HomeMy WebLinkAboutCFR-07.13.2017-EbyCANDIDATE / OFFICEHOLDER
FORM C/OH
CAMPAIGN FINANCE REPORT COVER SHEET PG 1
1 Filer ID (Ethics Commission Filers)
2 Total pages filed;
The C/OH Instruction Guide explains how to complete this form.
2
3 CANDIDATE/
MS / MRS / MR FIRST MI
OFFICE USE ONLY
OFFICEHOLDER
NAME
Anna
Date Received
• NICKNAME LAST SUFFIX
RECEIVED
Eby
JUL
4 CANDIDATE/
ADDRESS / PO BOX; APT / SUITE #; CITY: STATE; ZIP CODE
13 2017
OFFICEHOLDER
MAILING
ADDRESS
CITY SEC.
1206 College Street, Georgetown, TX 78626
❑ Change of Address
5 CANDIDATE/
AREA CODE PHONE NUMBER EXTENSION
OFFICEHOLDER
( ) 512 508-2396
Date Hand -delivered or Dale Postmarked
PHONE
6 CAMPAIGN
MS / MRS / MR FIRST MI
Receipt # Amount $
TREASURER
Rick
Date Processed
NAME
.., , , , , .
NICKNAME LAST SUFFIX
Date Imaged
Vasquez
7 CAMPAIGN
STREET ADDRESS (NO PO BOX PLEASE); APT / SUITE #; CITY: STATE;
ZIP CODE
TREASURER
ADDRESS
(Residence or Business)
2001 18th Street, Georgetown, TX 78626
AREA CODE PHONE NUMBER EXTENSION
8 CAMPAIGN
TREASURER
( 512 ) 868-8998
PHONE
9 REPORT TYPE
January 15 30th day before election❑ Runoff
❑ 15th day after campaign
treasurer appointment
(Officeholder Only)
1Y July 15 ❑ 8th day before election ❑ Exceeded $500 limit
Final Report (Attach C/OH - FR)
10 PERIOD
Month Day Year Month
Day Year
COVERED
01 01 2017 THROUGH 06
30 2017
11 ELECTION
ELECTION DATE
ELECTION TYPE
Month Day Year
❑ Primary ❑ Runoff ❑ Other
Description
❑ General ❑ Special
12 OFFICE
OFFICE HELD (if any) 13 OFFICE SOUGHT (if known)
Georgetown City Council
GO TO PAGE 2
Forms provided by Texas Ethics Commission www ethics.state.tx.us Revised 9/8/2015
CANDIDATE / OFFICEHOLDER
CAMPAIGN FINANCE REPORT
14 C/OH NAME
16 NOTICE FROM
POLITICAL
COMMITTEE(S)
0 Additional Pages
17 CONTRIBUTION
TOTALS
EXPENDITURE
TOTALS
CONTRIBUTION
BALANCE
FORM C/OH
COVER SHEET PG 2
15 Filer ID (Ethics Commission Filers) 1
THIS BOX IS FOR NOTICE OF POLITICAL CONTRIBUTIONS ACCEPTED OR POLITICAL EXPENDITURES MADE BY POLITICAL COMMITTEES TO
SUPPORT THE CANDIDATE/ OFFICEHOLDER. THESE EXPENDITURES MAY HAVE BEEN MADE WITHOUT THE CANDIDATES OR OFFICEHOLDERS
KNOWLEDGE OR CONSENT. CANDIDATES AND OFFICEHOLDERS ARE REQUIRED TO REPORT THIS INFORMATION ONLY IF THEY RECEIVE NOTICE
OF SUCH EXPENDITURES.
COMMITTEE TYPE COMMITTEE NAME
❑ GENERAL
COMMITTEE ADDRESS
SPECIFIC
COMMITTEE CAMPAIGN TREASURER NAME
COMMITTEE CAMPAIGN TREASURER ADDRESS
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)
3. TOTAL POLITICAL EXPENDITURES OF $100 OR LESS,
UNLESS ITEMIZED
4. TOTAL POLITICAL EXPENDITURES
5, TOTAL POLITICAL CONTRIBUTIONS MAINTAINED AS OF THE LAST DAY
OF REPORTING PERIOD
OUTSTANDING 6. TOTAL PRINCIPAL AMOUNT OF ALL OUTSTANDING LOANS AS OF THE
LOAN TOTALS I LAST DAY OF THE REPORTING PERIOD
18 AFFIDAVIT
$ 0
$
$ 0
$ 725.00
$
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, Sion Code.
DENISE PUTNAM Signature of Candidate or Offi holder
yNotary ID #6434548
AFFIX S S AL Psion Expires
May 21, 2021
Sworn to and subscribed before me, by the said Anna Eby this the 11th
day of July 17 to certify which, witness my hand and seal of office.
Denise Putnam Notary Public
Signature of officer administering oath Printed name of officer administering oath Title of officer administering oath
Forms provided by Texas Ethics Commission www. ethics. state. tx.us Hevised 9/8/201 b