HomeMy WebLinkAboutCFR-01.14.2013-EasonTexas Ethics Commission P.O. Box 12070 Austin, Texas 78711-2070 (512) 463-5800 (TDD 1-800-735-2989)
www. ethics. state. tx.us Revised 09/28/2011
CANDIDATE / OFFICEHOLDER
FORM C/OH
CAMPAIGN
FINANCE REPORT
COVER SHEET PG 1
The C/OH Instruction
Guide explains how to complete this form.
1 ACCOUNT #
(Ethics commission Filers)
2 Total pages filed:
3
CANDIDATE /
OFFICEHOLDER
NAME1ba11FfiwAk5p
MS/MRS/MR FIRST MI
NICKNAME LAST SUFFIX
tg ! r
JAN 14 2013
,
- °- a
4 CANDIDATE /
OFFICEHOLDER
MAILING
ADDRESS
change of address
ADDRESS IPO BOX;APT/SUITE#; CITY, STATE; ZIP CODE
/ j
1 6 f l t) � d f tl �t� rte. �y
t
SiL�+ deliveredeor�omrk
Receipt #
Amount
5
CANDIDATE/
AREA CODE PHONE NUMBER EXTENSION
Date Processed
OFFICEHOLDER
PHONE�
6
CAMPAIGN
TREASURER
NAME
MS/MRS/MR FIRST MI
. . . . . . .(J . . . . . . .
NICKNAME LAST SUFFIX
56af�
Date Imaged
e.
7
CAMPAIGN
TREASURER
ADDRESS
(residence or business)—A
STREETADDRESS (NO PO BOX PLEASE); APT/SUITE#; CITY; STATE;
ZIP CODE
8
CAMPAIGN
AREA CODE PHONE NUMBER EXTENSION
TREASURER
PHONE
(
9
REPORT TYPE
January 15 30th day before election Runoff
El15th day after campaign
treasurer appointment
(officeholder only)
July 15 F] 8th day before election E] Exceeded $500
Final report (Attach C/OH - FR)
limit
10
PERIOD
COVERED
Month Day Year Morxh Day
�")� r fEJ THROUGH
Year
11
ELECTION
ELECTION DATE
Month Day Year
ELECTION TYPE
Primary E-1 Runoff ED General El Special
ED
12
OFFICE
OFFICE HELD (if any) p^ !
rFV/jj/f(J1 (I v'
%13 OFFICE SOUGHT (if known)
✓
A
GO TOPAGE 2
www. ethics. state. tx.us Revised 09/28/2011
Texas Ethics Commission P.O. Box 12070 Austin, Texas 78711-2070 (512) 463-5800 (TDD 1-800-735-2989)
CANDIDATE / OFFICEHOLDER REPORT: FORM C/OH
SUPPORT
& TOTALS COVER SHEET PG 2
14 C/01-1 NAME'
15 ACCOUNT # (Ethics Commission Filers)
16 NOTICE FROM
THIS BOX IS I& NOTICE OF POLITICAL CONTRIBUTIONS ACCEPTED OR POLmCAL EXPENDITURES MADE BY POLITICAL COMMITTEES TO SUPPORT THE
POLITICAL
CANDIDATE / OFFICEHOLDER. THESE EXPENDITURES MAY HAVE BEEN MADE WITHOUT THE CANDIDATE'S OR OFFICEHOLDER's KNOWLEDGE OR
COMMITTEE (S)
CONSENT. CANDIDATES AND OFFICEHOLDERS ARE REQUIRED TO REPORT THIS INFORMATION ONLY IF THEY RECEIVE NOTICE OF SUCH EXPENDITURES.
COMMITTEE NAME
COMMITTEE TYPE
GENERAL
COMMITTEE ADDRESS
SPECIFIC
COMMITTEE CAMPAIGN TREASURER NAME
additional pages
COMMITTEE CAMPAIGN TREASURER ADDRESS
17 CONTRIBUTION
TOTALS
1. TOTAL POLITICAL CONTRIBUTIONS OF $50 OR LESS (OTHER THAN
Q
$ "moi
PLEDGES, LOANS, OR GUARANTEES OF LOANS), UNLESS ITEMIZED
2. TOTAL POLITICAL CONTRIBUTIONS
$
(OTHER THAN PLEDGES, LOANS, OR GUARANTEES OF LOANS)
J
EXPENDITURE
3. TOTAL POLITICAL EXPENDITURES OF $100 OR LESS, UNLESS ITEMIZED
TOTALS
4. TOTAL POLITICAL EXPENDITURES
71
CONTRIBUTION
BALANCE
5 TOTAL POLITICAL CONTRIBUTIONS MAINTAINED AS OF THE LAST DAY
p
OF REPORTING PERIOD
OUTSTANDING
TOTALS
6. TOTAL PRINCIPAL AMOUNT OF ALL OUTSTANDING LOANS AS OF THE
LOAN
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
�•Pv p�•
e�,;
me and Itle Election Code.
JESSICA ERIN BREI LE
• oP
i*
NOTARY PUBLIC
�'
State of Texas
}�;
'� oF?�
Comm. Exp. 06 01-2015
Signat of Candidate or Officeho r
AFFIX NOTARY STAMP / SEAL ABOVE
h c, n
Sworn to and subscribed
before me, by the said this the
(
day
of �° tt!`� 20 , to certify which, witness my hand and seal of office.
SS C4-{
gnats of officer aVM81ering
oath Printed name of officer administering oath Ti e of officer administ ring oath
ww eth'+;s.state.tx.us Revised 09/28/2011