HomeMy WebLinkAboutCFR-04.28.2017-JonroweCANDIDATE / OFFICEHOLDER
FORM C/OH
CAMPAIGN FBh\AMCE REPORT
COVER SHEET PG 1
1
Filer ID (Ethics Commission Filers)
2 Total pages filed:
The C/OH Instruction Guide explains how to complete this form.
19
3 CANDIDATE/
MS/MRS/MR FIRST
MI
OFFICE USE ONLY
OFFICEHOLDER
NAME
Ms. Rachael
Greulich
. . . . . . . . . . . . . . . . . . . . . . .
. . . . . . . . . . . . .
Dale ReceivedNICKNAME
LAST
SUFFIX
.Yonrowe
RECEIVED
4 CANDIDATE/
ADDRESS / PO BOX; APT / SUITE 9; CITY;
STATE; 21P CODE
OFFICMAILIPIEGHOLDER
308 S. Church Street Georgetown,
TX 78626
APR 2 8 2017
ADDRESS
❑ Change of Address
City Secretary
5 CANDIDATE/
AREA CODE PHONE NUMBER
EXTENSION
Date Hand-detivered ar Date Postmarked
OFFICEHOLDER
512 627-9596
PHONE
6 CAMPAIGN
MS / MRS / MR FIRST
MI
Receipt 9
Amount S
TREASURER
Mari
Date Processed
NAME
. . . . . .. . . . . .
. . . . . .
NICKNAME LAST
SUFFIX
Date Imaged
Ramirez
7 CAMPAIGN
STREET ADDRESS (NO PO BOX PLEASE); APT / SUITE
9: CIT'; STATE; ZIP CODE
TREASURER
407 W University Ave Suite 120
ADDRESS
Georgetown, TX 78626
(Residence or Business)
8 CAMPAIGN
AREA CODE PHONE NUMBER
EXTENSION
TREASURER
512 695-7226
PHONE
9 REPORT TYPE
January 15 El 30th day before election El Runoff 15th day after campaign
treasurer appointment
(Officeholder Only)
❑ July 15 ❑ 8th day before election
Exceeded$5001imi1 Final Report fAnach C/OH - FR)
10 PERIOD
Month Day Year
Month Day Year
COVERED
03 / 28 / 2017
04 / 26 / 2017
THROUGH
11 ELECTION
ELECTION DATE
ELECTION TYPE
Month Day Year
❑ Primary
Runoff ❑ Other
Description
05 / 06 / 2017X❑
General
Special
12 OFFICE
OFFICE HELD (it any)
13 OFFICE SOUGHr (9 known)
Georgetown City Council,
Georgetown City Council,
District 6
District 6
GO TO PAGE 2
Forms provided by Texas Ethics Commission www.ethics.stale.tx.us Revised 9/8/2015
CANDIDATE / OFFICEHOLDER
FORM C/OH
CAMPAIGN FINANCE REPORT COVER SHEET PG 2
14 C/OH NAME
15 Filer ID (Ethics Commission Filers)
16 NOTICE FROM
THIS BOX IS FOR NOTICE OF POLITICAL CONTRIBUTIONS ACCEPTED OR POLITICAL EXPENDITURES MADE BY POLITICAL COMMITTEES TO
POLITICAL
SUPPORT THE CANDIDATE/OFFICEHOLDER. THESE EXPENDITURES MAY HAVE BEEN MADE WTrHOUT THE CANDIDATES OR OFFICEHOLDERS
COMMITTEE(S)
KNOWLEDGE OR CONSENT. CANDIDATES AND OFFICEHOLDERS ARE REQUIRED TO REPORT THIS INFORMATION ONLY IF THEY RECEIVE NOTICE
OF SUCH EXPENDITURES.
COMMITTEE TYPE
COMMITTEE NAME
GENERAL
ADDRESS
r-JCOMMITTEE
SPECIFIC
COMMITTEE CAMPAIGN TREASURER NAME
Additional Pages
COMMITTEE CAMPAIGN TREASURER ADDRESS
17 CONTRIBUTION
1, TOTAL POLITICAL CONTRIBUTIONS OF $50 OR LESS (OTHER THAN
$ 755.00
TOTALS
PLEDGES, LOANS, OR GUARANTEES OF LOANS), UNLESS ITEMIZED
2. TOTAL POLITICAL CONTRIBUTIONS
$ 1,055.00
(OTHER THAN PLEDGES, LOANS, OR GUARANTEES OF LOANS)
TOTANS ITURE
3. TOTAL POLITICAL EXPENDITURES OF $100 OR LESS,
$ 531.87
UNLESS ITEMIZED
4. TOTAL POLITICAL EXPENDITURES
$ 5,350.14
CONTRIBUTION
BALANCE
5. TOTAL POLITICAL CONTRIBUTIONS MAINTAINED AS OF THE LAST DAY
$ 10, 973.75
OF REPORTING PERIOD
OUTSTANDING
6. TOTAL PRINCIPAL AMOUNT OF ALL OUTSTANDING LOANS AS OF THE
$ 0
LOAN TOTALS
LAST DAY OF THE REPORTING PERIOD
18 AFFIDAVIT
I swear, or affirm, under penalty of perjury, that the accompanying report is
MICHELE. NOWLING true and c '.act and includes all information required to be reported by me
Notary 10 e1129233532 under Ie 5, Election Code.
Commission Conission Expires
on6�r December 13, 2020
•d Sig tur Candid or Officehold r
AFFIX NOTARY STAMP/SEALABOVE
Sworn to and subscribed before me, by the said \\ Gk.�..i vl%nFOlt7� �` ,this the C
day of rrtf Q i L 20 ` to certify which, witness my hand and seal of office.
, ,
ei ` I l l
Signature of off car ad inistering oath Printed name of offic r dministering o th Title ofRicer dministering o
Forms provided by Texas Ethics Commission www.ethics.state.tx.us Revised 9/8/2015
Forms provided by Texas Ethics Commission www.ethics.state.tx.us Revised 9/8/2015
SUBTOTALS
- C/OH FORM C/OH
COVER SHEET PG 3
19
FILER NAME
Rachael Jonrowe
20 Filer ID (Ethics Commission Filers)
21
SCHEDULE SUBTOTALS
NAMEOFSCHEDULE
SUBTOTAL
AMOUNT
1.
a SCHEDULEAI:
MONETARY POLITICAL CONTRIBUTIONS
$ 300.00
2.
SCHEDULE A2: NON-MONETARY(IN-KIND)POLITICAL CONTRIBUTIONS
$ 145.41
3.
SCHEDULE B:
PLEDGED CONTRIBUTIONS
$
4.
SCHEDULE E:
LOANS
$
5.
SCHEDULE F1:
POLITICAL EXPENDITURES MADE FROM POLITICAL CONTRIBUTIONS
$ 4,818.27
8.
❑ SCHEDULE F2:
UNPAID INCURRED OBLIGATIONS
$
7•
SCHEDULE F3:
PURCHASE OF INVESTMENTS MADE FROM POLITICAL CONTRIBUTIONS
$
e.
SCHEDULE F4:
EXPENDITURES MADE BY CREDIT CARD
$
9.
E] SCHEDULE G:
POLITICAL EXPENDITURES MADE FROM PERSONAL FUNDS
$
10.
E-1 SCHEDULE H:
PAYMENT MADE FROM POLITICAL CONTRIBUTIONS TO A BUSINESS OF C/OH
$
11.
E] SCHEDULE I: NON-POLITICAL EXPENDITURES MADE FROM POLITICAL CONTRIBUTIONS
$
12
❑SCHEDULE K: INTEREST, CREDITS, GAINS, REFUNDS, AND CONTRIBUTIONS
RETURNED TO FILER
$
Forms provided by Texas Ethics Commission www.ethics.state.tx.us Revised 9/8/2015
MONETARY POLITICAL CONTRIBUTIONS SCHEDULE Al
The Instruction Guide explains how to complete this form.
1 Total pages Schedule At:
1
2 FILER NAME
3 Filer ID (Ethics Commission Filers)
Rachael Jonrowe
4 Date
5 Full name of contributor ❑ out-of-state PAC (Ion: I
7 Amount of contribution ($)
3-31-17
John Bucy
$100.00
......................................
6 Contributor address; City; State; Zip Code
11008 Shallow Water, Austin, TX 78717
B Principal occupation / Job title (See Instructions)
g Employer (See Instructions)
Date
Full name of contributor ❑ out-ol-state PAC (IDn: t
Amount of contribution ($)
4-1-17
Judy Jennings
$100.00
Contributor address; City; State; Zip Code
5327 Bull Run, Austin, TX 78727
Principal occupation / Job title (See Instructions) -T
Employer (See Instructions)
Date
Full name of contributor ❑ cut-of-state PAC (IDN: )
Amount of contribution ($)
4-1-17
Mary Ann Sauls
$100.00
Contributor address; City; State; Zip Code
400 Sunset Ridge Georgetown TX 78633
Principal occupation / Job title (See Instructions)
Employer (See Instructions)
Retired
Date
Full name of Contributor ❑ out-ol-slate PAC (IDN: 1
Amount of contribution ($)
. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
Contributor address; City; State; Zip Code
Principal occupation / Job title (See Instructions)
Employer (See Instructions)
Business Owner
ATTACH ADDITIONAL COPIES OF THIS SCHEDULE AS NEEDED
If contributor is out-of-state PAC, please see instruction guide foradditional reporting requirements.
Forms provided by Texas Ethics Commission www.ethics.state.tx.us Revised 9/8/2015
NON-MONETARY (IN-KWD) POLITICAL
CONTRIBUTIONS
SCHEDULE A2
The Instruction Guide explains how to complete this form.
1 Total pages Schedule A2:
2 FILER NAME
3 Filer ID (Ethics Commission Filers)
Rachael Jonrowe
4 TOTAL OF UNITEMIZED IN-KIND POLITICAL CONTRIBUTIONS
$ 468.75
5 Date
6 Full name of contributor ❑ out-of-state PAC (ID#-
t
8 Amount of 9 In-kind contribution
Contribution $ description
4-3-17
Sherwin Cahn
. . . . . . . . . . . . . . . . . . . . . . . . . . . .
. .
$145.41 Pizza for student
7 Contributor address; City; State; Zip Code
- event
908 E University Ave Georgetown TX 78626
❑Check if travel outside of Texas. Complete Schedule T.
10 Principal occupation / Job title (FOR NONJUDICIAL)(See Instructions)
11
Employer (FOR NON-JUDICIAL)(See Instructions)
12 Contributor's principal occupation (FOR JUDICIAL)
13
Contributor's Job title (FOR JUDICIAL) (See Instructions)
14 Contributor's employerAaw firm (FOR JUDICIAL)
15
Law firm of contributor's spouse (if any) (FOR JUDICIAL)
16 If contributor is a child, law firm of parent(s) (if any) (FOR JUDICIAL)
Date
Full name of contributor ❑ out-of-etate PAC (IDN:
7
Amount of In-kind contribution
Contribution $ description
Contributor address; City; State; Zip Code
-
❑Check if travel outside of Texas. Complete Schedule T.
Principal occupation / Job title (FOR NON-JUDICIAL) (See Instructions)
Employer (FOR NON-JUDICIAL)(See Instructions)
Contributor's principal occupation (FOR JUDICIAL)
Contributor's job title (FOR JUDICIAL) (See Instructions)
Contributor's employer/law firm (FOR JUDICIAL)
Law firm of contributor's spouse (if any) (FOR JUDICIAL)
If contributor is a child, law firm of parent(s) (if any) (FOR JUDICIAL)
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.stale.tx.us Revised 9/8/2015
PLEDGED CONTRIBUTIONS SCHEDULE B
1 Total pages Schedule S:
The Instruction Guide explains how to complete this form.
2 FILER NAME
3 Filer ID (Ethics Commission Filers)
4 TOTAL OF UNITEMIZED PLEDGES
$
5 Date
6 Full name of pledgor ❑ out-of-state PAC pox: t
e Amount . 9 In-kind contribution
of Pledge $ description
. . . . . . . . . . . . . . . . . . . . . . . .
7 Pledgor address; City; State; Zip Code
,
❑ Check if travel outside of Texas. Complete Schedule T.
10 Principal occupation / Job title (See Instructions)
11 Employer (See Instructions)
Date
Full name of pledgor ❑ out -of -stale PAC lips: t
Amount - In-kind contribution
of Pledge $ description
. ...........
Pledgor address; City; State; Zip Code
❑ Check if travel outside of Texas. Complete Schedule T.
Principal occupation / Job title (See Instructions)
Employer (See Instructions)
Date
Full name of led or
p g ❑ out-of-state PAC (Ipp: 1
Amount of , contribution
Pledge $ description
description
'
. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
Plecigor address; City; State; Zip Code
❑Check it travel outside of Texas. Complete Schedule T.
Principal occupation / Job title (See Instructions)
Employer (See Instructions)
Date
Full name of pledgor ❑ out-of-state PAC (ID#: t
Amount of In-kind contribution
Pledge $ description
. . . . . . . . . . . . . . . . . . . . . . . . . . . .
Pledgor address; City; State; Zip Code
❑Check if travel outside of Texas. Complete Schedule T.
Principal occupation / Job title (See Instructions)
Employer (See Instructions)
ATTACH ADDITIONAL COPIES OF THIS SCHEDULE AS NEEDED
It 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
LOANS SCHEDULE E
The Instruction Guide explains how to complete this form.
1 Total pages Schedule E:
2 FILER NAME
3 Filer ID (Ethics Commission Filers)
4 TOTAL OF UNITEMIZED LOANS
$
5 Date of loan
7 Name of lender ❑ out-of-state PAC (ton: I
. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
g Lender address; City; State; Zip Cade
9 Loan Amount ($)
6 Is lender
10 Interest rate
a financial
Institution?
11 Maturity date
Y N
12 Principal occupation / Job title (See Instructions)
13 Employer (See Instructions)
14 Description of Collateral
15 Check if personal funds were deposited into political
account (See Instructions)
❑ none
❑
16 GUARANTOR
17 Nameofguarantor
19 Amount Guaranteed($)
INFORMATION
. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
18 Guarantor address; City; State; Zip Code
❑ not applicable
20 Principal Occupation (See Instructions)
21 Employer (See Instructions)
Date of loan
Nameof lencler ❑ out -of -stale PAC poa: I
. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
Lender address; City; State; Zip Code
Loan Amount ($)
Is lender
Interest rate
a financial
Institution?
Maturity date
Y N
Principal occupation / Job title (See Instructions)
Employer (See Instructions)
Description of Collateral
Check if personal funds were deposited into political
account (See Instructions)
❑ none
❑
GUARANTOR
Name of guarantor
Amount Guaranteed (S)
INFORMATION
. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
Guarantor address; City; State; Zip Code
❑ not applicable
Principal Occupation (See Instructions)
Employer (See Instructions)
ATTACH ADDITIONAL COPIES OF THIS SCHEDULE AS NEEDED
It lender is out-of-state PAC, please see instruction guide for additional reporting requirements.
Forms provided by Texas Ethics Commission www.ethics.state.tx.us Revised 9/8/2015
POLITICAL EXPENDITURES MADE
FROM POLITICAL CONTRIBUTIONS SCHEDULE F1
EXPENDITURE CATEGORIES FOR BOX 8(a)
Advertising Expense Event Expense Loan Repayment/Reimbursemem Sdicilation/Fundralsing Expense
Acraunting/Banking Fees Office Overhead/Rental Expense Transportation Equipment& Related Expense
Consulting Expense FoodSoverage Expense Polling Expense Travel In District
ConldbuGons/Donations Made By GIItlAwards/Mermrials Expense Priming Expense Travel OutOf District
Canditlate/Ofllceholder/PolOical Committee Legal Services SalariesWages/Contract Labor Other (order a category not listed above)
Credt Cad payment
The Instruction Guide explains how to complete this form.
1 Total pages Schedule F7:
2 FILER NAME
3 Filer ID (Ethics Commission Filers)
a
J
Rachael Jonrowe
4 Date
5 Payee name
4-2-2017
FedEx Office
6 Amount ($)
7 Payee address; City; State; Zip Code
1013 W University Ave, Georgetown, TX 78628
159.35
6
(a) Category (See Categories listed ache lop of this schedule)
(b) Description
Printing
❑Ch.*ifuavelansidealTexas.ComplemScheduLT.
PURPOSE
OF
❑ Check if Austin, TX, olliceholder living expense
EXPENDITURE
9 Complete ONLY it direct Candidate / Officeholder name Office sought Office held
expenditure to benefit C/OH
Date
Payee name
VistaPrint.com
3-29-2017
Amount ($)
Payee address; City; State; Zip Code
300.98
275 Wyman Street, Waltham, MA 02451
Category (See Categories listed at the lop of this schedule)
Description
❑Check if travel outside of Texas. Complete Schedule T.
PURPOSE
printing
❑
OF
Check if Austin, TX, olficeholder living expense
EXPENDITURE
Complete ONLY if direct Candidate /Officeholder name Office sought Office held
expenditure to benefit C/OH
Date
Payee name
FedEx Office
4-2-2017
Amount ($)
Payee address; City; Slate; Zip Code
289.21
1013 W University Ave, Georgetown, TX 78628
Category (See Categories listed at the lop of this schedule)
Description
❑ Checklftravel outside of Texas. Complete Schedule T.
PURPOSE
OF
printing and stamps
❑ Check it Austin. TX, Officeholder living expense
EXPENDITURE
Complete ONLY if direct Candidate / Officeholder name Office sought Office held
expenditure to benefit C/OH
ATTACH ADDITIONAL COPIES OFTHIS SCHEDULE AS NEEDED
Forms provided by Texas Ethics Commission www.ethics.state.tx.us Revised 9/8/2015
POLITICAL EXPENDITURES MADE
FROM POLITICAL CONTRIBUTIONS SCHEDULE F1
EXPENDITURE CATEGORIES FOR BOX 8(2)
Advertising Expense Event Expense Loan Repayment/Heimbursemem Solidlation/Fundraising Expense
Accoun&xyElarildng Fees Offices Ovemead/Rental Expense Transportation Pquornema Related Expense
Consulting Expense FeotlrBeveraga Expense Polling Expense Travel In District
Contributions/Donalions Made By GifsAwards/hilemonals Expense Printing Expense Travel Out Of District
Candiciate/Officeholder/Political Committee Legal Services Salarles/Wages/Contrac[ Labor Other tenter a category net listed above)
Crede Card Payment
The Instruction Guide explains how to complete this form.
1 Total pages Schedule Ft:
2 FILER NAME
3 Filer ID (Ethics Commission Filers)
Rachael Jonrowe
4 Date
5 Payee name
Graphismo
4-5-2017
6 Amount ($)
7 Payee address; City; State; Zip Code
407 E 4th Street, Georgetown, TX 78626
500.00
g
(a) Category (See Categories listed of that top of this schedule)
(b) Description
Graphic Design of Signs
❑Check iftrawithiksMe afTexas Complete Schedule T.
PURPOSE
OF
❑ Check if Austin. TX. officeholder living expense
EXPENDITURE
9 Complete ONLY if direct Candidate /Officeholder name Office sought Office held
expenditure to benefit C/OH
Date
Payee name
Office Depot
4-14-2017
Amount ($)
Payee address; City; State; Zip Code
161.89
1013 W. University, Georgetown, TX 78626
Category (See Categories listed at the lop of this schedule)
Description
FCheckiflraveloulside of Texas. Complete Schedule T.
PURPOSE
printing
OF
❑ Check 11 Austin, TX, officeholder living expense
EXPENDITURE
Complete ONLY if direct Candidate / Officeholder name Office sought Office held
expenditure to benefit C/OH
Date
Payee name
4-20-2017
Office Depot
Amount ($)
Payee address; City; State; Zip Code
259.80
1013 W University Ave, Georgetown, TX 78628
Category (See Categories listed at the top of this schedule)
Description
❑ Check if travel outside of Texas. Complete SchedulaT.
PURPOSE
OF
printing
❑ Check It Auelln. TX, officeholder living expense
EXPENDITURE
Complete ONLY if direct Candidate / Officeholder name Office sought Office held
expenditure to benefit C/OH
ATTACH ADDITIONAL COPIES OF THIS SCHEDULE AS NEEDED
Forms provided by Texas Ethics Commission wwwsthics.staleAx.us Revised 9/8/2075
POLITICAL EXPENDITURES MADE
FROM POLITICAL CONTRIBUTIONS SCHEDULE F1
EXPENDITURE CATEGORIES FOR BOX 6(a)
Advertising Expense EventExpense Loan Repaym rdtHehnlwreement SollGlation/Fundrdang Expense
Accounfing/Sankig Fees Office Overhead/Rental Expense Transportation Equipment& Related Expense
Consulting Expense Foodraeverage Expense Polling Expense Travel In District
ComddNons/Dorutiors Made By Gii/Awards/Memodals Expense Printing Expense Travel Out Of District
CanditlateCHIlceholder/Political Committee Legal Services Salaries/Wages/Contract Labor Other (enter a category net listed above)
CmdtCardPayment
The Instruction Guide explains how to complete this form.
7 Total pages Schetlule FI:
2 FILER NAME
3 Filer ID (Ethics Commission Filers)
3
Rachael Jonrowe
4 Date
5 Payee name
4-26-2017
Ink Images
4
6 Amount ($)
7 Payee address; City; State; Zip Gods
2280.79
2544 Shell Road, Georgetown, TX 78628
g
(a) Category (See Categories listed of the top of this schedule)
(b) Description
PURPOSE
Printing
E] Check geavel mudeofT"as. Complete ScheduleT.
OF
❑ Check it Austin, TX, officeholder living expense
EXPENDITURE
9 Complete ONLY if direct Candidate / Officeholder name Office sought Office held
expenditure to benefit C/OH
Date
Payee name
Williamson County Sun Inc.
4-26-2017
Amount ($)
Payee address; City; State; Zip Code
866.25
707 S. Main Street, Georgetown, TX 78626
Category (see Categories listed at the lop of this schedule)
Description
❑Check lfgavel outside of Texas. Complete Schedule T.
PURPOSE
Advertising
OF
❑ Check it Austin, TX, officeholder living expense
EXPENDITURE
Complete ONLY if direct Candidate/ Officeholder name Office sought Office held
expenditure to benefit C/OH
Date
Payee name
Amount ($)
Payee address; City; State; Zip Code
Category(See Categories listed at the tap of this schedule)
Description
❑ Check ifpavel oudeideol Texas. Complete Schedule T.
PURPOSE
OF
❑ Check it Austin. TX, officeholder living expense
EXPENDITURE
Complete ONLY if direct Candidate / Officeholder name Office sought Office held
expenditure to benefit C/OH
ATTACH ADDITIONAL COPIES OF THIS SCHEDULE AS NEEDED
Forms provided by Texas Ethics Commission www.ethics.state.tx.us Revised 9/8/2015
UNPAID INCURRED ®BLICATIOMS SCHEDULE I=2
EXPENDITURE CATEGORIES FOR BOX 10(a)
Advertising Expense Event Expense Loan RepaymentReimbursemenl Solicitation/Fundraising Expense
AccountirglEankIng Fees Office OvemeadfRomal Expense Transportation Equipment B Related Expense
ComulMg Expense FoaYBeverage Expose Polling Expense Travel In District
Conldbuuons/Donations Made By Gift/AwardstMemorials Expense Printing Expense Travel Dui Of District
Candklale/OKceholder/Political Committee Legal Services Salarles/Wages Contract Labor Other (enter a category net listed above)
The Instruction Guide explains how to complete this form.
1 Total pages Schedule F2:
2 FILERNAME
3 Filer ID (Ethics Commission Filers)
4 TOTAL OF UNITEMIZED UNPAID INCURRED OBLIGATIONS
$
5 Date
6 Payee name
7 Amount ($)
8 Payee address; City; State; Zip Code
9 TYPE OF
EXPENDITURE
Political Non -Political
10
(a) Category (See Categories listed at the top of this schedule)
(b) Description
PURPOSE
❑ Check if travel outsideotTexas. Compleq ScheduleT.
OF
❑Cheek it Austin, TX, officeholder living expense
EXPENDITURE
11 Complete ONLY if direct Candidate / Officeholder name Office sought Office held
expenditure to benefit C/OH
Date
Payee name
Amount ($)
Payee address; City; State; Zip Code
TYPE OF
EXPENDITURE
L1 Political ❑ Non -Political
Category (See Categories listed at the top of this schedule)
Description
❑ Check ifiravelwlsideol Texas. Complete Schedule T.
PURPOSE
OF
❑Check it Austin, TX, officeholder living expense
EXPENDITURE
Complete ONLY if direct Candidate / Officeholder name Office sought Office held
expenditure to benefit C/OH
ATTACH ADDITIONAL COPIES OF THIS SCHEDULE AS NEEDED
Forms provided by Texas Ethics Commission wwvv ethics.stale.tx.us Revised 9/8/2075
PURCHASE OF INVESTMENTS MADE
FROM POLITICAL CONTRIBUTIONS SCHEDULE F3
The Instruction Guide explains how to complete this form.
1 Total pages Schedule F3:
2 FILER NAME
3 Filer ID (Ethics Commission Filers)
4 Date
5 Name of person from whom investment is purchased
. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
6 Address of person from whom investment is purchased; City; State; Zip Code
7 Description of investment
S Amount of investment ($)
Date
Name of person from whom investment is purchased
..........................................................
Address of person from whom investment is purchased; City; Slate; Zip Code
Description of investment
Amount of investment ($)
ATTACH ADDITIONAL COPIES OF THIS SCHEDULE AS NEEDED
Forms provided by Texas Ethics Commission www.ethics.state.tx.us Revised 9/8/2015
EXPEN®OTi URES MADE BY CREUT CAR®
SCHEDULE F4
EXPENDITURE CATEGORIES FOR BOX 10(a)
Advertising Expense Evert Expense Loan Repayment/Reimbursemeit Solicilation/Fundralsing Expense
Accoundrgr8anking Fees Office OvemeadfRental Expense Transportation Equipment 8 Related Expense
Consulting Expense Food/Beverage Expense Polling Expense Travel In District
ConldbutionsrDdrelions Made By Gif/AwarG4Memorials Expense Printing Expense TravelOut Ol District
Candidate/Officeholder/Political Committee Legal Services SalanesMfages/Conlraet Labor Other (enter a category not listed above)
The Instruction Guide explains how to complete this form.
1 Total pages Schedule F4:
2 FILER NAME
3 Filer ID (Ethics Commission Filers)
4 TOTALOF UNITEMIZED EXPENDITURES CHARGED TOACREDIT CARD
$
5 Date
6 Payee name
7 Amount ($)
8 Payee address; City; Slate; Zip Code
g TYPE OF
EXPENDITURE
F-1 Political F-1 Non -Political
10
(8) Category (See Categories listed at the top of this schedule)
(b) Description
PURPOSE
❑Check if travel outside of Texas. Complete Schedule T.
OF
❑Check If Austin. TX, officeholder living expense
EXPENDITURE
11 Complete ONLY if direct Candidate / Officeholder name Office sought Office held
expenditure to benefit C/OH
Date
Payee name
Amount ($)
Payee address; City; Stale; Zip Code
TYPE OF
EXPENDITURE
❑ Political Non -Political
Category (Sae Categories listed at the top of this schedule)
Description
PURPOSE
❑Check 11 travel outside of Texas Compete Schedule T.
OF
❑Check If Austin, TX, officeholder living expense
EXPENDITURE
Complete ONLY if. direct Candidate / Officeholder name Office sought Office held
expenditure to benefit C/OH
ATTACH ADDITIONAL COPIES OF THIS SCHEDULE AS NEEDED
Forms provided by Texas Ethics Commission www.ethics.state.tx.us Revised 9/8/2015
POLITICAL EXPENDITURES
MADE FROM PERSONAL FUNDS SCHEDULE G
EXPENDITURE CATEGORIES FOR BOX 8(a)
Advertising Expense Event Expense Loan Repayment/Reimbursement Solicilmon/Fundraising Expertise
AccoundrtgMenkrg Fees Office Overhead/Rental Expense Transportation Equipment& Related Expense
Consulting Expense FooNBeverage Expanse Polling Expense Travel In District
ConMbutions/Donations Made By GNAward4Memorals Expense Printing Expense Travel Out Of District
Cancklate/OHicanolder/Political Committee Legal services Salaries/Wages/Contract Labor Other (enter a category not listed above)
CreditCard Payment
The Instruction Guide explains how to complete this form.
1 Total pages Schedule G:
2 FILER NAME
3 Filer ID (Ethics Commission Filers)
4 Date
5 Payee name
6 Amount ($)
7 Payee address; City; State; Zip Code
❑Reimbursementfom
politiralwnlraxutions
intended
8
(a) Category (See Categories listed at the lop of this schedule)
(b) Description
PURPOSE
❑
OF
Cherkiitraveloulsideai Texas. Complete Schedule T.
EXPENDITURE
❑ Check II Austin, TX, officeholder living expense
9 Complete ONLY if direct Candidate / Officeholder name Office sought Office held
expenditure to benefit C/OH
Date
Payee name
Amount ($)
Payee address; City; State; Zip Code
❑Reimbumementhom
political contributions
intended
Category(See Categories listed at the top of this schedule)
(b) Description
PURPOSE
OF
Check Ntrevel outside of Texas. Complete Scheduler.
EXPENDITURE
❑ Chock it Austin, TX, officeholder living expense
Complete ONLY if direct Candidate / Officeholder name Office sought Office held
expenditure to benefit C/OH
Date
Payee name
Amount ($)
Payee address; City; State; Zip Code
❑Reimbursememfmm
political contributions
intencled
Category (See Categories listed at the tap of this schedule)
(b) Description
PURPOSE
Chedritlravelau4ddeot Texas. Cemplele Schedule T.
OF
EXPENDITURE
❑ Check if Austin, TX, officeholder living expense
Complete ONLY if direct Candidate / Officeholder name Office sought Office held
expenditure to benefit C/OH
ATTACH ADDITIONAL COPIES OF THIS SCHEDULE AS NEEDED
Forms provided by Texas Ethics Commission wvvw.ethics.state.lx.us Revised 9/8/2015
PAYMENT MADE FROM POLITICAL
CONTRIBUTIONS TO A BUSINESS OF C/OH SCHEDULE H
EXPENDITURE CATEGORIES FOR BOX 8(a)
Advertising Fxpense Event Expense Loan RepaymentRelmbursamem SolicitationuFmcmising Expense
AcwuntirrgBonMing Fees Office Overhead/Rental Expense Transpodation Equipment & Related Expense
Consulting Expense Foodreeverage, Expense Polling Expense Travel In District
Conhibutions/Donations Made By GiNAwards/Memonas Expense Printing Expense Travel Out Of District
Carcidate/Omceholder/Palifical Committee Legal Services Salaries/Wages/Conracl Labor Other (enter a category not listed above)
Credt Card Paymem
The Instruction Guide explains how to complete this form.
1 Total pages Schedule H:
2 FILER NAME
3 Filer ID (Ethics Commission Filers)
4 Date
5 Business name
6 Amount ($)
7 Business address; City; State; Zip Code
8
(a) Category (See Categories listed at the top of his schedule)
(b) Description
PURPOSE
❑ Cherklltrav ImMdeolTum.Complete SchWulaT.
OF
❑ Chock If Austin, TX, officeholder living expense
EXPENDITURE
9 Complete ONLY if direct Candidate / Officeholder name Office sought Office held
expenditure to benefit C/OH
Date
Business name
Amount ($)
Business address; City; State; Zip Code
Category (See Categories listed at the top of this schedule)
Description
PURPOSE
❑ Check it travel oulsideafTexas. Complete Schedule T.
OF
EXPENDITURE
Check it Austin. TX, officeholder living expense
Complete ONLY if direct Candidate / Officeholder name Office sought Office held
expenditure to benefit C/OH
Date
Business name
Amount ($)
Business address; City; State; Zip Code
Category (See Categories listed at the top of this schedule)
Description
❑ Checkilaavel oulsideof texas. Complete Schedule T.
PURPOSE
OF
❑ Check it Auslin, TX, officeholder living expense
EXPENDITURE
Complete ONLY If direct Candidate / Officeholder name Office sought Office held
expenditure to benefit C/OH
ATTACH ADDITIONAL COPIES OF THIS SCHEDULE AS NEEDED
Forms provided by Texas Ethics Commission www.ethics.state.tx.us Revised Woletj 10
NON-POLITICAL EXPENDITURES
MADE FROM POLITICAL CONTRIBUTIONS SCHEDULE I
The Instruction Guide explains how to complete this form.
1 Total pages Schedule I:
2 FILER NAME
3 Filer ID (Ethics Commission Filers)
4 Date
5 Payee name
6 Amount ($)
7 Payee address; City; State; Zip Code
8
(a)Category (See inslructions for examples of acceptable
(b)(Description (See instructions regarding type of information
PURPOSE
categories.)
required.)
OF
EXPENDITURE
Date
Payee name
Amount ($)
Payee address; City: State: Zip Code
Category (See instructions for examples of acceptable
Description (See instructions regarding type of Inlormation
PURPOSE
categories.)
required.)
OF
EXPENDITURE
Date
Payee name
Amount ($)
Payee address; City: State; Zip Code
PURPOSE
Category (See instructions for examples of acceptable
Description (See instructions regarding type of information
OF
categories.)
required.)
EXPENDITURE
Date
Payee name
Amount ($)
Payee address; City; State; Zip Code
Category (See instructions for examples of acceptable
Description (See instructions regarding type of information
PURPOSE
categories.)
required.)
OF
EXPENDITURE
ATTACH ADDITIONAL COPIES OF THIS SCHEDULE AS NEEDED
Forms provided by Texas Ethics Commission www.ethics.state.tx.us Revised 9/812015
INTEREST, CREDITS, GAINS, REFUNDS, AND
CONTRIBUTIONS RETURNED TO FILER SCHEDULE K
The Instruction Guide explains how to complete this form.
1 Total pages Schedule K:
2 FILER NAME
3 Filer ID (Ethics Commission Filers)
4 Date
5 Name of person from whom amount is received
. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
6 Address of person from whom amount is received; City; State; Zip Code
8 Amount ($)
7 Purpose for which amount is received Check if political contribution returned to filer
Date
Name of person from whom amount is received
. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
Address of person from whom amount is received; City; State; Zip Code
Amount ($)
Purpose for which amount is received Check if political contribution returned to filer
Date
Name of person from whom amount is received
............................................
Address of person from whom amount is received; City; Stale; Zip Code
Amount($)
Purpose for which amount is received ❑ Check if pouiicat contribution returned to filer
Date
Name of person from whom amount is received
. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
Address of person from whom amount is received; City; State; Zip Code
Amount ($)
Purpose for which amount is received Check if political contribution returned to filer
ATTACH ADDITIONAL COPIES OF THIS SCHEDULE AS NEEDED
Forms provided by Texas Ethics Commission www.ethics.state.tx.us Revised 9/8/2015
IN-KIND CONTRIBUTIONS OR POLITICAL EXPENDITURES
FOR TRAVEL OUTSIDE OF TEXAS SCHEDULE T
The Instruction Guide explains how to complete this form. 1 Total pages Schedule T:
2 FILER NAME
3 Filer ID (Ethics Commission Filers)
4 Name of Contributor / Corporation or Labor Organization/ Pledgor / Payee
5 Contribution / Expenditure reported on:
❑ Schedule A2 ❑ Schedule B ❑ Schedule B(J) ❑ Schedule C2 ❑ Schedule D ❑ Schedule F1
[-]Schedule F2 ❑ Schedule F4 ❑ Schedule G ❑ Schedule H ❑ Schedule COH-UC ❑ Schedule B -SS
6 Dates of travel
7 Name of person(s) traveling
B Departure city or name of departure location
9 Destination city or name of destination location
10 Means of transportation
11 Purpose of travel (including name of conference, seminar, or other event)
Name of Contributor / Corporation or Labor Organization / Pledgor / Payee
Contribution / Expenditure reported on:
❑ Schedule A2 ❑ Schedule B ❑ Schedule S(J) ❑ Schedule C2 ❑ Schedule D ❑ Schedule F1
❑Schedule F2 ❑ Schedule F4 ❑ Schedule G ❑ Schedule H ❑ Schedule COH-UC ❑ Schedule B -SS
Dates of travel
Name of persons) traveling
Departure city or name of departure location
Destination city or name of destination location
Means of transportation
Purpose of travel (including name of conference, seminar, or other event)
Name of Contributor / Corporation or Labor Organization / Pledgor / Payee
Contribution / Expenditure reported on:
❑ Schedule A2 [-]Schedule B ❑ Schedule B(J) ❑ Schedule C2 ❑ Schedule D ❑ Schedule F1
[-]Schedule F2 ❑ Schedule F4 ❑ Schedule G ❑ Schedule H ❑ Schedule COH-uC ❑ Schedule B -SS
Dates of travel
Name of person(s) traveling
Departure city or name of departure location
Destination city or name of destination location
Means of transportation
Purpose of travel (including name of conference, seminar, or other event)
ATTACH ADDITIONAL COPIES OF THIS SCHEDULE AS NEEDED
Forms provided by Texas Ethics Commission www.ethics.state.tx.us Revised 9/8/2015
CAda2'MDATE/ OFFiCEHOLDFR REPORT:
DESIG iNATRON OF MNAL REPORT FORM C/OH — FR
The Instruction Guide explains how to complete this form.
•• Complete only if "Report Type" on page 1 is marked "Final Report' •-
1 C/OH NAME
2 Filer ID (Ethics Commission Filers)
3 SIGNATURE
I do not expect any further political contributions or political expenditures in connection with my candidacy. I understand that designat-
ing 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.
Signature of Candidate / Officeholder
4 FILER WHO IS NOT AN OFFICEHOLDER
•• Complete A& B below only it you are not an officeholder. ••
A. CAMPAIGNFUNDS
Check only one:
0 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, § 254.204.
B. ASSETS
Check only one:
0 I do not retain assets purchased with political contributions or interest or other income from political contributions.
F-1 I do retain assets purchased with political contributions or interest or other income from political contributions. I 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.
Signature of Candidate
5 OFFICEHOLDER
-• Complete this section only if you are an officeholder --
F__J I am aware that I remain subject to filing requirements applicable to an officeholder who 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 contributions, or assets purchased with politi-
cal contributions or interest or other income from political contributions.
Signature of Officeholder
Forms provided by Texas Ethics Commission www.ethics.state.tx.us Revised 9/8/2015