HomeMy WebLinkAboutFinal-01.17.2012-JonroweTexas Ethics Commission P.O. Box 12070 Austin, Texas 78711-2070 (512)463-5800 {TDD 1-800-735-2989)
CANDIDATE/ OFFICEHOLDER REPORT:
FORM C/OH - FR
DESIGNATION OF FINAL REPORT
The Instruction Guide explains how to complete this form.
Complete only if "Report Type" on page I is marked "Final Report"
I C/01-1 NAME
6'
2 ACCOUNT # (Ethics Commission Filers)
c,
3 SIGNATURE
I do not expect any further political contributions or political expenditures in connection with my candidacy. I understand that designating a
report as a final report terminates my campaign treasurer appointment. I also understand that I may not accept any campaign contributions
or make any campaign expenditures without a campaign treasurer appointment on file. /-I
Signature of Candid to / 0older
4 FILER WHO IS NOT AN OFFICEHOLDER
— Complete A & B below only if you are not an officeholder.
A. CAMPAIGN FUNDS
Check only one:
I do not have unexpended contributions or unexpended interest or income earned from political contributions.
I have unexpended contributions or unexpended interest or income earned from political contributions. i understand that I may
not convert unexpended political contributions or unexpended interest or income earned on political contributions to personal
use. I also understand that I must file an annual report of unexpended contributions and that I may not retain unexpended
contributions or unexpended interest or income earned on political contributions longer than six years after filing this final
report. Further, I understand that I must dispose of unexpended political contributions and unexpended interest or income
earned on political contributions in accordance with the requirements of Election Code, § 254204.
B. ASSETS
k only one:
I do not retain assets purchased with political contributions or interest or other income from political contributions.
I do retain assets purchased with political contributions or interest or other income from political contributions. l understand that
I may not convert assets purchased with political contributions or interest or other income from political contributions to personal
use. I also understand that I must dispose of assets purchased with political contributions in accordance with the requirements
of Election Code, § 254.204.
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Signature qff CAAdirdate"
5 OFFICEHOLDER
Complete this section only if you are an officeholder
I arnaware that I remain subject to filing requirements applicable to an officeholderwho does not have a campaign treasurer on file.
I am also aware that I will be required to file reports of unexpended contributions if, after filing the last required report as an
officeholder, I retain political contributions, interest or other income from political ributions, or assets purchased with political
conte t I contributions.
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Signatureof6*4ceher
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www. ethics. state Revised 09/28/2011
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