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HomeMy WebLinkAbout141027 - Campaign Finance Report - Julie SchultzTexas Ethics Commission P.O. Box 12070 Austin, Texas 78711-2070 (512) 463-6800 (TDD 1-800-735-29139) CANDIDATE / OFFICEHOLDER FORM C/OH CAMPAIGN FINANCE REPORT COVER SHEET PG 1 1 ACCOUNT# 2 Total pages filed: The C/OH Instruction Guide explains how to complete this form. (Ethics Go umbseiohFilers) 3 CANDIDATE / MS/MRSIMR FIRST MI rO l NAME OFFICEHOLDER . ul--«/ N-1 YIGC 1' LT. . r Date Received NICKNAME LAST SUFFIX ICA r 4 CANDIDATE / ADDRESS/POBOY; APT/SUITE#; CITY; STATE; ZIPCODE m OFFICEHOLDER` _ Date Hand-dellvered or Postmarkedtmedced ADDRESS change of address, . L , Receipt 0 Amount 6 CANDIDATE/ AREA CODE PHONE NUMBER EXTENSION OFFICEHOLDER Date Processed PHONE 6 CAMPAIGN MS/MRS/MR FIRST Mi Date Imaged TREASURER 1 NICKNAME LAST SUFFIX 7 CAMPAIGN STREET ADDRESS (NO PO BOX PLEASE); APT/SUITE#; CITY; STATE; ZIPCODE TREASURER 1 1 ADDRESS residence or business) CAMPAIGN AREA CODE PHONE NUMBER EXTENSION TREASURER PHONE (CM) OZ21 9 REPORT TYPE January 15 El 30th day before election Runoff El 15th day after campaign treasurer appointment oficeholderonly) July 15 8th day before election ® Exceeded $500 Final report (Attach C/OH - FR) limit 10 PERIOD MonthDay Year Month Day Year COVERED /, THROUGH Icy /:'l / 11 ELECTION ELECTION DATE ELECTIONTYPE PrimaryMomDayYear ® ® Runoff General El Special 12 OFFICE ...__.._... OFFICE HEt.D (It any) . 13 OFFICESOUGHT (Ifknown) t www.ethics.state.tx.us Revised 07/28/2014 Texas Ethics Commission P.O. Box 12070 Austin, Texas 78711-2070 (512) 463-5800 (TDD 1-800-7: 5-2989) CANDIDATE / OFFICEHOLDER REPORT, FORM C/OH SUPPORT & TOTALS COVER SHEET PG 2 wW. ..... _._...._..m, . Ethics Comm14C/01-1NAM E 15 ACCOUNT # ( fission Filers) 16 NOTICE FROM THIS BOX IS FOR NOTICE OF POLITICAL CONTRIBUTIONS ACCEPTED OR POLITICAL EXPENDITURES MADE BY POLITICAL COMMITTEES TO SUPPORT THE POLITICAL CANDIDATE / OFFICEHOLDER. THESE EXPENDITURES MAY HAVE BEEN MADE HRTHOUT THE CANDIDATE'S OR OFFICEHOLDER'S KNOWLEDGE OR COMMITTEE (S) CONSENT. CANDIDATES AND OFFICEHOLDERS ARE REQUIRED TO REPORT THIS INFORMATION ONLY IF THEY RECEIVE NOTICE OF SUCH EXPENDITURES. COMMITTEE NAME __...... COMMITTEE TYPE GENERAL _ COMMITTEE ADDRESS SPECIFIC COMMITTEE CAMPAIGN TREASURER NAME _.._._ ... _..... m E] 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 2. TOTAL POLITICAL CONTRIBUTIONS OTHER THAN PLEDGES, LOANS, OR GUARANTEES OF LOANS) 119 w EXPENDITURE TOTALS 3. TOTAL POLITICAL EXPENDITURES OF $100 OR LESS, UNLESS ITEMIZED m 4. TOTAL POLITICAL EXPENDITURES f CONTRIBUTION 5. TOTAL POLITICAL CONTRIBUTIONS MAINTAINED AS OF THE LAST DAY Q BALANCE OF REPORTING PERIOD r OUTSTANDING 6. TOTAL PRINCIPAL AMOUNT OF ALL OUTSTANDING LOANS AS OF THE // LOAN TOTALS LAST DAY OF THE REPORTING PERIOD W •„. 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 JASON Nq JNd me under l'itle 15, Election Code. Notary Public, State of Texas/Z”,My Commission E ires JUNE 04, 202 Signature Of .ndl afate or Officeholder c ,. AFFIX NOTARY STAMP / SEAL ABOVE Sworn to and subscribed before me, by the said aU. IG Ulll• SLw'C _„_, this the 1H day of 20 I to certify which, witness my hand and seal of office. natu of officer administering oath Printed name of officer`administering oath Title of officerr adrrami g . run oath www. ethics. state.tx.us Revised 07/28/2014 Texas Ethics Commission P.O. Box 12070 Austin, Texas 78711-2070 512) 463-5800 ("i OD 1-800-735-2980) POLITICAL CONTRIBUTIONS SCHEDULE OTHER Guide how to complete this form. 7 Total pages Schedule A: -.... me The Instruction explains 2 FILER NAME o ® II 3 ACCOUNT # (Ethics Commission Filers) 4Date .._. .. ....... gyst rf... (t... _ _... 4Date 5 Full name of contribat or tate PAC s .-_.. w.._( ......__...,..,....,. .,.,...... 3 7 Amount of g In-kind contribution contribution $ description (if applicable) r add're'ss'; s City; State; ZipCoe N, M mmm If travel outside of Texas, complete Schedule T) 9 PrinciPal occupation r (See Instructions) PAC(IDJkDateFullnameofcontributor out -of -state_ mount -..kind -.._._ribAmountofIIn-kind contribution contribution ($) I description (if applicable) Contributor address; City; State; Zip Code 1 lI I Ifw4ravel outside of Texas complete Schedule T Principal occupation / Job title See Instructions Employer See Instructions) p Y ( Date Full name of contributor Elout-of-stetePAC(IM 1 Amount of In-kind contribution contribution ($) I description (if applicable) Contributor -address; City; State; Zip Code A If travel outside of Texas, complete Schedule T) Principal occupation / Job title (See Instructions) Employer (See Instructions) Date Full name of contributor out-of-statePAC (ID#. t Amount of In-kind contribution contribution ($) II description (if applicable) Contributor address; City; State; Zip Code I p If trBV wwl outside of Texas complete Schedule T)— loccu at.i-o.- n / Job title Instructions) Employer(see w.w...._ P._rin..c.-.t .a ._... Date Full name of contributor out-of-statePAC(IDM w-,.. W....m._. _--...-. t Amount of - In-kind contribution contribution ($) description (if applicable) Contributor address; City; State; Zip Code L, If travel outside of Texas com lets Schedule T Principal occupation / Job title (See Instructions) Employer (See Instructions) ATTACH ADDITIONAL COPIES OF THIS SCHEDULE AS NEEDED If contributor Is out-of-state PAC, please see instruction guide foraddltlonal reporting requirements. www.ethics.state.tx.us Revised 07/28/2014 Jullie Merrifield Schultz College Station City Council Place 5 Schedule A ( supplemental) Total for 10/27/14 report $2,350.00 Contribution Date Contributor Address Clit Ocu ati n Amount 10/24/14 !James Murr 4207 Camber Ct CS 77845 individual 100.00 10/24/14 Richard Robertson 3209 Innsbruck Cir CS 77845 individual 250.00 10/24/14 Fadi Kalaouze 4206 Serrano Ct B an 77802 individual 500.00 10/24/14 Sharon Brown 1825 Brothers CS 77845 individual 150.00 10/24/14 Brandi Cooper P.O. Box 9444 CS 77842 individual 250.00 10/24/14 Lar Hodges 5301 Woodall CS 77845 individual 250.00 10/24/14 David Scamardo P.O. Box 4508 Bryan 77805 individual 250.00 10/24/14 John Clark 3828 S Colle e Bryan 77801 individual 100.00 10/24/14 Heath Phillips I P.O. Box 262 Wellborn 77881 individual 500.00 Total for 10/27/14 report $2,350.00 Texas Ethics Commission P.O. Box 12070 Austin, Texas 78711-2070 512.) 463-5800 (TDD 1-800-735-2989) PLEDGED CONTRIBUTIONS 1 Total pages Schedule B - The Instruction Guide explains how to complete this form. 2 FILER NAME 1ie l' !'C.kia 3 ACCOUNT # (Ethics Commission Filers) eU _ - 4 GES b b w bTOTALOFUNITEMIZEDNE® b b $ 5 Date 6 Full name of pledgor o u4-of-state PAC (IDn: t ® Amoun4 of g In-kind description pledge ($) (if applicable) pledgor address City; Sf#te """'Z4) Code s.. If travel outside of Texas complete Schedule T) 1p Principal occupation / Job title (See Instructions) 11 Employer (See Instructions) Full name of pledgorDateP9 out-of-state P age t(of ._ In-kind1nd description applicable) Pledgor address; City; State; Zip Code 1 If travel outside of Texas, complete Schedule T) Principal occupation Jobtitle (See In structionsmm - mm.. Em to er See In-uctions) Date Full name of pledgor El out-of-stateof-stele PAC(I n1AmountofIIn-kind description pledge ($) (if applicable) Pledgor address; City; State; Zip Code if travel outside of Texas, complete Schedule T) Principal occupation / Job title (See Instructions) Employer (See Instructions) DatemmIT ._.. It name of pledgor out-of-state PAC(OP 1 Amount of In-kind description . -- pledge ($) (if applicable) Pledgor address; City; State; Zip Code If travel outside of Texas, complete Schedule T) SsTm.. lo InstructionsptitleEmployerSeeY ( ) Princi al occupation /Job 4t41e(ee Instructions) mmmmITmmm Date Full name of pledgor out-of-state PAC (I 1 Amount of In-kind description pledge ($) (if applicable) Pledgor address; City; State; Zip^Cod e g1I I If travel outside of Texas, complete Schedule T) Principal occupation /mmJob title (See Instructions) Employer (See Instructions) ATTACH ADDITIONAL COPIES OF THIS SCHEDULE AS NEEDED If contributor Is out-of-state PAC, please see instruction guide for additional reporting requirements. www.ethics.state.tx.us Revised 07/28/2014 Texas Ethics Commission P.O. Box 12070 Austin., Texas 78711-2070 (512) 463-5800 (TDO 1-800-735-2088) LOANS SCHEDULEE ww. mm.._.. . _. . 11111111 1 Total pages Schedule E: The Instruction Guide explains how to complete this form. 2 FILER NAME 3 ACCOUNT # (Ethics Commission Filers) TOTAL OF LINITEMIZED LOANS: b b b b $ 6 Date of loan of lender mITmm 7 Name er out-of-state PAC (Ioi6:)9 Loan Amoun4 ($) JLL(Sikw I 6 Is lender 8 Lender address; City; State; Zip Code 10 Interest rate e financialInstitutiont' w . _.._ .._. t 11 Maturity date Y N I . _ t 12 Principal occupation7/ Job title (See Instructions) 13 Employer (See Instructions) 14 Description of Collateral 15 Check If personal funds were deposited into political account none 16 GUARANTOR 17 Name of guarantor 19 Amount Guaranteed (S) INFORMATION 18 Guarantor address; City; State; Zip Code not applicable 20 Principal Occupation (See Instructions) 21 Employer (See Instructions) Date of loan Name of lender out-of-state PAC (IDM: Loan Amount ($) Is lender _._...._..._ r aLende ., . . . . , . _.___..............._ ................_ ddress; City; State; Zip Code Interest rate a financial Institution? Maturity date Y N w ........_...._. _...... _ ... .._ _ _ . _....... Principal occupation / Job title (See Instructions) Employer (See Instructions) Description of Collateral Check if personal funds were deposited into political account none GUARANTOR Name of guarantor Amount Guaranteed ($) INFORMATION Guarantor address; City; State; Zip Code not applicable Principal Occupation (See Instructions) Employer (See InsfructlonsyIstr ATTACH ADDITIONAL COPIES OF THIS SCHEDULE AS NEEDED If lender Is out-of-state PAC, please see Instruction guide for additional reporting requirements. www.ethics.state.tx.us - Revised 07/28/2014 Texas Ethics Commission P.O. Box 12070 Austin, Texas 78711-2070 (512) 463-5800 (TDD 1-800-735-2989) POLITICALI W _ITITIT IT -- EXPENDITURE CATEGORIES FOR BOX 8(a) _ ..._ __.._. Advertising Expense Gift/Awards/Memorials Expense Salaries/Wages/Contract Labor Loan Repayment/Reimbursement Accounting/Banking Legal Services Solicitation/Fundraising Expense Transportation Equipment & Related Expense Consulting Expense Food/Beverage Expense Travel In District Contributions/Donations Made By Event_ Expense Polling Expense_ Travel Out Of District Candidate/Officeholder/Political Committee Fees Printing Expense Office Overhead/Rental Expense OTHER (enter a category not listed above) The Instruction Guide explains how to complete this form. 1 Total pages Schedule F: 2 FILER NAME 1 -: 73 ACCOUNT # (Ethics Commission Filers) 4 Date 5 Payee name 6 Amount ($) 7 Payee-68dress; City; State; Zip Code o yam caCeg rias listed st dh kp,of.khksa f VCdta9ej (b) Description (If travel outside of Texas, complete Schedule T) 8 PURPOSE-K-Cat M1n OF EXPENDITURE CheekifAustin, TX, officeholder living expanse 9 Complete ONLY if direct Candidate / Officeholder name Office sought Office held expenditure to benefit C/OH Date Payee name Amount ($) Payee address; City; State; Zip Code PURPOSE Category (See categories listed at the top of this schedule) Description (If travel outside of Texas, complete Schedule T) OF EXPENDITURE Chock if Austin, TX, officeholder living expense Complete ONLY if direct Candidate /Officeholder name Office sought Office held expenditure to benefit C/OH n._._. .._ ...._....... _...... _.._.._ Date Payee name Amount ($) Payee address, City; State; Zip Code PURPOSE Category (See categories listed at the top of this schedule) Description (If travel outside of Texas complete Schedule T) OF EXPENDITURE ® Check tfAustin,TX, officeholder living expense Complete ONLY if direct Candidate / Officeholder name Office sought Office held expenditure to benefit C/OH Date—.... W.._ _. ...._... Payee name Amount ($} address; Payee - ... ..__. . w.._....._..............__ ....._. _.-mm.. ............mm..................... ..._._ _ _ y s; City; State; Zip Code A. pPURPOSE... Category (See categories listed at th eto... g p of this schedule) Description (If travel outside of Texas, complete Schedule T) OF EXPENDITURE ® Check IfAustln, TX, officeholder living expense to ONLY if directComplete ....._....... ..._....._... ......._........-.,... wm.m...__—__..m..,mn.. ._....mm p Candidate / Officeholder name Office sought Office held expenditure to benefit C/OH ATTACH ADDITIONAL COPIES OF THIS SCHEDULE AS NEEDEDITmITmm www.ethics.state.tx.us Revised 07/28/2014 f i f ` Invoice Paid Pa eenumbers F:::: amount A niTek HA38464 I'[ 259.67 Website 1004 1511 Texas Ave S, CS 77840 DeLucia's Inc 10263 462.88 cam ai n mailing 1 005 1673 Briarcrest Ste 103-A B an, TX 77802 CC Creations N121727 235.77 Cam ai n T-shirts 1001 1800 Shiloh, B an 77803 CC Creations N122603 108.25 si n stakes 1002 1800 Shiloh,.B an 77803 B an Broadcastin N/A 2,528.00 advertising 1003 2700 Earl Rudder Ste 5000 CS 77845 Total for 10/27/14 Report 3,594.57 Texas Ethics Commission P.O. Box 12070 Austin, Texas 78711-2070 (512) 463-5800 (TDD 1-800-735-2989) POLITICALEXPENDITURES MADE FROM PERSONAL FUNDS EXPENDITURE CATEGORIES FOR BOX 8(a) Advertising Expense Gift/Awards/Memorials Expense Salaries/Wages/Contract Labor Loan Repayment/Reimbursement Accounting/Banking Legal Services Solicitatlon/Fundraising Expense Transportation Equipment & Related Expense Consulting Expense Food/Beverage Expense Travel In District Contributions/Donations Made By Event -Expense - - - Polling Expense- -Travel Out Of District - -Candidata/Officeholder/Political -Committee- Fees Printing Expense Office Overhead/Rental Expense OTHER (enter a category not listed above) The Instruction Guide explains how to complete this form. 1 Total pages Schedule G: 2 FILER NAME 3 ACCOUNT # (Ethics Commission Filers) Il l 4 Date 6 Payee name 6 Amount ($) 7 Payee addrs, - - i?y;-.•.StaCa Zip Code Reimbursement from political contributions intended 8 PURPOSE a) Category (Sed caiagoriaa iistad at qt a top of this schedule) (b) Description (If travel outside of Texas, complete Schedule T) OF EXPENDITURE Check If Austin, TX, officeholder living expense Date mITITmmm Payee name Amount ($} Payee address; City; State; Zip Code fromEReimbursement political contributions Intended PURPOSE Category (See categories listed at the top of this schedule) Description (If travel outside of Texas, complete Schedule T) OF EXPENDITURE Check if Austin, TX, officeholderllvingexpense Date Payee name AmountPa m....._ _..._........... ....w w_ W,,. Y„w.w. yee address; City; State; Zip Code Reimbursement from political contributlons intended PURPOSE Category (See categories listed at the topofthis schedule) Description (If travel outside of Texas, complete Schedule T) OF EXPENDITURE Check If Austin, TX, officeholder living expense Date Payee name Amount ($} Payee address; City; State; Zip Code Reimbursement from political contributions intended PURPOSE Category (See categories listed at the top of this schedule) Description (If travel outside of Texas, complete Schedule T) OF EXPENDITURE Check if Austin, TX, officeholder living expense ATTACH ADDITIONAL COPIES OF THIS SCHEDULE AS NEEDED www.ethics.state.tx.us Revised 07/28/2014 Texas Ethics Commission P.O. Box 12070 Austin, Texas 78711-2070 (512) 463-5800 4"f DD 1-800-73 208•9) PAYMENT FROM POLITICAL I I SCHEDULE BUSINESSTOA / EXPENDITURE CATEGORIES FOR BOX 8(a) Advertising Expense Gift/Awards/Memorials Expense Salaries/Wages/Contract Labor Loan Repayment/Reimbursement Accounting/Banking Legal Services Solicitation/Fundraising Expense Transportation Equipment & Related Expense Consulting Expense Food/Beverage Expense Travel In District Contributions/Donations Made By Event -Expense - - - -- - Polling Expense- Travel OutOfDistrict -- Candidate/Officeholder/Political-Committee Fees Printing Expense Office Overhead/Rental Expense OTHER (enter a category not listed above) The Instruction Guide explains how to complete this form. 1 Total pages Schedule H: 2 FILER NAME3 ACCOUNT # (Ethics Commission Filers) 4 Date 5 Business name 6 Amount ($)........._ City; o.-........._- ww...........__...._ s w_ ,., rare i a CBu..iness S g SE (ategofy (See categoAes listed at hie igpofthf's ache 9 eta) (b) Description (If travel outside of Texas complete Schedule T) OF .....ro ...m._.w,..... EXPENDITURE Check if Austin, TX, officeholder living expense m-.... .... 9 Complete ONLY if direct Candidate / Officeholder name Office sought Office held expenditure to benefit C/OH Date Business name Amount ($} Business address, City; State; Zip Code PURPOSEmmm Category (See categories listed at the top of this schedule) mm mIT Description (If travel outside of complete , Texasm ^-^^ m Texesmplete Schedule T) OF EXPENDITURE Check ifAustin, TX, officeholder living expense Complete ONLY if direct Candidate / Officeholder name Office sought Office held expenditure to benefit C/OH Date Business name Amount ($} Business address; City; State, Zip Code PURPOSE a Category See categories listed at the top of this schedule) Description (If travel hed m mmmmm- m E g ry ( g p p - outside of Texas, complete Schedule 7) OF EXPENDITURE Check IfAustin, TX, officeholder living expense Complete 2M if direct Candidate / Officeholder name Office sought Office held expenditure to benefit C/OH Date Business name Amount ($) Business address; City; State; Zip Code PURPOSE Category See categories listed at the top of this schedule) Description (If travel outside of Texas, complete Schedule T) OF EXPENDITURE Check If Austin, TX, officeholder living expense Candidate/Officeholderna _ . .... Complete If direct me Office sought Office held expenditure to benefit C/OH ATTACH ADDITIONAL COPIES OF THIS SCHEDULE AS NEEDED www. ethics. state. tx.us Revised 07/28/2014 Texas Ethics Commission P.O. Box 12070 Austin, Texas 78711-2070 (512) 463-5800 (TDD 1-800-735-2989) EXPENDITURESSCHEDULE MADE FROM POLITICAL CONTRIBUTIONS 6...... The Instruction Guide explains how to complete this form. 1 Total pages Schedule LL 2 FILER NAME 3 ACCOUNT # (Ethics Commission Filers) Date 5 Payee name 6 Amount ($) 7 Pay-Ac6!1'ress City; StaR; ZipCde 8 PURPOSE (a)Category (See instructions for examples of acceptable (b) Description (See instructions regarding type of Information OF categories) required.) EXPENDITURE Date Payee name Amount ($) Payee address; City; State; Zip Code PURPOSE (a) Category (See Instructions for examples of acceptable (b) Description (See Instructions regarding type of Information OF categories) required.) EXPENDITURE Date Payee name Amount ($) Payee address; City; State; Zip Code PURPOSE (a) Category (See Instructions for examples of acceptable (b) Description (See instructions regarding type of Information OF categories) required.) EXPENDITURE Date Payee name Amount ($) Payee address; City; State; Zip Code PURPOSE (a) Category (See instructions for examples of acceptable (b) Description (See Instructions regarding type of information OF categories) required.) EXPENDITURE ATTACH ADDITIONAL COPIES OF THIS SCHEDULE AS NEEDED www.ethics.state.tx.us Revised 07/28/2014 Texas Ethics Commission P.O. Box 12070 Austin, Texas 76711-2070 (512) 463-5800 (TDD 1-800-735-2889) INTEREST EARNED, OTHER CREDITS/GAINS/ SCHEDULEKREFUNDS, AND PURCHASE OF INVESTMENTS 1 Total pages Schedule K: The Instruction Guide explains how to complete this form. 2 FILER NAME 3 ACCOUNT # (Ethics Commission Filers) 4 Date 5 Name of person from whom amount is received 3 Amount M 6 Address of pe fta fnt4 wlti`omrrr 'punt is received; City; State; Zip Code 7 Purpose for which amount is received Date Name of person from whom amount is received Amount M Address of person from whom amount is received; City; State; Zip Code Purpose for which amount is received Date Name of person from whom amount is received Amount M Address of person from whom amount is received; City; State; Zip Code Purpose for which amount is received Date Name of person from whom amount is received Amount M Address of person from whom amount is received; City; State; Zip Code Purpose for which amount is received ATTACH ADDITIONAL COPIES OF THIS SCHEDULE AS NEEDED www.ethics.state.tx.us Revised 07/28/2014 Texas Ethics Commission P.O. Box 12070 Austin, Texas 78711-2070 (512)463-5800 TDD 1-800-735-2989) IN-KIND I ION OR POLITICAL EXPENDITURE TRAVELFOROUTSIDEOFTEXAS The Instruction Guide explains how to complete this form. 1 Total pages Schedule T: 2 FILER NAME 3 ACCOUNT # (Ethics Commission Filers) w.._ ` l ...1.~.. ..._.... ... 4 Name of Contributor/ Corporation or La or Organization / Pledgor / Payee 5 Contribution / Expenditure reported on:._.... Schedule A ® Schedule B Schedule C Schedule D Schedule F Schedule G I Schedule N COH-C COH T a PAC-CSehelU a PAC-E person(s) - u on( Name of s) t- 6 Dates of travel raveling" 8 Departure city or name of departure locatron 9 Destination city or name of destination loci afar 10 Means of transportation 11 Purposee of travel (including name of conference, seminar, or other event) m.. ibutor ......_....__ .... ..._._ .__......._ Corporation or Labor Organization / Pledgor / PayeeNameofCo.nV__..-/Corporation Contribution / Expenditure reported on: Schedule A Schedule B Schedule C Schedule D Schedule F Schedule G Schedule H Schedule N COH-UC COH-T PAC-C PAC-E Dates of travel Name of person(s) travelingDates Departure city or name of departure location W... ationDestinationcityornameofdestinationlocation m Means oftransportation Purpose of travel (including name of conference, seminar, or other event) Name of Contributor / Corporation or Labor Organization / Pledgor / Payee Contribution / Expenditure reported on: Schedule A Schedule B Schedule C Schedule D Schedule F Schedule G Schedule H ® Schedule N COH-UC COH-T PAC-C PAC-E Dates of travel Name of person(s) traveling Departure city or name of departure location Destination city or name of destination location trans ortatio name of conference, seminar, or other eventMeansofP ...._...-_._. (includingPurposeoftravel (inc ....., 9 } ATTACH ADDITIONAL COPIES OF THIS SCHEDULE AS NEEDED www.ethics,state.tx.us Revised 07/28/2014