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HomeMy WebLinkAbout20230818114152i CANDNDATE / OFFICEHOLDER FORM C/OH CAMPAIGN FINANCE REPORT COVER SHEET PG 1 The C/OH Instruction Guide explains how to complete this form. 1 Filer ID (Ethics commission Filers) 2 Total pages filed: 3 CANDIDATE / OFFICEHOLDER MS I MRS / MR FIRST MI OFFICE USE ONLY NAME..' ..............-:. ..............................L ` .......... Date Received NICKNAME LAST SUFFIX g©b o_nc �/) 4 CANDIDATE / ADDRESS / PO BOX: APT I SUITE #; CITY; STATE; ZIP CODE OFFICEHOLDERMAILING ADDRESS 00 Change of Aodress 5 CANDIDATE/ AREA CODE PHONE NUMBER EXTENSION Date Hand -delivered or Date Postmarked OFFICEHOLDER PHONE !� p Q (9 /r� 9) Z 0-/ —S O V Receipt # Amount $ 6 CAMPAIGN I TREASURER MS / MRS / MR FIRST MI M Date Processed Mr. (ke NAME................................................................................. i NICKNAME LAST SUFFIX / ►O /� ^�� w Date Imaged 7 CAMPAIGN; STREET ADDRESS (NO PO BOX PLEASE); APT / SUrrE #; CITY; STATE; ZIP CODE TREASURER ADDRESS, /� Q �n 1( �1/��/_ 511$ /ie��e%/' 81niel ll�Vl ���� ki") �/ u / / O 7 J (Residence or Business) $ CAMPAIGN TREASURER AREA CODE PHONE NUMBER EXTENSION PHONE 2 2;1/ /15 9 REPORT T`{PE ❑ January ❑ 30th day before election Runoff 15th da after cam Y Paign treasurer appointment (Officeholder Only) Exceeded Modified July 15 ❑ 81h day before election El Final Report (Attach C/OH - FR) Reporting Limit 10 PERIOD COVERED Month Day Year Month Year Day Year I I / r / �O� THROUGH / 3 V / 2-02,3 11 ELECTION ELECTION DATE ELECTION TYPE ❑ Primary ❑ Runoff ❑ Other Month Day Year Description i I l / O j1 /ZQGG ❑ Genoral Special 12 OFFICE i OFFICE HELD (if any) 13 OFFICE SOUGHT (if known) .S.C'� (ptchv� P)57 re 14 NOTICE FROM THIS BOX IS FOR NOTICE OF POLITICAL'CONTRIBUTIONS ACCEPTED OR POLITICAL EXPENDITURES MADE BY POLITICAL COMMITTEES TO SUPPORT POLITICAL iL THE CANDIDATE / OFFICEHOLDER, THESE EXPENDITURES MAY HAVE BEEN MADE WITHOUT THE CANDIDATE'S OR OFFICEHOLDERS KNOWLEDGE OR 11111 CANDIDATES AND OFFICEHOLDERS ARE REQUIRED TO REPORT THIS INFORMATION ONLY IF THEY RECEIVE NOTICE OF SUCH EXPENDITURES. COMM ITTE COMMITTEE TYPE COMMITTEE;NAME I GENERAL COMMITTEE ADDRESS Additional Pages COMMITTEE CAMPAIGN TREASURER NAME i SPECIFIC COMMITTEE; CAMPAIGN TREASURER ADDRESS GO TO PAGE 2 Forms provided by `Texas Ethics Commission www.ethics.state.tx.us Revised 11/15/2022 CANDIDATE / OFFICEHOLDER FORM C/OH CAMPAIGN FINANCE REPORT COVER SHEET PG 2 15 C/OH NAME 16 Filer ID (Ethics Commission Filers) -S .VY1e S R - ©4 6� QV1 C 17 CONTRIBUTION 1. TOTAL UNITEMIZED POLITICAL CONT BUTIONS (OTHER THAN $ TOTALS PLEDGES, LOANS, OR GUARANTEES OF LOANS, OR CONTRIBUTIONS MADE ELECTRONICALLY) 2. TOTAL POLITICAL CONTRIBUTIONS $ (OTHER THAN PLEDGES, LOANS, OR GUARANTEES OF LOANS) EXPENDITURE 3 TOTAL UNITEMIZED POLITICAL EXPENDITURE. $ TOTALS 4. TOTAL POLITICAL EXPENDITURES $ CONTRIBUTION 5 TOTAL POLITICAL CONTRIBUTIONS MAINTAINED AS OF THE LAST DAY $ BALANCE OF REPORTING PERIOD S ............. OUTSTANDING 6. TOTAL PRINCIPAL AMOUNT OF ALL OUTSTANDING LOANS AS OF THE $ LOAN TOTALS LAST DAY OF THE REPORTING PERIOD 18 SIGNATURE 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, Election Code. Signature o 5di e o iceholder IAN WHITTENTON Please complete either option below: Notary Public STATE OF TEXAS 1.;. ID# 12W552-2 My �"n Exp. Jun. 06. 2025 ( I avit NOTARY STAMP/SEAL Swom to and subscribed before me byo.MtS �—J�ob,lyAnGti this the day of, `f 211- to certify which, witness my hand and seal of office. t — --310"' U 1'..' Signature of officer administering oath Printed name of officer administering oath k Title of Jfficer administ ing oath (2) Unsworn Declaration My name is _ My address is Executed in , and my date of birth is (street) (city) (state) (zip code) (country) County, State of on the day of 120 (month) (year) Signature of Candidate/Officeholder (Declarant) Forms provided by Texas Ethics Commission www.ethics.state.tx.us Kevlsea i it i olzuzz