HomeMy WebLinkAboutContributions and Expenditure Statements-Campaign Finance Reports & Filings-07/17/2017 (2) CANDIDATE / OFFICEHOLDER FORM C/OH
CAMPAIGN FINANCE REPORT COVER SHEET PG 1
1 Filer ID (Ethics Commission Filers) 2 Total pages filed:
The C/OH Instruction Guide explains how to complete this form.
a.
3 CANDIDATE/ MS/MRS/MR
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FIRST MI OFFICE USE ONLY
OFFICEHOLDER tDr p
NAME
Date Received
NICKNAME LAST SUFFIX _
Nje,(....1 k-20 E,EOVE 7
4 CANDIDATE/ ADDRESS /PO BOX; APT/SUITE#; CITY; STATE; ZIP CODE
OFFICEHOLDER '";� JUL 17 2017
ADDRESS 6 ZOg MAILING �-'`�� t.-6-14(--- C��l�� J��� 0� ���
n Change of Address `CITY SECRETARY'S OFFICE
5 CANDIDATE/ AREA CODE PHONE NUMBER EXTENSION
OFFICEHOLDER p _
Da and-delivere� ate Post arked
PHONE ���� � i-tl -` � late
11
6 CAMPAIGN MS/MRS/MR FIRST MI Receipt# Amount
TREASURER
NAME r., � � Date Processed
NICKNAME LAST SUFFIX
Date Imaged
Vce if-S��'e r
7 CAMPAIGN STREET ADDRESS (NO PO BOX PLEASE); APT/SUITE#; CITY; STATE; ZIP CODE
TREASURER
ADDRESS
(Residence or Business) 2 �/��f- r�N L �cod -� Cs, a C9\�a deLQ J ` ��
8 CAMPAIGN AREA CODE PHONE NUMBER EXTENSION
TREASURER
PHONE ( 8 kg ) 2.ZA_ p Cori‘
9 REPORT TYPE
n January 15 n 30th day before election I Runoff 15th day after campaign
treasurer appointment
(Officeholder Only)
IZI July 15 8th day before election n Exceeded$500 limit n Final Report(Attach C/OH-FR)
10 PERIOD Month Day Year Month Day Year
COVERED
/ \ /zon THROUGH "' /3D / 2...a 1
11 ELECTION ELECTION DATE ELECTION TYPE
Month Day Year ❑ Primary ❑ Runoff n Other
Description
/ / n General n Special
12 OFFICE OFFICE HELD (if any) 13 OFFICE SOUGHT (if known)
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Forms provided by Texas Ethics Commission www.ethics.state.tx.us Revised 9/8/2015
CANDIDATE / OFFICEHOLDER
FORM C/OH
CAMPAIGN FINANCE REPORT COVER SHEET PG 2
14 NAME 15 Filer ID (Ethics Commission Filers)
V.LAINO...r-CL N"e-(4-41sb lNif
16 NOTICE FROM THIS BOX IS FOR NOTICE OF POLmCAL CONTRIBUTIONS ACCEPTED OR POLITICAL EXPENDITURES MADE BY POLITICAL COMMITTEES TO
POLITICAL SUPPORT THE CANDIDATE/OFFICEHOLDER. THESE EXPENDITURES MAY HAVE BEEN MADE WITHOUT THE CANDIDATE'S OR OFFICEHOLDER'S
COMMITTEE(S) KNOWLEDGE OR CONSENT. CANDIDATES AND OFFICEHOLDERS ARE REQUIRED TO REPORT THIS INFORMATION ONLY IF THEY RECEIVE NOTICE
OF SUCH EXPENDITURES.
COMMITTEE TYPE COMMITTEE NAME
El GENERAL
COMMITTEE ADDRESS
❑SPECIFIC
COMMITTEE CAMPAIGN TREASURER NAME
n Additional Pages
COMMITTEE CAMPAIGN TREASURER ADDRESS
17 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)
TOTALS
EXPENDITURE 3. TOTAL POLITICAL EXPENDITURES OF $100 OR LESS, $
UNLESS ITEMIZED tO
4. TOTAL POLITICAL EXPENDITURES $
CO
BALANCE CONTRIBUTION 5. TOTAL POLITICAL CONTRIBUTIONS MAINTAINED AS OF THE LAST DAY $
OF REPORTING PERIOD or 1 tc As,
•
OUTSTANDING 6. TOTAL PRINCIPAL AMOUNT OF ALL OUTSTANDING LOANS AS OF THE
LOAN TOTALS LAST DAY OF THE REPORTING PERIOD $ R,4-1.Q 1"'�
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 me
`C
Amy Shelley und- a •,Election Code.
Notary Public
State of Texas
MY Comm.Exp.12/02/19 l
Notary ID#12476110-5 ----V
"" Signature of Candidate or Officeholder
AFFIX NOTARY STAMP/SEALABOVE 1�ISworn to and subscribed before me,by the said R\cvjaV 'e ,this the
' .` M of VI ,20 11- ,to certify which,witness my hand and seal of office.
O N% ► Ili Inc.II " ire.-fa
Si• •e of office inistering oath Printe n me of officaa inistering oath Title o icer administerin th
Forms provided by Texas Ethics Commission www.ethics.state.tx.us Revised 9/8/2015