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Home My WebLink AboutGilani, Amyn - 2022RECEIVED z-z6 Prescri6ed by Secretary of State SecNon 141.031, ChapEers 143 and 144, Texas Election Lode D9/2021 APPLICATIUN FOR A PLACE ON THE BALLOT FOR A GENERAL ELECTION FOR A ClTY, SCHQOL DiSiltlCf QR OTHER POLiTICAL 5UBDIVISION FEB 0 2 2D2x .��i *� ALl INFQRMAT[ON IS REQUIREDTO BE PROVIDED UNLESS INDICATED AS OPTIONALYFailure to pravide required informatipn may resait in rejection of a plitation. APPiICATION FORA PkACE ON THE Co�tey�,l��. GENERAL ELECTIQN BALLOf TO: City 5ecretary/SecreYary of Board (eame of electio�j I requestthat my narne be placed on the abov�named official ballot as a candidate forthe oifioe indicated befow_ OFFECESOIfGHT(Indude any piace numtreror other distinguishing number, if any.j INUfCATETERM Cl i CCrJ(�,C � 1 �ta�� LJFU�L � UNEXPIRED FULL NAME {Firs[, Middle, Last� PRINT NAME AS YOU WAI�fT IT TO APPEAR ON THE BALLpT' ��,��n� , (�my� �t-m,�� C��l�n; PERMANFJ�IT RESIDENCE Al}DRESS {Da nat include a P.O. Box or Ruraf Route. lf PiJBLIC MAILING ADDRES5 {bptional} �Ad�ess fur which you receive you do noi haye a residerice ad�ess, descrihe location of residence.j campaign related correspondence, if available_j (pD..�� C'j��f'(1 rYlf'��Qc.�7 P�1- CIiY SfATE ZiP CITY STATE Z!P Cnl��e�(U ' ��'- `�7� � � �3 �� PUBUC EMAIL ADDRE55 [O�tionalj (nddress for OCCUPATION {Do not leave 61ank]p DATE OF BIRTii VOTER REGISTRA;ION Wid whichyourereivecampaignrelatedemai(s.ifa+railabEej ��Lhirl['1�Q�� `)Cy�[.V}'f'`, IYUMBERZI�P�1 �r�►'k��Y1 � V[r�2. �� I� n'� - Go^�1 TELEAHONE CONTACT INFORMATION [Optionalj Home: `� OFFice: -• Cell: ��-(� �' --�J � ��'- ��"� � FELpNY COIYVICTION STATUS [You MUST check one) LEHGTH OF CON71NUqUS RESIpF�ICE AS OF DATE THIS APPiJCATIDN WAS SINORN �! have not 6een finally convicted of a felony. IN 7HE 5YATE OF TE7(AS IN TERRITORY/UISTRICT/PREGNCT FRdM � I have been finally convicted of a felony, 6ut [ have 6een r- WHICH THE OFFfCE SOUGM�il5 ELECTED pardoned or otherwise released from the resulting � year{s) � year(s} disahilities of that #efony conviction and I have provideri 2 proof of this fatt with the su6mission af this application 3 '"� month(s} � month{sj `If using a nickname as gart of your name to appear on the ballot, you are also signing and swearing to the fallowing state�nerts: I further swear that my nickname does not constiiuie a slugan or contain a tRle, nar does it indicate a polftical, economic, social, or religiaus view or affiliatian. E have 6een commaniy knawn 6y this nickname for at least three years prior to this election. Please rerriew settior�s 52_031, 52.032 and 52.033 of the Texas Election Code regarding the rules for how names may 6e listed on Fhe officiai 6aEfot. Before me, the undersigned a�rtharity, on this day personally appeared {name of candidate} ��jl�� , 1!�' Yl � , who heing by me here and now duly swom, upon oath says: "I, (name of candidatej /k fY�.� Yl -, of f' �'� Coun[y, i�exas, being a wndida#e far the office of '�p. u � �G �nc, p�• �� swear ihat I wiN support and defend the Consticertion and iaws of the United States and of the State of Texas. I am a c izen af the United States eligible to hald such affice under the canstRution and Eaws nf this state. I have not been determined by a final judgment of a court exercising probate jurisdiction to 6e totalEy mentally incapacitated or partially mentally incapacitated withou# the right to �ote. ! am aware of the nepotism law, Chapter 573, Govemment Code. I am aware that I must disctose any prior felony con�iction, and if so con�icted, must pro�ide praof that i have 6een pardoned or otherwise released from the resulting disabii�ties of any such final {elony con�iction_ ! am aware that knowingly pro�iding false i�forrr�aYion o he applitation regarding my possi6le felony tonvitiion status constituYes a Class B misdemeannr. I further swear that the foregoing state ents i clu d in my application are in all things true and carrect:' X 51G RE OF CANDIDATE Sworn to and su6scribed before me this the,�l� day of ��j,� � Q�`� O� by A 1'nV fL lS!_I a_�--� � � {dayj [month} ear � name of cancGdate]T � "'v Y �/ \ �`�`j.PY � / . � '�' B � �.+ SigRature of Officer Authorize to Administer OatM' Print �ia ofqbffic�IJl�fi�k3'L�9�i8�ster ath � O�" C� Q—�` �?;:�;oR ��'+r' �f2S May 2, 2022 Title of Officer Authorized to Administer Oath ' 7U BE COMALETEp BY FILING OFFICER: 17115 APPLICATION 15 ACCOMPANlED BY 7HE REQUIRED F111NG FEE (ff Applieable) PAID BY: ❑ CASH ❑ CHECK � M1AONEY ORDER � CASHIERS CHECK OR � PETITION fN LIEU pF A FILING F�E--E,.� This document and $"—U - filing fee or a nominating petition of � pages received. � Voter Re ' tr tion Status Verifled ��D� I D � � �Y�-Q-� U-V�---J . I � � (�,Jc�Q�+r�- (See Section 1.OU7) Date Received Oate Aocepted S�nature of Fiiing OfRcer or Designee Pr�rrt Rese# CODE OF FAIR CAMPAIGN FORM CFCP PRACTICES COVER SHEET OFFICE USE ONLV Pursuant to chapter 258 of the Election Code, every candidate and �R�� political committee is encouraged to subscribe to the Code of Fair RECEIVED Campaign Practices. The Code may be filed with the proper filing FEB 0 2 2021 authority upon submission of a campaign treasurer appointment form. Candidates or political committees that already have a �O current campaign treasurer appoinhnent on file as of September 1, 1997, may subscribe to the code at any rime. °aLeH""°e�VQe°°"�"'�"`�° Date ProoesseE Subscription to the Code ofl�air Campaign Yractices is voluntary. Oate Imagea 1 ACCOUNT NUMBER 2 TYPE OF FILER (Etl iics Commission Flets) CANDIDATE POLITICAL COMMITTEE � lf filing as a candidate, complete boxes 3- 6, If filing for a political cnmmittee, complete then read end sign page 2. boxes 7 and 8, (hen read end sign page 2. 3 NAME OF CANDIDATE nne�a,Mr,Ms,ex.� r�asr Mi ��,�,��, i�r� Rr�� ldCKNhME IASf SUFFlX(SR,JR.,III,eRJ �--�, �� ; 4 TELEPHONE NUMBER �� +a+E��M�R aTe+s�'+ OF CANDIDATE ,��,��a�a��,r, (�zuz.) Slo �-4y�� 5 ADDRESS OF CANDIDATE sraEEriroeox; aarisurrEr, am srarF; �PcooE �P�nsetrr�atcwrrp �Y�i�C/. O' �7 C� . f . COOS �'il��n d C9ll-e,��u�A� c. `l ��c� � � 6 OFFICE SOUGHT BY CANDIDATE �-l� CO'JnC. � I ��GC� � C�Ileyv; lle� C� � (PLEASETYPEORPRIIJn ] NAME OF COMMITTEE (v�Enns�rraEaa vrtierr� $ NAME OF CAMPAIGN PRE(Dr.,Mr,Ms.,c4.) aasr ui TREASURER 1��.� � ��a�-�� (RElSETYPEORPWN� _______ __________ _______ _ _ ____ _____ _____ _______ ____________________ MCIQJAME 1A5� SUFFl%(SR,JR_,Ill,ek.) C--�, I�n � GO TO PAGE 2 FormsprovitletlbyTexasEtMcsGommisslon www.emics.s�aie.ne.us Hemsetl vtrzolt CODE OF FAIR CAMPAIGN PRACTICES There are basic principles ofdece�cy, honesty, and fair play that every candidate and po(itical committee in ihis state has a moral obl igation to observe and uphold, in order diat, after vigoroasly contested but faidy conducted campaigns, ourcirizens may eacercisetheirconstihrtional rightstoafreeand�miranvneledchoiceandthe will ofthepaoplemay be fully and cleady expressed onthe issues. 'II IEREFORE: (1) I will wnduct ihe campaign op�ily and publicly and limit attacks on my opponentto legitimate chall�ges to my oppon�Ys record and stated positions on issues. (2) I will not use orpeanit ihe use ofcl�azacter defa�nalion, whispering campaigns, libel, slander, or scumlous attacks on any candidate or ihe candidate's pecsonal or family life. (3) [ will not use or pennit any appeal to negaUive prejudice based on race, sex, religion, or narional origin. (4) I will not use campaign maierial of any sort that misrepresents, distorts, or otherwise falsifies the facts, nor will I use malicious or tmfo�mded accusations that aim at creati�g oreacploiting doubts, without justiificalion, as to the personal integritp orpatriotism ofmy oppon�t (5) I will not imdettake or condone arry dishonest or im�hical practice ihatta�ds to comipt or imdermine our system offree elections orthathampers orprev�ts thefiill and free expression ofthe will ofthevoteis, includingarry xlivity aiined ffiintimidafingvotets ordiscowagingthemfrom voting. (6) I will defend and uphold the right ofevery qualified voter to full and equal participation in die electoral process, and will not engage in any adi�7ly aiined aY intimidaling voters ordisw�¢agmgthem from vofing. (7) I will immediately �d publicly r�udiate m�hods and tadics that may come from oth� thatI hac�e pladged aot to use or condone. I shall take firm achion against azry subordinate who violates azry provision ofthis code or the laws gov�ning elecUons. I, the undersigned, candidate for e(ection to public office in the State of Tesas or campaign lreasurer of a political committce,herebyvolwrtazilyendorse,subscribeto, andsole�nnlypledgemyse(ftoconductthecampaigiinaccordance with the above principles and practices. > � s;� 2�ZI2Z Date Forms provlded by Texas Eihics Commissian www.ethics.state.Dc.us Revised 7/1l2021 APPOINTMENT OF A CAMPAIGN TREASURER FORm CTA BY A CANDIDATE P� 1 7 Tobl paBes fled: See CTA Instruction Guide for detailed instructions. � 2 CANDIDATE MSIMRS/MR RRsr Mi OFFICE USE ONLY NAME N,/j(' Qr,P�L1Y� � �� J F��ios NiqcnqME vsr su�x �ertea,w�ECEfVED �-'�i �c'�Yll FEB 0 2 1012 3 CANDIDATE A�� x; avrisurrEr, cm; srq�; nPcooE MAILING 1 _/ 7 �/� ADDRESS �VI�J C'�(i�C� 1 � `�rnr Ci�`� �% �So C�,IIe��,tle, , � -'1�u�341 6ate Ha ndde5vered a Possnarketl 4 CANDIDATE /'R� �E PHONE NUMBFR IXTEN9oN Receiptv MnvtS PHONE ( `O u (z-(� C� ) �J ��- t"'t'"� oate pr«essm 5 OFFICE oateimagea HELD (it any) 6 OFFICE �7 SOUGHT �V�-� CV��nC.A� P�� -+^ � �0� ��V,II�, (rf Imown) 7 CAMPAIGN MSrtARS�MR RRST MI NICNNAME LAST SUFFi% TREASURER � `�l NAME '/�n �'sJ . ��.�� '"�I � lcxl'l l P"� 8 CAMPAIGN smEEraooREss: nrr�surtEr cm; srw� nacooE TREASURER STREET fu0:'j C,-�iY'P� ii�PG �J VJ_ Cn��2��:��, T� �� ADDRESS (resfOenCe or business) g CAMPAIGN �� +E NUMeEn ocrEns�ori TREASURER PHONE � (� � �\ `�, �.� r� j_ �' �� v 10 CANDIDATE SIGNATURE � am aware of the Nepotism Law, Chapter 573 of the Texas Govemment Code. 1 am aware of my responsibility to file timely reports as required by tiUe 15 of the Election Code. I am aware of the restrictions in tille 15 of the Election Code on contributions from corporations and labor organizations. _, —_ __ 2IZ I ZZ- � i t ofCandidate DateSigned GO TO PAGE 2 Forms provided by Texas Ethics Commission ww.v.ethics.state.tx.us Revised 1l1/2022 CANDIDATE MODIFIED FORM CTA REPORTING DECLARATION F'G 2 11 CANDIDATE NAME �z MODIFIED COMPLETE THIS SECTION ONLY IF YOU ARE REPORTING DECLARATION CHOOSING MODIFIED REPORTING » This de¢laration must be Tiled no later than the 30th day before the first eleotion to which the dealaration applies. » •• The mod�ed reporting option is valid for one eleotion oyole only. •• (Anekction�yde inepides a prinaryelerbon. a gene�alelectiw�. anAairyrelated nsaQs_) I — Candidates for the offiae oT state ahair ot a political party may NOT choose modHled reporting. » 1 do not intend to accept more than $940 in political contributions or make more than $940 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 wiil be required to file pre-election reports and, if necessary, a runoff report. vearofeiec6on(s)orelectionqdeto SignatureofCandidate which declaratlon appGes This appointment is effective on the da0e R is filed wtU� the appropriate fl1ing authority. TEC Filers may send this form to the TEC electronically attreasappoint(�ethics.state.bc.us or mail to Texas Ethics Commission P.O. Box'12070 Austin, TX 78711-2070 Non-TEC Fiiers must fiie this form with the local filing authority DO NOT SEND TO TEC For more information about where to file go to: https://www.ethics.state.bc.us/filinginfo/QuickFileAReport. php Forms provided by Texas Ethics Commission www.ethics.state.tx.us Revised 1/1/2022 City of Colleyville Financial Disclosure and Business ConNict of Interest Forms INFORMATION STATEMENT TOTAL NUMBER OF PAGES FILED: � OFPICE USE ONLY 1 NAME First, MI Date Received �Imy�� last, Suffix RECEIVED Cti", �3ni ZADDRESS Address/City/State/2ip f FEB 0210?? lon..1� C')�p� (�'4Pc7crloi,J N � C��leyv,�\�, � �TJ� � in0��{ 3 TELEPHONE Area Code, Phone Number, Extension NUMBER Zn-�, - 5( p- y�{ n5 ° REASON ❑ EMPLOYEE (CITV MANAGER OR *SENIOR STAFF) FOR FILING � CANDIDATE C�'1-�I Coo��c� � PI. .L �iNoicare oFr�ce� STATEMENT 0 ELECTED OFFICIAL ��noicn� orr�ce� ❑ ZONING BOARD OF ADJUSTMENT �arvuw�rr oa arvoirrr�� O PLANNING & ZONING COMMISSION �avrucarrronncvomrrff� ❑Two (2) business days following the end of the candidate filing period or if appointment, following the end of the application period stated in the official city advertisement for the position. � Supplemental disclosure filed annually and within five (5) business days of an occurrence in previously filed form. *SENIOR STAFF is defined as those employees who are classified as directors and above in the City's classification system and the City Manager and City Secretary. s SPOUSE NAME �`�n� C�� Iry� � DEPENDENT 1. r.Z�a C-;�Ic'ir�� CHILD/CHILDREN 2. �1. �,�� Ar�� NAME(S) 3. 4. COPY AND ATTACH ADDITIONAL PAGES AS NECESSARY INITIAL HERE: � DATE: ZIZ ��- Ciry of Colleyville Financial Disclosure and Business ConFlict of Interest Forms INTERESTS IN REAL PROPERTY Section 1 Describe the location, size, and current use of all property owned within the included map, or held in trust by the filer, spouse, and any dependent minor children, or any business entity in which the person has a financial interest. When reporting information about a dependent child's activity, indicate the child about whom you are reporting by providing the number under which the chiid is listed on the Information Statement. HELD OR ACQUIRED BY FILER SPOUSE DEPENDENT CHILD #_ DESCRIPTlON �ot l-`� cry Cc�ll�u�,11e_ &ock � county `\ cl ( ��.n-�-• Subdivision �.ic"Y=�c��Q�'J �� oiG Ad Valorum Tax Account Number R�.�,�.�.:�, s5 Z� �oc� Acre(s) and Trect •2-� STREET ADDRESS STREEf ADDRESS, INCLUDING CITY, COUNTY, AND STATE (yc%3 C ��Pe,� Y}��E'c��lr�.,� t� Co�lt'�(v,lie. "1 ;� "Icoc>3�1 l�=�c�r�r�}— C� ° NAME LIST THE NAMES AND ADDRESSES OF OTHER PERSONS OR BUSINESS ENTIfIES WHICH OWN AN INTEREST IN THE REAL PROPERTY D INDIVIDUAL Q BUSINESS HELD OR ACQUIRED BY FILER SPOUSE DEPENDENT CHILD #_ DESCRIPTION Lot city Block County Subdivision Ad Valorum Tax Acwunt Number Acre(s) and Tract 3 STREET ADDRESS STREEf ADDRESS, INCLUDING CITY, COUNTY, AND STATE ° NAME LIST THE NAMES AND ADDRESSES OF OTHER PERSONS OR BUSINESS ENTI7IES WHICH OWN AN INTEREST IN THE REAL PROPERTY QINDIVIDUAL Q BUSINESS COPY AND ATTACH ADDITIONAL PAGES AS NECESSARY ❑ NOT APPLICABLE INITIAL HERE:_� DATE: Z'L Z,Z City of Colleyville Financial Disclosure and Business ConfliU of Interest Forms FEE, SALARY, OR GIFT Section 2 The name and address of any person or corporation which currently has or during the preceding twelve (12) months has had a direct or indirect contrectual relationship with the City and from which the person(s), their spouse, or dependent minor children have received a fee, salary, or gift of value exceeding one hundred dollars ($100.00). When reporting information about a dependent chiid's activity, indicate the child about whom you are reporting by providing the number under which the child is listed on the Information Statement. ' RECIPIENT OFILER �SPOUSE ODEPENDENT CHILD #_ ZFEE, SALARY, GIFT NAME AND ADDRESS DESCRIPTION OF FEE, SALARY, GIFT 1 RECIPIENT �ILER OSPOUSE ODEPENDENT CHILD #_ 2 FEE, SALARY, GIFT NAME AND ADDRESS DESCRIPTION OF FEE, SALARY, GIFf ' RECIPIENT �FILER �SPOUSE �EPENDENT CHILD #_ Z FEE, SALARY, GIFT NAME AND ADDRESS DESCRIPTION OF FEE, SALARY, GIFf COPY AND ATTACH ADDITIONAL PAGES AS NECESSARY � NOT APPLICABLE INITIAL HERE:.� DATE: Z%i ZZ City of Colleyville Financial Disclowre and Business Conflict of Interest Forms BUSINESS INTERESTS Section 3 The name and address of any corporation or business, which currentiy has or in the preceding twelve (12) months has had a direct or indired contractual relationship with the City, of which person(s), their spouse, or any dependent minor children own more than two percent (2%) of the outstanding equity interest or more than two percent (2%) of the assets. When reporting information about a dependent child's activity, indicate the child about whom you are reporting by providing the number under which the child is listed on the Information Statement. 1 HELD OR ACQUIRED BY OFILER OSPOUSE ODEPENDENT CHILD #_ Z DESCRIPTION NAME AND ADDRESS 3 NATURE OF BUSINESS 1 HELD OR ACQUIRED BY �FILER �SPOUSE ODEPENDENT CHILD #_ 2 DESCRIPTION NAME AND ADDRESS 3 NATURE OF BUSINESS 1 HELD OR ACQUIRED BY OFILER OSPOUSE �EPENDENT CHILD #_ 2 DESCRIPTION NAME AND ADDRESS 3 NATURE OF BUSINESS COPY AND ATTACH ADDITIONAL PAGES AS NECESSARY � NOT APPLICABLE INITIAL HERE:;� DATE: Z Z 2�- RECEIVEp FEQ 0 2 1012 City of Colleyville Fnancial Disclowre and Business ConFlid of Interest Forms � PERSONAL FINANCIAL STATEMENT AFFIDAVIT Financial Disclosure and Business Conflict of Interest Forms shall be provided by candidates for Mayor and City Councii and by applicants seeking appointments to the Planning and Zoning Commission or the Zoning Board of Adjustment, and shall file such forms within two (2) business days following the end of the candidate filing period, or if for appointment, within (2) business day following the end of the application period stated in the official City advertisement for application for the position. The city manager and the city manager's senior staff members (inciuding any staff member who is appointed with City Council approval) shall also file the same within thirty (30) days of hiring. All person(s), as outlined above, shall have a duty to file supplemental disclosures annually and within five (5) business days of an occurrence of any change in the information reflected in the forms previously filed by the individual. Before �me, the undersigned authority, personally appeared: _N,YYI�f�\ ;i � ��: �� who, after being duly swom upon their oath and deposed and stated as follows: "My name is AYYli�ll�� \"til�Yli and I hereby submit for filing the attached Fir� ncial Disclosure and Business Conflict of Interest forms. I have personal knowledge of all information contained in said forms and all information contained in the forms is true and correct." "Further, all information contained in the forms is complete. There is no information that has been withheld or not disclosed which is responsive to or required to be disclosed by the forms." �U ` � Affiaht to and subscribed before me, this the �ND day of ��-i� 2��2� , 20 �� CHRISTINE LOVEN My Nptary ID # 11G92587 Expires May 2, 2022 ,h ,�:� � Notary Public, State of Texas INITIAL HERE:� DATE: � ( � l�i7i CANDIDATE / OFFIC�MOLDER �ORM C/oH CAMPAICN FINANCE REPORT COVER SHEET PG 1 Th� C/6H Inatruction Gulda explalns howto comp�ete thia Porm. � FIIO� ID (Ethics Commisslon Fllera) 2 To�al pagea flled: 7 S CANDIDAT�/ M�/MRA/MR FIR�T MI OFFIC�HOLD�Ft m� QF�ICE USE ON6Y NAME .......................... �.... .:�........................................... Data RacelvaQ NICKNdM� 6A�T SUFFIX c-,; �a�.; RECENED a cANDIDATE / ao�� o �ox; awfi r�u�r� � cirv; srAT�; zia cope APR 7� 101fl o��ic�Ho�o�� rne2dow r� m,ai�iNa Ui�3 C��een �DpRe o�r,aadreas �o112�v�1�2 fi`ti '� � ��3`-� � S CAN�IDAT�/ NR�P C9B� �b9N� NUM��R EXTENSION Bate Hand-dalivefaA or 9ata Pa�tmark�9 PHONEhiO4.t��R � 202 � �j10 — 4�-10 J`� � - � Receipt N Amaunt $ 6 CAMPhVON M�/MR9/MR FIR�fi MI TREASUR�R ��,a�2 NAM� ................................................................................. 9aia Procesa�C NIGKNAM� 6A�T SUFFIX C�,1 �� ^' Dat� Image�l 7 CAMR+61C3N S7fi@�TAB@R�� IN9 �0 �OX P6€A9�); dHT /�UfiE #; CITY; STdfi�; ZIH COB€ TRE,�sUR�R �,w N CoU2y�;�l�e. TX '1tn0'�L1 ,aoDR�ss Cop3 C�reer' �M2o� (Realdene� er 9uaine9e) 8 CAMPAIGN dR�d C09@ PH9N� NUM�€R �XTEN&ION TREASUR�R . PHON� ( $1 �' ) fnU2 -�121� 9 Pt�PORT TY�� J�nu�ry 16 �391h day h�fore elacllon ❑ Runofi � 75th tlay afiar campalyn . treaeurer eppointment (9fficahaldet qnly) � July 9� ��IP day bakre election � R p�n9 Mmnm� � Flnel Report (duaeh C/OH -PR) 70 PEF310L? MAnth Bay Year Month Uey Yeae COVER�D 2.., �� Z�2 TMROUGN �/�Q f Z�ZZ 11 �LECTION ��T�BN AAT� �I,ECTION TYPE Manfh Day Y��r ��'Mmary Q Runotf ❑ Olher Oescrlptiqn Y_ � � � L2 �G�neral � SPaclel :J 72 pFFICE ��b�� (��FlY) 13� o�FICesOuonr (aknvxn) Ci1-� Co.�,�e;l PIac,4. 1 -CcttEyv��'.: 1A NOTICE �R�M TNI� BOX IB FOR NB11C� OF P96RICA6 C9NiFI8U110N5 ACCEPIEU OR POLIIICAL E%PENUITURE8 MAPE BY POLITICpL CpMMITfEEB TO BUPPORT PQ��.'.1G.�L 9HB 6AN�I4pl� I OFFIC@N06C6R. 7XH9E ENFENWNRQ9 MAY NAVE BNHN Mr1DE WITNOUI' 7NE CIINDIDATE'9 OR OFF7CBHOLDER'31tNOWLHDOH OR CON4ENT. CAN910A1E8 dNOOFP�6@q06D�RSAR� R�QUIRE010 REPORT THIS INFORMPiION ONLYIF 7HEY R�CENE NOTIGE OF BUCX EXPENOIlUREB. GQMMITT��($) G9MMIii�€ iYR� COMMITT�� NAM� �BENERA6 ��MMITf��Ag9R��3 � Atltlition�l Pag�� A�CIFIG �OMMIfiP�€ 6FMRd1(3N TREASURER NAME � GOMMI7T€� CAM�AI@N iR�dSUR�R ADORESB GO i0 PAGE 2 �nYlfli pPOvitled by Texas Ethics Commission www.etmca,scate,a.ua RBV180p 6l97I2U2V C�►NDIDAiE / O�FICEHOLD�R CAMPAIGN FINANCE i2�POF�i 16 C/OFI NAM� 17 CONiR1�Ui'I�N T�T,AL.S .................. EX��NDIiUR� T9T�AI�^� .................. CON'YRI��J`I'ION BAI.AN�� .................. OUiS'YANDIN9 LOAN TOTA6S �rn� �,�; ��i 1, 2. a. T@i�L UNIfi�MI��@ ROLITI�AL C9NTRIBUTIONS (OTHER THAN P6�BQ�S, 69ANS, 9R GUARANREES OF LOANS, OR C9NTRI�UfifONS Md@� �6�CiRONICALIY) T�TAL P9LITICAI CONTRI�UTION9 (OTM�R fiMAN P6�AQES, LORNS, 9R GUARANTEES OF 40AN3) 'fOTAL UNIT�MI%�B POLIiICAL EXPENAITURE. FORM C/OH CAVER SFIEET PG 2 16 Fner i� (EthiCs COmrti16810� FII6te) � 2350= $ 2,5`o O ."'— $ 3a� `15 $ Zp� �IS R. TOTdI.P6LITICdLEXPENDITUR�3 G. 6, Y9TA6 R961TIC9L G9NTRI�UTI9NS MAINTAIN�A AS OF THE LAST DAY 9F R�P@RTINO P�RI99 f9fiA6 PftINCIPA6dM6UNfi OF ALL 9UTSTANOING I.OANS A3 OF THE t,A�T BAY 9� TW� R€RORTING P�RIOD $ ��0`-IZ SS � 18 SIGNAiUR� 1 swsar, or affirm, undar p�nalty of perJury, ihat the accompanying raport Is true and correct and Includes all Informatlon r�qulr�d to 4a report�A by m� undar T1tie 15, �IacNon Code. � Ig at m oT Cendidate or Officahpltler ..�'��:•.; criwsnNe �oveN lease complete either option below: `-€•i "'= MY �' lo # t1092587 �`i•• ... . `a: '•�,. s:t, Expires Mey 2, 2028 (1) Affidavit NOTARY STAMPlSEAL Swom to and subscribed before me by �� i�. l7'1 �(�' it-i� this the � day of l�(C. , 20 0'� a— , to certifywhich, witness my hand and seal of office. .. _.. . — � -----__._. Signature of offcer administering oath Printetl name of officer administering oath Title of officer administering oath (2) Unaw�m Declaratlon My nema is , and my date of birth Is My addraes I� , _ _ , (�tr��E) (ciry) (state) (zip code) (country) Executedin Gounry, 3tat� of,�,, on the day pf , 20 (month) yea�) Slgnature of CandldalelOfficeholdar (Oeolafant) FORns provid�d byT�xa� �thles Gommisslan www.ethics.stata.tx.us SUI�`�I"�1T'Q►1�.�''i � C/Q�'I FORM C/QH CQVER SM�ET PG 3 19 FIL�R NAME� �� 20 Filsr ID (Ethics Commission Fifara) � A�,��, C�,�� i�; 21 SCH�91J6� ^.�Ut3T@TAI�S f'aUBTQTlaL NAM� 4� SCM�94J6� AMOUNT �� GM�LiU6�A1:Mf1N�l'ARYP-9�I1'I�AI.��NTRISUTIONS $ 'Z'350� .. _ . _ .. --- - --- - - --_ __ __ . .. _. _. __ . . 2� � S�H�SILJL�F��: N9N-Ml?N�.17�itY(IN-KINI?)P-01.ITICALCONTRIBUTIONS � . _. ._..._ .....__ ..__.- ____..__ .. ---- -- �. � SCM�D416� �7' P��9C3�L7 �UNYFtI�UT10N^.3 � .. __. . ____ __ _ __ _ . __ . . _ .. . _ _ . . . .. . .. . .. . . _.. ____-_ _ - __ _ _ 4 � ^.�^�M�tASl6E_ �: 69AN`� $ . _-_._ - _ _— ___- _ _ __- . - ___ _.__.. ___.. _. 5 � SCM�Dl1L� F1; P91,11'IGF\6 �XPEN4ITUR�^a MAD� FROM R041TICAl. CONTRIBUTIONS $'7j(�'� �S - _ - - - .__. . 8. � SGMEqULE F^�; IINPAIA INGURR�f,1 Q�61DA9'I�NS $ _. --� - -- -- - . _.____._ . .. ... .... .._. �� ^aCM�L]U6� R�� P41R�MAS� OF INV�^aTM�NTg MRA� FRQM POLITICAL CONTRI6UTIONS $ _ _ ... _ _.._..__ �___._ __.....___.. . . . _.___ ___.__.__-_ _- __ 8� � SCH�9lJf-E F4: €XF'�NL]ITIJR'E..S MAA€ �Y �Ft�G11T CARI] $ ____- _-.__- _-__-_ _- ___. �• � 9CH��lUL.E (d• {391�ITI�AL �?(P�NPITL_1Fi�^.3 MApE FRQM P�RSONAL FUNDS $ �p� ��CH�4U4E H f'AYM�N� MAC�� RQM k'�OL,ITICAL CONTRIBUTIONS TO A BUSINESS O� C/OH $ ..._ ._______ 11 � SCM�R611,� I; NQN=F�4LITIC;A1, F.:aCH�NRITUR�S MADE FROM ppLITICAL CONTRIBUTIQNS $ _ .. .._.. . .._..__ _.._. _. ... ..... . . . . ... .. ._._ _.. _ . . . ._ _. 12. � S�M�9U�� K; INT�R�ST, C�F2�BIT�, OAIN�, R�FUNPS, AND CONTRIBUTIONS RETUFtNE[? $ TO FI6€R Forma prevideQ 4y Taxas Ethica Commission � www.athics.stata.Gc.us -� Revised 8/17I2020 MON�TARY POLITICAL CONTRIBUTIONS scH�Du�� A1 If the requested information is not appUeable, DO NOT include this page in the report. The InaSrucflon Duld� explain� how to wmpleSe lhia form. '� Tofal pag�s SchaAala A1: 3 2 FIL�R NAM� A�� I I��; 3�Filar ID (Ethlcs Cbmmiaaion Fil�ra) n 4 Dat� S�u11 neme o� eontrlFaufor� � Aehef=eiate PAC QDri: ) 7 Amount oP w�tdbutlon (S) .... Jean.... C�add� � � 2�Z�2L ........................................................ �� 8 Gontributor at�dre�a; Ciry; 9tete; Zlp Code L�f�Q\j 'Mi�� JCOO�C b� . ��2VV�U-f, �%� f .' � �'3 8 F'rineip�l ocoupatlon ! JaD tfA� (�� In�truatinn�) 9 Employer (3ee Instructions) p�� Fuil nam� eY c�ntriAutar � ou�=of=atate PaC (iex. � Amount of aontributlon ($) S��o�n \-FGSS�v� aau.................................................................................. �2I� �Z�, Cantributor ad€Ir��; 61ty; State; ZipCode Ao I(P 1 L ta.'i'i 1� C ca,�C �aSS � � oQ -" Rvs�t,� TX, �$`��' arincipai oaeupaean / dob title (so� Instrasti�n�) �mpioyer (See instructtona) �ate �ull n�m� a# c�ntrll�ut�r � out=af-at�t� w�a pom ) Amaunt oi contribudon ($) ��ie� i��/�5 . ... ...........:.........�......................................... . ... 1 'Z ��p �22- �entrlquter atlpr�aa; Ciry; State; Zip Gode.... y, Z�(� .�-^ 4�00 �(e��W;Gk. 1%c• �V Co�l��v.l�? T�C � coc�3�'i Peln6ip�1 A�eu�atlan / Jqq titla (ue� In�traetlons) �mployer (See InstrueUone) Date �ull nam� oF conlNkutor � aut=ef=etate PAc pem ) Amount of contdbuUon ($) ..�9/o�r�C{,.on....�@fl'L.:�"� .Q .......................................... Z I �� I'ys'+� �ontributor atldre�s; ei�y; su�te; zip coaa � Z� � `df2� Cat�� G+. �Z-4i12 ic�v� �J C.. 2� tv 1� Princip�l occupation / Job titl� (3�� In�tractl�n�) �mplayar (See Instructions) MTTACH ADt�ITIONAI.C9R1�$ OF TMIS SCHEDULEAS NE�p�p If eontNbutor la out•of�tate RA�, pieaae see Inatructlon guide foradditlonal reporting requlmments. Forms provldeQ bv T�xas Ethl6� �omml��lon www.�thlca.stata.tx.us Revised 8/17l2030 MONETARY POLIiICAL CONTRI�UTIONS sca��pu�.� A1 If the raquested infr�rm�ti9n i� nat appiicable, Iip NOT include thls page io the report. The Inatruction Qulde explaina how to complate thia farm. 1 Total paaes $chadula A1: 3 2 F16�R NdM� . 3 Fller 19 (Ethice Commlealon Rllars) �5n �1 �.-z��c�n� 4 Data a�ull nama of �ntMkutor � uui.ar.��a�a Pnc poa: � 7 Amount aP aantribudpn ($) Om'd�' �av-e� ........................... ri'................................................ o�, �ZI �� I 2-Z' 8 Contributor addr�as;� City; State; Zip Code �� 2`�JOrJ jCfl�jiYl��'o�n S�- j"�r l�v.< .}�,-� V�k 222t�$ 8 Princlpal �ccupat(�n ! Jok titl� (Se� Inatru�tien�) � 8 �mployar (Sea Instructlona) p�t� Full n�m� �f e�ntribut�r [� eukaf-stat� �nc (iea: 1 Amount ot contributiqn ($) vo�,ky �►��a. .............. ............. .............................:...................... '�jl C4 IZZ cor,cFln�,c�r eaare�e; �ity; s��; ziP coae � ZS � (oio 1 VPI�r� 1�'dn�, Col��, �:lt-e, TX, 'I �0°��1 Principei Aecupa4ion / Jo9 ti11� (�� Inatruction�) �mployer (See Inatructions) Date Fall n�m� eF cantributAr � Au4-ef-�t�4e RAC (IBN ) Amount of wntrlbution ($) 3o�P� C—,c^�r,Zal�eZ, .................................................................................. 'tj � 1 O Z��r con4nnNcer aaar�sa� �ny; s�aee; ziP coae �� lo'-i`-� iZcfa�cra�� Ln `jprk �1k ��yo3 Rrincipal e�cup�ti�n / d�A tltl� (9�8 In�truation�) Employer (Sae Instrucnons) Dat� �ell nam� of contrlqut�r � a��.eF.s�ate yqF �ipp; ) AmounS of contrlbution (�) �� Sa; � � 3�7................................. "�a'......................................... �o 2-1 �2-Z �entributera�dltl�C�� k�ity; State; zipCode �("('�,�- 3�0'� w Cn1�ey��i1-e. �`�C, i��3�1 Rrincip�l aecupatlon / J�q title (�� In�tructions) Employer (See Instructtans) ATTAGH AD�ITIANA� CqP1E3 OF TMIS SCH�DULE AS NEEDED If oontributor i� pu!•of•at�te PAC, plea�e aee Inetruotion guide for addidonal r�porting requirements. Fortns orovideci bv T�xaa �thi�s Commiaslon www.ethlcs.state.tx.us � Ravlaed 8/17/2020 MON�TARY POl�ITICAl� C�NTRIBUTIONS SCH�DULE A1 If the requasted Inform�tion is �at apylieable, DO NOT i�clude this page in the report. The In�Sructian Guide oxplalna how So complete thla form, 1 TOfal pa9ea Sch�Aul� A9: 3 P�II�R NdM� , � 3 Filer ID (Ethice Commlaalon FU�ra) �t�M ��'i C�,, ��s� � "� �t� $ �ull nam� of contNputor � au�.ar-ei�c� �no pon: � 7/amount of oontr�putia� (S) �,�u�a ,_.ee �a�n . ............................................... . . . ................................ ��'L,'�,I'L"� 8 ContributoraAQr�es; Ci4y; Stat�; ZipCode ��'�"' `311- �� iC�C-Qv.7� eoi�-��,,v� T� � �03� 8 Principal paeupation / Joq tftle (&ee In�true;ti�ns) 8 €mployar (Sea Ineuuctlona) g� Full nam� AP eentributor � eut=of-@tate PSG (ina; 1 Amount oP conlribution (�) �,ob�"i� �4b�'Q'N� ..... ................................................................ . . . . ... � C� �j IZ`{ 22 Gontr�putor �epr�s�; Ctty; sYate; z�p code '�� ,�. 25at kf�s,��^ '�I- colle v;l�-2 �'� 7to�3� Pdncipal accupatl�n / Ja4 €ttl� (�� In�huctlons) �mpfoyer (See Inatructlone) Dat� �all name of conlridutar � Auhof=ata�e Pd6 pAM � Amount of contrlbutian (S) N�Z�� .'��dri� . ........................... ................................................... � 21'3 22. ��ensriduc�r ��cira��; ��ry� stata� z�p coae `�Q(� � i35o �2�- ��I�A� o� • t_S�'rencA��-Q, �'!pC �`f� Annclp�l o�cup�tican / Job tltl� (S�� In�lrtictiAn�) �mployer (See Instruatlona) 9ate �UII t1Aff18 af cCtntfidut9P � Aut-af.ataie PAC (IA#; ) Amount oP contribullan ($) �a�� Y11ee,k 2- �� ...........................................�,......................P oa � 2Z' eontributar adelr��; �i State; Zi coae �� (pZo`-'� 12.AC}G �ue, C .r Col ,r�lle 1 �. 7co�"�"� Prineip�l oeeupation / Job titl� (�� Inatruetions) Employar (See Instruetions) ATTACM A��ITIONAL �QPIES QF TMIS SCMEDULE AS NEEp�p If c�ntributar ia oubqRstate PAC, pl�n�a see InsErucNon gulde foradditional reporting requirements. Forms provided by T�xaa �lhlce Cammissian www,�thics.atata.tx.ua Ravlsed 8/1712020 POLITICAL �XPENDITURES MADE FROM POL,ITIC�►L CONTRIBUTIONS SCMEDULE F1 IF the requested Infarmatfon is not a licable, DO NOT include this page In the report. EXP�N9ITURE CATEGORIES FOR BOX 8(a) A9v��tising �xp��is� �v�nt�nw LBsnRepaymerMielm6ureemem 3o11dtationlFun9r�1�1ngE�n�� Acwunting/�enking ��a pipceOva�haetllRentelExpenae 'R�nsyarlatien�qulpm�nt�R�l�tetl€xyan� Ganeutting€xpans�_ ��gAlQ�ve�age€�n§� R0111ngExpanea Trav�llnBl�irlct CentnkuUon�/BanepAn�M��1��y @iRldv�r9alMemArial§�nae PMndngExpanea 7Tav�lOutbfDlathcf pandidat�/Olfic�hel9��/f�allUsnlC�mmittee 6��18�rviw� 3�Iari�VNMgee/Contract6abor C)iher(ent�r�cntegerynoRll�te9aheee) 6��@��g� Tha Inetruotlon Ou1Aa 0xplalns how to complete thla farm. 1 Total pag�� ch�dula Fi: 3 FI6�R NA � . � 3 Fllar 19 (Eihic� Commlaalon Fll�re) � �n�+ -,n Cy,�lac-., 4 pat� .. S �'aY�� nam� 3, t I ZZ ''�;r,�v�a, «rn�a �s�.�'.w�-e.. 8 Ameunt (S) 7�ay�� Atlress; City; Stata; iip Oode ��„ .�I� E 5 1 `a• Pc�le�1 Sv �E, tb 1 ��v+n4.. T7L "t Cvp� I 1 8 (Hj batag9ry (�e�G��egefi�alief�AatlhetApafihiaschadula) (b) IJesc�iptlon PURP08L Cgi�Y�� j't"��,�,�$ �F EXP�N91T1�RE �C) � CheakifUav�laufsl9�AfT�x�a.6Ample��$c�aduleT. � Chack IFAusUn, TX, A(flFahalAer Ilving expanee A Coropl�t0 ,g,�1,' If dlf�Ot �anditlat� / affiemhold�r name Offlce aought Offlce held expenAltur� ta b�nefik C/QFi i�at� �aYe� name Amount (S) F�ay�� AdQre��; City; State; �Ip f;od� Gat�gory (9e�Ca��geri�xliet�Qanh��apaithiaechedu�a) Deacrlptlon �URPQS@ QF EXP�NDIT4R� � Ghe�krf�fav�lANsi9�a1'l�n�a.Camyl�i�9ch�duleT, � Chack IPAualln, TX, a�isehel�far Ilving expana� Gompl�t� �V If dlr�ct �anAlAat� / Offleaholdef n€�me OfFlca aought Oitic� h�ld exp�nAltur� to panefit CI9M 9ato A�y�� n�m� -- _ Amount ($) �ay�� aCUr��; � City, Stata� zip Coda ��i�gBry (9§�C�t€@aFl��fist�A�tih�iepAf�hl€ssh�Gule) DesCflptlon PUR�OB� OF �,7(R@N@ITUR� � 6heskit�r�valaiits�d�efT�x��.Femyl�t�$ch�9ul�T. � Chech HAustin. TX, pfllcaholdar living aHP@na� Complat� g�y IF dir�at Can€fid�t� / Ofli�hglci�r name � OfFlce sought qffice held �xp�nAitur� to 4�n�Fl1 G/9M - -- . -- --.. ATTACM AADITI9NAL COPIE3 OF THIS SCHEDULE AS NEEDED Fotms provlaea py l�oxaa �tmr,� Gommis�lan www.em�cs.s[ete.a.us R6VIBBQ tl/97/GOYU