HomeMy WebLinkAbout230117 -- Amended Affidavit for Candidate -- Nicole GallucciCORRECTION/AMENDMENT AFFIDAVIT
FOR CANDIDATE/OFFICEHOLDER
1 Filer ID (Ethics Commission Filers)
3 CANDIDATE/
OFFICEHOLDER
NAM
4 ORIGINAL REPORT
TYPE
@i JiiifiSeiAR
MUNAME
'~NICole��
January 15
ally 75
fl 39th day before ewe
8h day before election
2 Total pages Mad_
FIRST
CaNei' on
5 ORIGINAL PERIOD Month Day
COVERED
LAST
El Runoff
11
Year
MI Cote
8E1 i, n,n ash :y
iriat
15th day after treasurer
appointment (oirrcehaider only)
0,g/ 31 /.o2 THRMGH
6 EXPLANATION OF CORRECTION
SUFFIX
Final report
Ditrer (specify)
FORM COR-C/OH
OFFICE USE ONLY
Date Received
Date Hand -delivered or Date Postmarked
Receipt
Date Processed
#40r Day } reaT
D / i 2 / 2o9-
. imaged
Arrmard S
7 SIGNATURE I swear, or affirm, under penalty of perjury, that this corrected report is true and correct.
Check ONLY if applicable:
r Serriiannuat reports: I swear, or affirm, that the original report was made in good faith and without an intent to
t J mislead Of to misrepre-sent the information contained in the report
Other reports: I swear, or dFlii l t i, that I am filing this report not later than the 9 4th business day after the
date I learned that the report as originally filed is inaccurate or in ate. I swear, or aflirrrr, that any error or
omission in the report as originally filed was made in good faith.
Please complete ei# ter option below:
(1) Affidavit
NOTARY STAMP/SEAL
Sworn to and subscribed before me by
20 . bcedifywhcKwitness my hand and seal ofot .
Signature of officer administering oath
Printed name of officer administering oath
Ns the day of
Title of officer administering oath
Pik
(2) Unsworn Declaration
Myname isCafYi€,ron IV;C t°:let'i kIACC.[
MYaddress is i 05 CAI e r r I Si—ir ee4
and my date of birth is Of D 1 gO
ram)1 eje-s4 C i X, i1 4o v5A
(mot) (city) t (state) (zip code) (country)
Executed in C ,r X q ' a Z-0 5 County, State of t , on the I / day of .) a C13 i , 20 .c2, .
(year)
Signaof Card' idae r (Declarant)
Remember To Attach Any Part Of The Campaign Finance Report Form Needed To Report And Explain Corrections
Forms provided by Texas Ethics Co€ninlseo i v ww_etlhics.sfate.iti� us
Revised 411ff:2021
MONETARY POLITICAL CONTRIBUTIONS
If the requested information is not applicable, DO NOT include this page in the report.
The Instruction Guide explains how to complete this form.
2 FILER NAME CarqeP09 /4I'Co)e Gai4UCei°
4 Date 5 Full name of contributor out-of-state PAC t1C=
f 2 2 6K a iTin a 3+e-War f
Contributor address: City; State; Zip Code
8 Principal occupation / Job title (See instructions)
Date
P eci-o r oc PR
SCHEDULE Al
Total pages Schedule Al:
3 Filer in (Ethics Commission Filers)
7 Amount of contribution ($)
�0
9 Employer (See Instructions)
Pric C®lirgLAn}1-1
Full name of contributor 0 out-of-state PAC (IDe:
Contributor address; City;
Principal occupation / Job title (See Instructions)
Date
Full name of contributor 0 out-of-state PAC (9D:
State; Zip Code
Employer (See Instructions)
}
Contributor address; City;
Principal occupation I Job title (See Instructions)
Date Full name of contributor
Amount of contribution ($)
State; Zip Code
Employer (See Instructions)
❑ out-of-state PAC (IDS_
Contributor address;
Principal occupation ! Job title (See Instructions)
City; State; Zip Code
Amount of contribution ($)
Employer (See instructions)
Amount of contribution ($)
ATTACH ADDITIONAL COPIES OF THIS SCHEDULE AS NEEDED
If contributor is out-of-state PAC, please see Instruction guide for additional roporting requirements.
Forty-s provided by Texas Ethics Commission www.etracs,state.m.us
Revised 11115/2022
POLITICAL EXPENDITURES MADE
FROM POLITICAL CONTRIBUTIONS
If the requested information is not applicable, DO NOT include this page in the report,
EXPENDITURE CATEGORIES FOR BOX 8(a)
Advertising Expense Evont Expense Lean Repa ttReimbursement Soficitation,1 undraisin9 E xpense
Acr;oun#ingJEsankfng Fees Office CNerheadlF2ental Expense Transportation Equipment & Related Expense
Consulting Expense Food)6everage Expense Foiling Expense Travel in District
Contributioneponations Made By GM/Awards/Memorials Expense Printing Expense Travel Out Of District
Oartdidafe(OffrcebolderiPolitital Committee Legal Services SalariestWages+Contract Labor Otter (entera dory not listed above)
Cre3PCarctPa}mtent
The Instruction Guide explains how to complete this form.
SCHEDULE FI
I Total pages Schedule Ft 2 FILER NAME I 3 Filer ID (Ethics Commmssion Filers)
r y
1 CasG ten si tj;Cole a,itit_C6
4 Date 15 Payee name
l5 /22 ► F0s1- nonveefir e bank GC T exas
6 Amount ($) 7 Payee address; City; State; Zip Code
*12
8 (a) Category (See Categories listed at the top atthis schedule) (b) Description
Fees rn0f1 ervj uz-
PURPOSE
OF
EXPENDITURE
1 9 Complete ONLY if direct
expenditure to benefit C/OH
Date
1(45/22
Amount ($)
PURPOSE
OF
EXPENDITURE
(C) {7 Check if travel outside of Texas. CompleteSchedufe 7: fl Check it Austin, TX, ofF.caftoider living expense
Candidate 1 Officeholder name
IPayee name
Complete ONLY if direct
expenditure to benefit C/OH
Date
Amount ($)
PURPOSE
OF
EXPENDITURE
Office sought Office held
4 r rs+ COnVe- ui e RCS.. f?k o Te.) Ds
Payee address;
Category (See Categories listed at the lop of this schedule)
City; State; Zip Code
Description
1'65 fri a 0y 5ry c C4--
P1Chcd travel outside of Texas. Complete ScheduieT.
Candidate / Officeholder name
Payee name
Payee address;
I Check it Austin, TX, officeholder living expense
Office sought Office held
City;
Category (See Categories fisted at the top of this schedule( Description
State; Zip Code
1 ! Check iftravel outsideofTexas. ComprefeScheduleT. I Check if Austin, TX, officeholder living expense
Complete ONLY if direct Candidate / Officeholder name Office sought Office held
vxpenditute .o bene€t t OF
ATTACH ADDITIONAL COPIES OF THIS SCHEDULE AS NEEDED
Forms provided by Texas Ethics Commission vwwv.ethics.state.tx.us Revised 11/15/2022