HomeMy WebLinkAboutCFR - 07.15.2014 - 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
1 ACCOUNT #
2 Total pages filed:
The C/OH Instruction Guide explains how to complete this form.
(Ethics Commission Filers)
3 CANDIDATE /
MS/MRS MR FIRST MI
OFFICE USE ONLY
OFFICEHOLDER
NAME(�/�/�jf
Date Received
NICKNAME LAST SUFFIX
4 CANDIDATE /
OFFICEHOLDER
ADDRESS /PO BO , APT/SULTS#; ITY; STATE; ZIPCODE
}
! '�
Date Hand -delivered or Postmarked
ADDRESS
Receipt #
Amount
F—] change of address
(//� / � (
5 CANDIDATE/
AREA CODE PHONE NUMBER EXTENSION
Date Processed
OFFICEHOLDER/�
�� �' [
PHONE
/
6 CAMPAIGN
MSIMRS/MR FIRST/ MI Date Imaged
TREASURER
NAME
�(�J
�+..
NICKNAME SUFFIX
7 CAMPAIGN
TREASURER
STREET ADDRESS (NO PPBOX EASE); P (iSUITE#, �% CITY; STATE; ZIPCODE
�� /
ADDRESS
(residence or business)
8 CAMPAIGN
AREA CODE PHONE NUMBER EXTENSION
TREASURER
/ -
PHONE
\
9 REPORT TYPE
❑ January 15❑ 30th day before election ❑ Runoff ❑ 15th day after campaign
treasurer appointment
(offoehokleronly)
July 15 ❑ 8th day before election ❑ Exceeded $500 ❑ Final report (Attach C/OH - FR)
limit
10 PERIOD
NDA t Day Year, Month Day Year
COVERED
/ r / /fJ� THROUGH
11 ELECTION
ELECTION DATE
ELECTIONTYPE
Month Dal Year
❑ Primary ❑ Runoff ❑ General ❑ Special
12 OFFICE
OFFICE HELD (f any)
,7
13 OFFICE SOUGHT (if known)
GO TO PAGE 2
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)
CANDIDATE / OFFICEHOLDER REPORT: FORM C/OH
SUPPORT & TOTALS COVER SHEET PG 2
14 C/OH NAME%
15 ACCOUNT # (Ethics Commission Filers)
P� r;/'' �j j/'' fir'
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 WITHOUT THE CANDIDATES 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
RECEIVED
GENERAL
COMMITTEE ADDRESS JUL 15 2014
SPECIFIC
CITY SEC.
COMMITTEE CAMPAIGN TREASURER NAME
additional pages
COMMITTEE CAMPAIGN TREASURER ADDRESS
17 CONTRIBUTION
TOTALS
1. TOTAL POLITICAL CONTRIBUTIONS OF $50 OR LESS (OTHER THAN
Q
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
w GTI`, gs
CONTRIBUTION
5. TOTAL POLITICAL CONTRIBUTIONS MAINTAINED AS OF THE LAST DAY
Q �
BALANCE
OF REPORTING PERIOD
`p r
OUTSTANDING
LOAN TOTALS
6. TOTAL PRINCIPAL AMOUNT OF ALL OUTSTANDING LOANS AS OF THE
@
$
LAST DAY OF THE REPORTING PERIOD
r�
((((
18 AFFIDAVIT
I swear, or affirm, under penalty of perjury, that the accompanying report
is true and c rrect and includes all information re wired to be reported by
111MCHEI9 NOWLING me under le 15, EI ' n de.
My Commission Expires
December 13, 2016
Signature of Candidate or Officeholder
AFFIX NOTARY STAMP / SEAL ABOVE
`` \\
Sworn to and subscribed before me, by the said A&Ak N iJ t (SOU �C this the
's
5 1'1/ hand
day of 20 , to certify which, witness my and seal of office.
Signature of officer administering oa Printed name of officer administering oath Title f o cer d ist 'ng oath
I z ) _
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 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 how to complete this form.
1 Total pages Schedule F:
2 FILER NAME
3 ACCOUNT # (Ethics Commission Filers)
4 Date
5 Payee name
7���
6 Amount ($)
7 Payee address; City; State; Zip Code
8 PURPOSE
(a) CategoI (See categories listed/at the top of this schedule)
(b) Description (If travel outside of Texas, complete Schedule T)
OF
1EXPENDITURE
9 Complete ONLY if direct Candidate / Officeholder name Office sought Office held
expenditure to benefit C/OH
Date
Payee name
Amount ($)
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 / Officeholder name Office sought Office held
expenditure to benefit C/OH
Date
Payee name
Amount ($)
Payee address; City; State; Zip Code
PURPOSE
Category (See categories listed at the top of this schedule)
Description (If travel outside of Texas, complete Schedule T)
OF
EXPENDITURE
Complete ONLY if direct Candidate / Officeholder name Office sought Office held
expenditure to benefit C/OH
Date
Payee name
Amount ($)
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 / Officeholder name Office sought Office held
expenditure to benefit C/OH
ATTACH ADDITIONAL COPIES OF THIS SCHEDULE AS NEEDED
www. eth i cs. state.tx. us Revised 04/19/2013