HomeMy WebLinkAboutContributions and Expenditure Statements-Campaign Finance Reports & Filings-07/17/2017Texas Ethics Commission P.O. Box 12070 Austin, Texas 78711-2070 (512) 463-5800 (TDD 1-800-735-2989)
CANDIDATE I OFFICEHOLDER FORMC/OH
CAMPAIGN FINANCE REPORT COVER SHEET PG 1
1 ACCOUNT# 2 Total pages filed:
The C/OH Instruction Guide explains how to complete this form. (Ethics Commission Filers) 3
3 CANDIDATE I MS/MRS/MR FIRST Ml OFFICE USE ONLY
OFFICEHOLDER Michael A. NAME Date Received . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . ..
NICKNAME LAST SUFFIX
"Mike" Taylor
4 CANDIDATE I ADDRESS I PO BOX: APT /SUITE#; CITY; STATE; ZIP CODE
OFFICEHOLDER
MAILING 5209 Coventry Place Colleyville, Texas 76034 Date Hand-delivered or Postmarked
ADDRESS
D change of address Receipt# I Amount
5 CANDIDATE/ AREA CODE PHONE NUMBER EXTENSION
OFFICEHOLDER Date Processed
PHONE ( 817 ) 366-5557
6 CAMPAIGN MS/MRS/MR FIRST Ml Date Imaged
TREASURER Michael A. NAME . . . . . . . . . . . . . . . . . . . . . . . . . . . . ... . . . .
NICKNAME LAST SUFFIX
"Mike" Taylor
7 CAMPAIGN STREET ADDRESS (NO PO BOX PLEASE); APT/SUITE#; CITY; STATE; ZIP CODE
TREASURER 5209 Coventry Place Colleyville, TX 76034 ADDRESS
(residence or business)
8 CAMPAIGN AREA CODE PHONE NUMBER EXTENSION
TREASURER ( 817 ) 366-5557 PHONE
9 REPORT TYPE D January 15 D 30th day before election D Runoff D 15th day after campaign
treasurer appointment
(officeholder only)
lXl July 15 D 8th day before election D Exceeded $500 D Final report (Attach CIOH -FR)
limit
10 PERIOD Month Day Year Month Day Year
COVERED
01/ 18 /17 THROUGH 07 /17 /17
11 ELECTION ELECTION DATE ELECTION TYPE
Month Day Year D Primary D Runoff IZJ General D Special
05/ 9 /15
12 OFFICE OFFICE HELD (if any) 13 OFFICESOUGHT (ifknown)
Place 6, City of Colleyville N/A
GOTOPAGE2
www.ethics.state.tx.us Revised 07/28/2014
Texas Eth ics Commission P.O. Box 12070 Austin, Texas 78711-2070 (512) 463-5800 (TDD 1-800-735-2989)
CANDIDATE I OFFICEHOLDER REPORT: FORM C/OH
SUPPORT & TOTALS COVER SHEET PG 2
14 C/OH NAME
Michael A. "Mike" Taylor 115 ACCOUNT# (Ethics Commission Filers)
16 NOTICE FROM lHIS BOX IS FOR NOTICE OF POLITICAL CONlRIBUTIONS ACCEPTED OR POLITICAL EXPENDITURES MADE BY POLITICAL COMMITTEES TO SUPPORT lHE
POLITICAL CANDIDATE f OFFICEHOLDER. THESE EXPENDITURES MAY HAVE BEEN MADE WITHOUT THE CANDIDATE'S OR OFFICEHOLDER'S KNOWLEDGE OR
COMMITTEE(S) CONSENT. CANDIDATES AND OFFICEHOLDERS ARE REQUIRED TO REPORT lHIS INFORMATION ONLY IF lHEY RECEIVE NOTICE OF SUCH EXPENDITURES.
COMMITT EE NAME
COMMITTEE TYPE
D GENERAL
COMM ITTEE ADDRESS
D SPECIFIC
COMMITTEE CAMPAIGN TREASURER NAME
D additional pages
COMMITT EE CAMPAIGN TREASURER ADDR ESS
17 CONTRIBUTION 1 . TOTAL POLITIC A L CONTRIBUTIONS OF $50 OR LESS {O THER THAN
TOTALS PLEDGES , LO ANS, OR GUARANTEES OF LOANS ), UNLESS ITEMIZED $ 0.00
2 . TOTAL POLITICAL CONTRIBUTIONS $ 0.00 (O THER TH AN PLEDGES, LO ANS, OR GUARANTEES OF LO ANS)
EXPENDITURE
$ 0.00 TOTALS 3. TOTA L PO LITIC A L EXP ENDITURES OF $100 OR LESS , UNLESS ITEMIZED
4. TOTAL POLITICAL EXPENDITURES $ 0.00
CONTRIBUTION 5. TOTA L POLITICAL CONTRIBUTIONS MAINTAINED AS OF THE LAS T D AY BALANCE OF REPORTING PERIOD $ 0.00
OUTSTANDING 6. T OTA L PRIN C IP A L AMOUNT OF ALL OUTSTANDING LO ANS AS OF THE LOAN TOTALS LAS T DAY OF THE REPORTING PERIOD $ $11,900.00
18 AFFIDAVIT
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
•'''""''''' NANCY L STARNES me under itle 15, Election Code.
'" ~'fll'tJ: .. ,,. . ~1~ $"J.~1fj~'i:"~ Notary Public. State of Texas
i::. ).;~comm. Explres02·10-2019 \~·······+..-.~ '',//o•~":..•' Nolory 10 7058177 V Signature of Candidate or Officeholder
,,.,,.,,,
AFFIX NOTARY STAMP I SEAL ABOVE
Sworn to and subscribed before me , by the said Michael A. Taylor , this the
17 day of July ' 20 17 to certify which , witness my hand and seal of office .
71thl/xdt-~ J11rJc1 l . s tm<. tJ 6-S:. L1 C&lJS[p A j)/)111) 15~-rt I/ G /Ii ~
Signatur/ of officer administering oath Printed name of officer administering oath Title of officer administering oath
www.e thics .s tate .tx.us Revised 07/28/2 014
Texas Ethics Commission P.O. Box 12070 Austin, Texas 78711-2070 (512) 463-5800 (TDD 1-800-735-2989)
LOANS SCHEDULE E
1 Total pages Schedule E:
The Instruction Guide explains how to complete this form. 1/1
2 FILER NAME
Michael A. Taylor
3 ACCOUNT# (Ethics Commission Filers)
4
TOTAL OF UNITEMIZED LOANS: ¢ ¢ ¢ ¢ ¢ ¢ $
5 Date of loan 7 Name of lender 0 out-of-state PAC (ID#: ) 9 Loan Amount($)
07-16-09 Mike Taylor $11,900.00
6 ls lender 8 Lender address; City; State; Zip Code 10 Interest rate
a financial 1.00%
Institution? 5209 Coventry Place, Colleyville, TX 76034
11 Maturity date
y ® 07-15-18
12 Principal occupation I Job title (See Instructions) 13 Employer (See Instructions)
Financial Services I VP, Financial Adviser Provident Strategies Group -Independent Adviser
14 Description of Collateral 15 Check if personal funds were deposited into political account
.t8l. none ~
16 GUARANTOR 17 Name of guarantor 19 Amount Guaranteed ($)
INFORMATION
18 Guarantor address; City; State; Zip Code
D not applicable
20 Principal Occupation (See Instructions) 21 Employer (See Instructions)
Date of loan Name of lender 0 out-of-state PAC (ID#: \ Loan Amount($)
00-00-00 $0.00
ls lender Lender address; City; State; Zip Code Interest rate
a financial 0.00%
Institution?
®
Maturity date
y 00-00-00
Principal occupation I Job title (See Instructions) Employer (See Instructions)
Description of Collateral Check if personal funds were deposited into political account
r8J. none D
GUARANTOR Name of guarantor Amount Guaranteed ($)
INFORMATION
Guarantor address; City; State; Zip Code
D not applicable
Principal Occupation (See Instructions) Employer (See Instructions)
ATTACH ADDITIONAL COPIES OF THIS SCHEDULE AS NEEDED
If lender is out-of-state PAC, please see instruction guide for additional reporting requirements.
www.ethics.state.tx.us Revised 07/28/2014