $5.000-$9,999 D $10,000-$24,999 d $25,OOQ-OR MORE
HELD OR ACQUIRED BY FILER D SPOUSE D DEPENDENT CHILD
DESCRIPTIONNAME AND ADDRESS
l~] (Check If Filer's Home Address)
S. Fiberglass Ltd720 S. Tyler, Suite 100Amarillo, TX 79101
IF SOLDD NET GAIN
D NET LOSS
D LESS THAN $5,000 D $5,000-$9,999 D $10,000-$24,999 Q $25,OOCHOR MORE
COPY AND ATTACH ADDITIONAL PAGES AS NECESSARY
ttAHJMWT
Texas Ethics Commission P.O. Box12070 Austin, Texas 78711-2070 (512) 463-580O 1 -800-325-8506
INTERESTS IN BUSINESS ENTITIES PART 7B
NOTAPPUCABLE
Describe all beneficial interests in business entities held or acquired by you, your spouse, or a dependent child during thecalendar year. If the interest was sold, also indicate the category of the amount of the net gain or loss realized from the sale.For an explanation of "beneficial interest" and other spedfic directions for completing this section, see FORM PFS-INSTRUCTION GUIDE.
When reporting information about a dependent child's activity, indicate the child about whom you are reporting byproviding the number under which the child is listed on the Cover Sheet
HELD OR ACQUIRED BY FILER D SPOUSE D DEPENDENT CHILD
DESCRIPTION"AND ADDRESS
' Filer's Home Address)
The Secret Ring, LLC720 S. Tyler, Suite 100, AMarillo, TX 79101
IF SOLDD NET GAIN
D NET LOSS
D LESS THAN $5,000 D $5,000-$9.999 El $10.000-$24.999 D 525,000-OR MORE
HELD OR ACQUIRED BY FILER D SPOUSE D DEPENDENT CHILD
DESCRIPTIONNAME AND ADDRESS
Home Address)
IF SOLD
D NET GAIN
D NET LOSS
D LESS THAN $5,000 D $5,000-$9,999 D $10,000-$24.999 Q $25,000-OR MORE
HELD OR ACQUIRED BY : FILER D SPOUSE D DEPENDENT CHILD
DESCRIPTIONNAME AND ADDRESS
F] (Check If Fitef-s Home Address)
IF SOLD
D NET GAIN
D NET LOSS
D LESS THAN $5,000 D $5,000-$9,999 D $10,000-$24,999 D $25,000-OR MORE
COPY AND ATTACH ADDITIONAL PAGES AS NECESSARY
Revised 11/01/2007
Texas Ethics Commission P.O. BOX 12070 Austin, Texas 78711-2070 (512)463-5800 1-800-325-8506
GIFTS PARTS
Identify any person or organization that has given a gift worth more than $250 to you, your spouse, or a dependent child, anddescribe the gift. The description of a gift of cash or a cash equivalent, such as a negotiable instrument or gift certificate, mustinclude a statement of the value of the gift. Do not include: 1) expenditures required to be reported by a person required to beregistered as a lobbyist under chapter 305 of the Government Code; 2) political contributions reported as required by law; or3) gifts given by a person related to the recipient within the second degree by consanguinity or affinity. For more information,see FORM PFS-INSTRUCTION GUIDE.
When reporting information about a dependent child's activity, indicate the child about whom you are reporting byproviding the number under which the child is listed on the Cover Sheet.
NAME AND ADDRESS
DONOR
RECIPIENT FILER SPOUSE D DEPENDENT CHILD
DESCRIPTION OF GIFT
DONORNAME AND ADDRESS
RECIPIENT D FILER D SPOUSE D DEPENDENT CHILD
DESCRIPTION OF GIFT
NAME AND ADDRESS
DONOR
RECIPIENT D FILER D SPOUSE D DEPENDENT CHILD
DESCRIPTION OF GIFT
COPY AND ATTACH ADDITIONAL PAGES AS NECESSARY
Texas Ethics Commission P.O. Box12070 Austin, Texas 78711-2070 (512) 463-5800 1-800-325-8506
TRUST INCOME PART 9
NOTAPPLICABLE
Identify each source of income received by you, your spouse, or a dependent child as beneficiary of a trust and indicate thecategory of the amount of income received. Also identify each asset of the trust from which the beneficiary received morethan $500 in income, if the identity of the asset is known. For more information, see FORM PFS-INSTRUCTION GUIDE.
When reporting information about a dependent child's activity, indicate the child about whom you are reporting byproviding the number under which the child is listed on the Cover Sheet.
SOURCENAME OF TRUST
BENEFICIARY D FILER D SPOUSE D DEPENDENT CHILD
INCOME D LESS THAN $5,000 D $5,000-$9,999 D $10,000-$24,999 D $25,000-OR MORE
ASSETS FROM WHICHOVER $500 WAS RECEIVED
D UNKNOWN
SOURCENAME OF TRUST
BENEFICIARY D FILER D SPOUSE D DEPENDENT CHILD
INCOME D LESS THAN $5,000 D $5,000-$9,999 Q $10,000-$24,999 D $25,000-OR MORE
ASSETS FROM WHICHOVER $500 WAS RECEIVED
D UNKNOWN
SOURCE
BENEFICIARY
INCOME
ASSETS FROM WHICHOVER $500 WAS RECEIVED
D UNKNOWN
NAME OF TRUST
;
Q FII RR n spni 'SP n DFPFNDFNT HHII n
D LESS THAN $5,000 D $5,000-$9,999 D $10,000-$24,999 D $25,000-OR MORE
COPY AND ATTACH ADDITIONAL PAGES AS NECESSARY j
Texas Ethics Commission P.O. Box 12070 Austin, Texas 78711-2070 (512)463-5800 1-800-325-8506
BLIND TRUSTS PART 10 A
NOTAPPLICABLE
Identify each blind trust that complies with section 572.023(c) of the Government Code. See FORM PFS-INSTRUCTIONGUIDE.
When reporting information about a dependent child's activity, indicate the child about whom you are reporting byproviding the number under which the child is listed on the Cover Sheet.
NAME OF TRUST
TRUSTEENAME AND ADDRESS
BENEFICIARYD FILER D SPOUSE D DEPENDENT CHILD
4 FAIR MARKET VALUED LESS THAN $5,000 D $5,000-$9,999 D $10,000-$24,999 D $25,000-OR MORE
DATE CREATED
NAME OF TRUST
TRUSTEENAME AND ADDRESS
BENEFICIARYD FILER D SPOUSE D DEPENDENT CHILD
FAIR MARKET VALUED LESS THAN $5,000 D $5,000~$9,999 D $10,000-324,999 D $25,000-OR MORE
DATE CREATED
NAME OF TRUST
TRUSTEENAME AND ADDRESS
BENEFICIARYD FILER SPOUSE DEPENDENT CHILD
FAIR MARKET VALUED LESS THAN $5,000 D $5,000-$9,999 D $10,000-$24,999 Q $25,000-OR MORE
DATE CREATED
COPY AND ATTACH ADDITIONAL PAGES AS NECESSARYRevised 11/01/2007
Texas Ethics Commission P.O. Box 12070 Austin, Texas 78711-2070 (512)463-5800 1-800-325-8506
TRUSTEE STATEMENT PART! OB
HO NOTAPPLICABLE
An individual who is required to identify a blind trust on Part 10A of the Personal Financial Statement must submit astatement signed by the trustee of each blind trust listed on Part 10A. The portions of section 572.023 of the GovernmentCode that relate to blind trusts are listed below.
1
2
3
NAME OF TRUST
TRUSTEE NAME
FILER ON WHOSEBEHALF STATEMENTIS BEING FILED
NAME
4 TRUSTEE STATEMENT | affjrm> under penalty of perjury, that I have not revealed any information to the beneficiary of thistrust except information that may be disclosed under section 572.023 (bX8) of the GovernmentCode and that to the best of my knowledge, the trust complies with section 572.023 of theGovernment Code.
Trustee Signature
§ 572.023. Contents of Financial Statement in General
(b) The account of financial activity consists of:
(8) identification of the source and the category of the amount of all income received as beneficiary of a trust, otherthan a blind trust that complies with Subsection (c), and identification of each trust asset, if known to the beneficiary,from which income was received by the beneficiary in excess of $500;
(14) identification of each blind trust that complies with Subsection (c), including:
(A) the category of the fair market value of the trust;
(B) the date the trust was created;
(C) the name and address of the trustee; and
(D) a statement signed by the trustee, under penalty of perjury, stating that:
(i) the trustee has not revealed any information to the individual, except information that may be disclosedunder Subdivision (8); and
(ii) to the best of the trustee's knowledge, the trust complies with this section,
(c) For purposes of Subsections (b)(8) and (14), a blind trust is a trust as to which:
(1) the trustee:
(A) is a disinterested party;
(B) is not the individual;
(C) is not required to register as a lobbyist under Chapter 305;
(D) is not a public officer or public employee; and
(E) was not appointed to public office by the individual or by a public officer or public employee the individualsupervises; and
(2) the trustee has complete discretion to manage the trust, including the power to dispose of and acquire trustassets without consulting or notifying the individual.
(d) If a blind trust under Subsection (c) is revoked while the individual is subject to this subchapter, the individual must file anamendment to the individual's most recent financial statement, disclosing the date of revocation and the previously unreportedvalue by category of each asset and the income derived from each asset.
Texas Ethics Commission P.O. Box 12070 Austin, Texas 78711-2070 (512)463-5800 1-800-325-8506
ASSETS OF BUSINESS ASSOCIATIONSfj NOTAPPLICABLE
PART 11A
Describe all assets of each corporation, firm, partnership, limited partnership, limited liability partnership, professionalcorporation, professional association, joint venture, or other business association in which you, your spouse, or a depen-dent child held, acquired, or sold 50 percent or more of the outstanding ownership and indicate the category of the amountof the assets. For more information, see FORM PFS-INSTRUCTION GUIDE.
When reporting information about a dependent child's activity, indicate the child about whom you are reporting byproviding the number under which the child is listed on the Cover Sheet.
BUSINESSASSOCIATION
NAME AND ADDRESS(Check If Bier's Home Address)
Amarillo Incredible Pizza Company, Ltd.720 S. Tyler. Suite 100. AMarillo, TX 79101
BUSINESS TYPE Limited Partnership3 HELD, ACQUIRED,
OR SOLD BYFILER D SPOUSE D DEPENDENT CHILD
ASSETSDESCRIPTION
Cash
Accounts Receivable
Inventory
Other Current Assets
Equipment
Intangible Assets
CATEGORY
D LESS THAN $5,000 E] $5,000-$9,999
D $10,000-$24,999 Q $25,000-OR MORE
D LESS THAN $5,000 0 $5,000-$9,999
D $10,000-$24,999 D S25.000-OR MORE
D LESS THAN $5.000 0. $5,000~$9,999
D $10,000-$24,999 Q S25,000-OR MORE
D LESS THAN $5,000 D $5,000-$9,999
IS $ 10,000-$24,999 Q $25,000-OR MORE
D LESS THAN $5,000
D $10,000-$24,999
I $5,000-49,999
l$25,000-ORMORE
D LESS THAN $5,000 D $5,000-$9,999
D $ 10,000-$24,999 J2 $25,000-OR MORE
D LESS THAN $5,000 D $5,000-$9,999
D $10,000-$24,999 Q $25,000-OR MORE
D LESS THAN $5.000 D $K.OOO-$9,090
D $10,000-524,999 Ql $25,000~OR MORE
COPY AND ATTACH ADDITIONAL PAGES AS NECESSARY
Texas Ethics Commission P.O. Box 12070 Austin, Texas 78711-2070 (512)463-5800 1-800-325-8506r
ASSETS OF BUSINESS ASSOCIATIONS PART 11A
NOTAPPLICABLE
Describe all assets of each corporation, firm, partnership, limited partnership, limited liability partnership, professionalcorporation, professional association, joint venture, or other business association in which you, your spouse, or a depen-dent child held, acquired, or sold 50 percent or more of the outstanding ownership and indicate the category of the amountof the assets. For more information, see FORM PFS-INSTRUCTION GUIDE.
When reporting information about a dependent child's activity, indicate the child about whom you are reporting byproviding the number under which the child is listed on the Cover Sheet.
BUSINESSASSOCIATION
NAME AND ADDRESS
(Check " Rter'sWired For Fun Ltd720 S. Tyler, Suite 100, Amarillo, TX 79101
BUSINESS TYPE Limited Partnership3 HELD.ACQUIRED,
OR SOLD BYD FILER D SPOUSE D DEPENDENT CHILD
ASSETSDESCRIPTION
Equipment
Cash
Intangible Assets
I CATEGORYi
D LESS THAN $5,000 D $5,000-$9,999
D $10,000-$24,999 pj($25,OOQ-OR MORE
|2 LESS THAN $5,000 D $5,000-$9,999
D $ 10,000-524,999 Q S25.000-OR MORE
[H LESS THAN $5,000 O 55,000-$9.999
D $10,000-324,999 Q $25.000-OR MORE
D LESS THAN $5,000 D $5,000-$9,999
D $10,000-$24,999 D $25,000-OR MORE
D LESS THAN $5,000 D $5,000-$9,999
D $10,000-$24,999 D $25,000-OR MORE
D LESS THAN $5,000 D $5,000-$9,999
D $ 10.000-S24.999 D $25,000-OR MORE
D LESS THAN $5,000 D $5,000-$9,999
D $10,000-$24,999 D $25,000-OR MORE
D LESS THAN $5.000 d S5.nno_?o,ooo
D $10,000-$24,999 D $25,000-OR MORE
COPY AND ATTACH ADDITIONAL PAGES AS NECESSARY
Texas Ethics Commission P.O. Box12070 Austin, Texas 78711-2070 (512)463-5800 1-800-325-8506
ASSETS OF BUSINESS ASSOCIATIONS[J| NOTAPPLICABLE
PART 11A
Describe all assets of each corporation, firm, partnership, limited partnership, limited liability partnership, professionalcorporation, professional association, joint venture, or other business association in which you, your spouse, or a depen-dent child held, acquired, or sold 50 percent or more of the outstanding ownership and indicate the category of the amountof the assets. For more information, see FORM PFS-INSTRUCTION GUIDE.
When reporting information about a dependent child's activity, indicate the child about whom you are reporting byproviding the number under which the child is listed on the Cover Sheet.
BUSINESSASSOCIATION
NAME AND ADDRESSfj (Check If Filer's Home Address)
AIP Management, LLC720 S. Tyler, Suite 100, Amarillo, TX 79101
BUSINESS TYPE Single Member LLC3 HELD, ACQUIRED,
OR SOLD BYFILER D SPOUSE D DEPENDENT CHILD
ASSETSDESCRIPTION
Cash
CATEGORY
09 LESS THAN $5,000 D $5,000-59,999
D $10,000-$24,999 Q $25,000-OR MORE
D LESS THAN $5,000 D $5.000-$9,999
D $10,000-$24,999 D $25,000-OR MORE
D LESS THAN $5,000 Q $5,000-$9,999
D $10,000-324,999 D $25,000-OR MORE
D LESS THAN $5,000 D $5,000-$9.999
D $10,000-$24,999 D $25.000-OR MORE
D LESS THAN $5,000 D $5,000-$9,999
D $10,000-$24,999 Q $25,000-OR MORE
D LESS THAN $5,000 D $5,000-$9,999
D $10,000-$24.999 D $25,000-OR MORE
D LESS THAN $5,000 D $5,000-$9,999
D $ 10,000-$24,999 Q $25,000-OR MORE
D LESS THAN $5,000 D $5,000-$9,999
n $10,000-524,999 Q $25,000-OR MORE
COPY AND ATTACH ADDITIONAL PAGES AS NECESSARY
Texas Ethics Commission P.O. Box 12070 Austin, Texas 78711-2070 (512)463-5800 1-800-325-8506r
ASSETS OF BUSINESS ASSOCIATIONS PART 11A
NOTAPPUCABLE
Describe all assets of each corporation, firm, partnership, limited partnership, limited liability partnership, professionalcorporation, professional association, joint venture, or other business association in which you, your spouse, or a depen-dent child held, acquired, or sold 50 percent or more of the outstanding ownership and indicate the category of the amountof the assets. For more information, see FORM PFS-INSTRUCTION GUIDE.
When reporting information about a dependent child's activity, indicate the child about whom you are reporting byproviding the number under which the child is listed on the Cover Sheet.
NAMEAND ADDRESS
ASSOCIATION
2 BUSINESS TYPE
3 HELD, ACQUIRED,OR SOLD BY
4 ASSETS
Token Time LLC720 S. Tyler, Suite 100, AMarillo, TX 79101
Single Member LLC
(21 FILER D SPOUSE Q DEPENDENTr*i-iu n _
DESCRIPTION CATEGORY
£3 LESS THAN $5,000 D $5,000-59,999
Cash D $10,000-$24,999 D $25,000-OR MORE
D LESS THAN $5,000
I 'D $10,000-$24,999"
D LESS THAN $5,000
D $10.000-$24,999
D LESS THAN S5.000
D $10,000-S24,999
D LESS THAN $5,000
D $10,000-$24,999
D LESS THAN $5.000
D $10,000-$24,999
D LESS THAN $5,000
D $10,000-S24,999
CI LESS THAN S5.0OO
D $10,000-324,999
D $5,000-$9,999
D S25.000-OR MORE
D $5,000-$9,999
D $25,000-OR MORE
D $5,000-$9,999
D $25,000-OR MORE
D $5,000-$9,999
D $25,000-OR MORE
D $5,000-$9,999
D $25,000-OR MORE
D S5,000-$9,999
D $25,000-OR MORE
D Ss.ooo-*o,ooo
D S25.000-OR MORE
COPY AND ATTACH ADDITIONAL PAGES AS NECESSARY
Texas Ethics Commission P.O. Box 12070 Austin, Texas 78711-2070 (512)463-5800 1-800-325-8506
ASSETS OF BUSINESS ASSOCIATIONS PART 11A
NOTAPPUCABLE
Describe all assets of each corporation, firm, partnership, limited partnership, limited liability partnership, professionalcorporation, professional association, joint venture, or other business association in which you, your spouse, or a depen-dent child held, acquired, or sold 50 percent or more of the outstanding ownership and indicate the category of the amountof the assets. For more information, see FORM PFS-INSTRUCTION GUIDE.
When reporting information about a dependent child's activity, indicate the child about whom you are reporting byproviding the number under which the child is listed on the Cover Sheet.
BUSINESSASSOCIATION
NAME AND ADDRESS[3 (Check If Filer's Home Address)
Amarillo Incredible Pizza Mgmt., LLC720 S. Tyler, Suite 100, AMarillo, TX 79101
BUSINESS TYPE Single Member LLC3 HELD, ACQUIRED,
OR SOLD BY, FILER D SPOUSE D DEPENDENT CHILD
ASSETSDESCRIPTION
Cash
CATEGORY
jS LESS THAN $5,000 D $5,000-$9,999
D $10,000-$24,999 Q $25,000-OR MORE
D LESS THAN $5,000 D $5,000-$9,999
D $10,000-$24,999 D $25.000-OR MORE
D LESS THAN $5,000 D $5,000-$9,999
D $10,000-524,999 D $25,000-OR MORE
D LESS THAN $5,000 D $5,000-$9,999
D $10,000-$24,999 D $25,000-OR MORE
D LESS THAN $5,000 D $5,000-$9,999
D $10,000-$24,999 D $25,000-OR MORE
D LESS THAN $5,000 D $5,000-$9,999
D $10,000-524.999 D $25,000-OR MORE
D LESS THAN $5,000 D $5,000-$9,999
D $ 10,000-$24,999 Q $25,000-OR MORE
LESS THAN S5.0OO d S*.ooo_£0,ooo
$10,000-524,999 Q 525,000-OR MORE
COPY AND ATTACH ADDITIONAL PAGES AS NECESSARY
Texas Ethics Commission P.O. Box12070 Austin, Texas 78711-2070 (512)463-5800 1-800-325-8506
ASSETS OF BUSINESS ASSOCIATIONS PART 11A
NOT APPLICABLE
Describe all assets of each corporation, firm, partnership, limited partnership, limited liability partnership, professionalcorporation, professional association, joint venture, or other business association in which you, your spouse, or a depen-dent child held, acquired, or sold 50 percent or more of the outstanding ownership and indicate the category of the amountof the assets. For more information, see FORM PFS-INSTRUCTION GUIDE.
When reporting information about a dependent child's activity, indicate the child about whom you are reporting byproviding the number under which the child is listed on the Cover Sheet.
1 BUSINESSASSOCIATION
2 BUSINESS TYPE
3 HELD, ACQUIRED,OR SOLD BY
4 ASSETS
NAME AND ADDRESS
BC PiZZa LP f~l (Check If Filer's Home Address)
720 S. Tyler, Suite 100, AMarillo, TX 79101
Limited Partnership
DESCRIPTION CATEGORY
H LESS THAN $5,000 D $5,000--$9,999
Cash D $10,000-$24,999 D $25,000-OR MORE
® LESS THAN $5,000 D $5,000~$9,999
Accounts Receivable D $io,ooo-$24,999 D $25,ooo~OR MORE
D LESS THAN $5,000 5^ $5,000-$9,999
jn t D $10,000-424,999 Q $25,000~OR MORE
D LESS THAN $5,000 D $5,000-$9,999
Fixed Assets D $10,000-$24,999 £3 $25,000~OR MORE
D LESS THAN $5,000 D $5,000~$9,999
Other Assets D $io,ooo-$24,999 S3 $25,ooo~OR MORE
D LESS THAN $5,000 D $5,000-49,999
D $10,000-$24,999 D $25,000--OR MORE
D LESS THAN $5,000 D S5,000~$9,999
D $10,000~$24,999 D $25,000-OR MORE
D LESS THAN $5,000 D $5,000-$9,999
D $10,000-$24,999 D $25,000-OR MORE
COPY AND ATTACH ADDITIONAL PAGES AS NECESSARY
Texas Ethics Commission P.O. Box 1 2070 Austin. Texas 7871 1 -2070 (51 2) 463-5800 1-800-325-8506r— — •
ASSETS OF BUSINESS ASSOCIATIONS PART 1 1 A
fj NOTAPPUCABLE
Describe all assets of each corporation, firm, partnership, limited partnership, limited liability partnership, professionalcorporation, professional association, joint venture, or other business association in which you, your spouse, or a depen-dent child held, acquired, or sold 50 percent or more of the outstanding ownership and indicate the category of the amountof the assets. For more information, see FORM PFS-INSTRUCTION GUIDE.
When reporting information about a dependent child's activity, indicate the child about whom you are reporting byproviding the number under which the child is listed on the Cover Sheet.
1 BUSINESSASSOCIATION
2 BUSINESS TYPE
3 HELD.ACQUIRED,OR SOLD BY
4 ASSETS
NAME AND ADDRESSQ (Check If Piter's Home Address)
Renaissance Laser LP720 S. Tyler, Suite 100, Amarillo, TX 79101
Limited Partnership
j^j FILER D SPOUSE D DEPENDENT CHILD
DESCRIPTION CATEGORY
D LESS THAN $5,000 D $5,000-$9,999
, (Sf $10,000-$24,999 Q $25,000-OR MORECash *^
D LESS THAN $5,000 D $5.000-$9,999
Fixed Assets D $10,000-$24,999 5$ $25,000-OR MORE
D LESS THAN $5,000 O $5,000-$9,999
Inventory D $10,000-$24,999 ^$25,000-ORMORE
D LESS THAN $5,000 D $5,000-$9,999
D $10,000-S24,999 53 S25.000-OR MOREIntangible Assets ^
D LESS THAN $5,000 D $5,000-$9,999
Other Assets D $io,ooo-$24,999 fa$25,ooo-OR MORE
D LESS THAN $5,000 D $5,000-$9,999
D $10,000-324,999 D $25,000~OR MORE
D LESS THAN $5,000 D $5,000-$9,999
D $10.000-324,999 Q $25,000-OR MORE
O LESS THAW ss.ooo CD *e,ooo-«e,333
D $10,000-524,999 Q $25,000~OR MORE
COPY AND ATTACH ADDITIONAL PAGES AS NECESSARY- . . . .
Texas Ethics Commission P.O. Box 12070 Austin, Texas 78711-2070 (512)463-5800 1-800-325-8506
ASSETS OF BUSINESS ASSOCIATIONS PART 11A
NOTAPPUCABLE
Describe all assets of each corporation, firm, partnership, limited partnership, limited liability partnership, professionalcorporation, professional association, joint venture, or other business association in which you, your spouse, or a depen-dent child held, acquired, or sold 50 percent or more of the outstanding ownership and indicate the category of the amountof the assets. For more information, see FORM PFS-INSTRUCTION GUIDE.
When reporting information about a dependent child's activity, indicate the child about whom you are reporting byproviding the number under which the child is listed on the Cover Sheet.
BUSINESSASSOCIATION
NAME AND ADDRESSQ (Check If Bier's Home Address)
S Fiberglass Ltd.720 S. Tyler, Suite 100, AMarillo, TX 79101
BUSINESS TYPE Limited Partnership3 HELD, ACQUIRED,
OR SOLD BYFILER D SPOUSE D DEPENDENT CHILD
ASSETSDESCRIPTION CATEGORY
D LESS THAN $5,000 D $5,000-59,999
Cash D $10,000-$24,999 I $25,000-OR MORE
Accounts Receivable
D LESS THAN $5,000 D $5,000-$9,999
D $10,000-$24,999 j $25,000-OR MORE
InventoryD LESS THAN $5,000 D $5,000-$9,999
D $10,000-$24,999 W$25,000-OR MORE
Equipment
D LESS THAN $5,000 D $5,000-$9,999
D $10,000-$24,999 W $25,000-OR MORE
Other Current AssetsD LESS THAN $5,000 D $5,000-$9,999
D $ 10,000-$24,999 fe'$25,000-OR MORE
Intangible AssetsD LESS THAN $5,000 D $5,000-$9,999
D $10,000-$24,999 $25,000-OR MORE
D LESS THAN $5,000 D $5,000-$9,999
D $10,000-$24,999 Q $25,000-OR MORE
D LESS THAN S5.000 D $5,000-$9,999
O $10,000-$24,999 O $25,000-OR MORE
COPY AND ATTACH ADDITIONAL PAGES AS NECESSARY
Texas Ethics Commission P.O. Box 12070 Austin, Texas 78711-2070 (512)463-5800 1-800-325-8506
ASSETS OF BUSINESS ASSOCIATIONS PART 11A
NOTAPPUCABLE
Describe all assets of each corporation, firm, partnership, limited partnership, limited liability partnership, professionalcorporation, professional association, joint venture, or other business association in which you, your spouse, or a depen-dent child held, acquired, or sold 50 percent or more of the outstanding ownership and indicate the category of the amountof the assets. For more information, see FORM PFS-INSTRUCTION GUIDE.
When reporting information about a dependent child's activity, indicate the child about whom you are reporting byproviding the number under which the child is listed on the Cover Sheet.
BUSINESSASSOCIATION
NAME AND ADDRESS(Check If Filer's Home Address)
S Glass LLC720 S. Tyler, Suite 100, AMarillo, TX 79101
2 BUSINESS TYPE Limited Liability Company3 HELD, ACQUIRED,
OR SOLD BYD FILER D SPOUSE D DEPENDENT CHILD
ASSETSDESCRIPTION
Cash
CATEGORY
D LESS THAN $5,000 ^$5,000-$9,999
D $10,000-$24,999 Q $25,000-OR MORE
D LESS THAN $5,000 D $5,000-$9,999
D $10,000-$24,999 D 525,000-OR MORE
D LESS THAN $5.000 O $5,000-$9,999
D $10,000-$24,999 Q S25.000-OR MORE
D LESS THAN $5,000 D $5,000-S9,999
D $10,000-$24,999 D $25,000-OR MORE
D LESS THAN $5,000 D $5,000-$9,999
D $10,000-$24,999 D $25,000-OR MORE
D LESS THAN $5,000 D $5.000-$9,999
D $10,000-$24,999 D $25,000-OR MORE
D LESS THAN $5,000 D S5,000-$9,999
D $10,000-S24,999 D $25,000-OR MORE
[ LESS THAM SA.rwi *s,ooo-*o,ooo
D $ 10,000-$24,999 D $25,000-OR MORE
COPY AND ATTACH ADDITIONAL PAGES AS NECESSARY
Texas Ethics Commission P.O. Box 12070 Austin, Texas 78711-2070 (512)463-5800 1-800-325-8506
ASSETS OF BUSINESS ASSOCIATIONS PART 11A
NOTAPPLICABLE
Describe all assets of each corporation, firm, partnership, limited partnership, limited liability partnership, professionalcorporation, professional association, joint venture, or other business association in which you, your spouse, or a depen-dent child held, acquired, or sold 50 percent or more of the outstanding ownership and indicate the category of the amountof the assets. For more information, see FORM PFS-INSTRUCTION GUIDE.
When reporting information about a dependent child's activity, indicate the child about whom you are reporting byproviding the number under which the child is listed on the Cover Sheet.
BUSINESSASSOCIATION
NAME AND ADDRESS(Check If Bier's Home Address)
Madison Scott Enterprises, LLC720 5. Tyler, Suite 100, Amarillo, TX 79101
2 BUSINESS TYPE
3 HELD, ACQUIRED,OR SOLD BY
FILER D SPOUSE DEPENDENT CHILD
ASSETSDESCRIPTION
Cash
CATEGORY
|E] LESS THAN $5,000 D $5,000-$9,999
D S10,000-$24,999 D $25,000-OR MORE
D LESS THAN $5,000 D $5,000-$9,999
D $10,000-$24,999 Q $25,000-OR MORE
D LESS THAN $5,000 D $5,000-$9,999
D $10,000-524,999 D $25,000-OR MORE
D LESS THAN $5,000 D $5,000-$9,999
D $10,000-$24,999 D S25.000-OR MORE
D LESS THAN $5,000 D $5,000-$9,999
D $10,000-$24,999 Q $25,000-OR MORE
D LESS THAN $5,000 D $5,000~$9,999
D $10,000-$24,999 Q $25,000-OR MORE
D LESS THAN $5,000 D $5,000-$9,999
D $10,000-$24,999 D $25,000-OR MORE
D LESS THAN $5,000 D $5,000-$9,999
D $10,OOO-$24,999 D $25,000-OR MORE
COPY AND ATTACH ADDITIONAL PAGES AS NECESSARY
Texas Ethics Commission P.O. Box 12070 Austin, Texas 78711-2070 (512)463-5800 1-800-325-8506
ASSETS OF BUSINESS ASSOCIATIONS PART 11A
NOTAPPLICABLE
Describe all assets of each corporation, firm, partnership, limited partnership, limited liability partnership, professional
dent child held, acquired, or sold 50 percent or more of the outstanding ownership and indicate the category of the amountof the assets. For more information, see FORM PFS-INSTRUCTION GUIDE.
When reporting information about a dependent child's activity, indicate the child about whom you are reporting byproviding the number under which the child is listed on the Cover Sheet.
1 BUSINESSASSOCIATION
2 BUSINESS TYPE
3 HELD, ACQUIRED,OR SOLD BY
4 ASSETS
NAME AND ADDRESS[] (Check If Filer's Home Address)
The Secret Ring, LLC720 S. Tyler, Suite 100, AMarillo, TX 79101
Limited Liability Company
DESCRIPTION CATEGORY
( LESS THAN $5,000 D $5,000-$9,999
D $10,000-$24,999 D $25,000-OR MORECash . . . . . . . .
D LESS THAN $5,000 D $5,000-$9,999
D $10,000-$24,999 Q $25,000-OR MORE
D LESS THAN $5,000 D $5,000-$9,999
D $10,000~$24,999 Q $25,000-OR MORE
D LESS THAN $5,000 D $5,000-$9,999
D $10,000-$24,999 D $25,000-OR MORE
D LESS THAN $5,000 D $5,000-$9,999
D $10,000~$24,999 Q $25,000-OR MORE
D LESS THAN $5,000 D $5,000~$9,999
D $10,000-$24,999 D $25,000--OR MORE
D LESS THAN $5,000 D $5,000-$9,999
D $10,000-$24,999 D $25,000~OR MORE
D LESS THAN $5,000 D $5,000~$9,999
D $10,000-$24,999 D $25,000~OR MORE
COPY AND ATTACH ADDITIONAL PAGES AS NECESSARY
Texas Ethics Commission P.O. Box 12070 Austin, Texas 78711-2070 (512)463-5800 1-800-325-8506
LIABILITIES OF BUSINESS ASSOCIATIONS
FT] NOTAPPLICABLE
PART11B
Describe all liabilities of each corporation, firm, partnership, limited partnership, limited liability partnership, professionalcorporation, professional association, joint venture, or other business association in which you, your spouse, or a depen-dent child held, acquired, or sold 50 percent or more of the outstanding ownership and indicate the category of the amountof the assets. For more information, see FORM PFS-INSTRUCTION GUIDE.
When reporting information about a dependent child's activity, indicate the child about whom you are reporting byproviding the number under which the child is listed on the Cover Sheet.
1 BUSINESSASSOCIATION
2 BUSINESS TYPE
3 HELD, ACQUIRED,OR SOLD BY
* LIABILITIES
NAME AND ADDRESSQ (Check If Filer's Home Address)
Amarillo Incredible Pizza Co., Ltd.720 S. Tyler, Amarillo, TX 79101
Limited Partnership
^ FILER D SPOUSE Q DEPENDENT r*mi n -
DESCRIPTION CATEGORY
D LESS THAN $5,000 D $5,000-$9,999
Current Liabilities D $io,ooo-$24,999 0 $25,ooo-oR MORE
D LESS THAN $5,000
Notes Payable 1 yr. or mor Q $io,ooo-$24,999
D LESS THAN $5,000
D $10,000-$24,999
D LESS THAN $5,000
D $10,000-$24,999
D LESS THAN $5,000
D $10,000~$24,999
D LESS THAN $5,000
D $10,000-$24,999
D LESS THAN $5,000
D $10,000-$24,999
D LESS THAN $5.000
D $10,000-$24,999
D $5,000-$9,999
EJ $25,000-OR MORE
D $5,000-$9,999
D $25,000-OR MORE
D $5,000-$9,999
D $25,000-OR MORE
D $5,000-$9,999
D $25,000-OR MORE
D $5,000-$9,999
D $25,000-OR MORE
D $5,000-$9,999
D $25,000-OR MORE
n $5.000-$a.999
D $25,000-OR MORE
COPY AND ATTACH ADDITIONAL PAGES AS NECESSARY
Revised 11/01/2007
Texas Ethics Commission P.O. Box 12070 Austin, Texas 78711-2070 (512)463-5800 1-800-325-8506
LIABILITIES OF BUSINESS ASSOCIATIONS PART 11B
NOTAPPLICABLE
Describe all liabilities of each corporation, firm, partnership, limited partnership, limited liability partnership, professionalcorporation, professional association, joint venture, or other business association in which you, your spouse, or a depen-dent child held, acquired, or sold 50 percent or more of the outstanding ownership and indicate the category of the amountof the assets. For more information, see FORM PFS-INSTRUCTION GUIDE.
When reporting information about a dependent child's activity, indicate the child about whom you are reporting byproviding the number under which the child is listed on the Cover Sheet.
BUSINESSASSOCIATION
NAME AND ADDRESS[] (Check If Filer's Home Address)
Wired For Fun, Ltd.720 S. Tyler, Suite 100, AMarillo, TX 79101
2 BUSINESS TYPE Limited Partnership3 HELD,ACQUIRED,
OR SOLD BYFILER D SPOUSE D DEPENDENT CHILD
LIABILITIESDESCRIPTION
Notes Payable 1 yr or more
CATEGORY
D LESS THAN $5,000 D $5,000-$9,999
D $10,000-$24,999 $25,000-OR MORE
D LESS THAN $5,000 D $5,000-39,999
D $10,000-$24,999 D $25,000~OR MORE
I LESS THAN $5,000 D $5,000~$9,999
$10,000-$24,999 D $25,000~OR MORE
D LESS THAN $5,000 D $5,000-$9,999
D $10,000-$24,999 D $25,000~OR MORE
D LESS THAN $5,000 D $5,000-$9,999
D $10,000-$24,999 D $25,000-OR MORE
D LESS THAN $5,000 D $5,000-$9,999
D $10,000~$24,999 D $25,000-OR MORE
D LESS THAN $5,000 D $5,000-$9,999
D $10,000~$24,999 D $25,000~OR MORE
D LESS THAN $5,000 D $5,000-$9,999
CD $10,000-$24,999 D $25,000-OR MORE
COPY AND ATTACH ADDITIONAL PAGES AS NECESSARY
Revised 11/01/2007
Texas Ethics Commission P.O. Box 12070 Austin, Texas 78711-2070 (512) 463-5800 1 -800-325-8506
LIABILITIES OF BUSINESS ASSOCIATIONS
fj NOTAPPUCABLE
PART 11 B
Describe all liabilities of each corporation, firm, partnership, limited partnership, limited liability partnership, professionalcorporation, professional association, joint venture, or other business association in which you, your spouse, or a depen-dent child held, acquired, or sold 50 percent or more of the outstanding ownership and indicate the category of the amountof the assets. For more information, see FORM PFS-INSTRUCTION GUIDE.
When reporting information about a dependent child's activity, indicate the child about whom you are reporting byproviding the number under which the child is listed on the Cover Sheet.
1 BUSINESSASSOCIATION
2 BUSINESS TYPE
3 HELD, ACQUIRED,OR SOLD BY
* LIABILITIES
NAME AND ADDRESSfj (Check If Filer's Home Address)
Renaissance Laser, LP720 S. Tyler, Suite TOO, Amarillo, TX 79101
Limited Partnership
S3 FILER D SPOUSE D DEPENDENTy^t
DESCRIPTION CATEGORY
D LESS THAN $5,000 D $5.000-$9,999Notes payable 1 yr or
more D $10,000-$24,999 £3 $25,000-OR MORE
D LESS THAN $5,000
Other Payables D $io,ooo-$24,999
D LESS THAN $5,000
D $10,000-$24,999
D LESS THAN $5,000
D $10,000-$24,999
D LESS THAN $5,000
D $10,000-$24,999
D LESS THAN $5,000
D $10,000-$24,999
D LESS THAN $5.000
D $10,000-$24,999
D LESS THAN $5 OOO
D $10,000-$24,999
D $5,000-49,999
J2 $25,000-OR MORE
D $5,000-$9,999
D $25,000-OR MORE
D $5.000-$9,999
D $25,000-OR MORE
D $5,000-$9,999
D $25,000-OR MORE
D $5,000-$9,999
D $25,000~OR MORE
D $5,000-$9,999
D $25,000-OR MORE
O $s,nno-$o,Q09
D $25,000-OR MORE
COPY AND ATTACH ADDITIONAL PAGES AS NECESSARY— .. ti .
Texas Ethics Commission P.O. Box 12070 Austin, Texas 78711-2070 (512)463-5800 1-800-325-8506
LIABILITIES OF BUSINESS ASSOCIATIONS
fj NOTAPPUCABLE
PART11B
Describe all liabilities of each corporation, firm, partnership, limited partnership, limited liability partnership, professionalcorporation, professional association, joint venture, or other business association in which you, your spouse, or a depen-dent child held, acquired, or sold 50 percent or more of the outstanding ownership and indicate the category of the amountof the assets. For more information, see FORM PFS-INSTRUCTION GUIDE.
When reporting information about a dependent child's activity, indicate the child about whom you are reporting byproviding the number under which the child is listed on the Cover Sheet.
1 BUSINESSASSOCIATION
NAME AND ADDRESS(Check If Filer's Home Address)
BC Pizza, LP720 S. Tyler, Amarillo, TX 79101
2 BUSINESS TYPE Limited Partnership3 HELD, ACQUIRED,
OR SOLD BYFILER D SPOUSE D DEPENDENT CHILD
LIABILITIESDESCRIPTION
Accounts Payable
Other Current Liabilities
Long Term Liabilities
CATEGORY
D LESS THAN $5,000 D $5,000-$9.999
El $10,000-$24,999 $25,000-OR MORE
D LESS THAN $5,000 D $5,000-$9,999
D $10,000-524,999 0$25,000-OR MORE
D LESS THAN $5,000 D $5,000-$9,999
D $10,000-$24,999 fj& $25,000-OR MORE
D LESS THAN $5,000 D $5,000-$9,999
D $10,000-$24,999 Q $25,000-OR MORE
D LESS THAN $5,000 D $5,000-$9,999
D $10,OOO-$24,999 Q $25,000-OR MORE
D LESS THAN $5,000 D $5,000-$9,999
D $10,000-$24,999 D $25,000-OR MORE
D LESS THAN $5,000 D $5,000-$9,999
D $10,000-$24,999 D $25,000-OR MORE
0 LESS THAN ss.ooo CU $s,ooo 50,009
D $10,000-$24,999 Q $25,000-OR MORE
COPY AND ATTACH ADDITIONAL PAGES AS NECESSARY
Texas Ethics Commission P.O. Box 12070 Austin, Texas 78711-2070 (512)463-5800 1-800-325-8506rLIABILITIES OF BUSINESS ASSOCIATIONS PART 11B
NOTAPPLICABLE
USSUnOc ail liauillUSS Ul cawi uurjJUiauun, mill, pen iiiei&mp, iimiicu (jcuuioifiiiip, IIIIRUTU nauniiy pai u 10 CH up, piwioooimicii
corporation, professional association, joint venture, or other business association in which you, your spouse, or a depen-dent child held, acquired, or sold 50 percent or more of the outstanding ownership and indicate the category of the amountof the assets. For more information, see FORM PFS-INSTRUCTION GUIDE.
When reporting information about a dependent child's activity, indicate the child about whom you are reporting byproviding the number under which the child is listed on the Cover Sheet.
1 BUSINESSASSOCIATION
2 BUSINESS TYPE
3 HELD, ACQUIRED,OR SOLD BY
* LIABILITIES
NAME AND ADDRESS„ . , , . , ~I (Check If Filer's Home Address)S Fiberglass Ltd LJ
720 S.... Tyler, Suite. 100, AMarillo, TX 79101
Limited Partnership
D CII I=D I I *5POl I F I I npppwnpwr r*mr n
DESCRIPTION CATEGORY
D LESS THAN $5,000 D $5,000-$9,999
Notes payable 1 year ,-, .— .or more D $io,ooo-$24,999 0 $2s,ooo-OR MORE
D LESS THAN $5,000 D $5,000-$9,999
Accounts Payable D $io,ooo-$24,999 B $25,ooo~OR MORE
D LESS THAN $5,000 D $5,000-$9,999
D $10,000-$24,999 Q $25,000-OR MORE
D LESS THAN $5,000 D $5,000-$9,999
D $10,000-$24,999 D $25,000-OR MORE
D LESS THAN $5.000 D $5,000-$9,999
D $10,000-$24,999 Q $25,000-OR MORE
D LESS THAN $5.000 D $5,000-$9,999
D $10,000-$24,999 Q $25,000-OR MORE
D LESS THAN $5,000 D $5,000-$9,999
D $10,000-$24.999 D $25,000-OR MORE
D LESS THAN £5 OOO f~l s<;.fvvv_To,ooo
D $10,000-$24,999 D S25.000-OR MORE
COPY AND ATTACH ADDITIONAL PAGES AS NECESSARY
Revised 11/01/2007
Texas Ethics Commission P.O. Box 12070 Austin, Texas 78711-2O7O (512)463-5800 1-800-325-8506
BOARDS AND EXECUTIVE POSITIONS PART 12
NOT APPLICABLE
List all boards of directors of which you, your spouse, or a dependent child are a member and all executive positions you,
ships, professional corporations, professional associations, joint ventures, other business associations, or proprietorships,stating the name of the organization and the position held. For more information, see FORM PFS-INSTRUCTION GUIDE.
When reporting information about a dependent child's activity, indicate the child about whom you are reporting byproviding the number under which the child is listed on the Cover Sheet.
1 ORGANIZATION
2 POSITION HELD
3 POSITION HELD BY
ORGANIZATION
POSITION HELD
POSITION HELD BY
ORGANIZATION
POSITION HELD
POSITION HELD BY
ORGANIZATION
POSITION HELD
POSITION HELD BY
ORGANIZATION
POSITION HELD
POSITION HELD BY
Amarillo Chamber of Commerce
Executive Committee Board Member
£3 Fl! EP QSPOUSF D DEPENDENT CHILD
n Fll FR D SPOUSE D DEPENDENT CHII D
F| FILER [H SPOUSE fj DEPENDENT CHILD
PI FILER (~1 SPOUSE (~) DEPENDENT CHII D
l~~| Fll FR (~~| SPOI IRF |~~l nFPFWnFWT CHILD
COPY AND ATTACH ADDITIONAL PAGES AS NECESSARY
Revised 11/O1/2007
Texas Ethics Commission P.O. Box 12070 Austin, Texas 78711-2070 (512)463-5800 1-800-325-8506
EXPENSES ACCEPTED UNDER HONORARIUM EXCEPTION PART 13
NOTAPPLICABLE
Identify any person who provided you with necessary transportation, meals, or lodging, as permitted under section 36.07(b)of the Penal Code, in connection with a conference or similar event in which you rendered services, such as addressing anaudience or participating in a seminar, that were more than perfunctory. Also provide the amount of the expenditures ontransportation, meals, or lodging. You are not required to include items you have already reported as political contributionson a campaign finance report, or expenditures required to be reported by a lobbyist under the lobby law (chapter 305 of theGovernment Code). For more information, see FORM PFS-INSTRUCTION GUIDE.
1 PROVIDER
2 AMOUNT
PROVIDER
NAME AND ADDRESS
NAME AND ADDRESS
AMOUNT
PROVIDERNAME AND ADDRESS
AMOUNT
PROVIDERNAME AND ADDRESS
AMOUNT
COPY AND ATTACH ADDITIONAL PAGES AS NECESSARY
Revised 11/01/2007
Texas Ethics Commission P.O. Box 12070 Austin, Texas 78711-2070 (512)463-5800 1-800-325-8506
INTEREST IN BUSINESS IN COMMON WITH LOBBYIST PART 14
g] NOTAPPLICABLE
Identify each corporation, firm, partnership, limited partnership, limited liability partnership, professional corporation, profes-sional association, joint venture, or other business association, other than a publicly-held corporation, in which you, yourspouse, or a dependent child, and a person registered as a lobbyist under chapter 305 of the Government Code that both havean interest. For more information, see FORM PFS-INSTRUCTION GUIDE.
1 BUSINESS ENTITY
2 INTEREST HELD BY
BUSINESS ENTITY
INTEREST HELD BY
BUSINESS ENTITY
INTEREST HELD BY
- • " " - •"""
BUSINESS ENTITY
INTEREST HELD BY
BUSINESS ENTITY
INTEREST HELD BY
NAME AND ADDRESS
n FILER D SPOUSE D DEPENDENT CHILD
NAME AND ADDRESS
Q FILER D «P<">' isp D npPFNnpNT CHII n
NAME AND ADDRESS
[U Fl| FR D SPOIISF rj nFPFNDFNT CHII D
NAME AND ADDRESS
Q FH FR L~3 SPOI ISF Q DFPFNDFNT CHII O
NAME AND ADDRESS
Q FH FR fj RP01JSF O RFPFNIDFIMT CHII n
COPY AND ATTACH ADDITIONAL PAGES AS NECESSARY
Texas Ethics Commission P.O. Box 12070 Austin, Texas 78711-2070 (512)463-5800 1-800-325-8506
FEES RECEIVED FOR SERVICES RENDEREDTO A LOBBYIST OR LOBBYIST'S EMPLOYER
PART 15
NOT APPLICABLE
Report any fee you received for providing services to or on behalf of a person required to be registered as a lobbyist underchapter 305 of the Government Code, or for providing services to or on behalf of a person you actually know directly compen-sates or reimburses a person required to be registered as a lobbyist. Report the name of each person or entity for which theservices were provided, and indicate the category of the amount of each fee. For more information, see FORM PFS--INSTRUCTION GUIDE.
PERSON OR ENTITYFOR WHOM SERVICESWERE PROVIDED
FEE CATEGORY D LESS THAN $5,000 D $5,000~$9,999 D $10,000-$24,999 D $25,000-OR MORE
PERSON OR ENTITYFOR WHOM SERVICESWERE PROVIDED
FEE CATEGORY D LESS THAN $5,000 D $5,000-$9,999 D $10,000-$24,999 D $25,000~OR MORE
PERSON OR ENTITYFOR WHOM SERVICESWERE PROVIDED
FEE CATEGORY D LESS THAN $5,000 D $5,000-$9,999 D $10,000-$24,999 D $25,000~OR MORE
PERSON OR ENTITYFOR WHOM SERVICESWERE PROVIDED
FEE CATEGORY
PERSON OR ENTITYFOR WHOM SERVICESWERE PROVIDED
D LESS THAN $5,000 D $5,000-$9,999 D $10,000-$24,999 D $25,000-OR MORE
FEE CATEGORY D LESS THAN $5,000 D $5,000-$9,999 D $10,000-$24,999 D $25,000~OR MORE
PERSON OR ENTITYFOR WHOM SERVICESWERE PROVIDED
FEE CATEGORYD LESS THAN $5,000 CU $5,000-$9,999 D $10,000-$24,999 D $25,000-OR MORE
COPY AND ATTACH ADDITIONAL PAGES AS NECESSARY
Texas Ethics Commission P.O. BOX12070 Austin, Texas 78711-2070 (512)463-5800 1-800-325-8506
REPRESENTATION BY LEGISLATOR BEFORESTATE AGENCY
fyj NOTAPPLICABLE'^ TS,
PART 16
This section applies only to members of the Texas Legislature. A member of the Texas Legislature who represents a personfor compensation before a state agency in the executive branch must provide the name of the agency, the
information, see FORM PFS-INSTRUCTION GUIDE.
Note: Beginning September 1 , 2003, legistatorsr may not, for compensation, represent another person before a stateagency in the executive branch. The prohibition does not apply if: (1 ) the representation is pursuant to an attorney/clientrelationship in a criminal law matter; (2) the representation involves the filing of documents that involve only ministerial actson the part of the agency; or (3) the representation is in regard to a matter for which the legislator was hired beforeSeptember 1,2003.
1 STATE AGENCY
2 PERSON REPRESENTED
3FEE CATEGORY
STATE AGENCY
PERSON REPRESENTED
FEE CATEGORY
STATE AGENCY
PERSON REPRESENTED
FEE CATEGORY
STATE AGENCY
PERSON REPRESENTED
FEE CATEGORY
D LESS THAN $5,000 D $5,000-$9,999 D $10,000-$24,999 D $25,000-OR MORE
D LESS THAN $5,000 D $5,000-$9,999 D $10,000-$24,999 D $25,000-OR MORE
D LESS THAN $5,000 D $5,000-$9,999 D $10,000~$24,999 D $25,000-OR MORE
D LESS THAN $5,000 D $5,000~$9,999 D $10,000~$24,999 D $25,000-OR MORE
f*<"»DV AKin ATTAf^U AnniTH~>MAi OA/^ee? A o kier/^eoe" A nv
Revised 11/01/2007
Texas Ethics Commission P.O. Box12070 Austin, Texas 78711-2070 (512)463-5800 1-800-325-8506
BENEFITS DERIVED FROM FUNCTIONS HONORING PART 1 7PUBLIC SERVANT
fej NOTAPPLICABLE/"v
Section 36.10 of the Penal Code provides that the gift prohibitions set out in section 36.08 of the Penal Code do not applyto a benefit derived from a function in honor or appreciation of a public servant required to file a statement under chapter 572of the Government Code or title 1 5 of the Election Code if the benefit and the source of any benefit over $50 in value are: 1 )reported in the statement and 2) the benefit is used solely to defray expenses that accrue in the performance of duties oractivities in connection with the office which are nonreimbursable by the state or a political subdivision. If such a benefit isreceived and is not reported by the public servant under title 1 5 of the Election Code, the benefit is reportable here. For moreinformation, seeFORMP-FS-JNSTRUCTJON GUIDE.
1 SOURCE OF BENEFIT
BENEFIT
SOURCE OF BENEFIT
BENEFIT
SOURCE OF BENEFIT
BENEFIT
SOURCE OF BENEFIT
BENEFIT
NAME AND ADDRESS
NAME AND ADDRESS
NAME AND ADDRESS
NAME AND ADDRESS
COPY AND ATTACH ADDITIONAL PAGES AS NECESSARY
Texas Ethics Commission P.O. Box12070 Austin, Texas 78711-2070 (512)463-5800 1-800-325-8506
LEGISLATIVE CONTINUANCES PART 18
NOTAPPLICABLE
Identify any legislative continuance that you have applied for or obtained under section 30.003 of the Civil Practiceand Remedies Code, or under another law or rule that requires or permits a court to grant continuances on thegrounds that an attorney for a party is a member or member-elect of the legislature.
NAME OF PARTYREPRESENTED
DATE RETAINED
STYLE, CAUSE NUMBER,COURT & JURISDICTION
DATE OF CONTINUANCEAPPLICATION
WAS CONTINUANCEGRANTED?
NAME OF PARTYREPRESENTED
YES DNO
DATE RETAINED
STYLE, CAUSE NUMBER,COURT, & JURISDICTION
DATE OF CONTINUANCEAPPLICATION
WAS CONTINUANCEGRANTED? DYES DNO
COPY AND ATTACH ADDITIONAL PAGES AS NECESSARY
Texas Ethics Commission P.O. Box 12070 Austin, Texas 78711-2070 (512)463-5800 1-800-325-8506
PERSONAL FINANCIAL STATEMENT AFFIDAVIT
The law requires the personal financial statement to be verified. The verification page must have the signature of theindividual required to file the personal financial statement, as well as the signature and stamp or seal of office of a notarypublic or other person authorized by law to administer oaths and affirmations. Without proper verification, the statementis not considered filed.
I swear, or affirm, under penalty of perjury, that my financial statementis true and correct and includes all infoirnatjojwequired to be reportedby me under chapter 572 of the GoysFnTnent Code.
„ LJNDANOSCHESE%\ MY COMMISSION EXPIRES
September 3,2010
Signature of Filer
AFFIX NOTARY STAMP / SEAL ABOVE
Sworn to and subscribed before me, by the said ^> @~ 6TT" this the
, 20 & o , to certify which, witness my hand and seal of office.
day of
hinature of officer administering oath Print name of officer administering oath Title of officer administering oath
Revised 11/01/20O7