HomeMy WebLinkAboutKelly, DavidCANDIDATE / OFFICEHOLDER
FORM C/OH
CAMPAIGN FINANCE REPORT
COVER SHEET PG 1
The C/OH Instruction Guide explains how to complete this form.
1 Filer ID (Ethics commission Filers)
2 Total pages filed:
01
3 CANDIDATE/
MS IMRSI MR FIRST MI
OFFICE USE ONLY
OFFICEHOLDER
Mr David G
NAME.................................................................................
Dale Received
NICKNAME LAST SUFFIX
Kelly
4 CANDIDATE /
ADDRESS I PO BOX: APT I SUITE M; CITY; STATE; ZIP CODE
OFFICEHOLDER
905 Inwood Lane, Colleyville, TX 76034
(�
Tali
MAILING
ADDRESS
Change of Address
/0 P- e— �J
5 CANDIDATE/
AREA CODE PHONE NUMBER EXTENSION
Date Hand-tleliveretl or Data Postmarked
OFFICEHOLDER
(817 ) 235-6105
PHONE
Receipt #
Amount $
6 CAMPAIGN
MS I MRS I MR FIRST MI
TREASURER
Mr David G
NAME.................................................................................
Date Processed
NICKNAME LAST SUFFIX
Date Imaged
Kelly
7 CAMPAIGN
STREET ADDRESS (NO PO BOX PLEASE); APT I SUITE M; CITY;
STATE; ZIP CODE
TREASURER
905 Inwood Lane, Colleyville, TX 76034
ADDRESS
(Residence or Business)
8 CAMPAIGN
AREA CODE PHONE NUMBER EXTENSION
TREASURER
PHONE
(817 )
9 REPORTTYPE
12335'-6105
- January 15 30th day before election Runoff
15th day after Cam ai n
y campaign
I
Intment
Office older Oimly)
(Officeholder Only)
July 15 8lh day before election Exceeded Limit
Final Report (Attach C/OH - FR)
Reporting
10 PERIOD
Month Day Year Month
Day Year
COVERED
7 / 1 / 22 THROUGH 12
/ 31 / 22
11 ELECTION
ELECTION DATE
ELECTION TYPE
Month Day Year
Primary Runoff Other
Description
General Special
12 OFFICE
OFFICE HELD (if any)
13 OFFICE SOUGHT (if known)
14 NOTICE FROM
THIS BOX IS FOR NOTICE OF POLITICAL CONTRIBUTIONS ACCEPTED OR POLITICAL EXPENDITURES MADE BY POLITICAL COMMITTEES TO SUPPORT
POLITICAL
THE CANDIDATE I OFFICEHOLDER. THESE EXPENDITURES MAY HAVE BEEN MADE WITHOUT THE CANDIDATE'S OR OFFICEHOLDER'S KNOWLEDGE OR
CONSENT. CANDIDATES AND OFFICEHOLDERS ARE REQUIRED TO REPORT THIS INFORMATION ONLY IF THEY
RECEIVE NOTICE OF SUCH EXPENDITURES.
COMMITTEE(S)
COMMITTEE TYPE
COMMITTEE NAME
GENERAL
COMMITTEE ADDRESS
Additional Pages
COMMITTEE CAMPAIGN TREASURER NAME
SPECIFIC
COMMITTEE CAMPAIGN TREASURER ADDRESS
GO TO PAGE 2
Forms provided by Texas Ethics Commission www.ethics.state.tx.us Revised 8/17/2020
CANDIDATE / OFFICEHOLDER FORM C/OH
CAMPAIGN FINANCE REPORT COVER SHEET PG 2
15 C/OH NAME
16 Filer ID (Ethics Commission Filers)
David G Kelly
17 CONTRIBUTION
1. TOTAL UNITEMIZED POLITICAL CONTRIBUTIONS (OTHER THAN
$
TOTALS
PLEDGES, LOANS, OR GUARANTEES OF LOANS, OR
0.00
CONTRIBUTIONS MADE ELECTRONICALLY)
2. TOTAL POLITICAL CONTRIBUTIONS
THAN PLEDGES, LOANS, OR GUARANTEES OF LOANS)
$ 0.00
(OTHER
...................
TOTALS EXPENDITURE
3. TOTAL UNITEMIZED POLITICAL EXPENDITURE.
$
0.00
............... ....
4. TOTAL POLITICAL EXPENDITURES
$ 0.00
CONTRIBUTION
5. TOTAL POLITICAL CONTRIBUTIONS MAINTAINED AS OF THE LAST DAY
$ 7 9 96
BALANCE
OF REPORTING PERIOD
1 /
..................
OUTSTANDING
6. TOTAL PRINCIPAL AMOUNT OF ALL OUTSTANDING LOANS AS OF THE
$ 5,000.00
LOAN TOTALS
LAST DAY OF THE REPORTING PERIOD
18 SIGNATURE 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 under Title 15, Election Code..//���/^\\
ILaniG-��'�
Signature of Candidate r OfgK4Ider
Please complete either option below:
;vANGELALARSON
(1) Affidavit Z• My Notary ID # 133961970
-;a Expires September 15, 2026
NOTARY STAMP/SEAL
Sworn to and subscribed before me by 1 J�.UICh I �X.l h this the day of
2 , to certifliwhich, witness my hand and seal of office.
Signal a of officer administering oath Printed nalo of officer administering oath Title of offic r administering oath
(2) Unsworn Declaration
My name is , and my date of birth is
My address is ,
(street) (city) (state) (zip code) (country)
Executed in County, State of , on the day of 20
(month) (year)
Signature of Candidate/Officeholder (Declarant)
Forms provided by Texas Ethics Commission www.ethics.state.tx.us Revised 8/17/2020