HomeMy WebLinkAboutDesignations of Campaign Treasurer-Campaign Finance Reports & Filings-George Boll-2/23/2005 Texas Ethics Commission P.O.Box 12070 Austin,Texas 78711-2070 (512)463-5800 1-800-325-8506
APPOINTMENT OF A CAMPAIGN FORM CTA
TREASURER BY A CANDIDATE PG 1
1 I Total pages riled:
See CTA Instruction Guide for detailed instructions.
2 I MS/MRS 0 FIRST J�/MI OFFICE USE ONLY
CANDIDATE 6! D (J � NA Al
NAME Acct. # _„^ ^N
NICKNAME LAST/ SUFFIX 1.,,__ '`-` ` ” ��-�// g^�
3 I ADDRESS/PO BOX; APT/SUITE#: CITY; STATE; ZIP CODE I FEB a.) Cl /0 05
MAILING
CANDIDATE
/ ld� Fc� � L
J
ADDRESS
Co ilt y-01 i / 77. 76.90�(` CITY 0 SECRICE ETARY'S
AREA CODE PHONE NUMBER EXTENSION HD/PM
CANDIDATE
PHONE ( ?I 7 ) oz-C4)0 n2-23-05/09 : 57 RC\/II
1 3S �
Data Processed
5 1 /v/ A Date Imaged
OFFICE HELD
(if any)
6 I OFFICE SOUGHT 6;111._ e /, iiae 1
(if known)
7 MS E1.9MR FIRST MI NICKNAME LAST SUFFIX
CAMPAIGN j
TREASURER Bale f✓ iu - ''�,
NAME
81 STREET ADDRESS (NO PO BOX PLEASE); APT/SUITE#; CITY, STATE; ZIP CODE
CAMPAIGN
TREASURER f 9v4 EA-fir -, ( r.
STREET j \ ,
ADDRESS I(J/ILiav/ l/e. , TV_ 7/,03`i
(Residence or business)
I AREA CODE PHONE NUMBER EXTENSION
CAMPAIGN \
PHONE EASURER ( r 7 )17 ) -2isti . 91;1
10
CANDIDATE I am aware of the Nepotism Law, Chapter 573 of the Texas Government Code.
SIGNATURE
I am aware of my responsibility to file timely reports as required by title 15 of
the Election ode.
I am aware ref the restrictions in title 15 of the Election Code on contributions
from c,ar'• ations and I-•• organizations.
/‹?
Signature PC r.ire Date Signed/
/ G IF TO PAGE 2
t • Printed on recycled paper (Revised 01114/2004)
Texas Ethics Commission P.O.Box 12070 Austin,Texas 78711-2070 (512)463-5800 1-800-325-8506
CANDIDATE MODIFIED FORM CTA
REPORTING DECLARATION PG 2
11I
CANDIDATE NAME
12I COMPLETE THIS SECTION ONLY IF YOU ARE CHOOSING MODIFIED
MODIFIED
REPORTING REPORTING.
DECLARATION
•• This declaration must be filed no later than the 30th day before the
first election to which the declaration applies. ••
•• The modified reporting option is valid for one election cycle only. ••
(An election cycle includes a primary election,a general election,and any related runoffs.)
•• Candidates for the office of state chair of a political party and candidates for
county chair of a political party may NOT choose modified reporting. ••
I do not intend to accept more than $500 in political contributions or
make more than $500 in political expenditures (excluding filing fees)
in connection with any future election within the election cycle.
I understand that if either one of those limits is exceeded, I will be
required to file pre-election reports and, if necessary, a runoff
report.
Year of election(s)or election cycle to Signature of Candidate
which declaration applies
This appointment is effective on the date it is filed with the appropriate filing authority.
r1 Printed on recycled paper
(Revised 07/14/2004)
Texas Ethics Commission P.O.Box 12070 Austin,Texas 78711-2070 (512)463-5800 1-800-325-8506
CANDIDATE / OFFICEHOLDER FORM C/OH
CAMPAIGN FINANCE REPORT COVER SHEET PG 1
The C/OH INSTRUCTION GUIDE explains how to complete 1 ACCOUNT# 2 Total pages filed:
P P (Ethics Commission ission filers) /
this form. iV A
3 CANDIDATE/ MS r MRS/ AR FIRST r Mt
OFFICEHOLDER i' 4. a i-" ''."1 r' /Ai- --,
NAME
NICKNAME LAST SUFFIX
101/
JUI_. i b 2005 I
4 CANDIDATE/ ADDRESS /PO BOX: APT/SUITE a; CITY; STATE; ZIP CODE
OFFICEHOLDER
MAILING `/`/ L -t Cr CITY SECRETARY'S
ADDRESS / G� � ��I ��
r7 Change of Address Co�1e � ��L �� 7 l
5 CANDIDATE/ AREA CODE PHONE NUMBER EXTENSION
OFFICEHOLDER Z /- ' 1-1 I�—"I P Ci�' • 1 R ;`/ )
PHONE ( �17 � J5 - aj S(o 0 Receipt # Amount
6 CAMPAIGN MS RSi MR FIRST A, MI Date Processed
TREASURER t' N-es._
NAME Date Imaged
NICKNAME LAST ,011
7 CAMPAIGN STREET ADDRESS (NO PO BOX PLEASE); APT/SUITE X; CITY; STATE; ZIP CODE
TREASURER
ADDRESS 1./g J L zic), C� //C /a ✓ //� '; 7� 3V
(Residence or business)
8 CAMPAIGN AREA CODE PHONE NUMBER EXTENSION
TREASURER
PHONE ( 2 t 7 ) 9N4, - ‘ 7,26
9 REPORT TYPE
I I January 15 n 30th day before election n (1---1 Runoff I I 15th day after campaign treasurer
-A appointment(officeholder only)
July 15 I I 8th day before election n Exceeded$500 limit X Final report(Attach C/OH-FR)
10 PERIOD Month Day Year Month Day Year
COVERED 2/13 /G j THROUGH C.o/ / 3G / o s
11 ELECTION ELECTION DATE ELECTION TYPE
Month Day Year
5 / 7 / O; I I Primary I 1 Runoff rxi General I I Special
12 OFFICE OFFICE HELD (if any) 13 OFFICE SOUGHT (if known)
P'/46 t 1 c. � A„N c,.i m/A
14 NOTICE
OF DIRECT '• Direct campaign expenditures are campaign expenditures made by others without the candidate's prior consent or approval.
CAMPAIGN Candidates are required to disclose this information only if they receive notification of the direct campaign expenditure. ••
EXPENDITURE
BY OTHER Name
INDIVIDUALS /V/A
Address 1 PO Box. Apt.I Suite#; City; State; Zip Code
❑ additional pages
GO TO PAGE 2
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•
Texas Ethics Commission P.O.Box 12070 Austin,Texas 78711-2070 (512)463-5800 1-800-325-8506
CANDIDATE / OFFICEHOLDER REPORT: FORM C/OH
SUPPORT & TOTALS COVER SHEET PG 2
15 C/OH NAME 16ACCOUNT#/Ethics commission iders)
• Y�2 Ala(' &1/ //4
17 NOTICE •• This box is for notice of political expenditures by political committees to support the candidate/officeholder. These expenditures
FROM may have been made without the candidate's or officeholder's knowledge or consent. Candidates and officeholders are required to report
POLITICAL this information only if they receive notice of such expenditures. ••
COMMITTEE(S)
COMMITTEE NAME
COMMITTEE TYPE
N/A
n GENERAL
COMMITTEE ADDRESS
F-7 SPECIFIC
additional pages COMMITTEE CAMPAIGN TREASURER NAME
COMMITTEE CAMPAIGN TREASURER ADDRESS
18 CONTRIBUTION 1. TOTAL POLITICAL CONTRIBUTIONS OF$50 OR LESS(OTHER THAN
TOTALS PLEDGES,LOANS,OR GUARANTEES OF LOANS),UNLESS ITEMIZED $ —
2. TOTAL POLITICAL CONTRIBUTIONS
(OTHER THAN PLEDGES,LOANS,OR GUARANTEES OF LOANS) $ —
EXPENDITURE 3. TOTAL POLITICAL EXPENDITURES OF$50 OR LESS,UNLESS ITEMIZED
TOTALS $
4. TOTAL POLITICAL EXPENDITURES C
$ 132.
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 C
LOAN TOTALS LAST DAY OF THE REPORTING PERIOD $
19 AFFIDAVIT
I swear,or affi nder penalty of perjury,that the accompanying report
is true and co . and includes all information required to be reported by
me under Ti ,Election Code.
/ 4//
Fgnature•drandida_�orOfficeholder
AFFIX NOTARY STAMP/SEAL ABOVE
Sworn to and subscribed before me,by the said • L, n . • \ , this the A5-- day
o ., /i ,20 � ,to certify which,witness my hand and seal of office.
///✓�.�� :/IiL.� - ��!_ �. u ►, ern. r.
Signar(t•fficer administering oath Printed nam- . ' 'r administering oath "0.742._ • • i n•minis enng oa
• Pax��oo�uu
',I Printed on recycled paper : � MY COMMISSION EXPIRES ned I /05/2003
•Ar41� • 18,2006
Texas Ethics Commission P.O.Box 12070 Austin, Texas 78711-2070 (512)463-5800 1-800-325-8506
POLITICAL CONTRIBUTIONS SCHEDULE A
OTHER THAN PLEDGES OR LOANS
The INSTaucnoN GUIDE explains how to complete this form. 1 Total pages Schedule A: /
2 FILER NAME 3 ACCOUNT# (Ethics Commission titers)
G („, Aix, 1OH N / A
4 Date 5 Full name of contributor ❑out-of-state PAC(ID#: ) 7 Amount of 8 In-kind contribution
d contribution ($) description(if applicable)
rV/A
6 Contributor address; City; State; Zip Code
9 Principal occupation/Job titl (See Instructions) 10 Employer(See Instructions)
Date Full nam of contributor ❑out-of-state PAC(ID#: ) Amount of In-kind contribution
contribution ($) description(if applicable)
Contribut 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 In-kind contribution
contribution ($) description(if applicable)
Contributor address; City; State; Zip Code
Principal occupation/Job title See Instructions) Employer(See Instructions)
Date Full name cf contributor 0 out-of-state PAC(IN' ) Amount of In-kind contribution
contribution ($) description(if applicable)
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 mt. ) Amount of In-kind contribution
contribution ($) description(if applicable)
Contributor address; City; State; Zip Code
Principal occupation/Job title(See Instructions) Employer(See Instructions)
ATTACH ADDITIONAL COPIES OF THIS FORM AS NEEDED
If contributor is out-of-state PAC, please see instruction guide for additional reporting requirements.
,�! Primed on recycled paper Revised 11105/2003
Texas Ethics Commission P.O.Box 12070 Austin, Texas 78711-2070 (512)463-5800 1-800-325-8506
PLEDGED CONTRIBUTIONS SCHEDULE B
The INSTRUCTION GUIDE explains how to complete this form. 1 Total pages Schedule B:
2 FILER NAME 3 ACCOUNT# (Ethics Commission filers)
47 Go r Alan. 601// A/ / A
4 TOTAL OF UNITMIZED PLEDGES: b b b b * $
5 Date 6 Full name of pledgor 0 out-of-state PAC(ID#: ) 8 Amount of 19 In-kind description
/A pledge ($) (if applicable)
7 Pledgor address; City; State; Zip Code I
r I
10 Principal occupation/Job title(See Instructions) 11 Employer(See Instructions)
Date Full name of pledgor 0 out-of-state PAC(10#: ) Amount of In-kind description
pledge ($) (if applicable)
Pledgcr address; City; State; Zip Code
Principal occupation/Job title(See Instructions) Employer(See Instructions)
Date Full name of pledgor 0 out-of-state PAC(ID# ) Amount of In-kind description
pledge ($) (if applicable)
Pledgoe address; City; State; Zip Code
Principal occupation/Job titl= (See Instructions) Employer(See Instructions)
Date Full na e of pledgor 0 out-of-state PAC(ID#: ) Amount of In-kind description
pledge ($) (if applicable)
Pledgo address; City; State; Zip Code
Principal occupation/Job titl: (See Instructions) Employer(See Instructions)
Date Full na e of pledgor 0 out-of-slate PAC(ID#' ) Amount of I In-kind description
pledge ($) (if applicable)
Pledgo address; City; State; Zip Code
Principal occupation/Job title(See Instructions) Employer(See Instructions)
ATTACH ADDITIONAL COPIES OF THIS FORM AS NEEDED
If contributor is out-of-state PAC, please see instruction guide for additional reporting requirements.
• • Printed on rec cled paper
• •�-. Y Revised 11/05/2003
Texas Ethics Commission P.O.Box 12070 Austin, Texas 78711-2070 (512)463-5800 1-800-325-8506
LOANS SCHEDULE E
1 Total pages Schedule E: 1
The INSTRUCTION GUIDE explains how to complete this form.
2 FILER NAME 3 ACCOUNT#(Ethics Commission filers)
�eor e 4. Eon A/
4 /TOTAL OF UNITEMIZED LOANS: b b { ,c
5 Date of loan 7 Name of lender ❑out-of-state PAC ON: ) 9 Loan Amount($)
6 Is lender a 8 Lender address; City; State; Zip Code 10 Interest rate
financial Institution?
Y N 11 Maturity date
12 Principal occupation/Job title(See Instructions) 13 Employer(See Instructions)
14 Description of Collateral
❑ none
15 GUARANTOR 16 Name of guarantor 18 Amount Guaranteed($)
INFORMATION
17 Guarantor address; City; State; Zip Code
❑ not applicable
19 Principal Occupation 20 Employer
Date of loan Name of lender ❑out-of-state PAC(ID#7 Loan Amount($)
Is lender a Lender address; City; State; Zip Code Interest rate
financial Institution?
Y N Maturity date
Principal occupation/Job title(See Instructions) Employer(See Instructions)
Description of Collateral
❑ none
GUARANTOR Name of guarantor Amount Guaranteed($)
INFORMATION
Guarantor address; City; State; Zip Code
not applicable
Principal Occupation Employer
ATTACH ADDITIONAL COPIES OF THIS FORM AS NEEDED
If lender is out-of-state PAC, please see instruction guide for additional reporting requirements.
re Printed on recycled paper Revised 11,65:2003
Texas Ethics Commission P.O.Box 12070 Austin, Texas 78711-2070 (512)463-5800 1-800-325-8506
POLITICAL EXPENDITURES SCHEDULE F
The INSTRUCTION GUIDE explains how to complete this form. 1 Total pages Schedule F: I
2 FILER NAME 3 ACCOUNT# (Ethics Commission filers)
6to e .� Ala/)-, toll /A
4 Date 5 Payee name 7 Amount
<�/Ai;k Sc nc 4- ea 10, 4're CvS ($)
S/ /�� /
� 6 Payee address; City; State; Zip Code 307'
( i e ,/1 ;1k &lv2 Zo dep,v, J/./, TY.
7 6 d 3 t/ .
8 Purpose of payment(See instructions regarding type of information 9 •• Complete if direct expenditure to benefit C/OH •-
required.) Candidate/Officeholder name Office sought Office held
Date Payee name Amount
/ y /A ($)
Payee address; City; State; Zip Code
Purpose of payment(See instructions regarding type of information •• Complete if direct expenditure to benefit C/OH ••
required.) Candidate I Officeholder name Office sought Office held
Date Payee name Amount
(S)
Payee address; City; State; Zip Code
Purpose of payment(See instructions regarding type of information •• Complete if direct expenditure to benefit C/OH •-
required.) Candidate/Officeholder name Office sought Office held
Date Payee na e Amount
($)
Payee ad ress; City; State; Zip Code
Purpose of payment(See inst uctions regarding type of information •• Complete if direct expenditure to benefit C/OH ••
required.) Candidate/Officeholder name Office sought Office held
ATTACH ADDITIONAL COPIES OF THIS FORM AS NEEDED
1:' Printed on recycled paper Revised 11/05/2003
Texas Ethics Commission P.O.Box 12070 Austin, Texas 78711-2070 (512)463-5800 1-800-325-8506
POLITICAL EXPENDITURES SCHEDULE G
MADE FROM PERSONAL FUNDS
Total pages Schedule G:
The INSTRUCTION GUIDE explains how to complete this form.
2 FILER NAME 3 ACCOUNT# (Ethics Commission filers)
�� e Alm �o// Ai/4
4 Date 5 Payee name . 8 Amount
� �i�fYcs J e d k'' r fir' — ($)
6 Payee address; City; State; Zip Code /3 2, O 7
s 05 6301 'lci/c k, l?1vd ( !!!
76& V
7 Purpose of expenditure(See instructions regarding type of information required.) I I Reimbursement
A-----+ 1 from political
2 n wL^ '- n _ S contributions
(_ a intended
Date Payee name //A Amount
Payee address; City; State; Zip Code
Purpose of expenditure(See instructions regarding type of information required.) n Reimbursement
from political
contributions
intended
Date Payee name Amount
($)
Payee address: City; State; Zip Code
Purpose of expenditure(See instructions regarding type of information required.) I I from political
contributions
intended
Date Payee name Amount
($)
Payee address; City; State; Zip Code
Purpose of expenditure(See instructions regarding type of information required.) I I from Reimbursement political
contributions
intended
Date Payee name Amount
($)
Payee address; City; State; Zip Code
Purpose of expendit;re(See instructions regarding type of information required.) I I Reimbursement
from political
contributions
intended
ATTACH ADDITIONAL COPIES OF THIS FORM AS NEEDED
tPrinted on recycled paper Revised 11,0512003
Texas Ethics Commission P.O.Box 12070 Austin, Texas 78711-2070 (512)463-5800 1-800-325-8506
PAYMENT FROM POLITICAL CONTRIBUTIONS SCHEDULE H
TO A BUSINESS OF C/OH
The INSTRUCTION GUIDE explains how to complete this form. 1 Total pages Schedule H: '
2 FILER NAME 3 ACCOUNT# (Ethics Commission filers)
4 Date 5 Business name
7 Amount
($)
6 Business address; City; State; Zip Code
8 Purpose of payment(See instructions r-garding type of information 9 •• Complete if direct expenditure to benefit C/OH ••
required.) Candidate/Officeholder name Office sought Office held
Date Business name Amount
($)
Business address; City; State; Zip Code
Purpose of payment(See instructions reg-rding type of information •• Complete if direct expenditure to benefit C/OH ••
required.) Candidate/Officeholder name Office sought Office held
Date Business name Amount
($)
Business address; City; State; Zip Code
Purpose of payment(See instructions reg-rding type of information Complete if direct expenditure to benefit C/OH ••
required.) Candidate/Officeholder name Office sought Office held
Date Business name Amount
($)
Business address; City; State; Zip Code
Purpose of payment(See instructions regarding type of information Complete if direct expenditure to benefit C/OH •-
required.) Candidate/Officeholder name Office sought Office held
ATTACH ADDITIONAL COPIES OF THIS FORM AS NEEDED
P!mted on recycled paper
Revised 11,0512003
Texas Ethics Commission P.O.Box 12070 Austin, Texas 78711-2070 (512)463-5800 1-800-325-8506
NON-POLITICAL EXPENDITURES SCHEDULE
MADE FROM POLITICAL CONTRIBUTIONS
The INSTRUCTION GUIDE explains how to complete this form. 1 Total pages Schedule I:
2 FILER NAME 3 ACCOUNT# (Ethics Commission filers)
�o Y Al / o /) /V/A
4 Date 5 Payee name
8 Amount
//
w /A ($)
6 Payee address; �/ City; State; Zip Code
7 Purpose of expenditure(See instructions regarding type of information required.)
Date Payee name Amount
($)
Payee address; City; State; Zip Code
Purpose of expenditure(See instructions regarding type of information required.)
Date Payee name Amount
($)
Payee address; City; State; Zip Code
Purpose of expenditure(See instructions regarding type of information required.)
Date Payee name Amount
($)
Payee address; City; State; Zip Code
Purpose of expenditure(See instructions regarding type of information required.)
Date Payee name Amount
($)
Payee address; City; State; Zip Code
Purpose of expenditure,See instructions regarding type of information required.)
ATTACH ADDITIONAL COPIES OF THIS FORM AS NEEDED
r• Printed on recycled paper
Revised 11;0512003
Texas Ethics Commission P.O.Box 12070 Austin, Texas 78711-2070 (512)463-5800 1-800-325-8506
CREDITS (optional) SCHEDULE K
The INSTRUCTION GUIDE explains how to complete this form. 1 Total pages Schedule K: 1
2 FILER NAME / 3 ACCOUNT# (Ethics Commission filers)
tor re Ala .. poi/ �%/A 4 Date 5 Payor name ff 8 Amount
N/ A ($)
6 Payor address; City; State; Zip Code
7 Reason for credit
Date Payor name Amount
($)
Payor address; City; State; Zip Code
Reason for credit
Date Payor name Amount
($)
Payor address; City; State; Zip Code
Reason for credit
Date Payor name Amount
(5)
Payor address; City; State; Zip Code
Reason for credit
Date Payor name Amount
(5)
Payor address; City; State; Zip Code
Reason for credit
ATTACH ADDITIONAL COPIES OF THIS FORM AS NEEDED
�• Printed on recycled paper Revised 11/05/2003
Texas Ethics Commission P.O.Box 12070 Austin,Texas 78711-2070 (512)463-5800 1-800-325.8506
CANDIDATE / OFFICEHOLDER REPORT: FORM C/OH - FR
DESIGNATION OF FINAL REPORT
The Instruction Guide explains how to complete this form.
Complete only if "Report Type" on page 1 is marked "Final Report" ••
1 C/OH NAME D 2 ACCOUNT it Commisslon filers)
4 [,d-)1-1 A/ X 0 I/ w/A
3 SIGNATURE
I do not expect any further political contributions or political expenditures in connection with i didacy. I understand that designating
a report as a final report terminates my campaign treasurer appointment. I also undehat I may not a :-pt any campaign
contributions or make any campaign expenditures without a campaign treasurer appoint e.
�J dr Ad l
/ Sig.aof Can.(date/O•iceholder
4 FILER WHO IS NOT AN OFFICEHOLDER
•• Complete A&B below only if you are not an officeholder. ••
N / A
A. CAMPAIGN UNDS
Check only one:
ri I do not have unexpend•• contributions or unexpended interest or income earned from political contributions.
(-i I have unexpended contributio•s or unexpended interest or income earned from political contributions. I understand that I may not
convert unexpended political co tributions or unexpended interest or income earned on political contributions to personal use. I
also understand that I must file an •nnual report of unexpended contributions and that I may not retain unexpended contributions
or unexpended interest or income -•med on political contributions longer than six years after filing this final report. Further, I
understand that I must dispose of u -xpended political contributions and unexpended interest or income earned on political
contributions in accordance with the requirements of Election Code, §254.204.
B. ASSETS
Check only one:
I I I do not retain assets purchased with political contrib 'ons or interest or other income from political contributions.
I do retain assets purchased with political contributions or terest or other income from political contributions. I understand that I
may not convert assets purchased with political contributio or interest or other income from political contributions to personal
use. I also understand that I must dispose of assets purchas-• with political contributions in accordance with the requirements of
Election Code,§254.204.
Signature of Candidate
5 OFFICEHOLDER
•• Complete this section only if you are an officeholder •-
HIV I am aware that I remain subject to filing requirements applicable to an officeholder who •o s not have a campaign treasurer on file. I
am also aware that I will be required to file reports of unexpended contributions if, .t : time I cease holding office, I retain assets
purchased with political contributions or interest or other income from political c•. •utions. /
/
/ Signatur- of 1.4 ''is older
/
i• Pnnted on recycled paper Revised 11/05/2003