HomeMy WebLinkAboutCFR-07.15.2014-HesserTexas 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 1
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
^ h
Date Re t
NAME
��V I ` ! �%'.f� ��
EIVED
NICKNAME LAST SUFFIX
�4CC7R
JUL 15 2014
City Secreta
4 CANDIDATE /
ADDRESS/PO BOX; APT/SUITE#; CITY; STATE; ZIP CODE
OFFICEHOLDER
[� �%/!
ADDRESS
change of address
�L(1 �4 IX l C�
Receipt #
Amount
C
5 CANDIDATE/
AREA CODE PHONE NUMBER EXTENSIONOFFICE
_
Date Processed
PHONE HOLDER
6 CAMPAIGN
TREASURER
MS/MRS/MR FIRST t MI Date Imaged
��
NAME
u,aI\)o0 .
NICKNAME LAST SUFFIX
7 CAMPAIGN
STREET ADDRESS (NO PO BOX PLEASE); APT/SUITE#; CITY; STATE; ZIPCODE
�
(residence or business)
8 CAMPAIGN
AREA CODE PHONE NUMBER EXTENSION
-
PHONEURER
9 REPORT TYPE
❑ January 15 30th day before election Runoff 15th day after campaign
treasurer appointment
(officeholder only)
July 15 E]8lh day before election ElExceeded$500 ElFinalreport (Attach C/OH - FR)
���---"'JJJ limit
10 PERIOD
Month Day Year Month Day Year
COVERED
/ /0-1f/J
t L / /) THROUGH v-7
11 ELECTION
ELECTION DATE
ELECTION TYPE
Month Day Year
❑ primary ❑ Runoff General Special
12 OFFICE
OFFICE HELD (if any)
13 OFFICE SOUGHT (if known)
' 1
(' ! %%
-
��? ��% �✓� lel L-� (_.-�1(1 ��i L
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)
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 OFFICEHOLDERS KNOWLEDGE OR
C O M M I TT E E (S)
CONSENT. CANDIDATES AND OF ARE REQUIRED TO REPORT THIS INFORMATION ONLY IF THEY RECEIVE NOTICE OF SUCH EXPENDITURES.
COMMITTEE NAME
COMMITTEE TYPE
F--] GENERAL
COMMITTEE ADDRESS
SPECIFIC
COMMITTEE CAMPAIGN TREASURER NAME
additional pages
COMMITTEE CAMPAIGN TREASURER ADDRESS
17 CONTRIBUTION
1. TOTAL POLITICAL CONTRIBUTIONS OF $50 OR LESS (OTHER THAN
TOTALS
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
5. TOTAL POLITICAL CONTRIBUTIONS MAINTAINED AS OF THE LAST DAY
$
OF REPORTING PERIOD
J�
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
JESSICA ERIN BRETTLE me under Title 15, Election Code.
•`�� •����
# NOTARY PUBLIC
State of Texas V
'
9 G mm, Exp. 06-01-2015
.a.
Signatur�of Candidate or Officeholder
AFFIX NOTARY STAMP I SEAL ABOVE j
Sworn to and subscribed before me, by the said d CTS this the
day of U 20 to Certify which, witness my hand and seal of office.
u e of officer administering oath Printed name of officer administering oath Title of Wcer administerin oath
www.etVics.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)
NON-POLITICAL EXPENDITURES SCHEDULE I
MADE FROM POLITICAL CONTRIBUTIONS
The Instruction Guide explains how to complete this form.
1 Total pages Schedule I:
2 FILER NAME
3 ACCOUNT # (Ethics Commission Filers)
i
{{
J-0 f_I IVl ��JG
4 Date
),dl /
5 Payee name
����y�J `o 5.5c�Z
_,W
6 Amount ($)
7 Payee address; City State; Zip Code
-
,_ 2
�•
7 _
8 PURPOSE
(a)Category (see instructions for examples of acceptable
(b) Description (See instructions regarding type of information
OF
categories)
required.)
EXPENDITURE
Date
Payee name
Amount ($)
Payee address; City; State; Zip Code
PURPOSE
(a) Category (See instructions for examples of acceptable
(b)Description (See instructions regarding type of information
OF
categories)
required.)
EXPENDITURE
Date
Payee name
Amount ($)
Payee address; City; State; Zip Code
PURPOSE
(a) Category (See instructions for examples of acceptable
(b) Description (See instructions regarding type of information
OF
categories)
required.)
EXPENDITURE
Date
Payee name
Amount ($)
Payee address; City; State; Zip Code
PURPOSE
(a) Category (See instructions for examples of acceptable
(b) Description (See instructions regarding type of information
OF
categories)
required.)
EXPENDITURE
ATTACH ADDITIONAL COPIES OF THIS SCHEDULE AS NEEDED
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 - FR
DESIGNATION OF FINAL REPORT
The Instruction Guide explains how to complete this form.
-- Complete only if "Report Type" on page 1 is marked "Final Report" ••
1 C/OH NAME
2 ACCOUNT # (Ethics Commission Filers)
,1",w)
3 SIGNATURE
I do not expect any further political contributions or political expenditures in connection with my candidacy. I understand that designating a
report as a final report terminates my campaign treasurer appointment. I also understand that I may not accept any campaign contributions
or make any campaign expenditures without a campaign treasurer appointment on file.
Sig' ture of Candidate / Officeholder
4 FILER WHO IS NOT AN OFFICEHOLDER
•- Complete A & B below only if you are not an officeholder. ••
A. CAMPAIGN FUNDS
Check only one:
0 I do not have unexpended contributions or unexpended interest or income earned from political contributions.
I have unexpended contributions or unexpended interest or income earned from political contributions. I understand that I may
not convert unexpended political contributions or unexpended interest or income earned on political contributions to personal
use. I also understand that I must file an annual report of unexpended contributions and that I may not retain unexpended
contributions or unexpended interest or income earned on political contributions longer than six years after filing this final
report. Further, I understand that I must dispose of unexpended political contributions and unexpended interest or income
earned on political contributions in accordance with the requirements of Election Code, § 254.204.
B. ASSETS
Check only one:
F --J I do not retain assets purchased with political contributions or interest or other income from political contributions.
E-] I do retain assets purchased with political contributions or interest or other income from political contributions. I understand that
I may not convert assets purchased with political contributions or interest or other income from political contributions to personal
use. I also understand that I must dispose of assets purchased with political contributions in accordance with the requirements
of Election Code, § 254.204.
Signature of Candidate
5 OFFICEHOLDER
•• Complete this section only if you are an officeholder ••
am aware that I remain subject to filing requirements applicable to an officeholderwho does not have a campaign treasurer on file.
I am also aware that I will be required to file reports of unexpended contributions if, after filing the last required report as an
officeholder, I retain political contributions, interest orother income from political contributions, or assetspurcLedh political
contributions or interest or other income from political contributions.
Signature o Officeholder v
www.ethics.state.tx.us Revised 04/19/2013