150115 - Campaign Finance Report - John Nichols Texas Ethics Commission P.O.Box 12070 Austin,Texas 78711-2070 (512)463-5800 (TDD 1-800-735-2989)
CANDIDATE / OFFICEHOLDER FORM C/OH
CAMPAIGN FINANCE REPORT COVER SHEET PG 1
1 ACC.. ..OUN.....
T At 2 Total pages filed:
The C/OH Instruction Guide explains how to complete this form. (Ethics commission Filers)
3 CANDIDATE / MS/MRS/MR FIRST MI _-,_.m. __-- _.......... ................_........,.,.,.,
OFFICE USE ONLY
OFFICEHOLDER
NAME Jo.'�L) ate Re air
I D `ne�hw
�i
NICKNAME LAST SUFFIX
AJ /C A/tq
Pr/ �� �� CITY; .. .., ,..
4 CANDIDATE / ADDRESS/POBOX,A STATE; ZIP CODE �
OFFICEHOLDER �
Receipt# Amount
5 CANDIDATE/ AREA CODE PHONE NUMBER EXTENSION
OFFICEHOLDER Date
Processed
PHONE
MS/MRS/MR S�..... _.......... ... .... . ..... M�.. _
6 CAMPAIGN Dale Imaged
TREASURER
NAME
NICKNAME LAST SUFFIX
7 CAMPAIGN STREET ADDRESS(NO PO BOX PLEASE); APT/SUITE#; CITY; STATE; ZIP CODE
TREASURER
(residence or business) <`
8 CAMPAIGN AREA CODE PHONE NUMBER EXTENSION
TREASURER /(�•�
✓
9 REPORT TYPE NZ January 15 30th day before election Runoff El 15th day after campaign
t�J treasurer appointment
(officeholder only)
L] July 15 8th day before election ❑ Exceeded $500 ❑ Final report(Attach C/OH-FIR)
limit
10 PERIOD Month Day Year Month Day Year
COVERED I THROUGH
11 ELECTION ELECTION DATE ELECTIONTYPE
Month Day Year Primary,....� � Runoff � ..� General Special
12 OFFICE OFFICE HELD(if any) 13 OFFICE SOUGHT (if known)
Cdcpmz)
ffQa-&
GO TO PAGE 2
www.ethics.state.tx.us Revised 04/19/2013
Texas Ethics Commission P.O.Box 12070 Austin,Texas 78711-2070 (512)463-5800 (TDD 1-800-735-2989)
CANDIDATE / OFFICEHOLDER ® FORM C/OH
SUPPORT & TOTALS COVER SHEET PG 2
14 C/OH NAME �. .... ..... ,,..
-'rmv /��� 15 ACCOUNT# (Ethics Commission 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 WITHOUT THE CANDIDATES OR OFFICEHOLDERS 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
..... ....,mn_.....m,_ ___.._._ ..___._..._._..,,....,.._
COMMITTEE ADDRESS
�. SPECIFIC
COMMITTEE CAMPAIGN TREASURER NAME
❑ additional pages
COMMITTEE CAMPAIGN TREASURER ADDRESS
1 ..... TOTALESLITICAL O GUARANTEES
�............,,,,. .. ., .._.,..,
17 CONTRIBUTION ICAL CONTRIBUTIONS OF$50 OR LESS(OTHER THAN Q@
TOTALS TEES OF LOANS), UNLESS ITEMIZED �V
-. ................. ........... �... ..... mm.,. ., m. ...........
�
2. TOTAL POLITICAL CONTRIBUTIONS
(OTHER THAN PLEDGES,LOANS,OR GUARANTEES OF LOANS) $
3. TOTAL POLITICAL „ . ......„�„
EXPENDITURE
TOTALS EXPENDITURES OF$100 OR LESS,UNLESS ITEMIZED $
4. TOTAL POLITICAL EXPENDITURES $
CONTRIBUTION
5, TOTAL POLITICAL CONTRIBUTIONS MAINTAINED AS OF THE LAST DAY
BALANCE OF REPORTING PERIOD $
OUTSTANDING 6. TOTAL PRINCIPAL AMOUNT OF ALL OUTSTANDING LOANS AS OF THE Q
LOAN TOTALS LAST DAY OF THE REPORTING PERIOD $
18 AFFIDAVIT
I swear,or affirm, under penalty of perjury,that the accompanying report
Is trueec me und c' ct and includes all information required to be reported by
and correct
TH KLEIN 1 ,Election Code.
s Notary Public. State of Texas
My Commission Expires J
MARCH25,2018
Signature of Candidate or der
Sig Officeholder
it
AFFI
NOTARY STAMP SEAL
Sworn to ABOVE to and subscribed before me, by
the said _ 1' � , _........._......,, this the
day of '1101't _ _ ,-, 20 to certify which, witness my hand and seal of office.
Signature of officer administering oath Printed name of officer administering oath Title of finer administering oath
)
www.ethics.state.tx.us Revised 04/19/2013