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Home My WebLink About150115 - Campaign Finance Final Report - Blanche BrickTexas Ethics Commission P.O. Box 12070 Austin, Texas 78711-2070 (512) 463-5800 (TDD 1-800-735-2989) CANDIDATE I OFFICEHOLDER CAMPAIGN FINANCE REPORT The C/OH Instruction Gulde explains how to complete this form. 3 CANDIDATE I OFFICEHOLDER NAME 4 CANDIDATE I OFFICEHOLDER MAILING ADDRESS ADDRESS/POBOx; APT/SUITEll; 1�1 r�/JJltL- 1 ACCOUNT# (Ethlcs Commiuion Filers) Ml .#: SUFFIX FORM C/OH COVER SHEET PG 1 2 Total pages filed: OFFICE USE ONLY .R.'.tttEIVED JAN 15 2015 D ate Hand-delivered or Po�tmarked 1--D __ c_h a_n_ge_ot_a_d d_ress __ +---------------------------1 Recei pt# 5 CANDIDATE/ OFFICEHOLDER PHONE 6 CAMPAIGN TREASURER NAME 7 CAMPAIGN TREASURER ADDRESS {residence or business) 8 CAMPAIGN TREASURER PHONE 9 REPORT TYPE 10 PERIOD COVERED 11 ELECTION 12 OFFICE www.ethics.stale.tx.us AREA CODE (9 NICKNAME AREACOOE P110NE NUMBER <!/Jf) dcJ,f)-t!3J D January 15 D o July 1s D Mcnlh Dey Yeer 30th day before elecllon 8th d ay before election /(J / J<�/c:)t)f'/ THROUGH ELECTION DATE Mcnlh Dey Yea- / / aECTIONTYPE f!?i "G�� I ik I /J;!le e 51 EXTENSION Oa!e P rocessed I Ml O&te lmagad SUFFIX ZIPCOOE EXTENSION D Runoff D 15th day aner campaign treasure1 appointment ( officehold!ll onlY) D Exceeded $500 �nal report (Attaeh CIOH -FR) Ii mil D Ruioff �enetal D Special ,,ffe4�'7;,W; f"jup I 'tit. GOTOPAGE2 Revised 04/1912013 Texas Ethics Commission P.O. Box 12070 Austin, Texas 78711-2070 (512) 463-5800 (TDD 1-800-735-2989) CANDID ATE I OFFICEHOLDER REPORT: FORM C/OH COVER SHEET PG 2 SUPPORT & TOTALS 14 C/OH NAME 16 NOTICE FROM POLITICAL COMMITTEE(S) D add i ti onal pages 17 CONTRIBUTION TOT ALS EXPENDITURE TOTALS CONTRIBUTION BALANCE OUTSTANDING LOAN TOTALS 18 AFFIDAVIT 15 ACCOUNT# (Ethics Commission Filers) THIS BOX IS FOR NOTICE OF POLITICAL CONTRIBUTIONS ACCEPTED OR POUT1Cji.L EXPENDITURES MADE BY POLITICAL COMMITTEES TO SUPPORT THE CANDIDATE I OFFICEHOLDER. THESE EXPENDITURES MAY HAVE BEEN MADE WITHOUT THE CANDIDATE'S OR OFFICEHO�OER's KNOWU:OGE OR CONSENT. CANDIDATES ANO OfFICEHOLDER$ ARE REQUIRED TO REPORT THIS INFORMATIO�l ONLY IF THEY RECEIVE NOTICE OF SUCH EXPENDITIJRES. COMMITTEE TYPE D GENERAL D SPECIFIC 1. 2. 3. 4. 5. 6. TOTAL POLITICAL CONTRI BUTIONS OF $50 OR LESS (OTHER THAN PLEDGES, LOANS, OR GUARANTEES OF LOANS), UNLESS ITEMIZED TOTAL POLITICAL CONTRIBUTIONS (OTHER THAN PLEDGES. LOANS. OR GUARANTEES OF LOANS) TOTAL POLITICAL EXPENDITURES OF $100 OR LESS, UNLESS ITEMIZED TOTAL POLITICAL EXPENDITURES TOTAL POLITICAL CONTRIBUTIONS MAINTAINED AS OF T HE LAST DAY OF REPORTING PERIOD TOTAL PRINCIPAL AMOUNT OF All OUTSTANDING LOANS AS OF THE LAST DAY OF THE REPORTING PERIOD $ I swear, or affirm, under penal ty of perjury, that the accompanying report is tr ue and correct and includes all information required to be reported by m�Uo 15, Booboo COO.ff • [}/jj;_4L ,e&;, !hltzr:J_; / Sig nature of Candidate or Officeholder AFFIX NOTARY STAMP I SEAL ABOVE subscribe '\ before me, by the said __ ]J __ J�----�----'E'---'-/_/'-�-C_/_'.L-_____ , this the day of '-J �· 20 I � , to certify which, witness my hand and seal of office. �� Printed name of officer administering oath f officer administering oa h www.elhics.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 Advertising Expense Accounting/Banking Consu I ling El<pense Event Expense Fees 1 Total pages Schedule F: 4 Dale 11 _ Suv(j 6 IA/noun! ($) d,O, !tJ 8 PURPOSE OF EXPENDITURE 9 Com plete ONLY if direct EXPENDITURES SCHEDULE F EXPENDITURE CATEGORIES FOR BOX 8(a) GifVAwards/Memorials Expense Salaries/Wages/Contract Labor loan RepaymenVReimbursement Legal Services Solicitation/Fundraising Expense Transportation Equipment & Related E x pense Food/Beverage Expense Travel In 0 istrict Contributions/Donations Made By Polling Expense Travel Out Of District Candidate/Officeholder/Political Committee Printing Expense Office Overhead/Rental Expense OTHER (enter a category not listed above) The Instruction Guide explains how to complete this form. 2 �5ftRNAM � tr· � 'L tlM.l z.U i.L ' 13 ACCOUNT# (Ethics Commission Filers) -s PW�1211�cf5ru,J);/,{)7//;A111dN l'/1/_/ 3r1 7 (.0 '.'"�� pcode / fl (a) Category (See categories listed al the top of this schedule) (b) Descriptio n (If 1rave1 ou1side orTe�as, ce>mp1e1e Schedule T) Candidate I Officeholder name Office sought Office held expenditure to benefit C/OH Date Payee name Amount ($) Payee address; City ; State; Zip Code PURPOSE Category (See ca109ories listed a t \M 1op of lhi$ schedule) Description (If travel outside of Texas. complete Schedule T) OF EXPENDITURE Complete ONLY If direct Cand idate I Officeholder name Office sought Office held expenditure to benefit C/OH Date Payee name Amount ($) Payee address; City; State; Zip Code PURPOSE Cate g ory (Seecalegories llsted at the to p of this schedule) Des cription (tr travel outside of Texas. complete Schedule T) OF EXPENDITURE Complete Qli!.Y if direct Candidate I Officeholder name Office sought Office held expenditure to benefit CIOH Date Payee name Amount ($) Payee address; City: State; Zip Code PURPOSE Category (See categories !!steel at the top of this schedule) Description (tf l<avel outside of Texas. complet8 Schedule T) OF EXPENDITURE Complete ONLY if direct Candidate I Officeholder n ame Office sought Office held ex penditure to benefit C/OH ATTACH ADDITIONAL COPIES OF THIS SCHEDULE AS NEEDED www.ethics.state.tx.us Revised 04119/2013 1 3 CA NDIDATE I 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" •• 2 Filer ID (Ethics Commission Filers) 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 oootdbotio"' oc make aoy oampaigo e>peodiloc" wilhoot a oampaigo trnooocec �J tme:I o �ile. . , ' (�� Signature of Candidate I Officenolder 4 FILER WHO IS NOT AN OFFICEHOLDER •• Complete A & B below only if you are not an officeholder. •• A. CAMPAIGN FUNDS Check only one: D 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: I do not retain assets purchased with political contributions or interest or other income from political contributions. 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 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 frompoliti I contributions, or assets rchased with politi- cal contributions or interest or other income from political contributions.� ···""'---b��-=R�""'· Signature cif Officeholder Forms provided by Texas Ethics Commission www.ethics.state.tx.us Revised 9/8/2015