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HomeMy WebLinkAbout150121 - Campaign Finance Report - Julie SchultzAustin, Texas 78711-2070 512) 463-5800 TDD 1-800-735-2989) CANDIDATE / OFFICEHOLDER CAMPAIGN FINANCE REPORT FORM C/OH COVER SHEET PG 1 2 Total pages filed: L3TheC/OH Instruction Guide explains how to complete thls form. 1 ACCOUNT # Ethics Commission Fliers) 3 CANDIDATE / NAMOFFIEEHOLDER MS/MRS/MR I e5• uu P' ` NICKNAME SCALAL—TZ FIRST 1•'„ 2vet- MI G` SUFFIX OFFICE USE ONLY Date Recel vHANfe y6 0, JAN 2 1 2015 cILELLVERELMAILINGateHand -de livered or Postmarked LAST 4 CANDIDATE / OFFICEHOLDER ADDRESS change of address ADDRESS/PO BOX APT/SUITE#; Q IS r3208 7 "' CITY; G,` STATE; ZIP CODE e Ct. -n`v ` ST"-ATt G7«S. Receipt # Amount 5 CANDIDATE/ OFFICEHOLDER PHONE AREA CODE PHONE NUMBER EXTENSION Date Processed 6 CAMPAIGN TREASURER NAME MS/MRS/MR FIRST MI Date Imaged 11— NICKNAME LAST SUFFIX 7 CAMPAIGN TREASURER ADDRESS residence or business) STREET ADDRESS (NO PO BOX PLEASE); NJ tL Lo APT! SUTE #; CITY; STATE; ZIP CODE uf)o STP- toy t IZ i-1 `Z.) LA ------ C.o L..EC 8 CAMPAIGN TREASURER PHONE AREA CODE PHONE NUMBER EXTENSION LOn /) 2.2•p _ 6G3J Q 9 REPORT TYPE X January 15 30th day before election J Runoff 15th day after campaign treasurer appointment olficehdderoNy) July 15 8th day before election Exceeded $500 Final report (Attach C/OH - FR) limit 10 PERIOD COVERED Month Day Year Month Day Year THROUGH / / 11 ELECTION ELECTION DATE Month Day Year ELECTION TYPE Pdmery 0 Runoff General Special 12 OFFICE OFFICE HELD (Harty) COLiCztE- ST-A-riC,.-1 L.t T---`{ C_ Ot.a.'--iC—t Pi.-.'A,‹,, I_ c.—. 13 OFFICE SOUGHT (If known) J /A GO TO PAGE 2 www.ethics.state.tx.us Revised 07/2B12014 re of officer administering oath Printed name of officer administering oath Title of officer admtnisteril oath Texas Ethics Commission PO. Box 12070 Austin, Texas 78711-2070 512) 463-5800 (TDD 1-800-735-2989) CANDIDATE / OFFICEHOLDER REPORT: FORM C/OH COVER SHEET PG 2SUPPORT & TOTALS 14 C/OH NAME 15 ACCOUNT # (Ethics Commission Filers) 16 NOTICE FROM POLITICAL COMMITTEE(S) additional pages THIS BOX IS FOR NOTICE OF POLITICAL CONTRIBUTIONS ACCEPTED OR POLITICAL EXPENDITURES MADE BY POLITICAL COMMITTEES TO SUPPORT THE CANDIDATE / OFFICEHOLDER. THESE ECPENDITURES MAY HAVE BEEN MADE WITHOUT THE CANDIDATES OR OFFICEHOLDER'S KNOWLEDGE OR CONSENT. CANDIDATES AND OFFICEHOLDERS ARE REQUIRED TO REPORT THIS INFORMATION ONLY IF THEY RECEIVE NOTICE OF SUCH EXPENDITURES. COMMITTEE TYPE GENERAL n SPECIFIC COMMITTEE NAME COMMITTEE ADDRESS COMMITTEE CAMPAIGN TREASURER NAME COMMITTEE CAMPAIGN TREASURER ADDRESS 17 CONTRIBUTION TOTALS 1. TOTAL POLITICAL CONTRIBUTIONS OF $50 OR LESS (OTHER THAN PLEDGES, LOANS, OR GUARANTEES OF LOANS), UNLESS ITEMIZED 15 , ©t) 2. TOTAL POLITICAL CONTRIBUTIONS OTHER THAN PLEDGES, LOANS, OR GUARANTEES OF LOANS) EXPENDITURE TOTALS 3. TOTAL POLITICAL EXPENDITURES OF $100 OR LESS, UNLESS ITEMIZED 4. TOTAL POLITICAL EXPENDITURES 118(.7 CONTRIBUTION BALANCE 5. TOTAL POLITICAL CONTRIBUTIONS MAINTAINED AS OF THE LAST DAY OF REPORTING PERIOD OUTSTANDING LOAN TOTALS 18 AFFIDAVIT 6. TOTAL PRINCIPAL AMOUNT OF ALL OUTSTANDING LOANS AS OF THE LAST DAY OF THE REPORTING PERIOD r, JASON CORNELIUS Notary Public, State of Texas My Commission Expires JUNE 04. 2418 AFFIX NOTARY STAMP / SEAL ABOVE 31-,F347 I swear, or affirm, under penalty of perjury, that the accompanying report is true and correct and includes all information required to be reported by me Title 15, Election Code. Signature of Candidat6 or Officeholder Sworn to and subscribed before me, by the said Iu t-c c,t,, , this the tri-d day of WO/LW) , 20 t , to certify which, witness my hand and seal of office. www.ethics.state.tx.us Revised 07/28/2014 Texas Ethics Commission P.O. Box 12070 Austin, Texas 78711-2070 512) 463-5800 TDD 1-800-735-2989) www.ethics.state.tx.us Revised 07/28/2014 POLITICAL CONTRIBUTIONS OTHER THAN PLEDGES OR LOANS SCHEDULE A The Instruction Guide explains how to complete this form. 1 Total pages Schedule A: 2 FILER NAME Jute at( r,k 1e ce.KLA.(4- 3 ACCOUNT # (Ethics Commission Filers) 4 Date 5 Full name of contribu or 0 out-of-state PAC(ID#: 7 Amount of 18 In-kind contribution contribution ($) I description (if applicable) I I I If travel outside of Texas, complete Schedule T) 6 Contributor address; G1[y, Zip Code YT' -C*-t t 9 Principal occupation ! Job - (roes Instructions) tltte 10 Employer (See Instructions) Date Full name of contributor 0 out-of-state PAC(ID#: Amount of Y In-kind contribution contribution ($) description (if applicable) If travel outside of Texas, complete Schedule T) Contributor address; City; State; Zip Code Employer (See Instructions) Principal occupation / Job title (See Instructions) Date Full name of contributor out-of-state PAC(ID#: Amount of In-kind contribution contribution ($) description (if applicable) If travel outside of Texas, complete Schedule T) Contributor address; City; State; Zip Code Principal occupation / Job title (See Instructions) Employer (See Instructions) Date Full name of contributor out-of-state PAC(ID#: Amount of I In-kind contribution contribution ($) I description (if applicable) I I I If travel outside of Texas. complete Schedule T) Contributor address; City; State; Zip Code Principal occupation / Job title (See Instructions) Employer (See Instructions) Date Full name of contributor 0 out-of-state PAC(ID#: Amount of I In-kind contribution contribution ($) I description (if applicable) I I If travel outside of Texas, complete Schedule T) Contributor address; City; State; Zip Code 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 foradditional reporting requirements. www.ethics.state.tx.us Revised 07/28/2014 POLITICAL CONTRIBUTIONS OTHER THAN PLEDGES OR LOANS Jullie Merrifield Schultz College Station City Council Place 5 Schedule A ( supplemental) Date Contributor Address Cit Contribution Occupation Amount 10/29/14 Hayley Scott 305 Gleeson _ CS 77845 individual 150.00 10/29/14 Robert Gutierrez 404 N Haswell ' Bryan 77803 individual 250.00 10/29/14 Cathy Conlee PO Box 4142 Bryan 77802 individual 250.00 10/29/14 Larry Mariott 209 Rock Prairie Rd CS 77845 individual 100.00 10/29/14 Steve Arden 311 Cecilia Loop CS 77845 individual 100.00 10/29/14 TREPAC PO Box 2246 ,Austin 78768 PAC 5,000.00 11/7/14 Stan Jones 1005 Puryear CS 77840 individual 100.00 11/7/14 Heath Phillips PO Box 262 Wellborn 77881 individual 750.00 11/7/14 Robert Swearingen 3717 Stillmeadow Bryan 77802 individual 250.00 11/2/14 Kim Eubanks 351 Adriatic Pkwy McKinney75070 individual 1,000.00 11/2/14 Jesse Durden 4010 Sunny Meadow Brook CS 77845 individual 500.00 11/2/14 ML Red Cashion 3040 Hickory Ridge Crl Bryan 77807 individual 100.00 11/2/14 Sharon Cashion White PO Box 5727 Bryan 77805 individual 100.00 Total for 1/15/15 report 8,650.00 Texas Ethics Commission P.O. Box 12070 Austin, Texas 78711-2070 512) 463-5800 TDD 1-800-735-2989) PLEDGED CONTRIBUTIONS SCHEDULE B The Instruction Guide explains how to complete this form. 1 Total pages Schedule B: 2 FILER NAME3 6.1U e idte.iri c e «. C'c.kL& ACCOUNT # (Ethics Commission Filers) TOTAL OF UNITEMIZED Pk.EDGES: b b 5 Date 6 Full name of pledgor out-of-state PAC(ID#: ) 8 Amount of 9 In-kind description pledge ($) (if applicable) If travel outside of Texas, complete Schedule T) 7 Pledgor address; City; State; Zip Code 14.0 J.,.e....._ 10 Principal occupation / Job title (See Instructions) 11 Employer (See Instructions) Date Full name of pledgor out-of-state PAC Mt: Amount of In-kind description pledge ($) ii ( if applicable) II If travel outside of Texas, complete Schedule T) Pledgor address; City; State; Zip Code Principal occupation / Job title (See Instructions) Employer (See Instructions) Date Full name of pledgor out-of-state PAC(ID#: ) Amount of In-kind description pledge ($) (if applicable) If travel outside of Texas, complete Schedule T) Pledgor address; City; State; Zip Code Principal occupation / Job title (See Instructions) Employer (See Instructions) Date Full name of pledgor out-of-state PAC (16#: ) Amount of In-kind description pledge ($) (if applicable) If travel outside of Texas, complete Schedule T) Pledgor address; City; State; Zip Code Principal occupation / Job title (See Instructions) Employer (See Instructions) Date Full name of pledgor 0 out-of-statePAC(ID# ) Amount of I In-kind description pledge ($) (if applicable) If travel outside of Texas, complete Schedule T) Pledgor address; City; State; Zip Code Principal occupation / Job title (See Instructions) Employer (See Instructions) ATTACH ADDITIONAL COPIES OF THIS SCHEDULE AS NEEDED If contributor is out-of-state PAC, please see instruction guide for additional reporting requirements. www.ethics.state.tx.us Revised 07/28/2014 Texas Ethics Commission P.O. Box 12070 Austin, Texas 78711-2070 512) 463-5800 TDD 1-800-735-2989 LOANS SCHEDULE E The Instruction Guide explains how to complete this form. 1 Total pages Schedule E: 2 FILER NAME.3 Juie LIU(t ieiA re_JA.1l1-2_, ACCOUNT # (Ethics Commission Filers) TOTAL OF UNITEMIZED LOANS: * b * a ' b 5 Date of loan 5-b -1 ( 7 Name of lender out-of-state PAC (ID#: )q Loan Amount ($) JuL11 L Sc..P b., 343 c1 6 Is lender a financial Institution? Y de(C11 e— 8 Lender address; City; State; Zip Code L ,, 32c L1 vtc, .. 10 Interest rate 06l. Or T1'&4C 11 Maturity date 12 Principal occupation / Job title (See Instructions) la- 13 Employer (See Instructions) 14 Description of Collateral none 15 Check if personal funds were deposited into political account MI 16 GUARANTOR INFORMATION not applicable 17 Name of guarantor 18 Guarantor address; City; State; Zip Code 19 Amount Guaranteed ($) 20 Principal Occupation See Instructions) 21 Employer (See Instructions) Date of loan Name of lender 0 out-of-state PAC OM Loan Amount ($) Is lender a financial Institution? Lender address; City; State; Zip Code Interest rate Y N Maturity date Principal occupation / Job title (See Instructions) Employer (See Instructions) Description of Collateral none Check if personal funds were deposited into political account GUARANTOR INFORMATION not applicable Name of guarantor Guarantor address; City; State; Zip Code Amount Guaranteed ($) Principal Occupation (See Instructions) Employer (See Instructions) ATTACH ADDITIONAL COPIES OF THIS SCHEDULE AS NEEDED If lender is out-of-state PAC, please see instruction guide for additional reporting requirements. www.ethics.state.tx.us Revised 07/28/2014 Texas Ethics Commission P.O. Box 12070 Austin, Texas 78711-2070 512) 463-5800 TDD 1-800-735-2989) POLITICAL EXPENDITURES SCHEDULE F EXPENDITURE CATEGORIES FOR BOX 8(a) Advertising Expense Gift/Awards/Memorials Expense Salaries/Wages/Contract Labor Loan Repayment/Reimbursement Accounting/Banking Legal Services Solicitation/Fundraising Expense Transportation Equipment & Related Expense Consulting Expense Food/Beverage Expense Travel In District Contributions/Donations Made By Event Expense Polling Expense Travel Out Of District Candidate/Officeholder/Political Committee Fees Printing Expense Office Overhead/Rental Expense OTHER (enter a category not listed above) The Instruction Guide explains how to complete this form. 1 Total pages Schedule F: 2 FILER NAME i 3 ACCOUNT # (Ethics Commission Filers) 4 Date 5 Payee name 6 Amount ($) 7 Payee = - . ess; City; State; Zip Code 8 PURPOSE OF EXPENDITURE Category (See categories listed at the top of this schedule) escription (If travel outside of Texas, complete Schedule T) TX, officeholder living expenseCheckifAustin, 9 Complete ONLY if direct Candidate / Officeholder name Office sought Office held expenditure to benefit C/OH Date Payee name Amount ($) Payee address; City; State; Zip Code PURPOSE OF EXPENDITURE Category (See categories listed at the top of this schedule) Description (If travel outside of Texas, complete Schedule T) TX, officeholder living expenseCheckifAustin, Complete ONLY if direct Candidate / Officeholder name Office sought Office held expenditure to benefit C/OH Date Payee name Amount ($) Payee address; City; State; Zip Code PURPOSE OF EXPENDITURE Complete ONLY if direct Category (See categories listed at the top of this schedule) Description (If travel outside of Texas, complete Schedule T) TX, officeholder living expenseCheckifAustin, Candidate / Officeholder name Office sought Office held expenditure to benefit C/OH Date Payee name Payee address; City; State; Zip CodeAmount ($) PURPOSE OF EXPENDITURE Category (See categories listed at the top of this schedule) Description (If travel outside of Texas, complete Schedule T) TX, officeholder living expenseCheckifAustin, Complete ONLY if direct Candidate / Officeholder name 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 Julie Schultz Campaign Expenses Paee Invoice number amount descy Frame by Frame 750.00 advertising 1502 Nantucket, CS 77845 FXF9173 Fox Mktg Design v 186 90.00 postcard design 4313 Berwick Chik Fil A 29.73 Food for Campaign workers Chicken Express 49.84 Food for Campaign workers L Shackelford, Inc 1094 2,500.00 consulting 105E6th St Plainview, TX 79072 The Eagle 2,018.75 ads 1729 Birarcrest, Bryan 77802 L Shackelford, Inc 801.90 advertising support 105E 6th St Plainview, TX 79072 Facebook 382.94 ads Bryan Broadcasting 3,110.00 ads 2700 Earl Rudder Ste 5000 CS 77845 KBTX 8,066.00 ads 4141E 29th St Bryan, TX 77802 L Shackelford. Inc 63.03 credit card transaction fees 105E 6th St Plainview, TX 79072 Total for 1115115 Report 17,862.19 Texas Ethics Commission P.O. Box 12070 Austin, Texas 78711-2070 512) 463-5800 TDD 1-800-735-2989) POLITICAL MADE FROM EXPENDITURES SCHEDULE G PERSONAL FUNDS Advertising Expense Accounting/Banking Consulting Expense Event Expense Fees EXPENDITURE CATEGORIES FOR BOX 8(a) Gift/Awards/Memorials Expense Salaries/Wages/Contract Labor Loan Repayment/Reimbursement Legal Services Solicitation/Fundraising Expense Transportation Equipment & Related Expense Food/Beverage Expense Travel In District 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. 1 Total pages Schedule G: 2 FILER NAIVE1 1 St -kikJU4ieMoi+dt( iek l 3 ACCOUNT # (Ethics Commission Filers) 4 Date 5 Payee name 6 Amount ($) Reimbursement from political contributions intended 7 Payee ; • - =. , Stat=, Zip Code lo C 8 PURPOSE OF EXPENDITURE a) Catega • _ at the top of this schedule) b) Description (If travel outside of Texas, complete Schedule T) TX, officeholder living expenseCheckifAustin, Date Payee name Amount ($) Reimbursement from political contributions intended Payee address; City; State; Zip Code PURPOSE OF EXPENDITURE Category (See categories listed at the top of this schedule) Description (If travel outside of Texas, complete Schedule T) TX, officeholder living expenseCheckifAustin, Date Payee name Amount ($) I 1 Reimbursement from political contributions intended Payee address; City; State; Zip Code PURPOSE OF EXPENDITURE Category (See categories listed at the top of this schedule) Description (If travel outside of Texas, complete Schedule T) TX, officeholder living expenseIICheckifAustin, Date Payee name Amount ($) Reimbursement from political contributions intended Payee address; City; State; Zip Code PURPOSE OF EXPENDITURE Category (See categories listed at the top of this schedule) Description (If travel outside of Texas, complete Schedule T) TX, officeholder living expenseInCheckifAustin, ATTACH ADDITIONAL COPIES OF THIS SCHEDULE AS NEEDED www.ethics.state.tx.us Revised 07/28/2014 Texas Ethics Commission P.O. Box 12070 Austin, Texas 78711-2070 512) 463-5800 TDD 1-800-735-2989) PAYMENT FROM POLITICAL CONTRIBUTIONS SCHEDULE H TO A BUSINESS OF C/OH EXPENDITURE CATEGORIES FOR BOX 8(a) Advertising Expense Gift/Awards/Memorials Expense Salaries/Wages/Contract Labor Loan Repayment/Reimbursement Accounting/Banking Legal Services Solicitation/Fundraising Expense Transportation Equipment & Related Expense Consulting Expense Food/Beverage Expense Travel In District Contributions/Donations Made By Event Expense Polling Expense Travel Out Of District Candidate/Officeholder/Political Committee Fees Printing Expense Office Overhead/Rental Expense OTHER (enter a category not listed above) The Instruction Guide explains how to complete this form. 1 Total pages Schedule H: 1 2 FILER NAMEA '' J L til 4) lAtirr,.t1a cetul 3 ACCOUNT # (Ethics Commission Filers) 4 Date 5 Business name 6 Amount ($) 7 Business aIRs ; State; Zip Code 8 PURPOSE OF EXPENDITURE a) Categ, a categories listed at the to f this schedule) b) Description (If travel outside of Texas, complete Schedule T) TX, officeholder living expenseCheckifAustin, 9 Complete ONLY if direct Candidate / Officeholder name Office sought Office held expenditure to benefit C/OH Date Business name Amount ($) Business address; City; State; Zip Code PURPOSE OF EXPENDITURE Category (See categories listed at the top of this schedule) Description (If travel outside of Texas, complete Schedule T) TX, officeholder living expenseCheckifAustin, Complete ONLY if direct Candidate / Officeholder name Office sought Office held expenditure to benefit C/OH Date Business name Amount ($) Business address; City; State; Zip Code PURPOSE OF EXPENDITURE Category (See categories listed at the top of this schedule) Description (If travel outside of Texas, complete Schedule T) TX, officeholder living expenseCheckifAustin, Complete ONLY if direct Candidate / Officeholder name Office sought Office held expenditure to benefit C/OH Date Business name Amount ($) Business address; City; State; Zip Code PURPOSE OF EXPENDITURE Category (See categories listed at the top of this schedule) Description (If travel outside of Texas, complete Schedule T) TX, officeholder living expenseIICheckifAustin, Complete ONLY if direct Candidate / Officeholder name Office sought Office held expenditure to benefit C/OH ATTACH ADDITIONAL COPIES OF THIS SCHEDULE AS NEEDED www.ethics.state.tx.us Revised 07/28/2014 SCHEDULE Texas Ethics Commission P.O. Box 12070 Austin, Texas 78711-2070 512) 463-5800 (TDD 1-800-735-2989) NON-POLITICAL EXPENDITURES MADE FROM POLITICAL CONTRIBUTIONS The Instruction Guide explains how to complete this form. 1 Total pages Schedule I t 2 FILER NAME ri t te. I L SCJNz 3 ACCOUNT # (Ethics Commission Filers) 4 Date 5 Payee name 6 Amount ($) 7 Paye .dress; City; State; Zip Code PURPOSE OF EXPENDITURE a) Cate.. - categories) e instructions for exampless alLI e b) Description (See instructions regarding type of information required.) Date Payee name Amount ($) Payee address; City; State; Zip Code PURPOSE OF EXPENDITURE a) Category (See instructions for examples of acceptable categories) b) Description (See instructions regarding type of information required ) Date Amount ($) Payee name Payee address; City; State; Zip Code PURPOSE OF EXPENDITURE a) Category (See instructions for examples of acceptable categories) b) Description (See instructions regarding type of information required.) Date Payee name Amount ($) PURPOSE OF EXPENDITURE Payee address; City; State; Zip Code a) Category (See instructions for examples of acceptable categories) b) Description (See instructions regarding type of information required.) 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) INTEREST EARNED, OTHER CREDITS/GAINS/ REFUNDS, AND PURCHASE OF INVESTMENTS SCHEDULE K The Instruction Guide explains how to complete this form. 1 Total pages Schedule K: 2 FILER NAME3 1ulie JueA.eiciel a, Sdu4v ACCOUNT # (Ethics Commission Filers) 4 Date 4 5 Name of person from whom amount is received 6 Address of person fr. of ..... amount is - eived; City; State; Zip Code 1 8 Amount s- -.....:-'- . _ . received Date Name of person from whom amount is received Address of person from whom amount is received; City; State; Zip Code Amount Purpose for which amount is received Date Name of person from whom amount is received Address of person from whom amount is received; City; State; Zip Code Amount Purpose for which amount is received Date Name of person from whom amount is received Address of person from whom amount is received; City; State; Zip Code Amount 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 CONTRIBUTION FOR TRAVEL OR POLITICAL EXPENDITURE SCHEDULE T OUTSIDE OF TEXAS The Instruction Guide explains how to complete this form. 1 Total pages Schedule T: 2 FILER NAME 1 I, § i i , 3 ACCOUNT # (Ethics Commission Filers) D Schedule F Schedule G PAC -C PAC -E 4 Name of Contributor / Corporation or Labor Organization / Pledgor / Payee 5 Contribution / Expenditure reported on: Schedule A Schedule B 1 1 Schedule C Schedule Schedule H 1 I Schedule N COH-UC COH-T 6 Dates of travel 7 Name of person(s) traveling - — 8 Departure city or name of departure location 9 Destination city or name of destination location 10 Means of transportation 11 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 1 - 1 Schedule F Schedule G Schedule H Schedule N COH-UC 1 1 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 Means of transportation 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 LJ Schedule B Schedule C Schedule D r 1 Schedule F Schedule G I Schedule H Schedule N COH-UC COH-T PAC -C 11 PAC -E Dates of travel Name of person(s) traveling Departure city or name of departure location Destination city or name of destination location Means of transportation Purpose of travel (including name of conference, seminar, or other event) ATTACH ADDITIONAL COPIES OF THIS SCHEDULE AS NEEDED www.ethics.state.tx.us Revised 07/28/2014