HomeMy WebLinkAboutContributions and Expenditure Statements-Campaign Finance Reports & Filings-07/14/2017 (2)CANDIDATE / OFFICEHOLDER FORnn CioH
CAMPAIGN FINANCE REPORT COVER SHEET PG 1
7 Filer ID (Emke Commis¢lon Fllers) 2 TOtal pegee Nled: A
The C/OH Inatructlon Gultle explalns how to complete thls form. r �
3 CANDIDATE/ /Mp6� MR F MI
OFFICEHOLDER y OFFlCEUSEONLY
NAME �%1l'Y) .� , a e�a�,r.m,.„,�
NICKNAME LqST SUFFIX LL [L � �
4 CANDIDATE/ AD�HE66 /POBO%; APT/Sl1REk; ,CI � STATE; ZIPCO�B "��'�jA �`k r�{�p�
i;��
OFFICEHOLDER <10�0� � ///� ���/D
MAILING O�pe ` J"Y)
ADDRESS Ily `� �i �l� � 7� O�� CITY SECRETARY'S OFFICE
❑ Change ofAdtlress `,Q
5 CANDIDATE/ ARFA CA�E PHONE NUMBER EXTENSION
PHONE HOLDER � Q/ �� n�� ���y n� Dete Hentl-deliverad or Date Poatmerketl
C/ o� Y Z
8 CAMPAIGN MS /�H FIRSi MI Fecelpt # Amaunf $
TREASURER � ��a m m
NAME Y , �, , Date Processed
NICIQJAME. . . . . . . . .LAST • ./ . . . . . . . . SUFFIX
/� {(�/}ry� � Oete ImeBetl
NiIWt ��! �'
7 CAMPAIQN STREEfApDRESS (NOPOBO%PLEASE); APT/SUREp; CITV; STATE; 21PCADE
TREASURER �a � �
ADDRESS
(Residence or Business)
S CAMPAIGN AREA COOE PHONE NIIM9Ep E%TENSION
PHO EURER � a��l,� p1?�� �gg.�
e� Z�. o�
9 REPORTTYPE
� January 75 � 30M tlay betore election � RunoN ❑ �reasure� appoittlment�n
(Olilceholtler Only)
�Juty75 � g�daybeforeelectlon � Exceetletl$50011mfl � FinalReport(MechC/OH-FR)
10 PERIOD Mon�h Dey Y¢ar Manih Day Vear
COVERED / / �l / I � ! / /�/ I /
�� 7HROUGH
'11 ELECTION ELECTION UATE ELECTION TVPE
Mon�h Day Yaer ❑ Primary � Punaii O@er /
� �exriptlon
7 // 5 / / / ❑ Oenerel � SPecial Q �� !/ �,
l0 L.I
'12 OFFICE OFfICEHELD Qfany) 1$ OFFICESOIIGM (IiNrwwn)
GO TO PAGE 2
Forms provided bV Tezas Ethics Commission www.ethics.state.tz.us RBvised 9/8/2075
r
CANDIDATE / OFFICEHOLDER FORM C/OH
CAMPAIGN FINANCE REPORT COVER SHEET PG 2
14 C/OH NAME 15 Filer ID (Ethics Commission Filers)
I,�,�c� vn u /'c�.
'IB NOTICE FROM 1XIS BO% � FOH N CE OF POLRICpI COMqIBU110N5 ACCEPfED ON PpLRICN. EXPENURUXES NFUE BY POLITICAL COMNIiTEE9 TO
POLITICAL BUVPORfTXECANU1DRlEIOFFlCEHOLOEX. ]H68EEXPENORUflEBMAYXAVEBEEN//NOEWRHOUf1NECANW0AlE90AOFfiCIXO1DEq'9
COMMITTEE(S) q/OWLEIXiEORCONBFM. CRNDIDATESANOOFFlCEMOL�ERBNIEXE�YIREDTOREPOflTT1191NFORNATONONLYIFTHEYRECEIVENpT10E
OF 911CH IXPENORUqEB.
COMMITTEE TVPE COMMITTEE NAME
�GENEPAL �
COMMITTEE A��FESS
❑SPECIFIC
COMMITTEE CAMPAION TREPSUREfl NAME
� Additional Pages
COMMITTEE CAMPAIGN TREASUREP AODRESS
17 COMRIBUTION �, TOTAL POLITICAI CONTRIBUTIONS OF $50 OR LESS (OTHEfl THAN
TOTALS PLEDGES, LOANS, OR GUARANTEES OF LOANS), UNLESS I7EMIZED $
2. TOTAL POLITICAL CONTRIBUTIONS $ �
(OTHER THAN PLEDOES, LOANS, OF GUARANTEES OF LOANS)
TOTALS ITURE 3. TOTAL POLITICAI EXPENDITURES OF $100 OR LESS, $
UNLESS ITEMIZED �
4. TOTAL POLITICAL EXPENDITURES $ r� '
`y�
CONTRIBUTION 5. 70TAL POLITICAL CONTRIBUTIONS MAIN7AINED AS OF THE LAST DAY
BALANCE OF REPORTING PERIOD � �
OUTSTANDING 6. TOTALPRINCIPALAMOUN70FALLOIITSTANDINGLOANSASOFTHE �i ��0
LOAN TOTALS LAST �AY OF THE REPORTING PERIOD S
'IB AFFIDAVIT
1 swear, or aHirm, under penalty of peryury, that the accompanying �eport is
true and corred and includes ali information requ(red to be reported by me
r underTitl 5,ElectionCode. /����
.�ti�'?i�p•; CHRISTINELOVEN ,
° �.ei MyNoterylD#11092587 � �
i�''�• e��' F�c ires Ma 2 2018 '
'����7� •" p Y� Signat of Candidate r Officeholder
AFFIXNOTAflVSTAMP/SEALA60VE
Sworn to and subscribed before me, by the said j��rn i�[�IC[�i /%iL([ �. , this the _1�
day of i.�,� , 0 �� , to certify which, witness my hand and seal of office.
� G�,� , ov�.i S rn e� ti-� o-�a '
SlBnature of oHicer administering oeth Printetl name of officer administering oeth 7itle of oRicer administering oath
Forms provided by Texas Ethics Commission www.ethics.state.ix.us Revised 9/B/2015