Loading...
HomeMy WebLinkAbout161028 - Campaign Finance Report - Jerome Horace RektorikI CANDIDATE I OFFICEHOLDER I FORM C/OH CA�PAIGN FINANCE REPORT COVER SHEET PG 1 I 1 Filer ID (Ethics Conimlsslon Fliers) 2 Total pages liled: The C/01 Instruction Gulde explains how to complete this form. z.1- 3 CANDl'oATE I OFFICEHOLDER NAME ! I i I 4 CANDlbATE/ OFFICEHOLDER MAILl�G ADDRESS 0 Chanda ol Address I --5 CANDl'oATE/ OFFIC�HOLDER PHONE I 6 I CAMPAIGN TREAS URER NAME� I ! I 7 CAMPAIGN TREASURER ADDRl::SS (Residenci or Business) I I I 8 CAMP�IGN TREA, URER PHON,E I ! 9 REPdRT TYPE ; i ' ' 10 PERlcDD COVERED i : 11 ELEOTION I ! I .12 OFF18E I I I ! I I MS I MRS I MR 1111 NICKNAME - ADDRESS I PO BOX; tfJ l � FIRST I of<.A ct::-Ji Ml E: fa. t�; 111 /£ .. , , , . . .. LAST SUFFIX T{e K rc11l; k - APT I SUITE �; CITY; DA�;·/ ZIP CODE c A; 11110 e; J+, 1J \,t<..- c ,1 11 {J j f ,)' t t\ h Wf) PHONE NUMBER J �5118/0 AREA CODE EXTENSION ( f :;1) MS/ MRS/ MR in f-t . . NICKNAME JJM . . ?JL)(p-2 J-zt FIRST -JJ..'\ 1flf!,, s , . LAS.J_ T:Zt) S5 . . . . - .. CITY; STREET ADDRESS (NO PO BOX PLEASE); APT I SUITE �; l-o 2-'P l1 *e12. Ct' t11r1t Ml -- SUFFIX ...... STATE; . . OFFICE USE ONLY Dale Received HAND OCT 2 0 2015 DELIVERE Dale Hand-deliverod or Date Pos1ma1ked Receipt # I Amou111 S Dato Procossod Date lmagod ZIP CODE C' o )\ :J t .S�11 �) tvn1 It� AS l i&l/5 -- AREA CODE PHONE NUMBER EXTENSION ( 9?1) 22'/-� Lf-Y.1J- 0 30th day boloro election D January 15 D Ru no fl D 15th day alter campaign lraasurer appointment � 811> <lay before election (Oflicoholde1 Only) 0 Jl!lyt5 D Exceoded $500 li111it 0 Final Report (Attach CIOH Monlh Day Year Mon1h Ony Yeaf @d / /) / Z1JJ? THROUGH tfJC/i: /.JJ // J,,-tJ/� ELECTION DATE Monlh Day Yoar )Jr,l{/ g /,J.� 10 OFFICE HELD (ii any) Nt1Nl3� D Primary D �General D ELECTION TYPE Runoll D 011'"' Ocsc11p1ion Spcctal "t �·11f"' s·r� hk tit� c Otlff) c.:) / GO TO PAGE 2 j) IALf FR) 2 Forms proyided by Texas Ethics Commission www.ethics.state.tx.us Revised 9/8/2015 D i CJ}NDIDATE I OFFICEHOLDER FORM C/OH COVER SHEET PG 2 CJ}-MPAIGN FINANCE REPORT " C/( 1" NAME !-/_ C>f_L_--;_�f__ ;f;/2 tJ fYI L� � /l 1 /}It_ i _J�t "'" "__''. ""� ''"'"'""'" """' 16 NO ICE FROM THIS uox 1s FOH 11or1ce OF POLlllCAL co11rn1uu·11011s ACCEPIEO on POLlllCAL EXPe11011unes MADE av POllllCAl COMMITIEEs ro POlLITICAL SUPPOlll HIE C/INOIOAlE I OFFICEllOLDER. Tl/ESE EXPEND/TUnES f.IAY HAVE BEE// MAOli WtrllOVT TllE CANOIOATG0S on OFFICEHOLOE/1°5 CO�MITTEE(S) Kf/OVIL/iOGE on COliSEllT. CAl/O!OAfES Alli) OFFICEllOLDCAS ARE REOUll•EU TO REPO/ll llllS 111roAM/ITIOll ONLY IF TllEY RECEIVE IWllCE OF SUCH EXPENOJTUOE9. i 0 r,,�.,, .... 17 CO�TRIBUTION TOTALS I . I .. EXf?ENDITUf1E TO ALS COINTRIBUTION BA ANGE l OUTSTANDING r.o�;�:::n',::E C O MMITr �-----·11 1 --- C OMMl�REs-s--�---1¥-f--·-----------OsPE.c11:1c COMMITTEE CAMl'AIGN TAEASUflER NAME ·----------···--·---- COMMITTEE 01\MPAIGN Tl1EASUJ1ER ADDRESS I. TOTAL POLITICAL CONTAlllUTIONS OF $50 OR LESS (OTHER THAN PLEOOES, LOANS, OR GUARANTEES OF LOANS), UNLESS ITEMIZED 2. TOTAL POLITICAL CONTRIBUTIONS JOTHER THAN PLEDGES. LOANS, OR GUARANTEES OF LOANS) . -----------------------·--------·-- 3. TOTAL POLITICAL EXPENDITURES OF $100 on LESS, UNLESS ITEMIZED 4 • TOTAL POLITICAL EXPENDITURES $ $ $ $ . --�---.-------------------------.. ------------------ 5. TOTAL POLITICAL CONTRIBUTIONS MAINT1\INED AS OF THE LAST DAY OF REPORTING PERIOD $ -------------------------------·-------------1 6. TOTAL PRINCIPAL AMOUNT OF All OUTSTANDING LOANS AS OF THE LAST DAY OF illE RCPOATINO PERIOD $ LOtN TOTALS ====i=======�======:::::::===-=-::::.=-=-=----=--==--�======:;;:;:; 18 AFflO/\VIT I I I ! I I ! ,Jrr-1x NO fAAY STAMP I !!E/l�/\fjQVE Sw lrn to and subscribed before me, by the saldc:.2_-!.r.om.t_��fofi K---·-' this the -��.:!b__ d a �f2..c,� _, 20 \ (p , to cerllfy which, witness 111y hand and seal of office. � -W ___________ .. _ S lgnaturo ot olllr.er ad 11111 taring oolh Titlo of ofllo<>r administering ooth ! Forms p�ovlded by Texas Ethics ��m rnis�l<;'1 �-.----www.elhlcs.slale.tx.us #-1� �rJ� 6t.f�1, 7-()J b Flevlsed 9/U/2015 RANEY WHITWELL 13032029-J Notary Public, State of Texas My Commission Expires Au ust4.2019 SUBTOTALS -C/OH FORM C/OH COVER SHEET PG 3 . ::""NAME ;fc;;C-��:=;:;,:;-;-;-e f Iv,· ) 1 " __ F. _ ilo - -r -- 1 - D -- ( - E · tl - 1. _ lc _ s _ C � om_m_i-ss-lo-n - Fi-le - r-s) 21 SCHEDULE SUBTOTALS NAME OF SCHEDULE SUBTOTAL AMOUNT _ _:� ___ [_i_Y __ ·_:_ ; c H=��=-�����-E_T_A�� P o�_T _ 1c _,A _ L_:_c:_�_T_R_ 1B __ u _T 1 _ o _N_ s ________________ 4_s__,)?4·,_[__,t;,::_J_,,'.Lf_'_' �-y;:_.-- 0 SCHEDULE A2: NON-MONETARY (IN-l<IND) POLITICAL CONTRIBUTIONS $ --c)-•· 2. ----------------------·-------------------------------------···-------·--·--· -----------D SCHEDULE B: PLEDGED CONTRIBUTIONS $ ---�).. . .,, 3. -4--. --[�=--]- SCHEDULE E: LOANS ·------------···----··--------------------------------�-�-·--=u�---- 5. [�f: Fl: POLITICAL EXPENDITURES MADE FROM POLITICAL CONTRIBUTIONS [] 6. SCHEDULE F2: UNPAID INCURRED OBLIGATIONS -�--- [] 7 SCHEDULE F3: PURCHASE OF INVESTMENTS MADE FROM POLITICAL CONTRIBUTIONS 8. 0 ----- -------------- - --- - ���------� - ----- ---- - - -·- - ·- -- - - - >-- -- SCHEDULE F4: EXPENOITURES MADE BY Cf�EDIT CARD $ ---fJ-- ··--·--------· ........ ·-·-··-··------ · .. �---------------------·---------------�---------�-----------'-----� [-1 fl. _J SCHEDULE G: POL.ITICAL EXPENDITURES MADE FROM PERSONAL FUNDS $ · ·· -_, .-----------···------ - ------ - --·--··-··---�--------------------------------------- 10. rJ -- 11. D 12. [] --·-·- SCHEDULE H: PA YMENT MADE FFlOM POLITICAL CONTRIBUTIONS TO A BUSINESS OF C/OH $ -�c.,, SCHEDULE I: NON-POLITICAL EXPENDITURES MADE - ;��:����.;;,��-�������:-�����----- · ---�-----=11 =-,, ... SCHEDULE K: INTEREST, CREDITS, GAINS, REFUNDS. /\ND CONTRIBUTIONS RETUFlNED TO FILER ,., ;- \ l./ --------------�----·---·-----------·--··--···-----�--··-,. Forms provided by Texas Etilics Commission www.ethics.state.tx.us Revised 9/8/2015 MONETARY POLITICAL CONTRIBUTIONS SCHEDULE A1 The lnslructlon Gulde explains how to comploto this form. ·101�d pages Schedule t\ 1: J'tiJ'( � ,7-1}/� Contrihulor nddrons; City; Stato; 7,ip Code {; , --/;) 0 l't . I. /; /· ( I ___________________ ! .5_! __ � 1!1 �1ul�� ___ !_IL (1 /l_�j( .1. Y!F�_Zf:_!_�f(�-______________________ -----· - _ Prnwipal oc:cupallon I ,Job tltlo (Soc lnst .lctions) I/ Employer (S"e Instructions) i{,>1: 1;, z,, I __ ...... -� ·-· .. --- ------ - -.i .Jf_., __ ------------------ ., ____________ ---- - ... -- - - - - - --"" ------------ - - - .. - . - - - Dato Full narne of contl"ibutor Amount of contribution {$) ••c•e -� __ ,-•• �.-�"-•·•--·•-••••-"•"'--• ..... ,�,.---�----�---�-----·-·�------------ -·•-•···••--···"''""-'"�-··-·---"-"""··---•·•-•---•·• ••••-'n•"" •····-·---,.•···-·--··-···•··-·•-· •• ......... ,, ____ _ ____ , Da!<.l Full nnrnn of contributo1 I I ocd-ol "'"'" PM.: \ti)t:: Amount ol contribution ($) ·f"t 11-1 19, i71:/1t,1,,t-i\) e1· rJ J1r2 >d I· . ¥ )1/J ? I� 00/'"'"""0 �;z·��l.( 11 cit' "'[ vrl":jc'Sl°;,"f-; "'' I ,;2 6 /) -·· e;,;,;;,;,;,�� .. ,. .. :�".";: ,s.�· ,,;;,;;�;;,;�=-·· ····· · ··· · ·' (��Z;!.;f S.;,,;�,,,'.;'·····-�= ... ··=� .. ==·· �·----·-···----.. ------·-·- ·-"'-·"' -----···-------�·-" --·--------------------------------------····---· - - · - - - - - - - - - - - � - · - · - - - - - - - - - - - - - - - - - - - - - - - - - - - - - ATTACH ADDITIONAL COPIES OF THIS SCHEDULE AS NEEDED If contributor Is out-of·slalo PAC, please see lnslrucllon guide for addlllonal reporting requirements. Forms provided by Toms Ethics Commission 1w1V1.clt1ics.state.tx.us Revised 9/8/2015 MONETARY POLITICAL CONTRl.BUTIONS SCHEDULE A1 iho lnslructfon Gulde explal11s how lo r,omplQIO this lorm. fl,)!U �llJ /5; }IJ b fun nun!u f}co1'i.Ploutor \�fj ff) . /' lil/J(SilY' Con\ribvtor "tdtl>t)i�:i; (7'11'/: 1 &1 v-1n:�1�i=1�10y12, hJll nnmn ol �ontrit>utr..�r __ J; II\ , ;flJJ 7 /\fllOunt of contribuUon t$) I S!1>tu; l>r; Cq··h: .· . j ��r/lv; ;;' 17 Jyfl , -- _,, ... ,_,,.,.,�,.,. )_,,_,,,, ... ,.' '•"' �., "' i "") ,,·o· ,:;,1.j Arn1>11111 of c<>11t1ib<Jlion ($) Ainounl of CiHl(nbuUon ($) Z!p en(" '} �j\ � ··' j!11n t1�/� __ 1· iL ___ . F>nph.<iyor (See ln$tn;c!lonr-.} v..-.---'? ATTACH ADDITIONAL COPIES OF THIS SCHEDULE AS NEEDED It cootribu1or ts out-of-stnta PAC, plea so soe !n�tructhm guido lor odollional reporting requlremonts, MONETARY POLITICAL CONTRIBUTIONS 4ij J,1)1 2(1/k; Tho lnslrucllon Guide oxplulns how lo r.omplllto this lorm. Full 1111mv uf z:ontr1ou1ut )h; Kl cJ {)y k fi\l!f) Co11lrft.•J.J!G' d.1..klro�,:;.:: A .. ; .( ',. 11 I SCHEDULE A1 1�1�t)1J,:'"1x· , I . ...... 1:,:f .. tliL .. J ...... �� Etnpl yer {Sew Ins�.�,��} 4.711 s4tu � v;ut ..... L JJ1.t:l11 ... f�!ndpr�I oe:cupolioA / Job tiHo (S<�e !notrunHon.s} 1�:J zz, 1.,.c1Jk �---- ;;;;�;1·:5:fc11:t��0fX '17��-�L __ F;nph�>1!.11 \01!!'�;i lni;,Huct!on&) -��-__.,. ?�, �ji"�"r;�·!_I / . .. ..,L I( 778 'l '::i I C1npioy�•.·1 f�:i��o ln£.\�1,1d><Jf';!.<'J L Arno.in! cl contr1b11lion ($) A.mount or ct:mlrib\stlon f,$) ATIACH ADDITIONAL COPIES OF THIS SCHEDULE AS NEEDED If contributor Is oul·ol·slnte PAC, ple�90 seo i11s1Jucllo11 guldo fur addlllonal reporting rnqulrnm�111s. �;,..._ 0 Lt 3 J, "JtJJ h MONETARY POLITICAL CONTRIBUTIONS SCHEDULE A1 The lnslrncllon Gulde e•plalns how to complelu this lorm. -·---.. -···-- · •> . ----...... �-·""-·" l.l:Hfl' 4� l-9; I/ti)� r:.u11 namv Qr :-;:1)nU!t1i.HI'..'!' fl ffYi-) Jr/in (/) ·-- c d it�;j( ""'·'s� i1:�''." ·1 '" .. TX .... ' Frnp!oynr \0�i.l lnsltuc!iOrH�'I .... L .. ·- ;t I oo /\mount of CQnlrihution {$) J {/ p /{/{J ·.�·· Amount of C{)n!tibutton ($) ii J/) ,/ j.'/Ot) --· ATTACH AOOITIONAl COPIES OF THIS SCHEDULE AS NEEDED If uon!JibUl()r Is out·of·slala PAC, ploaso sou lns11ucl1011 guido for uddllionnl rnporllng requireinento. !W�� Ot:1'3t, uib 1 L/oO ... MONETARY POLITICAL CONTRIBUTIONS 0 PflpdpitJ (l(:f,\JPaHon l ,fob tltto (SG� to"&trw�Hon�) ...__.,..,�-"'"' (:�,/;8" .. J.7;, ?;:: ·71e-1v� .. /ll.. / Ernpk�yor tSe:('I ln.!itructlont.) i ______ ..,_ ... _,.,��" .L C1ly; ,r�Liiq: l·p Ct:ldo 8 t) Cfn JX, 7 78'P 2/ SCHEDULE A1 1\mt1nnt t>f contrill\11\on ($) ;I ·-·­ / {'/{) Armiunl ol contrib\l!IQl1 ($) ATTACH ADDITIONAL COPIES Of THIS SCHEDULE AS NEEOEO It conlrlbulor Is ovt·of.slate PAC, please soo lnstnmllon guiclo f(lt additional reporting requlrnmer11s. Fotms provided by 1'"�M Ethics Crnnmi>sh�n MONETARY POLITICAL CONTRIBUTIONS Tho lnslluc!lon Ouldo oxplult\$ how to complelo lhls form. 2 I'll ;0�A c. f-., __ /£=:12 (11/!l r �1 (1"�:, ,..,.,,_,�-1·; l"o�l-f:�:!�:H�;,, <''htl\r1!JV'Ol oJ;/ t/1Zp1 ::>A·1�' :1 I 6 Ct�n�n�1.1to1 -�(hjHH;�;, / l.11r I 1c5 t �)1i11J f, o/ J/711 /)l ··- ··-·-·· · .. / / mCUPHtlt)fl ( Jub hUn !St'H} ln�'11U•}hOn;$} .,();pf fl; ·)1/J t !Jato SfJt ;4 r)tJJ J:· ... • "!::::·:.;.::::.::. ·-·-··· ·.? '·- �;1010: ::tp GtJd>..:" ttf J k,( c.5dil11) .... 'J+:X······· .. . l.. f:.mpwyor {SOQ lnsuu1;!ionn} .. , ____ ., SCHEDULE A1 Amovnl of contrllJo\lon ($) I /OtJ Amounl ol 1�t.mlrll.x.1t!on ($) A TT ACM ADDITIONAL COPIES OF THIS SCHEDULE AS NEEOEO If contributor ls (tlil·of·slut� PAC, plonse seu instruction guide lor adoillonal reporling rnqulroment�. I�. . f /j_Z __ ::;_.,.A-J..L/· ' (/ l)�--rr;/ /''l/ / -w D cf '6 / / ·zv1 fa MONETARY POLITICAL CONTRIBUTIONS SCHEDULE lh<> lnslructlon Gulde explains how lo complolo lhi> lorin . . · '\ «/{L!f.!.2) 12:!& .... 7 A.ffH)lll\t r,t contrlbut!vn ($) Amoufll ol contrlb111ion ($) Amnun\ ot conhibotlon ($) Contrfhwor nddrnr.'.'t; ATf ACH ADDITIONAL COPIES OF THIS SCHEDULE AS NEEDED II conltibutor is ouH>l·slula PAC, plaaso soo i11str11ctlon guido !or addiilonol reporl\ng requirements. ·:L I .... · ;(.• ,Jj'. . .;.i;L_2J:Jl /.,, 1.,.tz>t-/ v I -.:::> Dc-1 3 J,2-01 /,.. NON�MONETARY (IN-KIND) POLITICAL CONTRIBUTIONS SCHEDULE A2 The Instruction Guido explains how to cornplote this form. � '":) Toial pagos Scl.w;jula A2: 'Y (;, 2 FILER NAME /(;!(}ljJ CE ""j1:_:· /2 t./ Ill{ .. I (��-l 1t11l i 1/�- -------··----�-.--.,· · - ---------�----· 3 Filer ID (Elr11cr; Cummission Hiers) !{)l/ 4 TOTAL OF UNITEMIZED IN-l<IND POLITICAL CONTRIBUTIONS $ 5 D;ite 6 Full nnmo ot conl11butor CJ out-ol-::;1:110 P/\C (HJ/1; 7 Contribulor mJdPJ:GG: City: Stutu; Zip Coda 10 Principal oc:cupatlon I .Job lillt< (FOR NON-,/UOICIAL) (Soc lrn1truclimw) JUDICIAL) Contributor's employer/law firm (l'OH JUDICIAL) If t;onlrlbutor Is a chllc1, l:iw firm of parnnl(s) (ii any) (FOR JUDICIAL) Date 8 Amount of 9 In-kind conlribulion ContribL1lion $ description I ']check ii 1r,wel outside <11 Texas. Gompla:e Schedule T. 11 Employer (FOFl NON-JLJDIGIAL)(Seo Instructions) ···---'"---------�------···-.--····--------�.-·-·--------·-13 Contribulor's job lillo (FOr� JUDICIAL) (Soe Instructions) 15 law fi1rn of contributor's spouse (if any) (FOR JUDICIAL) .J Amount of Contribution ·'ii In-kind contrlbtllion description Contdbl1tor acJdro�;s; City; Stalo; Zip Godo Principal occupullon I Job tltlo (FOR NON-JUDICIAL) (Soo Instructions) Contributor's etnpluyorliaw firm (r'Oli JUDICIAL) ·� "" •••••--·�·�-.-···------•·-�··.--·-----· • • • ·• •�•"•-•w""••' •+•.-•••••···-"•-• • •• ... �•-• •-••••.-•••••••··•·•• If cont ributor is a child, luw film ol pMont(s) (ii any) (FOR .JUDICIAL) ii travel outside ol TQxas. Complete Schedule T. Employet (FOR NON-.JLJDICIAL)(Soe lnslnJGlions) �-·•-• -._. � •·· ·•·• ·•· �·-••"'·--� ""••·---�o•-• -·-••·--··- Contribulor' s job \Hie (FOFi JUDICIAL) (See Instructions) Law firm ol contributor's spouse (if any) (FOi� JUDICIAi) .. -------------------------·-·-----·----"--- ATTACH ADDITIONAL COPIES OF THIS SCHEDULE AS NEEDED If contributor Is out·ol·state PAC, please soc Instruction guide lor addlllonal reporting roquiromonts. WW\V. ethics. state .1x. U!t 918/2015 Forn1s proviclod by Texas E,tt1ics Commission �if� b vf 31 r "'1/Jfa PLEDGED CONTRIBUTIONS SCHEDULE 8 5 Dato Date Date -�,.--- v·-·--• -•-•·•-·•�·�·--- ., -' . -··· -·"·--·-----· ··-"-•'-"" ___ _, ---·.-.... ' ., The Instruction GuidCl explnins how 10 complete this form, 3 filer ID (Flhics Comrnissi<>n FilCHS) 6 Full nurno of plod(Jor [1 out-ol-$1?.le PAC {1011: 7 Pleduor address; C<ty; Stute; Zip Code occupation I • .lob title (Seo Instructions) 11 Employer (See lrn;tructions) ..... ,.-.-·---�-------­ ·-···-------·------------- Pleidgor address; 0 oul ·of ·Bl<"i.le. PAC (!Olf: .. Cl!y; Stato; Zip Codu oc..,upation I .Job title (Seo lnslnJctions) Full name of plednor 0 out ol-s;alo PAC {IOJL Pledgor address; City; Stnto; Zip Code ;r I Arnount of r01edgn $ ln·kind r;ontrlbutlon description [�] Chech ii lravol O\Jlr;l<ie o� Toxas. Cornpleio Schedule T. Arnount of Plc1dgo $ In-kind contribution dcwcriplioll [] Clwek d travel oulsido of Toxas. Complete Schodulo T ·-r-·----·--··---------'------- occ1..1pallon I Job titl e (See lnst111Gt!ons) full namo of plt;aJuw Pleduor ndd1 ess: Employer (Sou hu;truclions) .. J City; Stnte; Zip Codo Amount of Plo<Jgo $ tn·ki11c1 con1rlbutlo11 description [�Jcnack !f travol outsido of Tr:xas. Cornplete Schedulo T, Prindpul occupation ! Job tillu (Sno Instructions) ATIACH ADDITIONAL COPIES OF THIS SCHEDULE AS NEEDED If contributor is out-of-state PAC, please see Instruction guide for additional reporting requirements. ��,�-..._-.. ---�------,,�¥-••·�·��"-·-�·· ---·-�-"-------�·--·--·-----·-· .... �--'·-���--"""""--------------- www.elhics.statA.IX.US Revised 918/2015 Forms provldod by Texas Ethics Con1misr;ion !� .. ,:;:l/i)J i9 ct ? J, UI ,(.. LOANS SCHEDULE E The Instruction Gulde explains how to completn this form. 4 TOTAL OF UNITEMIZED LOANS 5 6 Dqtn of loan Is londer a financial lnslit1Jtlon? Y-N 7 Nmno of lomJer 0 LondHr address; ·····�-··---····-· 12 P1;incipal occupation I Job titlfl (Soo ln!;\rtJC:ions) 14 Oilscriptlon ot Collateral [J none 16 GUARANTOR INFORMATION 17 Narno ol Htiarnntor 18 Guarontor addrenr.; l".J not applicable 20 Principal Occupnt!on (St:t.) h·;structicin!'i) Dnto ot loan 1$ loridcr :\ fmnncinl ln�;t/tulion? y N Lendor o.ddresr.; F'fincipal occupation / ,Job lillc {Bo1J lnstn.u;!lons) -.--···-·--�·-·-··--·--Ocs.crlplion of Collaturul GUAHANTOR INFORMATION [] mit applicable Guarantor addross; Principol Ocr.upalion (So:n 111:;\runtlons) City; City; City; Cit)': Stll:e: Zip Cod� 3 Film !D (f:1tdcs Comff'ission FHors.) -- - --- ---··1-------·c-··------- - $ JI j A�-/ v. I ..... - -----------.. ----· ---·------------------9 L oari i\mourit ($} 10 Interest rate 11 Maturlly date '13 Employor (S<,:u ln�tructi1.H1r;) Sia to; Check if pmsonnl fundt"> were deposited into political nccmJtll (Sen lnstruc1ions) I] 19 Ainuunt Guara11tci;d ($) Zip Godo �1'1 Employer {goo lrrntructlons) Lo;,n Amount($) ?.Ip Code lnternst rnte Maturity da\e r:rnpl()yor (Gee lnstnictlons) Chod<. ii pornonal It.ind�� were deposited into political account (Sne lnstructlohs) [] Amount t3uL\ronteed {$) Stato; Zip Corie l::rnploynt (See inHtn1ctio11s) ATTACH ADDITIONAL COPIES OF THIS SCHEDULE AS NEEDED POLITICAL EXPENDITURES MADE FROM POLITICAL CONTRIBU TIONS SCHEDULE F1 l\tivt'rl1�•ino f: ).Pfin:;o /\c1;1'.11J•1Ur1,r01JnKlng C0n:;vlfi11\.) E1po1t�K� Conlr:buti6f1s1Dona!1or1s r..�2dt1 Gy EXPENDITURE CATEGORIES FOR BOX 8(a) EVl)r1l �� '1{)()11'.1{} F•�>':�f· Lo;::ui Repayn101rt/H11irnb1.11m,+1n\�11! Qlfice Overhe:nrJ1n¢nlnl lizpen100 PnWno E :.0:µ1mse f30\1dtatio111f 1H1\t1al�ing fxp<�11�Ji! liv..nr.p<m!ll!on Eq>1:prmml 8. Rolciled txp�m!HJ T1avtJl l11 01t>!nct ftavf.'il 0111 Ol Olr>!1ic:t Cand1<i•�l�10ffb:-lwldnr1f)o!i!icc1l C01n111iHr�o Croo;i CaidP���n·!ffi F(.'1)1l/Bt;;ver�1gu �XIH�11��0 OHt!AvairOs.itv�crnorin!s E:.:p1m5;i, iJ:un! Servlc��:5 :-1rin!lng Exponr,e .Su!w1c&1Wan1�!.>/Co11ltw:.;l Labur The lnslructlon Guido cxplnlns how to complete this form. 01het (n11te1 a cn!u!JrnY no! lPl.\ed Hb(wn) 8 PURPOSE OF EXPENDITURE 9 C"rnplete 9Hl"Y 11 direc! expenditure to benofil C10H PURPOSE OF EXflENDITURE Date . . 41!/"2/z1 ;.!41/ f ..... , •• �·t-< -- • ,,_ • -- PURPQSE OF EXPENDITURE Complo:e �lND'. ii oirecl t.npomHuro to benehi CfOH (o) CD.tl..lQOIY (St!Q Ca\ygories !i's!i}d ;)I \ho top of !his schth-:l,1/0) tlt/ 1/ilt1>t�'5' l�c-..... k!1�!.: ·(� Cnndldnto I Otficoholdcr nan1e % ___ .,..,.,.,,.�--�-'-) --�--�· Poyen nnmo �)ayoB ;1ddress; City; Stato; '1 I 7 'f·f C/' f1tr/tF (/ ZlpCo<ie <�(/,''/! (b) l)crncrlptlon r �] Ctmc:i. ii lmvcl <h..1\sU� o! 1ox:i�. C0irip�1le S.Ct\00•.tl� T [.J Check if llo�;tin, TX, cf!1c·otwtdc1 livlno oxpf>r.:;:e Oflico sought Office t\Hld Dosr:riptlon l=] Oll•ffa, ti \l>LVt�! fJO'.s::je ril 1e"(i;f, cc.��HiJ1fll�! Sch1,.>!}t�� l r·.--_] ::;hock it f•.1,nlm, i X, o!!:u�hnldur !"1ir,fl o.•.�)f1ll5fl OlflCt' SOU!.]l1t Office hol<J ATIACH ADDITIONAL COPIES OF THIS SCHEDULE AS NEEDED UNPAID INCURRED OBLIGATIONS SCHEDULE f 2 '-----·---·---------·==-===:====·=--==========:==--=-====-=-=======-===--==! Advertising f:xpenso Atx:o1111ting$anking Consulting Expense Contribt11io11S!Oonations Ma<IB By EXPENDITURE CATEGORIES FOR BOX 1 O(a) Event Expensn Fm�s Loan nepaymenVRoimbursornon1 Olfice Overhead/Rental Expense Polling Exponso Sollcitation/fundralslng Expense Transportation Equipment & Related Expense Travel In District Travel Out Of District CandidatctOfliceholder/Polil!cal Committee Food/Beverage Expense G1fVAwnrds/Momorials Exponso Legal Services Printing E>:pense Salaries1Wages/Conlract Labor Other (enler a category not listed abovo) 9 TYPE OF EXPENDITURE 0 Political [] Non-Political ------·-------·--··-·--··-··-··--· ·--···-··--··--·-------··--·--·-···-·--------··-·----·--··-·····-····-·-·-····--····-·1c·-·····-·-----···--·--·----····----·-------·--··--, . ············-· .. ·------i 10 (a) Cakl\JOry (Seo C1t1ogories lisiod al 1t1e top ol 111is schedule) Description PUFIPOS E OF EXPENDITURE [�Check ii !lave! ou1sida ol Texas. Complete Schedule T. Oc1ic:cK II Austi11, TX, ollico h older living exponsc f------·--�---·---··---_.1-··------··-----·-·-------------------·-·--'---··-·-----··-------------·--------·I 11 Complet� QNLY ii direct oxpendiluro lo benefit CIOH Candidate I Officeholder name Office sought Office held =-====·=-=·========-=--=======-==========-==========-·=·-=======-=====··==========================::1 Date Payoo narne ·-----�---·--�----·----+--------------···--------------·-------------·--------·------------! Amount ($) Payoo address: City; Stato; Zip Godo ---------------�··--·--------·-------- --------------------------·----------TYPE OF EXPENDITURE 0 Political 0 Non-Political ----------------··-·-�-·----·---- ----E-� ._ : _ u _ ER-��� - -1.TSUER E - --- - Catego--ry (Soc Ca1ogorios _ · _ 1> _ s . _ t _ e _ d _ a1 _ 1;·,·o-· lop o_•._11,,.�; - h - �J . . ulo)] -Description 0 ChiJck ii t1avul otllsilJe ol Texas. Cornpluto Schedule T. 0 Ctwck ii Austin, TX, ofl1ceholder living oxponso ------------------------------ Complete Q.U�X ii direct expenditure to benefil CtOH Candidate I Officeholder name Office souyl1t Office held -----==-====-=-==-=-=-=--=·-=-=· ========---==·=--::::::····-=·-=· -=====-=--=========1·- �Wt-/{,. ATTACH ADDITION AL COPIES OF THIS SCHEDULE AS NEEDED , 1oi 1+ 3 I -Z.-1.1 k Forms provid0d by Texas Ethics Comm1ssion www.eti11cs.state.1x.us Revised 9/8/201 5 PURCHASE OF INVESTMENTS MADE FROM POLITICAL CONTRIBUTIONS The Instruction Guido explains how to complete this form. 2 f'ILEll NANIE .. __ .it (Y?!i_c e 4 [);;(IY 5 Na mo ol pm so11 1rorn w��n ;/'f.'�'lrnnn s purchnsod ........ /.v ... / I .• 6 Address of person frorn whqrn irrJ{;st )Ont is purchased; 7 Description of lnvostrnunl Dato Nurno of p£.HHOll frorn v.1110in lnves1mont is purchasFJd Address of pm!:;on fron1 whom Ir.vestment is purchased; De�..:;cription of 111vuslrnent Amounl of inve::.tmnnl ($•} SCHEDULE F3 City: Stato; Zip Code ---------.-�·-·-�----·-_. __ .. -·-----··�""-··-�·····�--�-"""'---------­ ·---·----------·-�� ... -·-···�---"-,------·--·---�-.-·-�-��·,,,,�-�--------·----·-- City: State; Zip Coda ----�-----·--·---------·-------·--------------·---------· ATTACH ADDITIONAL COPIES OF THIS SCHEDULE AS NEEDED Revised 9/8/2015 EXPENDITURES MADE BY CREDIT CARD SCHEDULE F4 1\mitH\lf;i11g Expon�;u Ac<lm1nting/Bankl1t11 Co1.'.svl!irig E:xpons•) C-oflUib,1\ton:s!Putl«ittu11�> P...1mhi By EXPENDITURE CATEGORIES FOR BOX '10(a) bvon? Expc1fl::.!Y reo::; I .ua11r·h.;ipaym1�n\iffr1.'1nbw1;rntnmll Olfico OvNt1ead1ncnlal Er.p·CO\i<: Pollinu E'l<pen:..o S1..>l•t:::ltnlh.vVF\i11d1 (i.i'tlng E;.:f>"Jrt.t><: T1un�porta1lm1Eq1.Jlp1nm1t8 fleln11�l-:(p,:_i.1�fi.u Trnve\ In District Trn·.rel Out 01 {)l5tr!ct C�u11fa"jatc-/Ollv:11h(>lclot/Po!i1ic;J; Cornr11il\eo Pro11inu E-.;1Mns.o Hnlu1!c��/WE;.fJ<':!VConlfnct Labor Ot11or (ontot a cnlogory not Hsled abovo) Tho Instruction Guido explains how to complete this lorm . . p�::s_!2:0��·-��-'---�-l-IL[/lir��.� ... ... �CJ£��[fl�!L._./(j' .• LJ;.·::�fs--:>· ·-·· 4 TOTAL OF UNITEMIZED EXPENDITURES CHAFIGED TO A CREDIT CAF-{O 5 Dato 7 ,l\mount ($) 9 10 , TYPE OF flXPENDITURE PURPOSE OF EXPENDITURE 11 Complete Qfil)'. II <Jircct r.xpilnditwe to benalit CIOH l)atu Amount ($) TYPE OF !:XPENDITURE PURPOSE OF EXPENDITUBE t.:ompleto QNLY 11 diroct Oxpcrndlture to bonelil C/OH G Pay&o nmno City; State. Zip Cot1o [] Political [] Non-Political (b) Description f'. :-:J Chea 11,Mol ouvJldo of ·ruxas. Co1l'piG\o $<J,e<lu'• l [.']check if Avtain, ·rx, CJftite:tioicJot llving e;i.ptmso Cund.datn ! OffiGHholdor rH.vna Offlco 8ougllt Offico held C!iy: State: Zip Codn [ .... , Political [.J Non-Foliilcal Candlcfnto J Ofllce�1ol:Jer name D!l>icriptlon �N-·,�·-•••••-"" ·�'•;'•�<' ' .. -e - ""·-�··-------�··-�--� 0 Ciieck ii travel ouiskh� ot Texas. Corh1�1Jta S<:htidL:\-0 l [.J Chock ;1 Austin, ·rx, o!!lr;ol1oh�or Hvlng u:<prtps11 Offico held ATTACH ADDITIONAL COPIES OF THIS SCHEDULE AS NEEDED ...... ................................. _.�·-------��---------·--� 1Nww.ethlcs.statn.tx.us 9/8/2015 Form$ providod by Texa�: Ell1ics Gom111lssion f> cf 3 Ir '7&! ft, POLITICAL EXPENDITURES MADE FROM PERSONAL FUNDS /\dvurli:;lno E:o:p<�m�o 1'.\ccovn1iOgtDm�k,ro Cn11:1\1�i1}n f!·,qx:nr�o Co11hlbtl!l{lr\$1'l)onmi01l!> tAnrJo By C•'lniJKIM1!/0ll1r.chold01JPoli\lcnl Co1nmilt•JH C1 (:�l! G;:··� p '�)'!Hflll'. [·--1 r��i;11h�J1<;erncmt from ·-· p9fillc.31 conlribuUons �n�ended EXPENDITURE CATEGORIES FOR BOX 8(a) Ev0.nt Exponse f(!t)[, F0tJ:JiH11vc1tsg>.! E:qm11t.�� G1HJA\W1nh\/'Me1n(1ri;il:; [':f.1:rn"�1.J Lti1JHIS1::t1vlco1; l.orui l'li�JJ.il)'fl1r:i•1Yfio rnbi1se1nr�r11 OH1ce Ovof11oot:t1f�unlal P..>:r.1m1!.itt Pollifl}l E,.pan'iiJ Pr\1\tu10 Eyp1:?ris11 S:�larln<,;;.1V/norn•/Gontt;lci Lnbo· Tho Instruction Gulde explains how to complete this form. SCHEDULE G .E31)!it:i1<tt!onll: �1rid1 ai5il1!J l:xpi:mse rranspo1\ulion Et1ulparn11t R. f tfil(1tf:td Expf!llSe T1nv1�l In O!n1tlci Travel O\JI Of Dlstrk;t O!hor (enter a cateoorv rml listod above) 3 Film ID (Ell\ics Commission Fil0<s) e' ,.-, .. --�---··-·--�-·� ... •-••,, 8 l'Uf1POSE OF EXPENDITURE ·--· .. ·"-t"·----------·--·-·-·· ... 9 Complete 9-Nb'!:'. ii direct expolldit<Jre to bonelll GIOH Amo�Jn! {$) l. "I f3(ii11_'.l>'-HSNH1i:n1 :�nin - . n<.)!wca! ccnl11bu11orn; lt1\nnd<x.t PURPOSE OF EXP.ENDITURE Comp!eto Qi'Jl�Y. if direct expeildilure to benelit G/OH Arnovnt ($) L�J �i�11:17(��:;1:�;�11:��1�,;��1,�:. lrnm·dc-d PURPOSE • OF EXPENDITURE Gonlplotu Q�l�Y ii dirocl oxpqnditure to benoH CIOH Candldnte I OHlcnholdo1 nnmo Pnyoenama City: S:ato; Zip Godo Candidate I Olficaholdar narn» Payee nnmu Gi!y; S�ut0; Zip Codn Cnntiidatu / Officcho!dor narno C!H;c" ii tr.-;vt:l 0111:-i;:fu ol 1t•xfl::i Gomp'.du SchW1 .. He T c�·] G!1t•t:k H J\qsHn TX, oHicehc)l<Je• !·vinr; oxpenso Olfice sm19l1t Oftico hold [:] Chock il \mvol 011bkl1.; n( Tttxu5. r;ompl<l\<1 $i;hedo1n i. [] Cho ex ii At1::.\in, t X, cfLi;;1.;hc>\dor ilvlng ctxpen!iQ Olficc sought Office held (b) Dr:-)sc;rir.itu;n [��] Ch:•:� :I h<i1.>€:I <n;b\{!•J oi Tthri�::. Com;1:e1'J ::-..o��},'.,!ulu "T, c:·] ('.n�cl\ ti /W�'\ln, iX, oil\(:(�rm\dttr livinq or.ponso Offico r;ought Oflico 110Jd ATIACH ADDITIONAL COPIES OF THIS SCHEDULE AS NEEDED f:-�;�;���·�-�dbyT�:Zis Ett;i;,�-c-;;-r�;;;-;s-;i;;--------:;;;;;;."c;thics�;1<;;;:,�;;:;;;:------------------·-------····---·----Revised 9/6/2015 0 ct �I, ::Z-01 h PAYMENT MADE FROM POLITICAL CONTRIBUTIONS TO A BUSINESS OF C/OH SCHEDULE H EXPENDITURE CATEGORIES FOR BOX 8(a) r\t�ve11bin�} ['.;.:pensn hcc.ur\ling/'!.lanldn!) Con�.uili11f) Ex11en�;u Ccin!rit�ullonr;/()onatto!lg M;tr1a By CnrK;dri.to!(':'llic:oh0!11n11PoF1i1.;1l(;unm1ilk1.• l/.t:d·l�)1df'.'l)Tlll't'! 4 Oat� 8 PURPOSE OF EXPENDITURE (a) Event E/lpon:10 F(Jt}f; Fthll11H1:vt:t1<ifJ1i" f:..:1if':bo GHl!f•,\N(.1.ffit�IMcmqitnh; E'A;pu0$(' L!.'iF•! Svrv!t:ns 9 C(lniplote Q!i�Y. ii diroct oxpt�fHliiurn to tm11efit CiOH Candldate I Offlceh(l!dar nan1e Dntq l.lian I l('p;:iy1nent,1:ii:;i!n\�u1sr;q�·�nt Olfico OvNIW7iif1n,1nlal l'7:•ri•Y)::n f'o!J;r10 [}lpp�i:>IJ Pr1nli11g f�xpf!nt;:;e �_i;f;11lr.n .. "'Naun�:;/Cq� 1!rnct L ail'.H Oe.scriptio11 S1ll:ci\,)Jirn11Ft11w}Jnimnu � xpr,m�n nan:1Jl(}fl<-1liv11 Equ1µrm!11\ & Rel.o.!t;J E.i'!µenG{t rr;w�i In D1shict Tt;i.w1iOlJI 01 Dif.1t1cl Olhor (nnte1 a <:a!ogc1y not tls\c(l above) Ch1.i2�: .j h<Yltil fJ\Ji::>'<io n{ T{�i.:n;., Co1111)!>,h� r:;;t;;,'(Jl,\ft T. J c1·;n,::1w, 11 ,fl,uo.!iri. 1X 01lico1o!d1..1r hving tn;pense ()Hice souotll Ollice held ,\mount ($) Buslnosr; addross; City; Stnto; Zip Code ,plJflPOSE , OF IOXPENDITURE Gorhplete 9.tlb:i If direct oxp!!ndlluro lo bcrrnlil C/OH Candidate i Olllceholdor nnmo -···-··�-'"-·-·----···-·�··--"---�--�-�-----.. ,.-��·--·-­ ·- ·· "·····--··�·--··-··-- Dalo Aniocmt ($) PU RP OSI:: OF !i.XPENDITURE Co'mp:ute QN�Y. ii diroc1 otpeo1H1J1e to bClnolil C!O!i Candidate I Ofllc0l1old0r narno Description f �·�]Chick 1' !111·1el.t;<-l..W·idf1d ·r1:1ut�. (;1,;qTfn\11Sow·d\Ao1. [ __ ] Ciw·Ji_ 1! l'1w.�1inj ! X, nllic�hol<l:ir :;·,.-Intl !JXJHlnSt: Ollico $ougrll Ofllco hold Onscrlptio11 [_�J Cht>c".\I t•,w(�l m1h:1fo o! T!1:.:<1•;. ('r.rnp!vl<: SG!H}l.hro l. [�] Ch(.-d: d /1�:�lin, -r X, uflict?tio!d�., living t•xpe11�n Olliec r,.olH]hl Office held -----��' �cf '3 /, �OJ b ATTACH ADDITIONAL COPIES OF THIS SCHEDULE AS NEEDED Forms provided by Tuxas Ethics Commission v!'-.V\v.ethics.};tnte.tx.us 9/8/2015 NON-POLITICAL EXPENDITURES MADE FROM POLITICAL CONTRIBUTIONS SCHEDULE The Instruction Gulde explains how to con1pleto this form. TotAI p�g0s Schvd,de I: .f/ 4 Date 6 Arrourit ($) a PURPOSE OF EXPENOITUHE Datu Amoun\ ($) PURPOSE OF EXPl':NDITURE Date Amow-11 ($) Pl)RPOSE OF EXPENDITURE Dntc AmOllnl ($) PURPOSE OF EXPENDITURE 7 Payoe addros,r.; C11y; State; Zip Codn (a) (.;alofjory {Seo IOS!t;J(:.!;OI�& 1�1f OXil!fl))IB:-: of <lt'C(ipl,'iti:o c;.,1!fl�)Olll'S.) City; Stato; Zip Code Cate9ory \Seo i11W<1Gl1cn1r; for ox'1mplos ol ai:ccolnb!c Gtttugofies.J Pnyoc namo Cily; Gtnto: Zip Code Catogory {Soo in�11uc1:01rn. tor 1namplf;i' of tlCC!!PWt•lo: cn\e(!Otit.H1.) City: State; Zip Coda C;\legory (S-&11 ln5\h.1ction� fur o,o.,a'nµlOf. of n1:rnptall!.1 cn1e�1<idus.) (b) Di:wcription (So(1 01s1ruwon�-rt)g1.�rding 1ypo <JI lnfonmwon requh1.'cf.) Descriµtion (Set.i lns!n.iclions 1n!_lardi11g lype ol inlcrmnlion required.) Description (Sel."l lnslniclions 1oua1dln9 lyp(' ol lnlormul!on rflqt1lftHI,) DnscdpHon (S�o insiruc\wns rag�\1r!mg lypo ol inlorirrntion roquiruu.) () i-t3f f 2--CJf ,h ATTACH ADDITIONAL COPIES OF THIS SCHEDULE AS NEEDED INTEREST, CREDITS, GAINS, REFUNDS, AND CONTRIBUTIONS RETURNED TO FILER SCHEDUl-E K lo!al paons �lchm1wr: I<: �· Tho Instruction Guide explains how to comploto this form. 2 Fll.FH NAME ' N"'"" "' "717" 1f, ""°""' "'"''"�' . . 6 Address of pr:rsnn from \Vhorn ilmnunt is received� 7 PurposH tor whict1 mnount iti received Name or µer-.> on h urn whurn amount Is rHceivod Ackflons of persor1 from whorn ;:vnount is received; Putpo��o fo1 wiiictl amount is rec;elvod Nnmo of porson tram whom amount ls roccived /\ddnJz:, of person frorn whom amount is rncoivod; PurpoH0 for \.Vhich rnnount Is rocoivod f'Jnme o( person tro111 whom amount iu. reccivod Address of person f1orn v1hom <.'!mount is n;coivod; Pwpose for whic.h amoun1 Is received 8 /\mount ($) City; Stale; Zip Code LJ Check if pollllcill contribution returned to filer Amount ($) City; Slato; Zip Code [�] Chock it pontlcal contfibution ruturnmJ lo filer /\mount ($) City; State; Zip Code [�] Ghecl< 11 political conl1ibutlon returned to Iller Arnount ($) City; Ziµ C·odo [_j Chee!<. ii politlcal conlribution r eturnod lo lilnr IN�KIND CONTRIBUTIONS OR POLITICAL EXPENDITURES FOR TRAVEL OUTSIDE OF TEXAS SCHEDULE T Tho Instruction Gulde explains how to complote this form. ?) /fot� 12··. /\rk ......... . 4 �ij'��°.:�(;�,,1:•t::'o'.' �:.'�P"'�''o''.''� .. �:�1 'A"' oz•H:'t/"1Pl ndoor1.rayeo 5 Conlribu\i()n I F:qierHJlturn rcp()rtod on: 7l i [] Sctwdulo A2 c:j Schoclulc F2 6 Datcis ol 1ravol I] Schedulo 8 [] Sct1odulu FA 0 Schedule l:l(J) tJ Sditctdulfl G 8 Dc11artwo <..:ity or 11;;mte of doparturu location Schodulo C2 J !';checJulo H 9 Do!..'1ination city or namn ot dcslinotion lrn:ntlnn 10 Maans of transportation of Contributor I Corporation or I <.bor Orgnni7-alion I f'lodgor I Pnyc;e Contribution I Cxpondlturo reported on: [) Sr:hodule A2 []sdwdulu F2 [] Sct10duh: B Schodulo f'<l [J Schedule 13(J) [] Schodulo G Narno o1 porson(s} Ha voling [J Schedule c2 CJ Sc:lw<lulo H Departure city or nan1e of dctpartwo !ocMion Destination city or nn.me of dosti natlon Jccatton 1 Total pages Schedule T: }1 3 Flier ID (Ethics Cornmlasion l'ilors) 0 Schedule D 0 Schedule F1 [J Sct1cdulo COi HJC [J Schodulo O·SS [) Schedulo D 0 Schedule 1"1 [j schodulc COH-UC [J Schedul e B·SS Purpose of trnvc·I {lncl11ding namo of conlcronco, somin(lr, or other event) Nartio of Contributor l Corpo1a!lon or LBbor 01ua11lzalion I r1tHJ!Jor I Puyee Contribution I Expenditure roported ow [] Schedule' A2 0 Scllodulo r2 nnt�;f) of travel Schudulo B [l Sct1';dulc• f'4 l] Schodulo B(.J) [] Schc�dulo G N<-tinc of person{s) traveling [] Sdiedula c2 rJ SchcdvhJ H DoparlUtu cHy or •HHTH-? of deparhHn locatk)fl Do5tination city or name or deslinnt!nn localion [] Sr,ii<HJulo [) 0 Schodl•le F'I [] Schodute COH-UG [] Sdrndul" B·SS Purpo�;l') ol 11avol (lnc:1udlng namo of conferonc1�. $Hminar, or olhor event} . ,·-.-·--·-· ··---·· �··�-.... ···--·-·--··-·-------���. - " _ , · � · - --·---�· ·---�--·· .d_t}��11!,��li··��;�;�;�-��;l��·�;�-�l�·��HED_UL��.�··�����--�-���=��������--� www.nthlGs.stalo.tx.us Revised 9/812015