HomeMy WebLinkAbout211025 -- Marie-Anne Mousseau-Holland -- Campaign Finance ReportCANDIDATE / OFFICEHOLDER
FORM C/OH
CAMPAIGN FINANCE REPORT
COVER SHEET PG 1
1 Filer ID (Ethics Commission Filers)
2 Total pages filed:
The C/OH Instruction Guide explains how to complete this form.
3 CANDIDATE /
OFFICEHOLDER
MS / MRS / MR Fr T MI
OFFICE USE ONLY
NAME..
s
J...54�i....... �
Date Received
........................ .�Z.� ................
""�"""'
NICKNAME j.AST // SUFFIX
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/41 /l C r2d
V E
4 CANDIDATE /
ADDRESS / PO BOX; APT / SUITE It CITY; STATE; ZIP CODE
OFFICEHOLDER
MAILING
� C
CANDIDATE/
AREA CODE PHONE NUMBER EXTENSION
Date Hand -delivered or Date Postmarked
OFFICEHOLDER
(
PHONE
6 CAMPAIGN
TREASURER
MS / MRS 1 MR FIRST MI
�r
Receipt #
Amount $
NAME
................. I ............W l ...........................................
Date Processed
NICKNAME LAST SUFFIX
Date Imaged
I tv 9 �In d
7 CAMPAIGN
STREET ADDRESS (NO PO BOX PLEASE); APT / SUITE #; CITY;
STATE; ZIP CODE
TREASURER
ADDRESS
f
or Business)
8 CAMPAIGN
AREA CODE PHONE NUMBER EXTENSION
TREASURER
PHONE
M
9 REPORT TYPE
❑ January 15 day before election Runoff
15th day after campaign
treasurer appointment
(Officeholder Only)
July 15 9 8th day before election Exceeded Modified
� Final Report (Attach C/OH - FRI
Reporting Limit
10 PERIOD
Month Day Year Month
Day Year
COVERED
/ ,
,() / � , J � Z t THROUGH � V �V� /ZO
11 ELECTION
ELECTION DATE
ELECTION TYPE
Month Day Year
❑ Primary ❑ Runoff ❑ Other
Description
i7 /n (
I' j n,
G
t-71
S t General ❑ Special
—r�
12 OFFICE
OFFICE HELD (if any)
13 OFFICE SOUGHT (ifknown)
VAckce
Ck Vj C01jmC
14 NOTICE FROM
THIS BOX IS FOR NOTICE OF POLITICAL CONTRIBUTIONS ACCEPTED OR POLITICAL EXPENDITURES MADE BY POLITICAL COMMITTEES TO SUPPORT
POLITICAL
THE CANDIDATE / OFFICEHOLDER. THESE EXPENDITURES MAY HAVE BEEN MADE WmK)UT rHE CANDIDATES 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 TYPE
COMMITTEE NAME
GENERAL
COMMITTEE ADDRESS
Additional Pages
SPECIFIC
COMMITTEE CAMPAIGN TREASURER NAME
COMMITTEE CAMPAIGN TREASURER ADDRESS
GO TO PAGE 2
Forms provided by Texas Ethics Commission www.ethics.state.tx.us Revised 8/17/2020
CANDIDATE / OFFICEHOLDER FORM C/OH
CAMPAIGN FINANCE REPORT COVER SHEET PG 2
15 C/OH NAME
16 Filer ID (Ethics Commission Filers)
q
n �ttw d
17 CONTRIBUTION
1. TOTAL UNITEMIZED POLITICAL CONTRIBUTIONS (OTHER THAN
TOTALS
PLEDGES, LOANS, OR GUARANTEES OF LOANS, OR
$
CONTRIBUTIONS MADE ELECTRONICALLY)
2. TOTAL POLITICAL CONTRIBUTIONS
$ n�
E1
...................
(OTHER THAN PLEDGES, LOANS, OR GUARANTEES OF LOANS)
TOTALSEXPENDITURE
3. TOTAL UNITEMIZED POLITICAL EXPENDITURE.
Q
..................
4. TOTAL POLITICAL EXPENDITURES
$ Q
CONTRIBUTION
BALANCE
5. TOTAL POLITICAL CONTRIBUTIONS MAINTAINED AS OF THE LAST DAY
$ �)
..................
OF REPORTING PERIOD
OUTSTANDING
LOAN
6. TOTAL PRINCIPAL AMOUNT OF ALL OUTSTANDING LOANS AS OF THE
$
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 of Candidate or Officeholder
Please complete either option below:
JACKIE RANGEL
*®* Notary Public -State of Texas
+ IN 13268326-5
(I)Affidavit �
Nly Comm. E)*a 01&2M
NOTARY STAMP/SEAL
/�j,�,f�
Swornto and subscribed before me by � i C I 1 Yl b"1. M 0 4SStrL(� I thisstthle day of bC r
614
20 to certify whI0hi—,'VyiJA0s my hand ands al of office.
ionat re of icer administering a (Tinted name of officer ad inistering oath Title of officer administering oath
i
(2) Unsworn Declaration •
My name is and my date of birth is
My address is ,
(street) (city) (state) (zip code) (country)
Executed in County, State of on the day of 20
(month) (year)
Signature of Candidate/Officeholder (Declarant)
Forms provided by Texas Ethics Commission vwvw.ethics.state.tx.us Revised 8/17/2020