HomeMy WebLinkAboutCFR - 09.26.2013 - BrainardTexas Ethics Commission P.O. Box 12070 Austin, Texas 78711-2070 (512)463-5800 (TDD 1-800-735-2989)
CANDIDATE / OFFICEHOLDER FORM C/OH
CAMPAIGN FINANCE REPORT COVER SHEET PG I
I ACCOUNT# 2 Total pages filed:�7 j
The C10H Instruction Guide explains how to complete this form.
i
(Ethics Commission Filers) L 1,
3 CANDIDATE
OFFICEHOLDER
MS/MRSi FIRST MI OFFICE USE ONLY
moll NOW 04 1 '111,01
NAME
NICKNAME AME LAST SUFFIX
r
i� C� 0('T 0 7 8113
ADDRESS IPO BOX, APT/SATE#; CITY; STATE; ZIPCODE
q
4 CANDIDATE
OFFICEHOLDER
MAILING
It, eqr�u lt'4
ADDRESS
—Receipt
[:] change of address
# Amount
AREA CODE PHONE NUMBER EXTENSION
Date Processed
,-
'/
6 CAMPAIGN
MSIMRSIMR FIR MI Date Imaged
TREASURER
7o
NAME
........... 14 . . . . . . . . . .
NICKNAME / /'4:�IST SUFFIX
AI e, P1 lill
/t
7 CAMPAIGN
TREASURER
ADDRESS
STREET ADDRESS (NO PO BOX PLEASE); APTISUITE#-, CITY; STATE; ZIP CODE
(residence or business)
8 CAMPAIGN
AREA CODE PHONE NUMBER EXTENSION
TREASURER
(
PHONE
9 REPORT TYPE15
30th day before election Runoff 15th day after campaign
El January El
9
treasurer appointment
(officeholder only)
F1 July 15 F-1 8th day before election El Exceeded $500 El Final report (Attach C/OH - FR)
limit
10 PERIOD
Month Day Year Month Day Year
COVERED/
I / 1� 1 611
11 ELECTION
ELECTION DATE
Month Day Year
ELECTION TYPE
/
[(/ 5 0
El Primary Ej Runoff El General special
12 OFFICE
OFFICE HELD (if any)
13 OFFICESOUGHT (ffknown)
GOTOPAGE2
www.ethics.state.tx.us Revised 04/19/2013
Texas Ethics Commission PO.Box 12O7O Austin, Texas 7OT11-2070 (512)463-5800 (TDD 1-800-735-2989)
CANDIDATE / OFFICEHOLDER REPORT: FORM C/OH
SUPPORT & TOTALS COVER SHEET PG 2
14 C/OH NAME
15 ACCOUNT# (Ethics Commission Filers)
16 NOTICE FROM
THIS BOX IS FOR NOTICE Or POLITICAL CONTRIBUTIONS ACCEPTED OR POLITICAL EXPENDITURES MADE BY POLITICAL COMMITTEES TO SUPPORT THE
POLITICAL
CANDIDATE I OFFICEHOLDER. THESE EXPENDITURES MAY HAVE BEEN MADE WITHOUT THE CANDIDATE'S OR OFRCEHOLDER's KNOWLEDGE OR
COMMITTEE(S)
CONSENT. CANDIDATES AM OFFICEHOLDERS ARE REQUIREDTO REPORT THIS INFORMATION ONLY IF THEY RECENE NOTICE OF SUCH EXPENDITURES.
COMMITTEE NAME
COMMITTEETYPE
r --j GENERAL
COMMITTEE ADDRESS
F --j SPECIFIC
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
(OTHER THAN PLEDGES, LOANS, OR GUARANTEES OF LOANS)
EXPENDITURE
TOTALS
3. TOTAL POLITICAL EXPENDITURES OF $100 OR LESS, UNLESS ITEMIZED
$
4. TOTAL POLITICAL EXPENDITURES
$
CONTRIBUTION
BALANCE
5TOTAL POLITICAL CONTRIBUTIONS MAINTAINED AS OF THE LAST DAY
OF REPORTING PERIOD
$
OUTSTANDING
LOAN TOTALS
6. TOTAL PRINCIPAL AMOUNT OF ALL OUTSTANDING LOANSASOFTHE
$
LAST DAY OF THE REPORTING PERIOD
18 AFFIDAVIT
I swear, or affirm, under penalty of perjury, that the accompanying report
is true and ffirrect ang4jric"s all information req ired to be reported by
me under 'te 15, Erktion de.
JESSICA ERIN BRETTLE
NOTARY
�
PUBLIC i
Wu 27
I 1 State of T '//
exas
COMMEXP. 06-01-2015 Signature of Candida�e or Officeholder
AFFIX NOTARY STAMP I SEAL ABOVE
Sworn to and subscribed before me, by the said this the
day of to certify which, witness my hand and seal of office.
ign 1� of officeer administering oath Printed name of officer administering oath -rihpjf officer aclmini,4tew)� oath
_
www,ethics.state.tx.us Revised 04/19/2013
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.
1 Total pages Schedule A: W
-1
2 FILER NAME
3 ACCOUNT# (Ethics Commission Filers)
4 Date
5 Full name of contributor E] out-of-state
. . . . . . . . . . .
. Cod
6 Contributor address; City; State; Zj"Cod a
7 Amount of 18 In-kind contribution
contribution description (if applicable)
(if travel outside of Texas, corriplete Schedule T)
9 Principal occupation / Job title (See Instructions)
10 Employer (See Instructions)
Date
Full name of contributor El loat-or-state aACt l
'J' -on '14 , 'address; Cit,y;, 'State'; *Zi . . . . . . . . . . .
t'
7-77-ff
Amount of In-kind contribution
contribution description (if applicable)
I -P
if travrat outside of Texas, corriptate Schedule -0
Principal occupation / Job title (See Instructions)
T Employer (See Instructions)
Date
Full name of contributor El
j.
Amountof In-kind contribution
contribution description (if applicable)
v
. . . . . . . . . . . . . . . . . . . . .
Contributor address; City; State; Zip Code
an
(if travel OU— of Texas,—riplate Schedule T)
Principal occupation / Job title (See Instructions)
Employer (See Instructions)
Date
Full name of cont;ributor El
0111
.)Vcj� tel . . . . . . . . . . . . . . . . . . . . .
Co address; City" Zip Coda
Amount of ln4,j.d contribution
contribution description Cif applicable)
IV
Of travel outside —npleta Schedule T)
Principal occupation / Job title (See Instructions)
Employer (See Instructions)
Date
Full name of contributor n out-of-statePAC(Mj
Amount of In-kind contribution
contribution description (if applicable)
.......................... I .......
Contributor address; City; State; Zip Code
I I
if bevel outside of 1--, caniplete 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 04/19/2013
Texas Ethics Commission P.O. Box 12070 Austin, Texas 78711-2070 (512)463-5800 (TDD 1-800-735-2989)
POLITICAL EXPENDITURES SCHEDULE F
EXPENDITURE CATEGORIES FOR BOX 8(a)
Advertising Expense Gift/Awards/Memorials Expense SalariestWages/Contract Labor Loan RepaymenttReimbursement
Accounting/Banking Legal Services ScificitatknYFundraising 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/Portfical 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 Sch ule F:
2 FILER NAME
3 ACCOUNT # (Ethics Commission Filers)
4 Date
0 —yee name//
6 Amount
7 Payee address; City State; Zip Code
/r / /
Ufiqr
8 PURPOSE
OF
(a) Category (See categories listed at the top of this schedule)
Description (if travel outside ofTexas, complete Schedule T)
EXPENDITURE
4a1
C51
9 Complete ONLY if direct Candidate / Offi8e'holcler name Office sought Office held
expenditure to benefit C/OH
Date
/ZL3 l
/
Payee name
v
Amount
Payee address; City; State; Zip Code
PURPOSE
OF
Category (see,categories listed at the top of this schedule)
'
Description (11' travel outside of Texas, complete Schedule 1)
I
EXPENDITURE
4, - i,,') &,,,, �; � �
L &
-jy
Complete ONLY if direct Candidate I Offiix-holder name Office sought Office held
expenditure to benefit C/OH
Date
Payee name
Amount
Payee address; City; State; Zip Code
Ila.
PURPOSE
OF
Cp"ory (See categories listed at the top of this schedule)
Description (If travel outside of Texas, complete Schedule T)
EXPENDITURE
Complete ONLY if direct Candidate /,01116eholdler 'name Office sought Office held
expenditure to benefit C/OH
Date
ze A7
Payee name
1163rle 5� -7
Amount
Payee address- City; State; Zip Code
LIP
PURPOSE
OF
Categlory (See categories listed at the top of this schedule)
Description (if travel quWde of Texas, complete schedule T)
Ai"'Ivl
EXPENDITURE
tiqjqj L
Complete ONLY if direct Candidate Officeholder Rime Office sought Office held
expenditure to benefit C/OH
ATTACH ADDITIONAL COPIES OF THIS SCHEDULE AS NEEDED
www.ethics.state.tx:.us Revised 04119/2013