HomeMy WebLinkAboutCFR-09.13.2019-EbyCANDIDATE / OFFICEHOLDER
FORM C/OH
CAMPAIGN FINANCE REPORT COVER SHEET PG 7
1 Filer ID (Ethics Commission Filers)
2 Total pages filed:
The C/OH Instruction Guide
explains how to complete this form.
MS / MRS / MR FIRST MI
3 CANDIDATE /
OFFICE USE ONLY
OFFICEHOLDER
NAME
Anna
_ _ _ _
Date Received
NICKNAME LAST SUFFIX
Eby
ADDRESS / PO BOX; APT / SUITE #; CITY; STATE; ZIP CODE~
��+rr �y
RECEIVED
4 CANDIDATE /
OFFICEHOLDER
G
MAILING
Georgetown, Texas 78626
ADDRESS
SEP 13 2019
❑ Change of Address
5 CANDIDATE/
AREA CODE PHONE NUMBER EXTENSION
OFFICEHOLDER
(
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
Georgetown, Texas 78626
(Residence or Business)
8 CAMPAIGN
AREA CODE PHONE NUMBER EXTENSION
TREASURER
( 512 )
PHONE
639-7327
9 REPORT TYPE
Fl January 15 30th day before election ElRunoff
El15thday after campaign
treasurer appointment
(Officeholder Only)
❑ July 15 Bth day before election Exceeded $500limit
lvl Final Report (Attach C/OH - FIR)
10 PERIOD
Month Day Year Month
Day Year
COVERED
07 01 2019 THROUGH 08
31 2019
11 ELECTION
ELECTION DATE
ELECTION TYPE
❑ Primary ❑ Runoff ❑ Other
Month Day Year
Description1-1General
❑ Special
12 OFFICE
OFFICE HELD (if any) 13 OFFICE SOUGHT (if known)
Georgetown City Council, District 1
GO TO PAGE 2
Forms provided by Texas Ethics Commission www.ethics.state.tx.us Revised 9/8/2015
CANDIDATE / OFFICEHOLDER
FORM C/OH
CAMPAIGN FINANCE REPORT COVER SHEET PG 2
14 C/OH NAME
15 Filer ID (Ethics Commission Filers)
16 NOTICE FROM
THIS BOX IS FOR NOTICE OF POLITICAL CONTRIBUTIONS ACCEPTED OR POLITICAL EXPENDITURES MADE BY POLITICAL COMMITTEES TO
POLITICAL
SUPPORT THE CANDIDATE / OFFICEHOLDER. THESE EXPENDITURES MAY HAVE BEEN MADE WITHOUT THE CANDIDATES OR OFFICEHOLDERS
COMM ITTEE(S)
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 c
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
0
2. TOTAL POLITICAL CONTRIBUTIONS
$
(OTHER THAN PLEDGES, LOANS, OR GUARANTEES OF LOANS)
O
EXPENDITURE
TOTALS
3. TOTAL POLITICAL EXPENDITURES OF $100 OR LESS,
$ 47.70
UNLESS ITEMIZED
4. TOTAL POLITICAL EXPENDITURES
$ 47.70
CONTRIBUTION
5. TOTAL POLITICAL CONTRIBUTIONS MAINTAINED AS OF THE LAST DAY
$ O
OF REPORTING PERIOD
OUTSTANDING
6. TOTAL PRINCIPAL AMOUNT OF ALL OUTSTANDING LOANS AS OF THE
LOAN TOTALS
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 me
DENISE PUTNAM under Title 15, Election e.
Notary ID #6434548
My
Commission Expires
May 21, 2021 _ _
Signature of Candidate ❑ Officeholder
AFFIX NOTARY STAMP / SEALABOVE
Sworn to and subscribed before me, by the said Anna Eby this the 31 st
day f-4WguSt
, 20 19 to certify which, witness my hand and seal of office.
c
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 Revised 9/8/2015
CANDIDATE / OFFICEHOLDER REPORT:
DESIGNATION OF FINAL REPORT FORM C/OH - FR
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 Filer ID (Ethics Commission Filers)
Anna Eby
3 SIGNATURE
I do not expect any further political contributions or political expenditures in connection with my candidacy. I understand that designat-
ing 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 apponi nl le.
Signature of Candidate fficeholder
4 FILER WHO IS NOT AN OFFICEHOLDER
•• Complete A & B below only if you are not an officeholder. ••
A. CAMPAIGN FUNDS
Check only one:
V 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:
[V I do not retain assets purchased with political contributions or interest or other income from political contributions.
j� 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 Ii r9alribyliLift in accordance with the
requirements of Election Code, § 254.204.
Signature ❑ Candidate
5 OFFICEHOLDER
-- Complete this section only if you are an officeholder ••
0 I am aware that I remain subject to filing requirements applicable to an officeholder who 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 or other income from political contributions, or assets purchased with politi-
cal contributions or interest or other income from political contributions.
Signature of Officeholder
Forms provided by Texas Ethics Commission www.ethics.state.tx.us Revised 9/8/2015