HomeMy WebLinkAboutCFR-07.12.2010-MeigsTexas Ethics Commission P.OBox12070 Austin,78711-2070 • 80 1-800 -325-8506
CANDIDATE / OFFICEHOLDER
FORM CIOH
CAMPAIGN FINANCE REPORT
COVER SHEET PIS 1
1 ACCOUNT #
2 Total pages filed:
The CfCH Instruction
Guide explains how to complete this form. (Ethics Commission Filers)
3 CANDIDATE f
Ms I MRS I MR FIRST MI
OFFICE L
OFFICEHOLDER
a
NAME
�
e Sued
tzivru
NICKNAME .MAST SUFFIX
JUL 12 2010
4 CANDIDATE (
ADDRESS / PO BOX; APT/ SUITE #; CITY; STATE; ZIP CODE
OFFICEHOLDERMAILING
,
t d- D
ADDRESS
h
f I} P
Change of Address
A
CANDIDATE/
AREA CODE PHONE NUMBER EXTENSION
Receipt # Amount
OFFICEHOLDERd
,._
_
PHONE
MS / MRS / MR FIRST MI
Date Processed
_......
6 CAMPAIGN
TREASURERDate
e.. �
Imaged
NAME
. . . . . . . . . . . . . .
NICKNAME LAST SUFFIX
r.
'(L V 4r ''., (,
% CAMPAIGN
STREETADDRESS (NO PO BOX PLEASE); APT ISUITE #; CITY; STATE;
ZIP CODE
TREASURER
ADDRESS
(Residence or Business)
-
8 CAMPAIGN
PHONE NUMBER EXTENSION
AREA CODE PHONE
II
PHONETREAS
9 REPORT TYPE
January 15 30th day before election Runoff
15th day after campaign treasurer
appointment (officeholder only)
July 15 F] 8th day before election F-1 Exceeded $500 limit
Final report (Attach CIOH - FR)
10 PERIOD
Month Day Year Month
Day Year
COVERED
/ /
.i / o THROUGH /
/ELECTION
(.:f / I
11 ELECTION
DATE
ELECTION TYPE
Month Day Year
/,
/ t� ICA
I
M Primary Runoff
General Special
12 OFFICE
HELD fi any)
OF�.
13 OFFICE SOUGHT (if
known)
ggFyICE
94 NOTICE
OF DIRECT
DIRECT CAMPAIGN EXPENDITURES ARE CAMPAIGN EXPENDITURES MADE BY OTHERS WITHOUT THE CANDIDATE'S PRIOR CONSENT OR APPROVAL.
CAMPAIGN
CANDIDATES ARE RE64IRED TO DISCLOSE THIS INFORMATION ONLY if THEY RECEIVE NOTIFICATION OF THE DIRECT CAMPAIGN EXPENDITUPE.
EXPENDITURE
BY OTHER
Name
INDIVIDUALS
Address / PO Box; Apt. ! Suite #; City; ate; Zip Code
additional pages
Texas Ethics Commission P.O. Box 12070 Austin, Texas 78711-2070 (512) 463-5800 1-800-325-8506
CANDIDATE/ OFFICEHOLDER REPORT:
FORM C/OH
& TOTALS
COVER
SHEETSUPPORT
15 C/OH NAPE,
1E ACCOUNT# (Ethics Commission Filers)
17 NOTICE:
THIS BOX is FOR NOTICE OF POLITICAL CONTRIBUTIONS ACCEPTED OR POLITICAL EXPENDITURES MADE BY POLITICAL COMMITTEES TO SUPPORT THE
FROM
CANDIDATE / OFFICEHOLDER. THESE EXPENDITURES MAY HAVE BEEN MADE wnwOur THE CANDIDATE °S OR OFF10EHoLDER`S KNOWLEDGE oR
POLITICAL
~``.CONSENT TES AND OFFICEHOLDERS ARE REQuREO TO REPORT THIS INFORMATION ONLY IF THEY RECEIVE NOTICE of SUCH EXPENDITURES.
N
COMMITTEE(S)
COMMITTEE NAME
COMMIT7EE
GENERAL
COMMITTEE ADDR
SPECIFIC
O
COMMITTEE CAMPAIGN TREASURER NAME
additional pages
COMMITTEE CAMPAIGN TREASURER ADDRESS
1$ CONTRIBUTION
TOTALS
1. TOTAL POLITICAL CONTRIBUTIONS OF $50 OR LESS (OTHER THAN
PLEDGES, LOANS, OR GUARANTEES OF LOANS), UNLESS ITEMIZED
2. TOTAL. POLITICAL CONTRIBUTIONS
(OTHER THAN PLEDGES, LOANS, OR GUARANTEES OF LOANS)
3 2
EXPENDITURE
TOTALS
3. TOTAL POLITICAL EXPENDITURES OF $50 OR LESS, UNLESS ITEMIZED
4. TOTAL POLITICAL EXPENDITURES
CONTRIBUTION
5. TOTAL POLITICAL CONTRIBUTIONS MAINTAINED AS OF THE LAST DAY
BALANCE
OF REPORTING PERIOD
Chi
OUTSTANDING
LOAN TOTALS
g_ TOTAL PRINCIPAL AMOUNT OF ALL OUTSTANDING LOANS AS OF THE
LAST DAY OF THE REPORTING PERIOD
19 AFFIDAVIT
I swear, or affirm, under penalty of perjury, that the accompanying report
is true and correct and includes all
all information required to be reported by
y illif0
g� s�
me under Tltl Elec €I 41Si1%e.
JESSICA
E. ILTON
My COMMISSION EXPIRES
June f, 20f S
Signature of Candidate or Officeholder
AFFIX NOTARY STAMP I SEAL ABOVE
Sworn to and subscribed before me, by the said 1 kQ i \i ��� �
this the
J
day
of LA 20 to certify which, witness my
hand and seal of office.
r
1
7
1. S,fgnature of offlC r a
tering oath Printed name of officer administering oath
Titldfl$ j f$ICef administering�f dath
Texas Ethics Commission P.O. Box 12070 Austin, Texas 78711-2070 (512) 463-5800 1-800-325-8506
POLITICAL EXPENDITURES SCHEDULE
EXPENDITURE CATEGORIES FOR BOX S(a)
Advertising Expense Gift/Awards/Memorials Expense Salaries/Wages/Contract Labor Loan Repayment/Reimbursement
Accounting/Banking Legal Services Solicitation/Fundraising Expense Transportation Equipment & Related Expense
Consulting Expense Food/Beverage Expense Travel In District Contributions/Donations Made By
Event Expense Polling Expense Travel Out Of District Candidate/Officeholder/Political Committee
Fees Printing Expense Office OverheadtRental Expense OTHER (enter a category not listed above)
The Instruction Guide explains how to complete this form.
9 Total pages Schedule F: 2 FILER NAME 3 ACCOUNT # (Ethics Commission Filers)
c4 h n U�°
4 Date
`1 (
5 Payee name
t/t.J t � �U €` tk- k -r -I ' C r�' G �' t , t
6 Amount ($}
7 Payee address; City; Zip Code
(State;
a s
8 PURPOSE
a} C (See categories listed at the top of this schedule)
(b) Description (if travel outside of Texas, complete Schedule T)
OF
EXPENDITURE
pat�egory
f i (r 4l.� � i J i t i
9 Complete ONLY if direct Candidate / Officehol r name Office sought Office held
expenditure to benefit C/OH
Date ¢ i
3 _ !(
Payee name
ttE✓ t`t 1lcV1
Amount ($}
Payee address; City; State; Zip Code
I W 7�>
( g CI '"t ( e 4 0 t. iyt E "a I 4
t
PURPOSE
Category (See categories listed at the top of this schedule)
Description (if travel outside of Texas, complete Schedule T)
OF
EXPENDITURE
� �" � v} $ C VA
Complete ONLY if direct Candidate / Officeholder name Office sought Office held
expenditure to benefit C/OH
Date
Payee name
Amount ($)
Payee address; City; State; Zip Code
PURPOSE
Category (See categories listed at the top of this schedule)
Description (if travel outside of Texas, complete Schedule T)
OF
EXPENDITURE
Complete ONLY if direct Candidate t Officeholder name Office sought Office held
expenditure to benefit CION
Date
Payee name
Amount ($)
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
Texas Commission , P.O.'o6ox 12070 Austin, Texas 78711-2070 463-5800 1-800-325-8506
CANDIDATE/ OFFICEHOLDER REPORT:
FORM I FR
DESIGNATION OF FINAL REPORT
She Instruction Guide explains how to complete this form®
®w Complete only if "Report Type" on page 1 is marked "Final Report"
I
C/OH N6Liiri%E 2 ACCOUNT" # (Ethics Commission Filers)
{' {f,
X6..8 3 l 4.I' e • ^` "'t 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.
pp
Signature of Candidate / Officeholder
4
FILER WHO IS NOT AN OFFICEHOLDER
oe Complete A & B below only if you are not an ofnceholyder. ee
A. CAMPAIGN FUNDS
Cited only one:
I do not have unexpended contributions or unexpended interest or income earned from political contributions.
0 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. ASSET'S
Check only one:
F --J 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, § 254204.
Signature of Candidate
5
OFFICEHOLDER
m® Complete this section only if you are an officeholder o.
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 contrib ns, ar assets purchased with political
contributions or interest or other income from political contributions.
i
Signature of Officeholder
i