HomeMy WebLinkAboutCFR-04.12.2012-EasonThe C10H Instruction Guide explains how to complete this form. I (Ethics Commission Filers)
3 CANDIDATE / MSIMRSIMR MI
OFFICEHOLDER
NAME 1
a a_ . .
NiCKNAIviE . . . LA�. SUFFIX
`±
CANDIDATE J ADDRESS/PO BOX; APTISUITeE#; CITY; STATE, ZIPCODE
OFFICEHOLDER
7
a d live art d
ADDRESS
G
change of address
Receipt #
AREA CODE PHONE NUMBER EXTENSION
Amount
5 CANDIDATE/
OFFICEHOLDER
PHONE
Date Processed
6
CAMPAIGN
MS/MRS/MR FIRST W Dateimaged
TREASURER
s
�
NAME
. . . . . . f � . . . . . . . .
NICKNAME jAST SUFFIX
�4A�✓comas
4Y�
d
CAMPAIGN
STREETADDRESS I,NOPOBOX PLEASE), APT/SUITE#, CITY; STATE; ZiPCODE
TREASURER
(residence or business)
o
�%
8
CAMPAIGN
AREA CODE PHONE NUMBER EXTENSION
TREASURER
PHONE
REPORT TYPE
❑ January 15 30th day before election Runoffi54h day Y
after campaign
P 9 n
treasurer
appointment
(officeholder
only)
July 15 Pl 8th day before election ❑ Exceeded $500 ❑ Final report
(Attach C/OH - FR)
limit
10
PERIOD
Month Day Year Month Day Year
COVERED
� � a THROUGH
11
ELECTION
ELECTION DATE ELECTIONTYPE
-
Month Day Year rima
�...-^`"" � Primary u Runoff General
� Special
/X �/ 8
12
OFFICE
OFFICE HELD (if any)13
OFFICE SOUGHT (If known)
JD)
www.ethics.state.tx.us Revised 0912812011
Texas Ethics CommissionP.O. Box 1207078711-2070 iiE 1-800-735-2989)
REPORT:CANDIDATE I OFFICEHOLDER FORM C/OH
SUPPORT
& TOTALS VES SHEET PG 2
14 C1Ohl A
t
y77/
�5 ACCOUNT # (Ethics Commission Filers)
`ung
16 NOTICE FROM
%THIS SOX IS FOR NOTICE OF POLITICAL CONTRIBUTIONS ACCEPTED OR POLITICAL EXPENDITURES MADE BY POLITICAL COMMITTEES TO SUPPORT THE
POLITICAL
CANDIDATE 1 OFFICEHOLDER. THESE EXPENDITURES MAY HAVE BEEN MADE TM£HOUT THE CANDIDATE'S OR OFFICEHOLDERS KNOV&EDGE OR
COMMITTEE(S)
CONSENT. CANDIDATES AND OFFICEHOLDERS ARE REQUIRED TO REPORTTHIS INFORMATION ONLY IF THEY RECEIVE NOTICE OF SUCH EXPENDITURES,
COMMITTEE NAME
COMMITTEE TYPE
GENERAL
COMMITTEE ADDRESS
SPECIFIC
0
COMMITTEE CAMPAIGN TREASURER NAME
additional pages
COMMITTEE CAMPAIGN TREASURER ADDRESS
17 CONTRIBUTION
TOTALS
1. TOTAL POLITICAL CONTRIBUTIONS OF $50 OR LESS (OTHER THAN
PLEDGES, LOANS, OR GUARANTEES OF LOANS), UNLESS ITEMIZED
2. TOTAL POLITICAL CONTRIBUTIONS
THAN PLEDGES, LOANS, OR GUARANTEES OF LOANS)v0
(OTHER
EXPENDITURE
TOTALS
3. TOTAL POLITICAL EXPENDITURES OF $144 OR LESS, UNLESS ITEMIZED
f
4. TOTAL POLITICAL EXPENDITURES
/-�s
CONTRIBUTION
BALACE
BALANCE
fi. TOTAL POLITICAL CONTRIBt1�Tl MAINTAINED AS OF THE LAST DAY
t
OF REPORTING PE
t , e J
OUTSTANDING
g. TOTAL PRINCIPAL AMOUNT OF ALL OUTSTANDING LOANS AS OF THE
LOAN TOTALS
LAST DAY OF THE REPORTING PERIOD
IS AFFIDAVIT
I swear, or affirm, under penalty of perjury, that the accompanying report
is true and correct and includes all information required to be reported by
me under Title 15;` Iechon Code.
„•,<,,
LrAURA UL:KINS:
'* *
MY COMMISSIOES2
Signature of° ndidate or Officeholder
AFFIX NOTARY STAID 1 SEAL ABOVE
��q
Sworn to and subscribed
P before me, by the said ( � W this the
%r day of ' til to certify which, fitness my hand and seat of office.
k7
Signature of officer administering oath Printed name of officer administering oath Title of officer administering oath
www.ethics.state.tx.us Revised 0912812011
Texas Ethics Commission P.O. Box 12070 Austin, Texas 78711-2070 (512)463-5800 (TDD 1-800-735-2989)
POLITICAL CONTRIBUTIONS SCHEDULE A
OTHER THAN PLEDGES OR LOANS
The Instruction Guide explains how to complete this form.
I Tota( pages Schedule A:
2 FILER DAME 1 ACCOUNT # (Ethics Commission Filers)
/ - a
4 Lute 5 Full name of contributor ❑ out-of-state PAC(lo#: _ 7 Amountof In-kind contribution
J��gr( {j contribution (S) C description (if applicable)
)G.s'd
�6 Cczntributoraddres Ctr�
City, State; Zip ode _
t (If travel outside of Texas, ca {Mete Schedule T)
k9'�—'rincipal occupatioR 1 Job title (See lnstru tions) r �Q Empl er (S e instruction/,, - 6r"' f
Bate Full name of contr' utor ❑ out-of-state PAC(ID#: Amount of In-kind contribution
contribution ($} i description (if applicable)
(. 'r i
} f C Contributor address; arty; State; Zip Code l i
/ `� f �o if trovel outside of Texas, complete Schedule T
Principal occupation / Job title (See Instructions) Employer (See Instructions)
I
Date Full name of contributor ❑ out-of-state PAC ([D# Amountof #n -kind contribution
-_ contribution (S} description (if applicable)
4) J Contributor address; City; Sia#e; iipTCd)e
"`r % 1' f r (if travel outside of Teras, comple Schedule T)
rincipai occupation /Jena lila (See Instructions) Employe ( t Instructions))
R2144 1� Y102 - A5 -
Gate �uli name of contributor ❑ out-of-state PAC( Amount. Ii/kind contribution
d¢ r J j' } contribution (S) des ription (if applicable)
- -
Contributor address; City; State; Zip Code
.'I f
I (If travel outside of Texas, complete Schedule T
Principal occup ion / Job title (See Instructions) Employer (See Instructions)
Crate E€ name of contributor ❑ out of-stateaAC(10#: Amount of In-kind contribution
z contribution ($) description (if applicable)
m f ).
1 ontributor address; City; State; Zip Code°, j
3 / 9Y/ (if travel outside of Texas, complete Schedule T
Principa ccupation I Job title (See Instructions) ° Employer (See Instructions)
ATTACH ADDITIONAL COPIES OF THIS E UL.E AS NEEDED
If contributor is out-of-state PAC, please see instruction guide foradditional reporting requirements.
www.ethics.state.tx.us Revised 09128/2011
s sad
Texas• •P.O.s• �.. G Austin,
Texas 78711-20 70 (512)463-5800 D •S?! s .
POLITICAL CONTRIBUTIONS
SCHEDULE A
OTHER THAN PLEDGES OR LOANS
I Total pages Schedule A:
The Instruction Guide explains hove to complete this form.
2 FILER NAME
e
3 ACCOUNT # (Ethics Commission Filers)
k Date
5 Full name of contributor ❑ out-of-state PAC(Qt }
i Amount of In-kind contribution
contribution description (if applicable)
M g tt
/i
COdeV
Ontrfl]UtOr address" Cttjy;
pState-
{
'_CI ' YG j
Texas, Schedule T)
!, ,-`
(if travel outside of complete
g Principal oceup T ,lob title (Sega jnstrw`ctions)
10 Employer (See Instructions)
Date .
Full name of contributor Cj out-of-state PAC (Uk
Amount of In-kind contribution
3
90
contribution {S} t description (if applicable)
j
Contributor addres City; State; Zrp Code
Z/� t
-
'A`
r
Z A
Texas, =fete Schedule
-R c"
if travel outside of
Pr c'pal occyrpation f Job title (See Inst cons)
Employer (See Instructions)
bolIv, ZL 4
Date
Full name of contributor El out-of-state PAC (Ot )
Amount of In-kind contribution
i
contribution ($)pp description (if applicable)
Contributor address;. City; State; Zip Code 4
i
f
I
(if travel outside of Texas, complete Schedule T)
Principal occupation f Job title (See Instructions)
Employer (See Instructions)
Date
Full name of contributor out-of-statePAC(lEg i
Amount of In-kind contribution
contribution ($) # description (if applicable)
i!
Contributor address; City; State; Zip Code
E
if travel outside of Texas, com tete Schedule
Principal occupation f Job title (See Instructions)
Employer (See Instructions)
Date
Full name of contributor Cf out-of-statePACOD#: 3
Amountof In-kind contribution
contribution {$) I description (if applicable)
Contributor address; Cit y; State; Zip Code
t�
1
if travel outside of Texas, oom fete Schedule
Principal occupation f Job title (See Instructions) Employer (See Instructions)
ATTACH ADDITIONAL COPIES OF THIS SCHEDULE AS NEEDED
If contributor is out-of-state RAC, please see instruction guide foradditional reporting requirements.
i
I
www.ethics.state.tx.us Revised 09/2812011
Texas Ethics Commission P.O. Dox 12070 Austin, Texas 78711-2070 (512) 463-5800 (TDD 1-890-735-2989)
POLITICAL EXPENDITURES SCHEDULE
I
EXPENDITURE CATEGORIES FOR BOX (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 hoer to complete this form.
1 Total pages Schedule F:
2 FILER NAME
ACCOUNT # (Ethics Gammission Filers)
4 Dattel
fjP�ayeepj name p y
Amo, nt M
7 Payee address, City; State; Zip Code
s CD
PURPOSE
OF
(al Category (See catones listed at the top oft schedule
19
(b) Description (if travel outsi Texas, complete SchedulaT)/
EXPENDITURE
' f a isPs
Complete ONLY if direct a didat / Officeholder name Office sough tl�9� Office held
1 1
expenditure to benefit C/OH777/ A
:y ( ry r
f fff "
dd
DateIV
Payee nam
Am nt (
ayes addre>sps; ity; State; Zip Code
�d�Z
e.. 3,. P' -^"'s° "'�� 4a✓'' Cry? .,..""..
PURPOSE
Category (See categories listed at the top of this schedule)
cription (If travel outside of Texas, complete Schedule T)
OF
EXPEtV 4`fiDREC
"Candidate
<
Complete ONLY if direct !/Officeholder nme Office sought Office held
expenditure to benefit C/OH f ,mid
Date
Payee name
\7;; 0/
An'aou t ($)
Payee address; City; State; Zip Code
AJ?7Z r`:,�"--
PURPOSE
Category (See categories listed at the top of this sched le)
Description (If travel outside of Texas, complete Schedule T)
OF
EXPENDITURE
k� ��
nc�77VG _ .:-
Complete ONLY if direct Candidate / Officeholder name Office sought Office held
expenditure to benefit CIOFt- ..
Date
Payee nAme =
}"'
< w.
Anou t!
Payee address- /Ci y; p State; Zi , qe } A
}
PURPOSE gory (See categoriesr listed at the top of this schedule) Description (if tray tside of Texas, complete Schedule T)
OF
EXPENDITURE
Complete ONLY if direct Candidate / Officeholder name y Office sought Office held
expenditure to benefit C/OH
�l / i
�`
ATTACH ADDITIONALCOPIE OF THIS CHED LE AS WEEDED i
viww.ethics. state. tx.us Revised 09128/2011
Will iiiiiiiiiii !I
11 ilill=giiljim��Il
POLITICAL SCHEDULE
EXPENDITURE CATEGORIES FOR BOX (a)
Advertising Expense Gift/Awards/Memorials Expense SalariesfWages/Contract Labor Loan Repayment/Reimbursement
Accounting/Banking Legal Services Solicitation/Fundraising Expense Transportation Equipment & Related Expense
Consulting Expense Food/Beverage Expense Travel In District Contributions/Donations Prude By
Event Expense Polling Expense Travel Out Of District Candidate/Officeholder/Political Committee
Fees Printing Expense Office Overhead/Rental Expense OTHER (enter a category not listed above)
The Instruction Guide explains how to complete this form.
1 Total pages Sc edule F: FILER NAME t 3 ACCOUNT # (Ethics Commission Filers)
f a. t
5P name
�€Date
Amount ($}
Z Payee address; City; State; Zip Code
n>
i L
S PURPOSE
(a) Category (See categories listed at the top of this schedule)
4bt ascription (it travel outside of Texas, complete Schedule T)
OF
EXPENDITURE
?„�-s,
A
.�nr`d i ' F i --'"
"�- '.oe9
9 Complete ONLY if direct Ca ate / Of6ceh r name�PF ffice sought � O ce held
benefit C/OH
expenditure to
Date
Paydee name✓
iX
5
A0/)f/V'°"
_
~ f '4 K�k! I R /
Amount (S)
Payee address; Ci State; p Code
'
3
7w
t?vG
<' 1 ,
PURPOSE
Category (See categories listed at the top of this schedul)
Description (if travel outside of Texas, complete Schedule T)
OF
EXPENDITURE/'Ror'/
Complete ONLY if direct Candi ate / 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
EXPIENDrrURE
Complete ONLY if direct Candidate I Officeholder name Office sought Office held
expenditure to benefit C/OH
Date
Payee name
Amount (y }
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 CH ADD! 'E L COPIES OF THIS SCHEDULE AS NEEDEDI
www.ethics.state.tx.us Revised 0912812011
Texas Ethics Cornmiscion P.O. Box 12070 Austin, Texas 78711-2070 (512) 463-58130 {TDD 1-800-735-2989)
POLITICAL EXPENDITURES SCHEDULE
MADE FROM PERSONAL FUNDS
EXPENDITURE AT GORIE FOR BOX (a)
Advertising Expense Gift/Awards/Memorials Expense Salaries/Wages/Contract Labor Loan Repayment/Reirnbursement
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.
1 Total pages Schedule G: 2 FILER IVIE 3 ACCOUNT #f (Ethics Commission Filers)
E
_w
4 Date
a� y
Jp
5 Payee name
`mµ.7 ��a
t
6 Amount ($)10)p
Reimbursement from
political
intended
intended
7 Payee address; City; State; Zip Code
8 PURPOSE
F
EXPENDITURE
(a) Category (See categories listed all je top of this schedule)
(b) Description (If travel outside of Texas, complete Schedule T)
Date
Payee name
Amount ($}
Payee address; City; State; Zip Code
❑Reimbursement from
political contributions
intended
PURPOSE
Category (See categories listed at the top of this schedule)
Description (if travel outside of Texas, complete Schedule T)
F
EXPENDITURE
Date
Payee name
Amount M
Payee address; City, State; Zip Code
Reimbursement from
political contributions
intended
PURPOSE
Category (See categories listed at the top of this schedule)
Description (if travel outside of Texas, complete Schedule T)
OF
EXPENDITURE
I.
Date
Payee name
Amount {$)
Payee address; City; State; Zip Code
❑P.eimbursement from
political contributions
l
intended
PURPOSE
Category (See categories listed at the top of this schedule)
Description ilf travel outside of Texas, complete Schedule T)
F
EXPENDITURE
I ATTACH ADDITIONAL COPIES OF THIS SCHEDULE AS NEEDED
www.ethics.state.tx.us Revised 09/28/2011