Texas Ethics Commission P.O. Box 12070 Austin, Texas 78711-2070 (512) 463-5800 (TDD 1-800-735-2989I

CANDIDATE 1 OFFICEHOLDER FORM C/OHCAMPAIGN FINANCE REPORT COVER SHEET PG I

1 ACCOUNT # 2 Total pages filed:The C/OH Instruction Guide explains how to complete this form. (Ethics OornmissianFilers)

3 FIRST , MI

LAST SUFFIX

CANDIDATE / MS JMRS/ÿ.iÿOFFICEHOLDERNAME

• . .ÿ.'-oÿ.NICKNAME

4- CANDIDATE /OFFICEHOLDERMAILINGADDRESS

F--] change of address

ADDRESS 1 PO BOX; APT/SUITE#; CITY; STALE; ZIP CODE

!2 OFFICE

6 CANDIDATE/OFFICEHOLDERPHONE

I AREA CODE PHONE NUMBER EXTENSION6 CAMPAIGN I MS/MRS/MR FIRST MI Datelmaged

TREASURERI ÿ'ÿ6,,.._,NIAM F: ............... L. .....................

NICKNAME LAST SUFFIX

L/4g .CITY; STATE; ZIP CODE7 CAMPAIGN

TREASURERADDRESS(residenceorbusinesÿ

8 CAMPAIGNTREASURERPHONE

9 REPORT TYPE

tOPERIODCOVERED

it! ELECTION

(\,.

STREET ADDRESS (N0 PO BOX PLEASE); APTI SUITE-#;

AREA CODE PHONE NUMBER EXTENSION

[] January 15 [] 30th day before election [] Runoff [] 15th day after campaigntreasurer appointment

8ÿ (officeholder only)[---I July 15 day before electionÿI---1 Exceeded $500 [] Final report (Attach ClOH-FR)limit

Month Day year Month Day Year

ELECTION DATEMonth Day Year

¢/I / If

ELECTION TYPE

OFFICE HELD (if any) 13 OFFICESÿUGHTI ÿ.D{ifkn°wn)

OFFICE USE ONLY

Date Received

Date Hand-delivered or Postmarked

Receipt # Amount

Date Processed

GO TO PAGE 2

www.ethics.state.tx.us Revised 07/28/2014

Texas Ethics Commission R O. Box 12070 Austin, Texas 78711-2070

CANDIDATE / OFFICEHOLDER REPORT:SUPPORT & TOTALS

(512) 463-5800 (TDD 1-800-735-2989'

FORM C/OHCOVER SHEET PG 2

t4 C/OH NAME

16 NOTICE FROMPOLITICALCOMMITTEE(S)

t5 ACCOUNT.# (Ethics Commission Filets)

THIS BOX 1S FOR NOTICE OF POLITICAL CONTRIBUTIONS ACCEPTED OR pOLFnCAL F.X, PENDITLIRES ]ÿADE BY POLITICAL GOM Mnq'EES TO SUPPORT THE

CANDIDATE J OFFICEHOLDFPÿ THESE EXPENDITURES MAY HAVE BEEN MADE WITHOUT THE CANDIDATErS OR OFFICEHOLDERrS KNOWLEDGE OR

CONSENT, CANDIDATES AND OFFICEHOLDERS ARE REQUIRED TO REPORT THIS INFOP,ÿTION ONLY IF THEY RECEIVE NOTICE OF SUCH EXPENDITURES,

\

!7 CONTRIBUTIONTOTALS

2. TOTAL POLITICAL CONTRIBUTIONS(OTHER THAN PLEDGES, LOANS, OR GUARANTEES OF LOANS)

EXPENDITURETOTALS 3. TOTAL POLITICAL EXPENDITURES OF $100 OR LESS, UNLESS ITEMIZED $

4. TOTAL POLITICAL EXPENDITURES $

CONTRIBUTION 5. TOTAL POLITICAL CONTRIBUTIONS MAINTAINED AS OF THE LAST DAY eBALANCE OF REPORTING PERIOD ,p

OUTSTANDING 6. TOTAL PRIN CIPAL AMOU NT OF ALL OUTSTAN DING LOANS AS OF THE $LOAN TOTALS LAST. DAY OF THE REPORTING PERIOD

"18 AFFIDAVIT

[] additional pages

COMMITTEE TYPE

[ÿ1 GENERAL

'---]SPECIFIC

r-! COM[#]ITTEE NAMEIiiiI

COMMITTEE ADDRESS

COMMiTi-EE CAMPAIGN TREASURER NAME

COIvlMITTEE CAMPAIGN TREASURER ADDRESS

TOTAL POLITICAL CONTRIBUTIONS OF $50 OR LESS (OTHER THANPLEDGES, LOANS, OR GUARANTEES OF LOANS), UNLESS iTEMIZED $

$

I swear, or affirm, under penalty of perjury, that the accompanying reportis true and correct and includes all information required to be reported by

me under Title 15, Election Code.

Signature of Candidate or Officeholder

AFFIX NOTARY STAMP i SEAL ABOVE

Sworn to and subscribed before me, by the said

day of , 20 ____, this the

, to eeÿify which, witness my hand and seal of office.

Signature of officer administering oath Printed name of oÿcer administering oath Title of offic.÷r administering oath

www.ethics.state.tx.us Revised 07/28/2014

Texas Ethics Commission P.O. Box 12070, Austin, Texas 78711-2070 (512) 463-5800

POLITICAL CONTRIBUTIONSOTHER THAN PLEDGES OR LOANS

(TDD i-800-735-2989

SCHEDULE A

1 Total pages ScheduleA:The Instruction Guide explains how to complete this form.

2 FILER NAME 3 ACCOUNT # (Ethics Commission Filers)

4- Date 5 Full name of contdbutor r-]out-of-statePAC(ID#: )

9 Principal occupation I Job title (See Instructions)

Date

t!.

At

Principal occupation / Job title (See Instructions)

6 Contributor address; City; State; Zip Code

Furl name of contributor

Contributor address; City; State; Zip Code

[] out-of-state PAC(ID#:..

10 Emptoyer (See Instructions)

) Amount of 1contribution ($) I

III

7 Amountof t 8 in-kind contributioncontribution ($) I description (if applicable)

!1]

(If travel outside of Texas, complete Schedule T)

in-kind contributiondescription (if applicable)

(If travel outside of Texas, complete Schedule T)Employer (See Instructions)

Date

Principal occupation I Job title (See Instructions)

Full name of contributor [] out-of-state PAC (IEÿ

Contributor address; City; State; Zip Code

) Amount of } In-kind contributioncontribution ($) ] description (if applicable)

III

(If travel outside of Texas, complete ,Schedule T)

Employer (See Instructions)

Date

Principal occupation / Job title (See Instructions)

Full name of contributor [] out-of-state PAC(ID#:

Contributor address; City; Sÿate; Zip Code

Amount ofcontribution ($)

In-kind contributiondescription (if applicable)

(if travel outside of Texas, complete Schedule T)Employer (See Instructions)

Date

Principal occupation / Job title (See Instructions)

Full name of contributor [] 0ut-ef-statePAO(IDik.

Contributor address; City; ÿate; Zip Code

Amount of Icontribution ($) I

I]l

('If travel outside of Texas, complete Schedule T)

Employer (See Instructions)

In-kind contributiondescription (if applicable)

ATTACH ADDITIONAL COPIES OF THIS SCHEDULE AS NEEDEDIf contributor is out-of-state PAO, please see instruction guide foradditional reporting requirements.

www,ethics.state.tx.us Revised 07/28/2014

Texas Ethics Commission P.O. Box 12070 Austin, Texas 78711-2070 (512) 463-5800

POLITICAL EXPENDITURES

(TDD 1-800-735-2989'

SCHEDULE F

Advertising ExpenseAccounting/BankingConsulting ExpenseEvent ExpenseFees

"i Total pages Schedule F:

4- Date

EXPENDITURE CATEGORIES FOR BOX 8(a)Gift/Awards/Memorials Expense Salaries!Wages/Contract LaborLegal Services Selicitation!Fundraising ExpenseFood/Beverage Expense Travel In DistrictPolling Expense Travel Out Of DistrictPrinting Expense Office Overhead!Rental Expense

The Instruction Guide explains how to complete this form.

5 Payee name

7 Payee address; City; State; Zip Code

Loan Repayment/Reim bursem ant

Transportation Equipment & Related ExpenseContributions/Donations Made By

Candidate/Offioeholder/P olitical CommitteeOTHER (enter a category not listed above)

3 ACCOUNT # (Ethics Commission Filers)

8 PURPOSE I {a) Category (See cetegaries listed at the top of this schedule) I (b} Description (]ftravel outside of Texas, complete Schedule T)

OFtl I [] ChecktfAustth, T×, o#]ceholder living e×penee

9 Complete ONLY if direct Candidate I Officeholder name Office sought Office heldexpenditure to benefit C./OH

Date

Amount ($)

PUP.POSEOF

F-J(PENDITU RE

Payee name , ÿ,ÿ

Payee address; City; State Zip Code

Complete ONLY if directexpenditure to benefit CtOH

Category (See categories listed at the top of this schedule)

Candidate ] Officeholder name

Description (If travel outside of Texas, complete Schedule T)

r-] Check ifAustth, TX, o#3ceholder living expense

Office sought" Oÿce held

Date

Amount ($) Payee address; City; State; Zip Code

Category (See categories listed at the top of this schedule)PUP.POSE

JOF|'f" ' 'ÿ"ÿ" : "ÿ "lÿOÿ)ÿ. [] Check ifAustin, "IX, ofÿceholder living expense

i

EÿPENDITURE

C0mplete Oh]LY if direct Candidate I Officeholder name Office sought Oÿce heldexpenditure to benefit CIOH

Date Payee name

Amount (S) Payee address; City; State; Zip Code

Category (See categories listed at the top of this schedule)

Description (If travel outside of Texas, complete Schedule T)

PURPOSEOF

vE,,.PENDITURE

Complete ONLY if directexpenditure to benefit C/OH

Candidate / Oÿceholder name

Description (If travel outside of Texas, complete Schedule T)

[] Check ifAu slJn, l-X, oÿceholder living expense

Office sought Office held

ATTACH ADDITIONAL COPIES OF THIS SCHEDULE AS NEEDED

www.ethics.state.tx.us Revised 07/28t2014