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HomeMy WebLinkAbout191001 - Campaign Finance Report - Karl P. MooneyMONETARY POLITICAL CONTRIBUTIONS SCHEDULE Al The Instruction Guide explains how to complete this form. 1 Total pages Schedule Al 2 FILER NAME `erg 3 Filer ID (Ethics Commission Filers) 4 Date Full name of contributor ❑ ou -of-state PAC (to#: Amount of contribution ($) 6 Contributor address; City; State; Zip Code 8 Principal occ pation / Job title (See Instructions) 9 Em toyer (Se,� Instructions) Date Full.naTTM of contributor ❑ out-of-state PAC (to#: Amount of contribution ($) li� s./ C)o utor address; City; Sta Zip Code '2 Al 6� d r I Princ�accupat� b ee In tructi ns) f E Io eee Instructions) Date Full name of con utor ❑ out-of-state PAC (ICE#: A ount of contribution ($) Contributor. address; City; State; Zip Code a Principp�l occupation / Job title (See Instructions) Emlo e ee Instructions) Date Fu name of contributor > ❑ out-of-state PAC tloTM: Amount of contribution ($) F; Contributor address; City; State: Zip Code Principal occupation job tit e (See Instructions) Er t�ploy�e'r (Seeii Instructions) ATTACH ADDITIONAL COPIES OF THIS SCHEDULE AS NEEDED If contributor is out-of-state PAC, please see instruction guide for additional reporting requirements. Forms provided by Texas Ethics Commission www.ethics.state.tx.us Revised 9/8/2015 MONETARY POLITICAL CONTRIBUTIONS SCHEDULE Al The Instruction Guide explains how to complete this form. 1 Total pages Schedule At__7 2 FILER NAME /ten 3 Filer ID (Ethics Commission Filers) c ,/ rX /1 4 Date 5 Full nam of contri utor out-of-state PAC (ID#: 7 Amount of contribution ($) ,, 6 Contributor address; City; State; Zip Code 8 Principal occupation / Job titl (See I ctions) `g Employer k8yj Instru ns) 4ull rDate name of cont ibuto ❑ out-of-state PAC (ID#: Amount of contribution ($) 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#: . . . . . . . . . . . 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#: Contributor address: City; State; Zip Code Principal occupation / Job title (See Instructions) Employer (See Instructions) Amount of contribution ($) Amount of contribution ($) ATTACH ADDITIONAL COPIES OF THIS SCHEDULE AS NEEDED If contributor is out-of-state PAC, please see instruction guide for additional reporting requirements. Forms provided by Texas Ethics Commission www.ethics.state.tx.us Revised 9/8/2015 SUBTOTALS - C/OH FORM C/OH COVER SHEET PG 3 19 FILER NAME 20 Filer ID (Ethics Commission Filers) � �/ , r 21 SCHEDULE S BTOTALS / SUBTOTAL NAMEOFSCHEDULE ff AMOUNT 1. 14�SCHEDULEAI: MONETARY POLITICAL CONTRIBUTIONS $�S� 2- F_/fr SCHEDULE A2: NON -MONETARY (IN -KIND) POLITICAL CONTRIBUTIONS $ 0 3. f" SCHEDULE B: PLEDGED CONTRIBUTIONS $ 4. SCHEDULE E: LOANS $ C 5. SCHEDULE F1: POLITICAL EXPENDITURES MADE FROM POLITICAL CONTRIBUTIONS $ 6. �' SCHEDULE F2: UNPAID INCURRED OBLIGATIONS $ 7" SCHEDULE F3: PURCHASE OF INVESTMENTS MADE FROM POLITICAL CONTRIBUTIONS $ i 8" SCHEDULE F4: EXPENDITURES MADE BY CREDIT CARD $ i 9. SCHEDULE G: POLITICAL EXPENDITURES MADE FROM PERSONAL FUNDS $ 10. SCHEDULE H: PAYMENT MADE FROM POLITICAL CONTRIBUTIONS TO A BUSINESS OF C/OH $ r-� 11. SCHEDULE 1: NON -POLITICAL EXPENDITURES MADE FROM POLITICAL CONTRIBUTIONS $ / 12 '�SCHEDULE K: INTEREST, CREDITS, GAINS, REFUNDS, AND CONTRIBUTIONS $ RETURNED TO FILER Forms provided by Texas Ethics Commission www.ethics.state.tx.us Revised 9/8/2015 NON -MONETARY (IN -KIND) POLITICAL CONTRIBUTIONS SCHEDULE A2 The Instruction Guide explains how to complete this form. 1 Total pages Schedule A2: F 2 -f f f Ethics Commission Filers FILER NAME ,% 3 Filer ID F �� ( ) 4 TOTAL 0( UNITEMIZED IN -KIND POD, ICAL CONTRIBUTIONS 5 Date 6 Full name of contributor ❑ out-of-state PAC (IDF: 8 Amount of 9 In -kind contribution Contribution $ description . . . . . . . . . . . . . . . . . . 7 Contributor address; City; State; Zip Code ❑Check if travel outside of Texas. Complete Schedule T. 10 Principal occupation / Job title (FOR NON -JUDICIAL) (See Instructions) 11 Employer (FOR NON-JUDICIAL)(See Instructions) 12 Contributor's principal occupation (FOR JUDICIAL) 14 Contributor's employer/law firm (FOR JUDICIAL) 16 If contributor is a child. law firm of parent(s) (if any) (FOR JUDICIAL) Date Full name of contributor ❑ out-of-state PAC (IDii: 13 Contributor's job title (FOR JUDICIAL) (See Instructions) 15 Law firm of contributor's spouse (if any) (FOR JUDICIAL) . . . . . . . . . . . . . . . . . . . . . . . . Contributor address; City; State; Zip Code Principal occupation / Job title (FOR NON -JUDICIAL) (See Instructions) Contributor's principal occupation (FOR JUDICIAL) Contributor's employer/law firm (FOR JUDICIAL) If contributor is a child, law firm of parent(s) (if any) (FOR JUDICIAL) Amount of In -kind contribution Contribution $ description Check if travel outside of Texas. Complete Schedule T. Employer (FOR NON-JUDICIAL)(See Instructions) Contributor's job title (FOR JUDICIAL) (See Instructions) Law firm of contributor's spouse (if any) (FOR JUDICIAL) ATTACH ADDITIONAL COPIES OF THIS SCHEDULE AS NEEDED If contributor is out-of-state PAC, please see instruction guide for additional reporting requirements. Forms provided by Texas Ethics Commission www.ethics.state.tx.us Revised 9/8/2015 PLEDGED CONTRIBUTIONS The Instruction Guide explains how to complete this form. 1 Total pages Schedule B: 2 FILER NAME 3 Filer ID (Ethics Commission Filers) 4 TOTAL OF 6NITEMIZED PLEDGES S Date 6 Full name of pledgor ❑ ou of -state PAC (ID#: 8 Amount 9 In -kind contribution of Pledge $ description . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .A? 7 Pledgor address; City: State; Zip Code ❑ Check if travel outside of Texas. Complete Schedule T. 10 Principal occupation / Job title (See Instructions) 111 Employer (See Instructions) Date Full name of pledgor ❑ out-of-state PAC (011: Amount In -kind contribution of Pledge $ description . . . . . . . . . . . . . . . . . . . . . . . . . . . . Pledgor address; City; State; Zip Code ❑ Check if travel outside of Texas. Complete Schedule T. Principal occupation / Job title (See Instructions) I Employer (See Instructions) Date Full name of pledgor ❑ out-of-state PAC (ID#: Amount of In -kind contribution Pledge $ description . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Pledgor address; City; State; Zip Code ❑ Check if travel outside of Texas. Complete Schedule T. Principal occupation / Job title (See Instructions) Employer (See Instructions) Date Full name of pledgor ❑ out-of-state PAC (ID#: Amount of In -kind contribution Pledge $ description . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Pledgor address; City; State; Zip Code ❑ Check if travel outside of Texas. Complete Schedule T. Principal occupation / Job title (See Instructions) I 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. Forms provided by Texas Ethics Commission www.ethics.state.tx.us Revised 9/8/2015 LOANS SCHEDULE E The Instruction Guide explains how to complete this form. 1 Total pages Schedule E 2 FILER NAME 3 Filer ID (Ethics Commission Filers) 4 TOTAL OF`UNITEMIZED LOANS $ 5 Date of loan 7 Name of lender ❑ out-of-state PAC (IDff: 9 Loar� Amoun � GG' . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 6 Is lender 8 Lender address; City; State; Zip Code 10 Interest rate a financial Institution? 11 Maturity date Y N 12 Principal occupation / Job title (See Instructions) 13 Employer (See Instructions) 14 Description of Collateral 15 Check if personal funds were deposited into political account (See Instructions) ❑ none ❑ 16 GUARANTOR 17 Name of guarantor 19 Amount Guaranteed ($) INFORMATION . . . . . . . . . . . . . 18 Guarantor address; City; State; Zip Code ❑ not applicable 20 Principal Occupation (See instructions) Date of loan Name of lender 21 Employer (See Instructions) ❑ out-of-state PAC (ID#-. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Is lender Lender address; City; State; Zip Code a financial Institution? Y N Principal occupation / Job title (See Instructions) Employer (See Instructions) Loan Amount ($) Interest rate Maturity date Description of Collateral Check if personal funds were deposited into political account (See Instructions) ❑ none ❑ GUARANTOR Name of guarantor Amount Guaranteed ($) INFORMATION Guarantor address; City; State; Zip Code ❑ not applicable 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. Forms provided by Texas Ethics Commission www.ethics.state.tx.us Revised 9/8/2015 POLITICAL EXPENDITURES MADE FROM POLITICAL CONTRIBUTIONS EXPENDITURE CATEGORIES FOR BOX $(a) Advertising Expense Event Expense LoanRepayment/Reimbursement Accounting/Banking Fees Office Overhead/Rental Expense Consulting Expense Food/Beverage Expense Polling Expense Contributions/Donations Made By Gift/Awards/Memorials Expense Printing Expense Candidate/Officeholder/Political Committee Legal Services Salaries/Wages/Contract Labor Credit Card Payment The Instruction Guide explains how to complete this form. 1 Total pages Schedule F1: 2 FILER NAME 4 Date 5 Payee name 6 Amount ($) 5 7 Payee address; City; State; Zip Code PURPOSE OF EXPENDITURE 9 Complete ONLY if direct expenditure to benefit C/OH Date Amount ($) PURPOSE OF EXPENDITURE Complete ONLY if direct expenditure to benefit C/OH Date Amount ($) PURPOSE OF EXPENDITURE (a) Category (See Categories listed at the top of this schedule) Complete ONLY if direct expenditure to benefit C/OH Candidate / Officeholder name Payee name Payee address; City; State; Zip Code Category (See Categories listed at the top or this schedule) Candidate / Officeholder name Payee name Payee address; City; State; Zip Code Category (See Categories listed at the top of this schedule) Candidate / Officeholder name SCHEDULE F1 Solicitation/Fundraising Expense Transportation Equipment & Related Expense Travel In District Travel Out Of District Other (enter a category not listed above) 3 Filer ID (Ethics Commission Filers) (b) Description ❑ Check if travel outside of Texas. Complete Schedule T. ❑ Check if Austin, TX, officeholder living expense Office sought Office held Description ❑ Check if travel outside of Texas. Complete Schedule T. ❑ Check if Austin. TX, officeholder living expense Office sought Office held Description ❑ Check if travel outside of Texas. Complete Schedule T. ❑ Check if Austin, TX, officeholder living expense Office sought Office held ATTACH ADDITIONAL COPIES OF THIS SCHEDULE AS NEEDED Forms provided by Texas Ethics Commission www.ethics.state.tx.us Revised 9/8/2015 UNPAID INCURRED OBLIGATIONS EXPENDITURE CATEGORIES FOR BOX 10(a) Advertising Expense Event Expense Lcan Repayment/Reimbursement Accounting/Banking Fees Office Overhead/Rental Expense Consulting Expense Food/Beverage Expense Polling Expense Contributions/Donations Made By Gift/Awards/Memorials Expense Printing Expense Candidate/Officeholder/Political Committee Legal Services Salaries/Wages/Contract Labor The Instruction Guide explains how to complete this form. 1 Total pages Schedule F2: I 2 FILE 'ME 4 TOTAL OF UNITEMIZEUNPAID INCURRED ®BLIGAT NS 5 Date 6 Payee name 7 Amount ($) 9 TYPE OF EXPENDITURE 10 PURPOSE OF EXPENDITURE 11 Complete ONLY if direct expenditure to benefit C/OH Date Amount ($) TYPE OF EXPENDITURE PURPOSE OF EXPENDITURE Complete ONLY if direct expenditure to benefit C/OH 8 Payee address; City; State; Zip Code SCHEDULE F2 Solicitation/Fundraising Expense Transportation Equipment & Related Expense Travel In District Travel Out Of District Other (enter a category not fisted above) 3 Filer ID (Ethics Commission Filers) Political Non -Political (a) Category (See Categories listed at the top of this schedule) (b) Description Check if travel outside of Texas. Complete ScheduleT. Check if Austin, TX, officeholder living expense Candidate / Officeholder name Office sought Office held Payee name Payee address; City; State; Zip Code El Political Non -Political Category (See Categories listed at the top of this schedule) Description ElCheck if travel outside of Texas. Complete Schedule T. Check if Austin, TX, officeholder living expense Candidate / Officeholder name Office sought Office held ATTACH ADDITIONAL COPIES OF THIS SCHEDULE AS NEEDED Forms provided by Texas Ethics Commission www.ethics.state.:x.us Revised 9/8/2015 PURCHASE OF INVESTMENTS MADE FROM POLITICAL CONTRIBUTIONS SCHEDULE F3 1 Total pages Schedule F3: The Instruction Guide explains how to complete this form. 2 FILER NAME 3 Filer ID (Ethics Commission Filers) 4 Date 5 fName of person from whom investment i urchased . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 6 Address of person from whom investment is purchased; City; State; Zip Code 7 Description of investment 8 Amount of investment ($) Date Name of person from whom investment is purchased . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Address of person from whom investment is purchased; City; State; Zip Code Description of investment Amount of investment ($) ATTACH ADDITIONAL COPIES OF THIS SCHEDULE AS NEEDED Forms provided by Texas Ethics Commission www.ethics.state.tx.us Revised 9/8/2015 EXPENDITURE CATEGORIES FOR BOX 10(a) Advertising Expense Event Expense Loan Repayment/Reimbursement Accounting/Banking Fees Office Overhead/Rental Expense Consulting Expense Food/Beverage Expense Polling Expense Contributions/Donations Made By Gift/Awards/Memorials Expense Printing Expense Candidate/Officeholder/Political Committee Legal Services Salaries/Wages/Contract Labor The Instruction Guide explains how to complete this form. 1 Total pages Schedule F4: 2 FILER NAIYE 1 4 TOTAL OF UN ITEMIZED EXPENDITURES CHARGED T CREDIT CARD 5 Date 6 Payee name I 7 Amount ($) 9 TYPE OF EXPENDITURE 10 PURPOSE OF EXPENDITURE 11 Complete ONLY if direct expenditure to benefit C/OH Date Amount ($) TYPE OF EXPENDITURE PURPOSE OF EXPENDITURE Complete ONLY if direct expenditure to benefit C/OH 8 Payee address; City; State; Zip Code SCHEDULE F4 Solicitation/Fundraising Expense Transportation Equipment & Related Expense Travel In District Travel Out Of District Other (enter a category not listed above) 3 Filer ID (Ethics Commission Filers) $ (m on ❑ Political Non -Political (a) Category (See Categories listed at the top of this schedule) (b) Description ❑ Check if travel outside of Texas. Complete Schedule T. El Check if Austin, TX, officeholder living expense Candidate / Officeholder name Office sought Office held Payee name Payee address; City; State; Zip Code ❑ Political ❑ Non -Political Category (See Categories listed at the top of this schedule) Description ❑ Check if travel outside of Texas. Complete Schedule T. ❑ Check if Austin, TX, officeholder living expense Candidate / Officeholder name Office sought Office held ATTACH ADDITIONAL COPIES OF THIS SCHEDULE AS NEEDED Forms provided by Texas Ethics Commission www.ethics.state.tx.us Revised 9/8/2015 POLITICAL EXPENDITURES MADE FROM PERSONAL FUNDS EXPENDITURE CATEGORIES FOR BOX 8(a) Advertising Expense Event Expense Loan Repayment/Reimbursement Accounting/Banking Fees Office Overhead/Rental Expense Consulting Expense Food/Beverage Expense Polling Expense Contributions/Donations Made By Glft/Awards/Memorials Expense Printing Expense Candidate/Officeholder/Political Committee Legal Services Salaries/Wages/Contract Labor Credit Card Payment The Instruction Guide explains how to complete this form. 1 Total pages Schedule G: 2 FILER NAM -� Vyr 4 Date 5 Payee na 6 Amount ($) f. t. G ❑Reimbursenentfrom political contributions intended 8 7 Payee address; City; State; Zip Code (a) Category (See Categories listed at the top of this schedule) (b) Description PURPOSE ❑ Check if travel outside of Texas. Complete ScheduleT. OF EXPENDITURE ❑ Check if Austin, TX, officeholder living expense g Complete ONLY if direct Candidate / Officeholder name Office sought Office held expenditure to benefit C/OH SCHEDULE G Solicitation/Fundraising Expense Transportation Equipment & Related Expense Travel In District Travel Out Of District Other (enter a category not listed above) 3 Filer ID (Ethics Commission Filers) Date Payee name Amount ($) Payee address; City; State; Zip Code ❑Reimbursement from political contributions intended Category (See Categories listed at the top of this schedule) (b) Description PURPOSE ❑ Check if travel outside of Texas. Complete Schedule OF EXPENDITURE ❑ Check if Austin, TX, officeholder living expense Complete ONLY if direct Candidate / Officeholder name Office sought Office held expenditure to benefit C/OH Date Payee name Amount ($) Payee address; City; State; Zip Code ❑Reimbursement from political contributions intended Category (See Categories listed at the top of this schedule) (b) Description PURPOSE OF Check if travel outside of Texas. Complete Schedule EXPENDITURE ❑ Check if Austin, TX, officeholder living expense Complete ONLY if direct Candidate / Officeholder name Office sought Office held expenditure to benefit C/OH ATTACH ADDITIONAL COPIES OF THIS SCHEDULE AS NEEDED Forms provided by Texas Ethics Commission www.ethics.state.tx.us Revised 9/8/2015 PAYMENT MADE FROM POLITICAL CONTRIBUTIONS TO A BUSINESS OF C/OH SCHEDULE H EXPENDITURE CATEGORIES FOR BOX 8(a) Advertising Expense Event Expense Loan Repayment/Reimbursement Solicitation/Fundraising Expense Accounting/Banking Fees Office Overhead/Rental Expense Transportation Equipment & Related Expense Consulting Expense Food'Beverage Expense Polling Expense Travel In District Contributions/Donations Made By Gift/Awards,/Memorials Expense Printing Expense Travel Out Of District Candidate/Officeholder/Political Committee Legal Services Salaries/Wages/Contract Labor Other (enter a category not listed above) Credit Card Payment The Instruction Guide explain%s tow to complete this form. 1 Total pages Schedule H: 2 FILER NAM.E , ,'%, / / %%1/74 3 Filer ID (Ethics Commission Filers) 4 Date 5 / v Business 4a66.4. _ / j / 6 Amount ($) 7 Business address; City; State; Zip Code /1 $ (a) Category (See Categories listed at the top of this schedule) (b) Description PURPOSE ❑ CheckiftraveloutsideofTexas.CompleteScheduleT. OF EXPENDITURE Check if Austin, TX. officeholder living expense 9 Complete ONLY if direct Candidate / Officeholder name Office sought Office held expenditure to benefit C/OH Date Business name Amount ($) Business address; City; State; Zip Code Category (See Categories listed at the top of this schedule) Description PURPOSE ❑ Check if travel outside of Texas. Complete ScheduleT. OF El Check if Austin, TX, officeholder living expense EXPENDITURE Complete ONLY if direct Candidate / Officeholder name Office sought Office held expenditure to benefit C/OH Date Business name Amount ($) Business address; City; State; Zip Code Category (See Categories listed at the top of this schedule) Description PURPOSE ❑ Check if travel outside of Texas. Complete Schedule T. OF ❑ Check if Austin, TX. officeholder living expense EXPENDITURE Complete ONLY if direct Candidate / Officeholder name Office sought Office held expenditure to benefit C/OH ATTACH ADDITIONAL COPIES OF THIS SCHEDULE AS NEEDED Forms provided by Texas Ethics Commission www.ethics.state.tx.us Revised 9/8/2015 NON -POLITICAL EXPENDITURES MADE FROM POLITICAL CONTRIBUTIONS The Instruction Guide explains how to complete this form. a 1 Total pages Schedule I: 2 FILER N ,- 4 Date 5 Pay:ante i 6 Amount ($) 7 Payee address; City; State; Zip Code I� 8 (a)Category (See instructions for examples of acceptable PURPOSE categories.) OF EXPENDITURE Date Payee name Amount ($) Payee address; City; State; Zip Code Category (See instructions for examples of acceptable PURPOSE categories.) OF EXPENDITURE Date Payee name Amount ($) Payee address; City; State; Zip Code PURPOSE Category (See instructions for examples of acceptable OF categories.) EXPENDITURE Date Payee name Amount {$) Payee address; City; State; Zip Code Category (See instructions for examples of acceptable PURPOSE categories.) OF EXPENDITURE SCHEDULE 3 Filer ID (Ethics Commission Filers) (b) Description (See instructions regarding type of information required.) Description (See instructions regarding type of information required.) Description (See instructions regarding type of information required.) Description (See instructions regarding type of information required.) ATTACH ADDITIONAL COPIES OF THIS SCHEDULE AS NEEDED Forms provided by Texas Ethics Commission www.ethics.state.tx.us Revised 9/8/2015 INTEREST, CREDITS, GAINS, REFUNDS, AND CONTRIBUTIONS RETURNED TO FILER SCHEDULE K The Instruction Guide explains how to complete this form. 1 Total pages Schedule K: 2 FILER NAME .,� 3 Filer ID (Ethics Commission Filers) 4 Date 5 ame of person from who Innount is eceived 8 Amount ($) 6 Address of person from whom amount is received; City; State; Zip Code Date Date Date 7 Purpose for which amount is received Check if political contribution returned to filer Name of person from whom amount is received Amount ($) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Address of person from whom amount is received; City; State; Zip Code Purpose for which amount is received Name of person from whom amount is received Check if political contribution returned to filer . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Address of person from whom amount is received; City; State; Zip Code Purpose for which amount is received Name of person from whom amount is received Amount ($) Check if political contribution returned to filer . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Address of person from whom amount is received; City; State; Zip Code Amount ($) Purpose for which amount is received 0 Check if political contribution returned to filer ATTACH ADDITIONAL COPIES OF THIS SCHEDULE AS NEEDED Forms provided by Texas Ethics Commission www.ethics.state.tx.us Revised 9/8/2015 IN -KIND CONTRIBUTIONS OR POLITICAL EXPENDITURES FOR TRAVEL OUTSIDE OF TEXAS SCHEDULE T The Instruction Guide explainshowto complete this form. 2 FILER NAME4ribt.r i J 4 Name of Con / Corporation or Labor Organization / /edgor/ Payee 5 Contribution / Expenditure reported on: ❑ Schedule A2 ❑ Schedule B ❑ Schedule B(J) ❑ Schedule C2 []Schedule F2 ❑ Schedule F4 ❑ Schedule G ❑ Schedule H 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 1 Total pages Schedule T:f 3 Filer ID (Ethics Commission Filers) ❑ Schedule D ❑ Schedule F1 ❑ Schedule COH-UC ❑ Schedule B-SS 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 A2 ❑ Schedule B ❑ Schedule B(J) ❑ Schedule C2 ❑ Schedule D ❑ Schedule F1 ❑ Schedule F2 ❑ Schedule F4 ❑ Schedule G ❑ Schedule H ❑ Schedule COH-UC ❑ Schedule B-SS 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 I 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 A2 ❑ Schedule B ❑ Schedule B(J) ❑ Schedule C2 ❑ Schedule F2 ❑ Schedule F4 ❑ Schedule G ❑ Schedule H Dates of travel Name of person(s) traveling Departure city or name of departure location Destination city or name of destination location ❑ Schedule D ❑ Schedule F1 ❑ Schedule COH-UC ❑ Schedule B-SS Means of transportation I Purpose of travel (including name of conference; seminar, or other event) ATTACH ADDITIONAL COPIES OF THIS SCHEDULE AS NEEDED Forms provided by Texas Ethics Commission www.ethics.state.tx.us Revised 9/8/2015