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Home My WebLink AboutDesignations of Campaign Treasurer-Campaign Finance Reports & Filings-Specific Purpose Committee -5/7/2015Texas Ethics Commission P.O. Box 12070 Austin, Texas 78711-2070 (512) 463-5800 (TDD 1-800-735-2989) APPOINTMENT OF A CAMPAIGN TREASURER FORM STA BY A SPECIFIC -PURPOSE COMMITTEE PG 1 See STA Instruction Guide for detailed instructions. 1 Total pages filed: 2 2 COMMITTEE NAME Protect Colleyville Ac.# 3 COMMITTEE ADDRESS ADDRESS /PO BOX; APT/SUITE#; CITY; STATE; ZIP CODE 7802 Tillman Hill Ct. Colleyville, TX 76034 Da ``CITY 3 2e ived MAY 07 2015 SECRETARY'S OFFICE 4 CAMPAIGN TREASURER MS/MRS/MR FIRST MI Mr. Larry Ht7lwm NICKNAME LAST SUFFIX D d � Pro sseJDI t t V Autrey Date Imaged 5 CAMPAIGN STREET ADDRESS (NO PO BOX PLEASE); APT I SUITE #; CITY; STATE; ZIP CODE TREASURER STREET ADDRESS (residence or business) 2201 Carlisle Avenue Colleyville TX 76034 6 MAILING ADDRESS I. same as above ADDRESS /PO BOX; APT/SUITE#; CITY; STATE; ZIP CODE P.O. Box 394 Colleyville TX 76034-0394 7 CAMPAIGN TREASURER PHONE AREA CODE PHONE NUMBER EXTENSION ( 817 ) 259-9190 8 PERSON APPOINTING TREASURER FIRST MI LAST SUFFIX Larry Autrey 9 SIGNATURE I understand that I have been appointed as the campaign treasurer for this specific -purpose committee and that I am responsible for filing all required reports a that I may be subject to fines for failure to do so. I am aware of the restrictions in title f the Election Code on contributions from corporations and labor organizations. Signatu e Campaign Treasurer 10 ASSISTANT CAMPAIGN TREASURER (see instructions) FIRST MI LAST SUFFIX 11 ASSISTANT CAMPAIGN TREASURER ADDRESS ADDRESS /PO BOX; APT /SUITE #; CITY; STATE; ZIP CODE 12 ASSISTANT CAMPAIGN TREASURER PHONE AREA CODE PHONE NUMBER EXTENSION ( ) CONTINUE ON PAGE 2 www.ethics.state.tx.us Revised 09/04/2014 Texas Ethics Commission P.O. Box 12070 Austin, Texas 78711-2070 (512)463-5800 (TDD 1-800-735-2989) SPECIFIC -PURPOSE COMMITTEE: FORM STA PURPOSEAND MODIFIED REPORTING DECLARATION PG 2 13 COMMITTEE NAME Protect Colleyville 14 COMMITTEE PURPOSE SUPPORT CANDIDATE OPPOSE CANDIDATE CANDIDATE/OFFICEHOLDER NAME OFFICE SOUGHT (candidate)/ OFFICE HELD (officeholder) M ASSIST OFFICEHOLDER SUPPORT MEASURE BALLOT IDENTIFICATION OF MEASURE / # City of Colleyville, Resolution 1 ELECTION DATE Month Day/Year 05 09 2015 DESCRIPTION Resolution 1 would limit the Colleyville City Council's ability to make improvements to Glade Road. OPPOSE MEASURE 15 MODIFIED REPORTING DECLARATION COMPLETE THIS SECTION ONLY IF YOU ARE CHOOSING MODIFIED REPORTING. ••This declaration must be filed no later than the 30th day before the first election to which the declaration applies. •• ••The modified reporting declaration is valid for one election cycle only. •• (An election cycle includes a primary election, a general election, and any related runoffs.) The committee does 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. The committee understands that if either one of those limits is exceeded, the committee's campaign treasurer will be required to file pre-election reports and, if necessary, a runoff report. Year of election(s) or election cycle to Signature of Campaign Treasurer which declaration applies ATTACH ADDITIONAL COPIES OF THIS FORMAS NEEDED www.ethics.state.tx.us Revised 09/04/2014 SPECIFIC -PURPOSE COMMITTEE FORM SPAC CAMPAIGN FINANCE REPORT COVER SHEET PG 1 The SPAC Instruction Guide explains how to complete this form. 1 Filer ID (Ethics Commission Filers) 2 Total pages filed: 4 3 COMMITTEE NAME ..2FFICE USE ONLY Protect Colleyville D"' eEEEL1 V E 4 COMMITTEE ADDRESS ❑ Change of Address ADDRESS / PO BOX; APT / SUITE #; CITY; STATE; ZIP CODE 7802 Tillman Hill Ct. Colleyville, TX 76034 MAY 0 7 2015 CITY SECRETARY'S OFFIC Date Hand -delivered or Date Postmarked Receipt # Amount 5 CAMPAIGN MS / MRS / MR FIRST MI TREASURER NAME Mr. Larry NICKNAME LAST SUFFIX D" •'-rocessed �]",, ---Ct,O1-Y � Autrey Date Imaged 1 6 CAMPAIGN TREASURER STREET ADDRESS (Residence or Business) STREET ADDRESS (NO PO BOX PLEASE): APT / SUITE #; CITY; STATE; ZIP CODE 2201 Carlisle Avenue Colleyville TX 76034 7 CAMPAIGN TREASURER MAILING ADDRESS Change of Address STREET ADDRESS OR PO BOX; APT / SUITE #; CITY; STATE; ZIP CODE P.O. Box 394 Colleyville TX 76034-0394 8 CAMPAIGN TREASURER PHONE AREA CODE PHONE NUMBER EXTENSION ( 817 ) 259-9190 9 REPORT TYPE ❑ January 15 ❑ July 15 ❑ X ❑ 30th day before election ❑ Exceeded 5500 limit 8th day before election ❑ Dissolution (Attach PAC -DR) Runoff ❑ 10th day after campaign treasurer termination 10 PERIOD COVERED Month Day Year Month Day Year 04 / 01 / 2015 THROUGH 04 / 29 / 2015 11 ELECTION ELECTION DATE Month Day Year 05 / 09 /2015 ❑ x ELECTION TYPE Primary ❑ Runoff ❑ Other Description General ❑ Special GO TO PAGE 2 Forms provided by Texas Ethics Commission www.ethics.state.tx.us Revised 02/27/2015 SPECIFIC -PURPOSE COMMITTEE REPORT: FORM SPAC PURPOSE AND TOTALS COVER SHEET PG 2 12 COMMITTEE NAME Protect Colleyville 13 Filer ID (Ethics Commission Filers) 14 COMMITTEE PURPOSE (Attach lists on plain paper to complete this report if necessary.) SUPPORT (Candidate or Measure) I^1 OPPOSE (Candidate or Measure) ASSIST (Officeholder) ❑ CANDIDATE OFFICEHOLDER CANDIDATE/OFFICEHOLDER NAME OFFICE SOUGHT (candidate)/OFFICE HELD (officeholder) BALLOTIDENTIFICATION /# ELECTION DATE Resolution 1 Month Day Year 05/ 09 / 2015 x MEASURE DESCRIPTION Resolution to Limit Ability to Improve Glade Rd. 15 CONTRIBUTION TOTALS 1. TOTAL POLITICAL CONTRIBUTIONS OF $50 OR LESS (OTHER THAN PLEDGES, LOANS, OR GUARANTEES OF LOANS), UNLESS ITEMIZED 2. TOTAL POLITICAL CONTRIBUTIONS (OTHER THAN PLEDGES, LOANS, OR GUARANTEES OF LOANS) $ 3550.00 EXPENDITURE TOTALS 3. TOTAL POLITICAL EXPENDITURES OF $100 OR LESS, UNLESS ITEMIZED 4. TOTAL POLITICAL EXPENDITURES $ 0 . 00 CONTRIBUTION BALANCE 5. TOTAL POLITICAL CONTRIBUTIONS MAINTAINED AS OF THE LAST DAY OF THE REPORTING PERIOD 5430.08 OUTSTANDING LOAN TOTALS 6. TOTAL PRINCIPAL AMOUNT OF ALL OUTSTANDING LOANS AS OF THE LAST DAY OF THE REPORTING PERIOD $ $ 16 AFFIDAVIT I swear, or affirm, under penalty of perjury, that the accompanying report is true and correct and i dudes all information required to be reported by me under Tit • 1. Election Code. S NZ' 2-01. 'dxl '1•WWO3 SWX11 JO 3.LV.LS OI7nd AIV1ON� N fn1I f r,✓ AFFIX NOTARY STAMP /SEALABOVE Sworn to and subscribed before day of Cl , 20 ANI 1t du .?., ,� (:) me, by the said Sig .tare of Campaign Treasurer L Ct r r y u0i,e 7 , this the tet" 15 , to certify which, witness my hand and seal of office. / v 04 -art/ A,J-0-(at —De -b0 rah of Signature of officer, inisterin o th Printed name of officer administering oath Title of officer ad(ninistering oath Forms provided by Texas Ethics Commission www.ethics.s(ate.tx.us Revised 02/27/2015 FORM SPAC SUBTOTALS - SPAC COVER SHEET PG 3 17 COMMITTEE NAME Protect Colleyville 18 Filer ID (Ethics Commission Filers) 19 SCHEDULE SUBTOTALS NAME OF SCHEDULE SUBTOTAL AMOUNT 1. X SCHEDULE AI: MONETARY POLITICAL CONTRIBUTIONS $ 3550.00 2. SCHEDULE A2: NON -MONETARY (IN-KIND) POLITICAL CONTRIBUTIONS $ 3. SCHEDULES: PLEDGED CONTRIBUTIONS $ 4. SCHEDULE C1: MONETARY CONTRIBUTIONS FROM CORPORATION OR LABOR ORGANIZATION $ 5 ❑SCHEDULE C2: NON -MONETARY (IN-KIND) CONTRIBUTIONS FROM CORPORATION OR LABOR ORGANIZATION $ 6. SCHEDULE D: PLEDGED CONTRIBUTIONS FROM CORPORATON OR LABOR ORGANIZATION $ 7. ❑ SCHEDULE E: LOANS $ 6. SCHEDULE FI: POLITICAL EXPENDITURES FROM POLITICAL CONTRIBUTIONS $ 9. SCHEDULE F2: UNPAID INCURRED OBLIGATIONS $ 10. I SCHEDULE F3: PURCHASE OF INVESTMENTS FROM POLITICAL CONTRIBUTIONS $ 11, SCHEDULE H: PAYMENT FROM POLITICAL CONTRIBUTIONS TO A BUSINESS OF C/OH $ 12. SCHEDULE I: NON-POLITICAL EXPENDITURES MADE FROM POLITICAL CONTRIBUTIONS $ 13 SCHEDULE K: INTEREST, CREDITS, GAINS, REFUNDS, AND CONTRIBUTIONS RETURNED TO FILER Forms provided by Texas Ethics Commission www.ethics.state.tx.us Revised 02/27/2015 Forms provided by Texas Ethics Commission www.ethics.state.tx.us Revised 02/27/2015 MONETARY POLITICAL CONTRIBUTIONS SCHEDULE Al The Instruction Guide explains how to complete this form. 1 Total pages Schedule Al: 1 2 FILER NAME Protect Colleyville 3 Filer ID (Ethics Commission Filers) 4 Date 04/07/15 5 Full name of contributor 0 out-of-state PAC Robert Beall 6 Contributor address; City; State; 5300 Miramar Lane Colleyville, (IDN: ) 7 Amount of contribution 3000.00 ($) Zip Code TX 76034 8 Principal occupation / Job title (See Instructions) g Employer (See Instructions) Date 04/21/15 Full name of contributor 0 out-of-state PAC Joseph Fulghum Contributor address; City; State; 1800 Arthur Dr. Colleyville, ON: ) Amount of contribution 300.0 ($) Zip Code TX 76034 Principal occupation / Job title (See Instructions) Employer (See Instructions) Date 04/21/15 Full name of.contributor D out-of-state PAC Robert Nicholson Contributor address; City; State; 2101 Highgate Dr. Colleyville, ON: ) Amount of contribution 250.00 ($) Zip Code TX 76034 Principal occupation / Job title (See Instructions) Employer (See Instructions) Date Full name of contributor 0 out-of-state PAC Contributor address; City; State; (IDN: ) Amount of contribution (5) Zip Code Principal occupation / Job title (See Instructions) 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 02/27/2015 SPECIFIC-PURPOSE COMMITTEE FORM SPAC CAMPAIGN FINANCE REPORT COVER SHEET PG 1 The SPAC Instruction Guide explains how to complete this form. 1 Filer ID (Ethics Commission Filers) 2 Total pages filed: 8 3 COMMITTEE NAME • FICE USE ,, Protect Colleyville i: �en, d N � 4 COMMITTEE ADDRESS ❑ Change of Address ADDRESS / PO BOX; APT / SUITE #; CITY; STATE; ZIP CODE 7802 Tillman Hill Ct. Colleyville, TX 76034 CITY MAY O ( 2015 SECRETARY'S OFFICE Date Hand-delivered or Date Postmarked Receipt # Amount 5 CAMPAIGN MS/MRS/MR FIRST MI TREASURER NAME Mr. Larry NICKNAME LAST SUFFIX Date Plocessed 4/��l[Y LI,0q Autrey Dale Imaged 6 CAMPAIGN TREASURER STREET ADDRESS (Residence or Business) STREET ADDRESS (NO PO BOX PLEASE); APT / SUITE 5; CITY; STATE; ZIP CODE 2201 Carlisle Avenue Colleyville TX 76034 7 CAMPAIGN TREASURER MAILING ADDRESS Change of Address STREET ADDRESS OR PO BOX; APT / SUITE #; CITY; STATE; ZIP CODE P.O. Box 394 Colleyville TX 76034-0394 8 CAMPAIGN TREASURER PHONE AREA CODE PHONE NUMBER EXTENSION ( 817 ) 259-9190 9 REPORT TYPE ❑ January 15 ❑ July 15 X ❑ ❑ 30th day before election ❑ Exceeded 5500 limit 8th day before election ❑ Dissolution (Attach PAC-DR) Runoff ❑ 10th day after campaign treasurer termination 10 PERIOD COVERED Month Day Year Month Day Year 03 / 06 / 2015 THROUGH 03 / 31 / 2015 11 ELECTION ELECTION DATE Month Day Year 05 / 09 /2015 ❑ x ELECTION TYPE Primary ❑ Runoff ❑ Other Description General ❑ Special GO TO PAGE 2 Forms provided by Texas Ethics Commission www.ethics.state.tx.us Revised 02/27/2015 SPECIFIC -PURPOSE COMMITTEE REPORT: FORM SPAC PURPOSE AND TOTALS COVER SHEET PG 2 12 COMMITTEE NAME Protect Colleyville 13 Filer ID (Ethics Commission Filers) 14 COMMITTEE PURPOSE (Attach lists on plain paper to complete this report if necessary.) I SUPPORT (Candidate or Measure) I X I OPPOSE (Candidate or Measure) ASSIST (Officeholder) CANDIDATE 1 J OFFICEHOLDER CANDIDATE/OFFICEHOLDER NAME OFFICE SOUGHT(candidate)/OFFICE HELD (officeholder) 1 XI MEASURE BALLOT IDENTIFICATION /i! ELECTION DATE Resolution 1 Month 09y/ 2015 DESCRIPTION Resolution to Limit Ability to Improve Glade Rd. 15 CONTRIBUTION TOTALSPLEDGES, 1. TOTAL POLITICAL CONTRIBUTIONS OF $50 OR LESS (OTHER THAN LOANS, OR GUARANTEES OF LOANS), UNLESS ITEMIZED $ 50.00 2. TOTAL POLITICAL CONTRIBUTIONS (OTHER THAN PLEDGES, LOANS, OR GUARANTEES OF LOANS) $ 5, 700 . 00 EXPENDITURE TOTALS 3. TOTAL POLITICAL EXPENDITURES OF $100 OR LESS, UNLESS ITEMIZED $ 4. TOTAL POLITICAL EXPENDITURES $ 4,064.65 CONTRIBUTION BALANCE 5. TOTAL POLITICAL CONTRIBUTIONS MAINTAINED AS OF THE LAST DAY OF THE REPORTING PERIOD $ 5,694.73 OUTSTANDING LOAN TOTALS 6. TOTAL PRINCIPAL AMOUNT OF ALL OUTSTANDING LOANS AS OF THE LAST DAY OF THE REPORTING PERIOD $ 16 AFFIDAVIT I swear, or affirm, under penalty report is true and correct . be reported by me under of perjury, that the accompanying d includes all information required to le 15, Election Code. i 0 vAYotkc, DEBORAH J RUFFU JL NOTARY PUBLIC s 7/< STATE OF TEXAS ''e of , My Comm. Exp. 10-21-2015 I S : ture of Campaign Treasurer L Q r r y A ut,r- ey 7 _ ,this the t Sworn day AFFIX NOTARY STAMP / SEAL ABOVE to and�subscribed before me, by the /( o f `� a\ 20 1 5 , to certify said which, �Orah witness my hand and seal of office. i afar+ _sl -A j/� . Lk. ( Cu- Signature of officer". inistering oa h Printed name of officer administering oath Title of officer a .ministering oath Forms provided by Texas Ethics Commission www.ethics.state.tx.us Revised 02/27/2015 FORM SPAC SUBTOTALS - SPAC COVER SHEET PG 3 17 COMMITTEE NAME Protect Colleyville 18 Filer ID (Ethics Commission Filers) 19 SCHEDULE SUBTOTALS NAME OF SCHEDULE SUBTOTAL AMOUNT 1. X SCHEDULE Al: MONETARY POLITICAL CONTRIBUTIONS $ 5700.00 2. I XI SCHEDULE A2: NON-MONETARY(IN-KIND) POLITICAL CONTRIBUTIONS $ 50.00 3. I I SCHEDULE B: PLEDGED CONTRIBUTIONS $ 4. SCHEDULE C1: MONETARY CONTRIBUTIONS FROM CORPORATION OR LABOR ORGANIZATION $ 5 I I SCHEDULE C2 : NON -MONETARY (IN-KIND) CONTRIBUTIONS FROM CORPORATION OR LABOR ORGANIZATION $ 6. SCHEDULE D: PLEDGED CONTRIBUTIONS FROM CORPORATON OR LABOR ORGANIZATION $ 7. SCHEDULE E: LOANS $ 8. X SCHEDULE F1: POLITICAL EXPENDITURES FROM POLITICAL CONTRIBUTIONS $ 4064.65 9. I I SCHEDULE F2: UNPAID INCURRED OBLIGATIONS $ 10. I l SCHEDULE F3: PURCHASE OF INVESTMENTS FROM POLITICAL CONTRIBUTIONS $ 11. SCHEDULE H: PAYMENT FROM POLITICAL CONTRIBUTIONS TO A BUSINESS OF C/OH $ 12. I I SCHEDULE I: NON-POLITICAL EXPENDITURES MADE FROM POLITICAL CONTRIBUTIONS $ 13. I I SCHEDULE K: INTEREST, CREDITS, GAINS, REFUNDS, AND CONTRIBUTIONS RETURNED TO FILER $ Forms provided by Texas Ethics Commission www.ethics.state.tx.us Revised 02/27/2015 MONETARY POLITICAL CONTRIBUTIONS SCHEDULE Al The Instruction Guide explains how to complete this form. 1 Total pages Schedule Al: 3 2 FILER NAME Protect. Colleyville 3 Filer ID (Ethics Commission Filers) 4 Date 03/06/15 5 Full name of contributor 0 out-of-state PAC Louis Miller 6 Contributor address; City; State; 7802 Tillman Hill Ct. Colleyville, (ID#: ) 7 Amount of contribution 100.00 ($) Zip Code TX 76034 8 Principal occupation / Job title (See Instructions) 9 Employer (See Instructions) Date 03/12/15 Full name of contributor 0 out-of-state PAC Stanley Hall Contributor address; City; State; 6229 Cimmaron Trail Colleyville, (ID#: ) Amount of contribution 1000.00 ($) Zip Code TX 76034 Principal occupation / Job title (See Instructions) Employer (See Instructions) Date 3/23/15 Full name of contributor ❑ out-of-state PAC Joseph Moore Contributor address; City; State; 133 Acuff Lane Colleyville, (10#: ) Amount of contribution 500.00 ($) Zip Code TX 76034 Principal occupation / Job title (See Instructions) Employer (See Instructions) Date 3/23/15 Full name of contributor 0 out-of-state PAC Melissa McConnell Contributor address; City; State; 1717 Avondale Dr. Colleyville, (ID#. ) Amount of contribution 100.00 ($) Zip Code TX 76034 Principal occupation / Job title (See Instructions) 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 02/27/2015 MONETARY POLITICAL CONTRIBUTIONS SCHEDULE Al The Instruction Guide explains how to complete this form. 1 Total pages Schedule Al: 3 2 FILER NAME Protect Colleyville 3 Filer ID (Ethics Commission Filers) 4 Date 03/23/15 5 Full name of contributor 0 out-of-state PAC (ID#: ) 7 Amount of contribution ($) 1000.00 Louis Miller 6 Contributor address; City; State; Zip Code 7802 Tillman Hill Ct. Colleyville, TX 76034 8 Principal occupation / Job title (See Instructions) 9 Employer (See Instructions) Date 03/23/15 Full name of contributor 0 out-of-state PAC (ID #: ) Amount of contribution ($) 1000.00 Jon Bullock Contributor address; City; State; Zip Code 5808 Bettinger Dr. Colleyville, TX 76034 Principal occupation / Job title (See Instructions) Employer (See Instructions) Date 03/24/15 Full name of contributor ❑ out-of-state PAC (IN: ) Amount of contribution ($) 500.00 Tom Hart Contributor address; City; State; Zip Code 1717 Avondale Dr. Colleyville, TX 76034 Principal occupation / Job title (See Instructions) Employer (See Instructions) Date 03/24/15 Full name of contributor 0 out-of-state PAC (ID#: ) Amount of contribution ($) 500.00 Danny Walker Contributor address; City; State; Zip Code 5501 Normandy Colleyville, TX 76034 Principal occupation / Job title (See Instructions) 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 02/27/2015 MONETARY POLITICAL CONTRIBUTIONS SCHEDULE Al The Instruction Guide explains how to complete this form. 1 Total pages Schedule Al: 3 2 FILER NAME Protect Colleyville 3 Filer ID (Ethics Commission Filers) 4 Date 03/24/15 5 Full name of contributor ❑ out-of-state PAC Jim Fletcher 6 Contributor address; City; State; 1108 Nueces Court Colleyville, (ID#: ) 7 Amount of contribution 250.00 ($) Zip Code TX 76034 8 Principal occupation / Job title (See Instructions) g Employer (See Instructions) Date 03/26/15 Full name of contributor ❑ out-of-state PAC James Maken Contributor address; City; State; 1312 Somerset Court Colleyville, (105: ) Amount of contribution 500.00 ($) Zip Code TX 76034 Principal occupation / Job title (See Instructions) Employer (See Instructions) Date 03/27/15 Full name of contributor 0 out-of-state PAC Thomas Mitchell Contributor address; City; State; 4209 Gateway Dr., #200 Colleyville, (105: ) Amount of contribution 250.00 ($) Zip Code TX 76034 Principal occupation / Job title (See Instructions) Employer (See Instructions) Date Full name of contributor ❑ out -of -stale PAC Contributor address; City; State; (ID#: ) Amount of contribution ($) Zip Code Principal occupation / Job title (See Instructions) 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. orms provided by Texas Ethics Commission www.ethics.state.tx.us Revised 02/27/2015 NON-MONETARY (IN-KIND) POLITICAL CONTRIBUTIONS SCHEDULE A2 The Instruction Guide explains how to complete this form. 1 Total pages Schedule A2: 2 FILER NAME Protect Colleyville 3 Filer ID (Ethics Commission Filers) 4 TOTAL OF UNITEMIZED IN-KIND POLITICAL CONTRIBUTIONS $ 50.00 5 Date 6 Full name of contributor 0 out-of-state PAC (ID#: ) 8 Amount of . g In-kind contribution 7 Contributor address; City; State; Zip Code Contribution $ . description ❑ 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 Contributors principal occupation (FOR JUDICIAL) 13 Contributor's job title (FOR JUDICIAL) (See Instructions) 14 Contributor's employer/law firm (FOR JUDICIAL) 15 Law firm of contributor's spouse (if any) (FOR JUDICIAL) 16 If contributor is a child, law firm of parent(s) (if any) (FOR JUDICIAL) Date Full name of contributor 0 out-of-state PAC (ID#: ) Amount of In-kind contribution Contribution $ , description • Check if travel outside of Texas, complete Schedule T Contributor address; City; State; Zip Code Principal occupation / Job title (FOR NON-JUDICIAL) (See Instructions) Employer (FOR NON-JUDICIAL)(See Instructions) Contributor's principal occupation (FOR JUDICIAL) Contributor's job title (FOR JUDICIAL) (See Instructions) Contributor's employer/law firm (FOR JUDICIAL) Law firm of contributor's spouse (if any) (FOR JUDICIAL) If contributor is a child, law firm of parent(s) (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 02/27/2015 POLITICAL EXPENDITURES FROM POLITICAL CONTRIBUTIONS SCHEDULE F1 EXPENDITURE CATEGORIES FOR BOX 8(a) Advertising Expense Event Expense Loan Repaynient/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/VVages/Contract Labor Other (enter a category not listed above) The Instruction Guide explains how to complete this form. 1 Total pages Schedule F1: 1 2 FILER NAME Protect Colleyville 3 Filer ID (Ethics Commission Filers) 4 Date 03/22/15 5 Payee name 91 Design 6 Amount ($) 4059.38 7 Payee address; City; State; Zip Code 4115 Steeplechase Colleyville, TX 76034 8 PURPOSE OF EXPENDITURE (a) Category (See categories listed at the top of this schedule) Advertising Expense (b) Description 1-1 1 Check if travel outside of Texas, complete Schedule T 1 1 Check if Austin, TX, officeholder living expense Yard signs & double -sided signs 9 Complete ONLY if direct Candidate / Officeholder name expenditure to benefit C/OH Office sought Office held Date 03/31/15 Payee name Worthington National Bank Amount ($) 5.27 Payee address; City; State; Zip Code 200 West Main Street Arlington, TX 76010 PURPOSE OF EXPENDITURE Category (See categories listed at the top of this schedule) Accounting/Banking Description 1 Check if travel outside of Texas, complete Schedule T I I Check if Austin, TX, officeholder living expense Printed Statement Fee Complete ONLY if direct Candidate / Officeholder name Office sought Office held expenditure to benefit CIOH Date Payee name Amount ($) Payee address; City; State; Zip Code PURPOSE OF EXPENDITURE Category (See categories listed at the top of this schedule) Description 1 1 Check if travel outside of Texas, complete Schedule T I 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 02/27/2015