HomeMy WebLinkAboutCFR-04.14.2011 thru 05.6.2011-GarverTexas Ethics Commission P.O. Box 12070 Austin, Texas 78711-2070 (512) 463-5800 (TEDD} 1-800-735-2989)
CANDIDATE 1 OFFICEHOLDER FORM C/OH
CAMPAIGN FINANCE REPORT COVER SHEET PG
1 ACCOUNT # 2 Total pages flied:
The C10H Instruction wide explains how to complete this form. (Ethics Commission Filers)
CANDIDATE/ MS/MR /MR FIRST MI
OFFICEHOLDER
NAME ��o- _ a o ram
NICKNAME LAST CSUFFIX
AY06 2011
4 CANDIDATE/ ADDRESS IPO BOX; APT SUITE CITY; STATE; ZIP CODE m
MAILING .. elv dL It
ADDRESS
change of address Receipt # Amaunt
5 CANDIDATE/ AREA CODE PHONE NUMBER EXTENSION
OFFICEHOLDER / (
)
CAMPAIGN MSIMRS/MR FIRST Nil
Date Imaged
TREASURER
NAME . �..s � . .
NICKNAME LAST SUFFIX
7 CAMPAIGN STREET ADDRESS (NO PO BOX PLEASE); APTISUITE#; CITY; STATE; ZIPCODE
TREASURER
ADDRESS
(residence or business)
8 CAMPAIGN AREA CODE PHONE NUMBER EXTENSION
TREASURER
PHONE
9 REPORT TYPE January 15 ❑ 30th day before election Runoff El 15th day after campaign treasurer
appointment (officeholder only)
El July 15 8th day before election Exceeded $500 limit El Final report (Attach CIOH - FR)
10 PERIOD Month Day Year Month Day Year
COVERED / r/ THROUGHf
010 eel/
11 ELECTION ELECTION DATE ELECTION TYPE
Month Day Year
Primary Runoff General Special
12 OFFICE OFFICE HELD (if any) 13 OFFICE SOUGHT (if known)
tort1
14 NOTICE
OF DIRECT DIRECT CAMPAIGN EXPENDITURES ARE CAMPAIGN EXPENDITURES MADE BY OTHERS WITHOUT THE CANDIDATE'S PRIOR CONSENTOR APPROVAL.
CAMPAIGN CANDIDATES ARE REQUIRED TO DISCLOSE THIS INFORft9AitON ONLY IF THEY RECEIVE NOTIFICATION OF THE DIRECT CAMPAIGN EXPENDITURE.
EXPENDITURE
BY OTHER Name
INDIVIDUALS
Address / PO Box; Apt, i Suite #; City; State; Zip Code
additional pages
GO TO PAGE 2
WWW, ethics. state.tx.us Revised 04/21/2010
Texas o ... Box 12070 Austin, Texas78711-2070 (512)463-5800
CANDIDATE 1 OFFICEHOLDER REPORT: FORM C/OH
SUPPORT
& TOTALS COVER SHEET PG 2
16 CIOH NAME$�
1S ACCOUNT# (Ethics Commission Filers)
�"
17 NOTICE
THIS BOX IS FOR NOTICE OF POI IMCk CONTRIBUTIONS ACCEPTED OR POL117CAL EXPENDITURES MADE BY POLITICAL COMMITTEES TO SUPPORT THE
FROM
CANDIDATE /OFFICEHOLDER. THESE EXAEwrrunES MAY HAVE BEEN MADE WITHOUT THE CANDIDATE'S OR OFFICEHOLDER'S KNOWLEDGE OR
POLITICAL
CONSENT. CANDIDATES AND OFFICEHOLDERS ARE REQUIRED TO REPORT THIS INFORMATION ONLY IF THEY RECEIVE NOTICE OF SUCH EXPENDITURES.
COMMITTEE(S)
COMMITTEE NAME
COMMITTEE TYPE
GENERAL
COMMITTEE ADDRESS
SPECIFIC
COMMITTEE CAMPAIGN TREASURER NAME
additional pages
COMMITTEE CAMPAIGN TREASURER ADDRESS
18 CONTRIBUTION
TOTALS
1. TOTAL POLITICAL CONTRIBUTIONS OF $50 OR LESS (OTHER THAN
PLEDGES, LOANS, OR GUARANTEES OF LOANS), UNLESS ITEMIZED
t�
2. TOTAL POLITICAL CONTRIBUTIONS
(OTHER THAN PLEDGES, LOANS, OR GUARANTEES OF LOANS)
EXPENDITURE
TOTALS
3. TOTAL POLITICAL EXPENDITURES OF $50 OR LESS, UNLESS ITEMIZED
4. TOTAL POLITICAL EXPENDITURES
CONTRIBUTION
5. TOTAL POLITICAL CONTRIBUTIONS MAINTAINED AS OF THE LAST DAY
BALANCE
OF REPORTING PERIOD
l j
OUTSTANDING
g
TOTAL PRINCIPAL AMOUNT OF ALL OUTSTANDING LOANS AS OF THE
LOAN TOTALS
LAST DAY OF THE REPORTING PERIOD
19 AFFIDAVIT
I swear, or affirm, under penalty of perjury, that the accompanying report
" LL is true and correct and includes all information required to be reported by
((
me under Title 15, Election Code.
f ryr
4 r E
r h
d i9
Y3
Signature of Candidate or Officeholder
AFFIX NOTARY STAMP 1 SEAL ABOVE
�1
(4,'m
Sworn to and subscribed
before me, by the Said this the
day
of 20 i to certify which, witness my hand and seal of office.
�
Signature of officer administering oath Printed name of officer administering oath Itl e df ofce a` ring of a
www.ethics.state.tx.us Revised 04/21/2010
Texas Ethics Commission P.0, Box 12070 Austin, Texas 78711-2070 (512) 463-5800 (TDD 1-800-735-2989)
POLITICAL CONTRIBUTIONS
OTHER THAN PLEDGES OR LOANS
The Instruction Guide explains how to complete this form. } Total pages Schedule A:
2 FILER NA 3 ACCOUNT # (Ethics Commission Filers)
cn
4 Date 6 Full name of contributor ❑ out-of-state PAC(ID#: T Amount of 3 In-kind contribution
contribution {$} I description (if applicable)
F .tV.L
6 Conntriiib'sutt�or address; City; State;; Zip Code
Z(If travel outside of Texas, complete Schedule T)
Principal occupation I .lob title (See Instructions) ftp Employer (See Instructions)
Date Full name of contributor ❑ out-of-state PAC(ID#_ 7 Amount of in-kind contribution
contribution ($} ( description (if applicable)
Contributoraddress; City; State; Zip Code
(if travel outside of Texas, complete Schedule T)
Principal occupation / Job title (See Instructions) Employer (See instructions)
Date Full name of contributor ❑ out-of-state PAC(ID# 1 Amount of In-kind contribution
contribution ($} description (if applicable)
Contributor address; City; State; Zip Code
(if travel outside of Texas, complete Schedule T)
Principal occupation I Job title (See instructions) Employer (See Instructions)
Date Full name of contributor ❑ out-of-state PAC(IC#: ) Amount of In-kind contribution
contribution {$} I� description (if applicable)
Contributor address; City; State; Zip Code i
If travel outside of Texas, complete Schedule T
Principal occupation I Job title (See Instructions) Employer (See Instructions)
Date Full name of contributor ❑ out-of-statePAC(ID# Amount of In-kind contribution
contribution {$} description (if applicable)
Contributor address; City; State; Zip Code
If travel outside of Texas, complete Schedule T
Principal occupation I Job title (See Instructions) Employer (See instructions)
ATTACH ADDITIONAL COPIES OFTHIS SCHEDULEAS NEEDED
If contributor is out-of-state PAC, please see instruction guide foradditional reporting requirements.
ethics.state.tx.us Revised 04/21/2010
Texas Ethics Commission P.0, Box 12070 Austin, Texas 78711-2070 (512)463-5800 (TDD 1-800-735-2989)
POLITICAL EXPENDITURES SCHEDULE
EXPENDITURE CATEGORIES FOR BOX 8(a)
Advertising Expense Gift/Awards/Memorials Expense Salaries/Wages/Contract Labor Loan Repayment/Reimbursement
Accounting/Banking Legal Services Solicitation/Fundraising Expense Transportation Equipment & Related Expense
Consulting Expense Food/Beverage Expense Travel In District Contributions/Donations Made By
Event Expense Polling Expense Travel Out Of District Candidate/Officeholder/Political Committee
Fees Printing Expense Office Overhead/Rental Expense OTHER (enter a category not listed above)
The Instruction Guide explains how to complete this form.
ME � ACCOUNT # (Ethics Commission Filers)
I Total pages Schedule F: 2 FIL7�11AA
c
4 Date
S Payee name
44 01�
6 Amount {$)
'7 Payee address, City; ate, Zip ddcle
8 PURPOSE
(a) Category (See categories listed at the top of this schedule)
(b) Description (If travel outside of Texas, complete Schedule T)
OF
EXPENDITURE
J?CLJS9
Complete ONLY if direct Candidate / Officeholder name Office sought Office held
expenditure to benefit C/OH
Date
Payee name
Amount ($)
Payee address; City; State; Zip ade
JVIONO
PURPOSE
Category (See categories listed at the top of this schedule)
Description (if travel outside of Texas, complete Schedule T)
OF
EXPENDITURE
Complete ONLY if direct C idate / Officeholder na Office sought Office held
expenditure to benefit C/OH
Date
Payee name
Amount {$)
Payee address; City; State; Zip Code
PURPOSE
Category (See categories listed at the top of this schedule)
Description (If travel outside of Texas, complete Schedule T)
OF
EXPENDITURE
Complete ONLY if direct Candidate / Officeholder name Office sought Office held
expenditure to benefit C/OH
Date
Payee name
Amount {$)
Payee address; City; State; Zip Code
PURPOSE
Category (See categories listed at the top of this schedule)
Description (if travel outside of Texas, complete Schedule T)
OF
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
wvwv.ethics.state.tx.us Revised 04121/2010