Texas Ethics Commission P.O.Box 12070 Austin, Texas 78711-2070 (512) 463-5800 1-800-325-8506
SPECIFIC-PURPOSE COMMITTEESPECIFIC-PURPOSE COMMITTEESPECIFIC-PURPOSE COMMITTEESPECIFIC-PURPOSE COMMITTEE
FORMFORMFORMFORM
SPACSPACSPACSPAC
CAMPAIGN FINANCE REPORTCAMPAIGN FINANCE REPORTCAMPAIGN FINANCE REPORTCAMPAIGN FINANCE REPORTCOVER SHEET PG 1COVER SHEET PG 1COVER SHEET PG 1COVER SHEET PG 1
The SPAC Instruction Guide explains how to complete thisThe SPAC Instruction Guide explains how to complete thisThe SPAC Instruction Guide explains how to complete thisThe SPAC Instruction Guide explains how to complete this
form.form.form.form.
1 ACCOUNT #
(Ethics Commission filers)
2 Total Pages Filed:
OFFICE USE ONLYOFFICE USE ONLYOFFICE USE ONLYOFFICE USE ONLY
Date ReceivedDate Hand-delivered or Date PostmarkedReceipt #AmountDate ProcessedDate Imaged
3 COMMITTEE NAME5 CAMPAIGNTREASURERNAME
MS / MRS / MRFIRSTMINICKNAMELASTSUFFIX
4COMMITTEEADDRESS
c
Change of AddressADDRESS / PO BOX;
APT / SUITE #;CITY;STATE;ZIP CODE
11 ELECTION
ELECTION DATEELECTION TYPE
10 PERIOD COVERED
THROUGH
9REPORT TYPE8CAMPAIGNTREASURERPHONE
AREA CODEPHONE NUMBEREXTENSION
7CAMPAIGNTREASURER'SMAILING ADDRESS
c
Change of AddressSTREET OR PO BOX;APT / SUITE #;CITY;STATE;ZIP CODE
6CAMPAIGNTREASURER'SSTREET ADDRESS
(Residence or business)STREET ADDRESS (NO PO BOX PLEASE);APT / SUITE #;CITY;STATE;ZIP CODE
GO TO PAGE 2
Revised 04/21/2010
145Mike Rawlings For Mayor3232 McKinney Ave660Dallas TX 75204MrJMJoeHaggar7428 GlenshannonDallas TX 752257428 GlenshannonDallas TX 75225(214)368 215630th Day Before Main Election2/10/20114/4/20115/14/2010General
Texas Ethics Commission P.O.Box 12070 Austin, Texas 78711-2070 (512) 463-5800 1-800-325-8506
SPECIFIC-PURPOSE COMMITTEE REPORT:SPECIFIC-PURPOSE COMMITTEE REPORT:SPECIFIC-PURPOSE COMMITTEE REPORT:SPECIFIC-PURPOSE COMMITTEE REPORT:
FORMFORMFORMFORM
SPACSPACSPACSPAC
PURPOSE AND TOTALSPURPOSE AND TOTALSPURPOSE AND TOTALSPURPOSE AND TOTALSCOVER SHEET PG 2COVER SHEET PG 2COVER SHEET PG 2COVER SHEET PG 2
12 COMMITTEE NAMEACCOUNT #
(Ethics Commission filers)
13 COMMITTEEPURPOSE
(Attach lists on plainpaper to complete thisreport if necessary.)
c
SUPPORT
(Candidate or Measure)
c
OPPOSE
(Candidate or Measure)
c
ASSIST
(Officeholder)
c
CANDIDATE
c
OFFICEHOLDER
c
MEASURECANDIDATE / OFFICEHOLDER NAMEOFFICE SOUGHT (candidate) / OFFICE HELD (officeholder)BALLOT IDENTIFICATION / #ELECTION DATEDESCRIPTION
19 AFFIDAVIT
I swear, or affirm, under penalty of perjury, that the accompanying reportis true and correct and includes all information required to be reported byme under Title 15, Election Code. _____________________________________________________________Signature of campaign treasurerAFFIX NOTARY STAMP / SEAL ABOVESworn to and subscribed before me, by the said _______________________________________________, this the ____________________ dayof ________________, 20__________, to certify which, witness my hand and seal of office.Signature of officer administering oathPrinted name of officer administering oathTitle of officer administering oath
Revised 04/21/2010
18 CONTRIBUTIONTOTALS..................................EXPENDITURETOTALS..................................CONTRIBUTIONBALANCE..................................OUTSTANDINGLOAN TOTALS
1. TOTAL POLITICAL CONTRIBUTIONS OF $50 OR LESS (OTHER THANPLEDGES, LOANS, OR GUARANTEES OF LOANS), UNLESS ITEMIZED2. TOTAL POLITICAL CONTRIBUTIONS2. TOTAL POLITICAL CONTRIBUTIONS2. TOTAL POLITICAL CONTRIBUTIONS2. TOTAL POLITICAL CONTRIBUTIONS
(OTHER THAN PLEDGES, LOANS, OR GUARANTEES OF LOANS)3. TOTAL POLITICAL EXPENDITURES OF $50 OR LESS, UNLESS ITEMIZED4. TOTAL POLITICAL EXPENDITURES4. TOTAL POLITICAL EXPENDITURES4. TOTAL POLITICAL EXPENDITURES4. TOTAL POLITICAL EXPENDITURES
5. TOTAL POLITICAL CONTRIBUTIONS MAINTAINED AS OF THE LAST DAYOF REPORTING PERIOD6. TOTAL PRINCIPAL AMOUNT OF ALL OUTSTANDING LOANS AS OF THELAST DAY OF THE REPORTING PERIOD
$$$$$$
1060.001028208.770807254.83221119.780Mike Rawlings For MayorMichael RawlingsMayor05/14/2011XXMr J M Haggar14thApril11***ELECTRONICALLY CERTIFIED***
Texas Ethics Commission P.O.Box 12070 Austin, Texas 78711-2070 (512) 463-5800 1-800-325-8506
POLITICAL CONTRIBUTIONSPOLITICAL CONTRIBUTIONSPOLITICAL CONTRIBUTIONSPOLITICAL CONTRIBUTIONS
SCHEDULE ASCHEDULE ASCHEDULE ASCHEDULE A
OTHER THAN PLEDGES OR LOANSOTHER THAN PLEDGES OR LOANSOTHER THAN PLEDGES OR LOANSOTHER THAN PLEDGES OR LOANS
The Instruction Guide explains how to complete this formThe Instruction Guide explains how to complete this formThe Instruction Guide explains how to complete this formThe Instruction Guide explains how to complete this form
3 ACCOUNT #
(Ethics Commission filers)
1 Total pages Schedule A:2 FILER NAME4DateDateDateDateDate9Principal occupation / Job title (See Instructions)Principal occupation / Job title (See Instructions)Principal occupation / Job title (See Instructions)Principal occupation / Job title (See Instructions)Principal occupation / Job title (See Instructions)10Employer (See Instructions)Employeer (See Instructions)Employer (See Instructions)Employer (See Instructions)Employer (See Instructions)
ATTACH ADDITIONAL COPIES OF THIS FORM AS NEEDEDATTACH ADDITIONAL COPIES OF THIS FORM AS NEEDEDATTACH ADDITIONAL COPIES OF THIS FORM AS NEEDEDATTACH ADDITIONAL COPIES OF THIS FORM AS NEEDED
If contributor is out-of-state PAC, please see instruction guide for additional reporting requirements.If contributor is out-of-state PAC, please see instruction guide for additional reporting requirements.If contributor is out-of-state PAC, please see instruction guide for additional reporting requirements.If contributor is out-of-state PAC, please see instruction guide for additional reporting requirements.
Revised 04/21/2010
5Full name of contributor
c
out-of-state PAC (ID#:___________________)............................................................................................................................
6Contributor address; City; State; Zip Code7 Amount of Contribution ($)8 In-kind contributiondescription (if applicable)
(If travel outside of Texas, complete Schedule T)(If travel outside of Texas, complete Schedule T)(If travel outside of Texas, complete Schedule T)(If travel outside of Texas, complete Schedule T)
Full name of contributor
c
out-of-state PAC (ID#:___________________)............................................................................................................................
Contributor address; City; State; Zip CodeAmount of Contribution ($)In-kind contributiondescription (if applicable)
(If travel outside of Texas, complete Schedule T)(If travel outside of Texas, complete Schedule T)(If travel outside of Texas, complete Schedule T)(If travel outside of Texas, complete Schedule T)
Full name of contributor
c
out-of-state PAC (ID#:___________________)............................................................................................................................
Contributor address; City; State; Zip CodeAmount of Contribution ($)In-kind contributiondescription (if applicable)
(If travel outside of Texas, complete Schedule T)(If travel outside of Texas, complete Schedule T)(If travel outside of Texas, complete Schedule T)(If travel outside of Texas, complete Schedule T)
Full name of contributor
c
out-of-state PAC (ID#:___________________)............................................................................................................................
Contributor address; City; State; Zip CodeAmount of Contribution ($)In-kind contributiondescription (if applicable)
(If travel outside of Texas, complete Schedule T)(If travel outside of Texas, complete Schedule T)(If travel outside of Texas, complete Schedule T)(If travel outside of Texas, complete Schedule T)
Full name of contributor
c
out-of-state PAC (ID#:___________________)............................................................................................................................
Contributor address; City; State; Zip CodeAmount of Contribution ($)In-kind contributiondescription (if applicable)
(If travel outside of Texas, complete Schedule T)(If travel outside of Texas, complete Schedule T)(If travel outside of Texas, complete Schedule T)(If travel outside of Texas, complete Schedule T)
1 of 131Mike Rawlings For MayorAmerican Airlines PAC04/04/20112500.001101 17th St NWWashington, DC 20036Arteriors Home04/01/2011250.004430 Simonton RdDallas, TX 75244BOK Financial Corp PAC03/11/2011500.00P.O. Box 24128Oklahoma City, OK 73124Booth Partners LLC04/04/2011500.005427 Farquhar LaneDallas, TX 75209Bustin & Co Of Texas03/30/20111000.001999 Bryan StDallas, TX 75201
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