HomeMy WebLinkAboutCFR-05 thru 12.2011-JonroweTexas Ethics Commission P.O. Box 12070 Austin, Texas 78711-2070 (512)463-5800 (TDD 1-8n0-7.1.5-9qRQ1
CANDIDATE / OFFICEHOLDER FORM C/OH
CAMPAIGN FINANCE REPORT COVER SHEET PG I
I ACCOUNT# 2 Total pages filed:
The C10H Instruction Guide explains how to complete this form.
(Ethics Commission Filers)
$ CANDIDATE
MSIMRS/MR FIRST MI
OFFICEHOLDER
NAME
rs fi
r
NICKNAME LAST SUFFIX
C-7 ric'm (1,('41 'AN 17 2012
ADDRESS JPO BOX; APT/SUITE#; CITY; STATE; ZIP CODE
4 CANDIDATE i
OFFICEHOLDER
MAILING
ADDRESS
— - &ezrc a
❑ change of address
Receipt # Amount
AREA CODE PHONE NUMBER EXTENSION
6 CANDIDATE/
OFFICEHOLDER
PHONE
(
6 CAMPAIGN
MS/MRS/MR FIRST MI Datelmaged
TREASURER
NAME
NICKNAME LAST SUFFIX
a5
0 r
7 CAMPAIGN
STREETADDRESS (NO PO BOX PLEASE); APT/SUITE#, CITY; STATE: ZIP CODE
TREASURER
ADDRESS
(residence or business))X
8 CAMPAIGN
AREA CODE PHONE NUMBER EXTENSION
TREASURER
PHONE
)
9 REPORT TYPE
F-1 January 15 F-1 30th day before election ❑ RunoffEl 15th day after campaign
treasurer appointment
(officeholderonly)
F1 July 15 F-1 8th day before election ❑ Exceeded $500 Final report (Attach CIOH - FR)
limit
10 PERIOD
Month Day Year Month Day Year
COVERED
THROUGH 12-13111(
111 ELECTION
ELECTION DATE
ELECTIONTYPE
Month Day Year
Primary F-1 Runoff General Special
/K
12 OFFICE
OFFICE HELD (if any)
13 OFFICE SOUGHT (if known)
gg
L$
www.ethics.state.tx.us Revised 09/28/2011
I
Texas Ethics Commission P.O. Box 12070 Austin, Texas118711-2070 (512) 463-58OG (TDD 1-800-735-29891
CANDIDATE/ OFFICEHOLDER REPORT: FORM C/OH
SUPPORT & TOTALS COVER SHEET PG 2
14 C/OHrME 9S ACCOUNT # (Ethics Commission Filers)
r
di
16 NOTICE FROM THIS BOX IS FOR NOTICE OF POLITICAL CONTRIBUTIONS ACCEPTED OR POLITICAL EXPENDITURES MADE BY POLITICAL COMMITTEES TO SUPPORT THE
POLITICAL CANDIDATE/ OFFICEHOLDER. THESE EXPENDITURES MAY HAVE BEEN MADE MTHOUT THE CANDIDATE'S OR OFFICEHOLDERS KNOALEDGE OR
COMMITTEE (S) CONSENT CANDIDATES AND OFFICEHOLDERS ARE REQUIRED To REPORT THIS INFORMATION ONLY IF THEY RECEIVE NOTICE OF SUCH EXPENDITURES.
COM41TTEE TYPE
COMMITTEE NAME
F --j GENERAL
COMMITTEE ADDRESS
SPECIFIC
COMMITTEE CAMPAIGN TREASURER NAME
additional pages
COMMITTEE CAMPAIGN TREASURER ADDRESS
17 CONTRIBUTION
TOTALS
1TOTAL 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)
EXPENDITURE
TOTALS
3. TOTAL POLITICAL EXPENDITURES OF $100 OR LESS, UNLESS ITEMIZED
s �2
2
4. TOTAL POLITICAL EXPENDITURES
$
CONTRIBUTION
BALANCE
5. TOTAL POLITICAL CONTRIBUTIONS MAINTAINED AS OF THE LAST DAY
$
OF REPORTING PERIOD
2,r
OUTSTANDING
LOAN TOTALS
6. TOTAL PRINCIPAL AMOUNT OF ALL OUTSTANDING LOANS AS OF THE
$
LAST DAY OF THE REPORTING PERIOD
18 AFFIDAVIT
I swear, or affirm, under penalty of perjury, that the accompanying report
is true and correct and includes all information required to be reported by
me and Title 15, Election Code,
U, " JESSIGA ERIN BRERLE
�=My PLOW
Sim co Texes
Of Corm. Exp. 0&01-2015
Signature of Can4date orOlifij-e�hol`
AFFIX NOTARY STAMP I SEAL ABOVE
Sworn to before by Ir CQ—
and subscribed me, the said this the
day of tf 20 to certify which, witness my hand and seat of office.
4-r
i 'Si nature ofoffic "raffifniistering oath Printed name of officer administering oath ftilti6 of offit ce r administ 5gath
'
wvW,ethics.state.tx.us Revised 09/28/2011
Texas Ethics Commission P.O. Box 12070 Austin, Texas 78711-2070 (512) 463-5800 (TDD 1-800-735-2qRq)
POLITICAL CONTRIBUTIONS
TSCHEDULE A
OTHER HAN PLEDGES OR LOANS
The Instruction Guide explains how to complete this form.
I Total pages Schedule Ai
2 FILER NAMEC,
3 ACCOUNT # (Ethics Commission Filers)
�' lawkd-o
4 Date
6 Full name of contributor El out -or -state PAC (]D#-
7 Amount of 8 In -kid contribution
contribution description (if applicable)
'
6 Contributor a
address, City; State; Zip Code
k
(if travel outside of Texas, complete Schedule T)
9 Principal occupation I Job title (See Instructions)
10 Employer (See Instructions)
Date
Full name of contributor El out-of-statePAG(ID#:
Amount of In-kind contribution
Y) M 15D rA
contribution description (if applicable)
Contributor address; City-, State; Zip Code
ju
.
if travel outside of Texas, complete Schedule T)
Principal occupation I Job title (See Instructions)
Employer (See Instructions)
Date
Full name of contributor El out-of-statePACODft:
Amount of I. -kind contribution
Y)
contribution description (if applicable)
Contributor address; City; State-, Zip Code
L - L L
Cxffaf A'' -)an .7*Nl
(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
Amount of In-kind contribution
V,
' Cd U c , 5
Avre-k GkV0C_ P
contribution description (if applicable)
............ . r
Contributor address; City; State; Zip Code
51 VIt 5 5
if travel side of Texas, compete Schedule T)
Principal occupation / Job title (See Instructions)
Employer (See Instructions)
Date
Full name of contributor 0 out -or -state PAC (to#---
Amount of In-kind contribution
contribution description (if applicable)
Contributor address; City; State; Zip Code
If travel outside ofi Texas, 00-0.1e Schedule T)
Principal occupation / Job title (See Instructions) Employer (See Instructions)
ATTACH ADDITIONAL COPIES OF THIS SCHEDULE AS NEEDED
If contributor is out-of-state PAC, please see instruction guide foradditional reporting requirements.
www.ethics.state.tx.us Revised 09/2812011
Texas Ethics Commission P.O. Box 12070 Austin, Texas 78711-2070 (512)463-5800 (TDD I-80n-7'1r,-9qRQi
POLITICAL EXPENDITURES SCHEDULE F
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 Contribution s/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.
I Total pages Schedule F:
2 FILER NAME-�COIJNT
�A
� # (Ethics Commission Filers)
T
la'e-� - 69C11-11
AA i
4 Date
ct
6 Payee name
C) a0l)
6 Amount
7 Payee address; Cqy-, State; Zip Code
1013 VO,'-)
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
b
9 Complete ONLY if direct Candidate / Offiiieholcler name Office sought Office held
expenditure to benefit CJOH
Date
r G
:2- '1\N�A\
Payee k 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
C_
Complete ONLY if direct Candidate I Officeholder Office sought Office held
expenditure to benefit CION .0me
Date
Payee n
V a, r)
Amount
Payee address; City; State; Zip Code
-41
LoC`3 1 Ve'1'5 Awt, I A
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 n Office sought Office held
expenditure to benefit C/OH
Dateyee
name
Zi
C"
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
I
Loan Qp0m meyi+-
Complete ONLY if direct Candidate / OIce hQAder name Office sought Office held
expenditure to benefit QC/OH 'G '
A adiot(
4fA WhC I
ATTACH ADDITIONAL COPIES OF THIS SCHEDUEE AS NEEDED
www.ethics.state.tx.us Revised 09128/2011
Texas Ethics Commission P.O. Box 12070 Austin, Texas 78711-2070 (512) 463-5800 (TDD 1-800-735-2989)
EPOLITICAL
EXPENDITURES �+ gig gp
SCHEDULE
UL
EXPENDITURE CATEGORIES FOR BOX 8(ca)
Advertising Expense
Gift/Awards/,Mielnorials 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 Contribution sibonations Made By
Event Expense
Polling Expense Travel Out Of District Candidate/Officeholder/Political Committee
Fees
Printing Expense Office Overhead/Rentai Expense OTHER (enter a category not listed above)
The Instruction Guide explains how to complete this form.
1 Tafai pages Schedule F:`2
FILER NAME ` 3 ACCOUNT # (Ethics Commission Filers)
t
4 Date
5 Payee name
((
t
v
B Amount (S}
7 Payee address; C y; State; Zip Code
8 PURPOSE
(a) Category (See categores listed at the top of this schedule)
(i7) Description (I€ travel outside 06 Texas, complete Schedule T)
OF
EXPENDITURE
-1 ok g2 a �
9 Complete ONLY if direct
Candidate / Officeholder name Office sought Office held
expenditure to benefit CIOH
Date
Payee name
Amount
[ Payee address; City; State; Zip Code
1
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 (S}
Payee address; City; State; Zip Code
PURPOSE
Category (See categories listed atthe top of this schedule) f Description W, 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 (S)
Payee address; City; State; Zip Code
PURPOSE i
Category (See categories listed at the top of this schedule) Description (if' ravel outside of—, axes, complete Schedule T)
OF j
EXPENDITURE
Complete ONLY if direct
Candidate 1 Officeholder name Office sought Office held
expenditure to benefit C/OH
ATTACH ADDITIONAL. COPIES OF THIS SCHEDULE AS NEEDED
www.ethics.state.tx.us Revised 04/21/2010
Texas Ethics Commission P.O. Box 12070 Austin. Texas 78711-2070 14;191 AR'4_rR0n (Tnn I_5Zr1r)_7':Zr, ')000
www.ethics.state.tx.us Revised 09/28/2011
NON-POLITICAL EXPENDITURES
SCHEDULEI
MADE FROM POLITICAL CONTRIBUTIONS
EXPENDITURE CATEGORIES FOR BOX 8(a)
Advertising Expense Gift/Awards/Memorials Expense Salaries/Wages/Contract Labor Loan Repayment/Reimbursement
Accounting/Banking Legal Services Solicitation/Fund raising 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.
I Total pages Schedule L
I
2 F ER NAME
i /')
P,�, n
tj
ACCOUNT # (Ethics Gornmission Filers}
4 Date
5 Payee name
) Y- (nds
6 Amount
7 Payee address; City; State; Zip Code
II�320o 72- GV'CWcfrj'_n( _76r 5 _3 0
8 PURPOSE
(a) Category (See categories listed at the top of this schedule)
(b) Description (See instructions regarding type of information required.)
OF
EXPENDITURE
Date
Payee name
Amount
Payee address; City; State; Zip Code
PURPOSE
Category (See categories listed at the top of this schedule)
Description (See instructions regarding type of information required.)
OF
EXPENDITURE
Date
Payee name
Amount
Payee address; City; State; Zip Code
PURPOSE
Category (See categories listed at the top of this schedule)
Description (See instructions regarding type of information required.)
OF
EXPENDITURE
Date
Payee name
Amount
Payee address; City; State; Zip Code
PURPOSE Category (See categories listed at the top of this schedule) Description (See instructions regarding type of information required.)
OF
EXPENDITURE
ATTACH ADDITIONAL COPIES OF THIS SCHEDULE AS NEEDED
www.ethics.state.tx.us Revised 09/28/2011