972-721-2384

04:12:46p,m, 04-14-2011

50/64

Texas Ethics Commission

Austin, Texas 78711-2070

(TOO 1-600-735-2989)

(512) 463·5600

P.O. 80x 12070

CANDIDATE I OFFICEHOLDER FORM C/OH
CAMPAIGN FINANCE REPORT COVER SHEET PG 1
,
1 ACCOUNT # 2 Total pages filed:
Tho C/OH Instruction Guido explains how to complete this form. IEthiCl Comml ... on AI"",) J~
~--::-::'= -"
3 CANDIDATE I MS/MRS/MR ARST MI ,-'" III: uk rIi¥ 1: II
OFFICEHOLDER .. :ru \.,:t,.. "-
NAME \J.~. Ilill"" r"
I ••••• . . ." .. . . . . .. . . . .' APR 14 2011
NICKNAME I.AIi1 SUFFIX
6::rP,A t--J T City Secretary's Of ice
4 CANDIDATE I ADDRESS I PO BOX; APT I SUITE ~:, CITY; STATE: ZtPcoDe
OFFICEHOLDER \::) h :::r::rz._,../ 11\l~
MAILING :Lt)"l_~ '-l'f'- o..~ rX 7SO""_ O.I'H.n~t~mllnID.W
ADDRESS
o cI1an~B of addrolS R ... lpl. JAmDunl
5 CANDIDATE! AREA CODE PHONE NUMBER EKn:N510N
OFFICEHOLDER ('1_~) D.t.P~~ IL\~l~ ~~~
PHONE ~("'eJ 'l-.J74
6 CAMPAIGN MSIMRS/MR ARBT loll Dal'IWQg.d~' KDf
TREASURER - .~~~~~t.
NAME . ;; ... " . , . . .. . .. .... . , . . . . .
NICKNAME LAST SUFFIX
CUo~Ic..\J! 1-
7 CAMPAIGN IiTJlEET ADDRESS (NO PO BOX PLEASE I: APT~ftE#; CITY; STATE; ZlPCODE
TREASURER
ADDRESS 70? If'f\.t.,wy DfL '")::._Y.l..v \ ~ '(>Co. 7~"ll' ?_
(resIdence Dr bulln8nl
8 CAMPAIGN AREA COPE PHONE NUMBER EXTENSION
TREASURER '(1(1.\ ) ~~\ ".--
PHONE ;)_q l()
. 9 REPORTlYPE if301h day bel,,", .1.cUan
0 January 15 0 Runoff 0 15th day after aunpalgn IInsurer
"PPolnlr",ml (clliceholdtr only)
0 July 15 o 8th day b.'ore elecllon 0 Ela:soded $500 limlI 0 Final report (l!.tIodl CIOH • Fill
10 PERIOD MD~th Day vesr M0111h Day ViaI'
COVERED J... //\ ~ /'1.11) \ \ THROUGH t..t /13·/c?c9\ \
11 ELECTION ELECTION CATe ELECTION TYPE
l,Ionlh Day V .... ~~t
'5 / \'-\.//~O\ \ o P~""ry o Run"" o Special
12 OFFICE OFFICE HELD (Wanyl rCO~bUG~=-\ \ ~ \ r\-c..o_ s-
14 NOTICE DIRECT CAr,IPIIIGN eXPENDITURes ARE CAIII'AIIlN EXPENDITURES MADE ev OTHERlI WlTHDIIT llIE CANDIDATE'S PRIOR CONSENT DR APPROVAL
OF DIRECT
CAMPAIGN C.a.NDlDATEB ARE REQUIRED TO DISCI.09E THIS INFoRMAnoN ONLY IFllIEV RECEIVE NOnFlCA.nON Of WE DIRI!CT CAMPAlIiIf UPIlNDITURE.
EXPENDITURE
BY OTHER N.m~
INDIVIDUALS
Addnl .. / PO 801; Apt. 1 Sullo N; City; SlI.la; lipC<KI.
o Bddilional pagel
GO TO PAGE 2
. www.elhlcB.9Iale.lx.u8

Revised 04/2112010

972-721-2384

04:13:14p,m, 04-14-2011

Texas Elhlcs Commission

P.O. Box 12070

Austin, Texas 78711·2070

(512) 463-5800

(TOO 1-800-735·29SS)

CANDIDATE IOFFICEHOLDER REPORT:

SUPPORT & TOTALS

FORM C/OH COVER SHEET PG 2

16 ACCOUNT # (Ethics Comml.slan Alers)

15C/OH NAME

17 NOTI C E THIS BOX IS FOR iIIOTICE OF PDiJ11cALCONlRlBUllON8 ACCEPTED DR I'OUTICALEXPENDITUREllIIADE BY POunCALCOMfoIlTlEES lD MlPPORT1I£

F ROM CANDIDATE I DFFlOEtlDLDER. THaE EXPENDITURES MAY HAVE BEEN MADE 'MTHOI/T THE CANDIDATE'S OlHlFRCfHDUlER'S KNOMfOGE DR

POLITICAL CONSENT. CANlIOATEIIANDOFf1CalOUlERBAREREQUlRalTOFIEPORTTIIIBltf'tlIIMAllONDNLVIFlHEYRECflVEN01lCEOFIlUCHElIPBG1UREII.

COMMITTEE(S) ~--------r-------------------------------------------------_'

COMMITlEIi TYPE

COMMITTEE NAME

o GENERAL

COMMITIEE ADDRESS

o SPECIFIC

COMMITTEE CAMPAIGN TREASURER NAME

o oddlUooal pages

COMMITTEE CAMPAIGN TREASURER ADDRESS

18 CONTRIBUTION 1. TOTAL POLITICAL CONTRIBUTIONS OF $50 OR LESS (OTHER THAN $
TOTALS PLEOGES, LOANS, OR GUARANTEES OF LOANS). UNLESS ITEMIZED
2. TOTAL POLITICAL CONTRIBUTIONS $~bO,u-U
(OTHER THAN PLEDGES. LOANS, OR GUARANTEES OF LOANS)
. . ~ . . ~ . . . .
EXPENDITURE $
TOTALS 3. TOTAL POLITICAL EXPENDITURES OF sao OR LESS, UNLESS ITEMIZED $ Q.\C:r~,\~

. . . . . . . . . . 'I-------------------------t----I---------J

$

4 •

TOTAL POLITICAL eXPENDITURES

CONTRIBUTION BALANCE

5.

TOTAL POLITICAL CONTRIBUTiONS MAINTAINED AS OF THE LAST DAY OF REPORTING PERIOD

OUTSTANDING LOAN TOTALS

6.

TOTAL PRINCIPAL AMOUNT OF ALL OUTSTANDING LOANS AS OF THE LAST DAY OF THE REPORTING PERIOD

19 AFFIOAVIT

I swear, or affinn, under penally of pe~lllY, that the accompanying report Is true and correct and Includes allinfonnalion required to be reported by me under TIUe 15. Election Coda.

AFFIK NOTARY STAMP I SEAL ABOVE

Sworn t~ and subscribed beforJ! me, by the said .J\iAkB ill ~ , thIs the

ay of ~ ,20 \ \ • to certify which, witness my hand and seal of office.

ministering Dath

RevIled 04/2112010

51/64

972-721-2384

04:13:42 p.rn, 04-14-2011

52/64

Texas EthIcs CommissIon

PO Box 12070

Aus"n Texas 78711·2070

(512) 463-5800

rroo 1-800-735-2989)

,
POUTICALCONT~BUnONS SCHEDULE A
OTHER THAN PLEDGES OR LOANS
Tho Instruction Guide oKplalns how to cDmplote this form. 1 Tolal pages S?;Ula A:
2 FILER NAME ']\ . .1\ ,---e. 3 ACCOUNT # (Ethics Commission Fllera)
~.~. ~\t..(o\t-...'
4 Dalo 6 FilII rr.>D of CIllllrlbulol 0 ilill·CHIII. PAC'(11lil I 7 Amount of I 8 In-kind contrlbuUon
~/J_~/" ,-l.t_ e.\l'JO-v"'- c....Vi"~ '"N. ... ~'t- D'If) 1~1.S"'I ~ contribution (5) I doscrlptlon (if applicable)
~~~~,,~t~"'~'.(9~~"'~' . J ~~~~., ~,~ ~tI-~ \u-ata-a :
6 onl. tilr B roall; City; Slnlll; lip Code
\ 1-. e ~ ~"'- C4.tou c.l C ... ·\
3::.-.L ..... \ 1V~ \)<. 7 s- 0," \ - "-\ ~ \l '7 I
(11 travet culalda of Texas, ,cDmplele Schedule n
9 Principal eecupatlon I Job lIt1e (Se8 Inslructlons) 110 Employer (See Instructlona)
Dale k Full name oJ cDnldbulor '0 0.1-c1"'1'. PAC (!\lJ' J Amountaf I In-kind contribution
3)\'(;/\\ S.IVNE-~\T ~ 6u..rIVl...:> conlrlbutlon ($) 1 descrIption (If applicable)
.1:)\ ~~~. e;,." r;;~ \ ¥;> ....... . . . .... .~ I
Contrlbutar addllls'5\.- CIII';51I1t8; Zip Codil
l. 'S-:l..'-\. G'fle'So V\'t.IJ.J c.",,- Sb~"",,, I
.!::.v-....,.... f'-A;::, I ~ 7Q:)t.. 2- +S "1;,\:3"- I
[lr travel cul51ds'orTIII!PI 1lCrn~let.1I Sdl=.dultt n
Prlnclpel occupetlon I Job title (See Instructions) I_ Employer (See InulrucUons)
Dale k. Full name of contributor jt.~out'.I .. tDle PACIIDII' I Amount or I In-kind contribution
,¥1.:~/11 ~ M.p,~"1-t:: It. So I 0.). to....-.Ir- ~_ Y't'j\.'Nr-.'i contributlen ($) I deacrlpUon {If applicabla}
~I~,~~ .'-:~.'?~~.~ .......... , . - .. ,),
Contribulor addreu: CM:' Stele; Zip COda .. 1~5.(J'O I
3SO~ ~I\N'G.O"'- c.'\ W I
UV\"'"\I ,~ 7~"'1--7't1".:> I
(If travel Dul~de or Tums, compl91 5chadule T)
Principal occupation I Job tlUe (SeB Instructions) I Employer (See Instructions)
Dale Full name of contributor o ou!.o'·,IlIIBPACODl' I Amount of I In-kind contribution
3J;}.~l\. 'RP¢-t W S\..~\ \, contribution ($) I description (If applicable)
·l~~t'~~~:j~clt~ ...... __ , _ • 7 • '1tbO,uX) I
ZlpCelde
I
::I:lL..t \~ I '\"'1- '?~~ "2... - "-\ ~ '1 7 I
(IJ inI'ow oul!;lde oI1!Jc1\e. camoJo.lIt Schedule n
Principal occupallon I Jelb title (See Instructlona) I Employer (S8e InstruCtions)
Dale Full neme of contributor 0 oul-oJ,"lale PACIlOtl' I Amount or I In-ktnd contribution
i,-Lj\\ ':J~)..t-J ~. 'b A- f\..rLe;-(T I .3 ~ contr/bullon ($) I description elf applicable)
•• conir!bUiO~dd're~s'; . 'city'; 'S[Bt~;' Zip Coda" . . ~ . . . . . I
2.- ~\~ e.\.\.MT~ S'\ fSc.~ I
l::YI-.., ..... ~I '\y;; 7~-O b 'L. I
Wln.ve! oUlslde oJ T~JUlS comlll.1B Sdledulo n
PrinCipal occupation I Job IIl1e (See Inslructlona) 1 Employer (See Inatlllctions)
ATTACH ADDITIONAL COPIES OF THIS SCHEDULE AS NEEDED
If cDntrlbutor II out-or-state PAC, please soa InstrUction guide foraddltlonal reporting requirements. www.elhlcs.slala.tx.u6

Revised 04/2112010

972-721-2384

04:14:12 p.m, 04-14-2011

53164

Texas Ethics Commission

P.O BCllC12070

AustIn Texas 78711-2070

(512)463-5800

(lDD 1-800-735-2£189)

,
POLITICAL CONTRIBUTIONS SCHEDULE A
OTHER THAN PLEDGES OR LOANS
The In.tructlon Guide explains how to complete this form. 1 Talal pagea Schedule A:
'>
2 FILER NAME 3 ACCOUNT" (Elhlr;ll Commission Filerti)
~u\\"t \J. ~. ~~t-A-r
4 Date {{ Fu" name 01 contrlbulor 0 DUI-a' .. r. ... PAC(1o.; 7 Amount or I B In-ldnd contribution
~/'t.,'"':>/t I Q\~\-~, ~~I > contributlDn ($) I description (il app"cable)
.C;)O,l~\~.l:-: :~~~, , . , .... ......... 1Sb,uo I
6 Contributor address; City; state; Zip Code
~:S-(J~ re, PrN Co, 1.'"'fI-.- c, \"' VJ 'I
:s:.~-.J \,._,~ \f 7Sb b'"L-- I
(If havel oulslde 01 Teras. complete Schedule T)
9 Prlnolpel occupation I Job title (See Instrucllom.) 110 Employer (See InstructiDns)
Dale Fu" name 01 ~ntrlbutor 0 OU1-D'-et1U1 PACOIlt. 1 Amount of I In·klnd contribution
L.lt-.JID", ...... tIA~-S'l'IIIJ~ conlrlbution ($) I description (if applicable)
?J/1..1../11 ~~~ .~.' ~.'f.I,~~ ... , , , ... .. - - .... , 1
Contributor address; coy; SlBte; Zip Code f:.2-fn:J .o-o 1
\ ?, \Co\. t-.l, ~"'IJ~ l~.+h Ih
:n..v ~"'~ T~ 75bb\ I
(If lm",,) oulalde of TeJaI& comole!f! SChedule T)
Pr1nolpet occuplltlon I Job title (See Instruction&) I Employer (See Instructions)
Date \t.FUIl nlme 01 contributor 0 DUl-DI-IItIIb! PACQDI: Amount of I In-kind contribullon
'J-j)"'-I/t\ e':) 1I\...l..1-\--, (~ contributIon ($) 1 description (If applicable)
.~~~, .l:- .... ~\~.,.".,., .... " .... ·~,crV ,I
Contributor addre~; city; SIBle; ZIp Code
\ \ ~1 A-t.a4.50 "'- S1- I
:t.~.., '..,.~ ,\,,,,,, 7SQb'l.- I
(If havel oulalde of Texas. cample1e Schedule 1)
Pr1nclpel occupation' Job title (See Instrudlons) I Employer (See Instrudlons)
Date Full name of contributor o DUl-DI-IIIIID AAC(IDI; I Amount of I In-kind contribution
~ {4ft' .~~\ . '~~'\~0 contribution ($) I descripUon (II applicable)
'cily; 'siste;' Zip Code' ....... " . I
COnlrlbU~ Ildd1ss; ;. I cJ1' • tJ'O
\-SOjp \ ..... ~ ~t.l 1
1..'L...r Vl'--_) \)( '] S-OC:.:L~ Y.'1;,~7 I
(II lr.Iwl DlJlslde of Texas complele Schedule T)
Principal occupation I Job !Ille (See Instructions) I Employer (5ee Instructions)
Date Full name 01 contributor o ouH>!'lbo'" AACQD#: 1 Amount or I In-kind contribution
~J~/I' \.Jc... '-k,h'b vy- contribution ($) I descrlpUon (il applicable)
• • coninbuior add'reSs'; , 'city: 'siBle;' Zip Code' ...... , , , fYOdJD I
~q l , ru~ "t I\-..,.J 'Mi'r-w yl_ ~ I
.l...vt V \ ... > I I'?C- 7 $tlc;,. )__ I
_lIf Wllel outside of Tems complele Schedule. TI
Principel occupllUon I Job title (see Instructions) 1 Employer (See Instructions)
ATTACH ADOmoNAL COPIES OF THIS SCHEDULE AS NEEDED
IF contributor Is eut-et-state PAC, please see Instruction guide foradditlonal reporting requirements. www.athlcs.state.lx.us

Revised 04/21/2010

972-721-2384

04: 14:40 p.rn,

04-14-2011

54/64

Texas Ethics Commission

P.D Box12070

AustIn Texas 78711-2070

(512) 463-5800

(1"bD 1-800-735-2989)

.
POLITICAL CONTRIBUTIONS SCHEDULE A
OTHER THAN PLEDGES OR LOANS
The Inatructlon Guide explains how to complete thIs form. 1 Total pagea S~edUle A:
2 FILER NAME 3 ACCOUNT # (Ethics Commlllllion Filera) ,
:ru\\~ .~ ,,~. ~ {'-..PN\
'" Dale 5 Full name 01 conlrlbutor 0 aUl-<lr ... 1a1e R1C~0t. 1 7 Amount 01 I 8 In-kind contribution
~/rJ_Yll \J tJ \<.. ... .) \.U-t\J -o...rv '-.) t..Jy ~). cL~ ~'~',;;:: descrlptlcn ,. ,ppl;~bl.,
• • • ~ • • • • • • • • ~ • • • • • 4 F • • • • • • ~ 4 • • • • • •
6 Conlrlbutor address; City; Slale; Zip Code
\k \~ ... Cf\:>lA Co """ ~; ~w kw- " J
.1
n...~c:.e.~ ..Jr- ~"'-"'-~ \(',,-,\<;.-0 N!-- ~ ~ (II travel oulBIde of Tems, complete Schedule T)
9 Prlnclpal occupation I Job Itlle (See Il1&tructlons) 110 Employer (See Instructions)
Date Full name 01 contrlbutor o DtJt.aI ... 1a1e R1COIl': 1 Amounlol ! In-kind conlrlbutlon
conlributlon ($) t description (II applicable)
. . . •. . . . .~, . . . . • t, •• 4 ••• 4 •• ~ • • 4 • • 4' • . . I
Contributor address; cny; Slate; ZIp Code
I
I
III traveloul6ide 01 T@!6 COIl\otele SchaIDJJe Tl
Principal occupation I Job IItle (See Instructions) 1 Employer (See Inslrucllons)
Date Full name of contrlbulor o out-<>r-alolfl R\C(IDI; I Amount or 1 In-Idnd contribution
contrtbution ($) I descrlptlon (If applicable)
Ccinirtbuio; eddreSS; • · ......... • 4 .. • • ~ " , • , I
City; Slate; ZIp Code
I
I
(If travel oul5lde of Texas. complele Schedule T)
Ptlnclpal oooupation I Job title (See Instructions) I Employer (See In&lrudlons)
Date Full name 01 contributor o DtJt.DI-ItIIl1 R1CODl: 1 Amounlof ) In-klnd conttlbutlon
contribution ($) ) descrtptlon (If applicable)
.. Cciniribuior eddre~; • • sial~;' :ZIp code' · . ,. . . . ~, . ,. '. !
Clly;
I
I
Ilf travel oul5ide of Texas comDleli! Schedule.D
Principal occupation' Job Hlle (See Inslrudlons) I Employer (See in&lructlons)
Date Full neme 01 contributor o .u~aI .. 1II1l1 R1CODl: I Amountol 1 In-kind contribution
conlrlbution ($) I description (if applicable)
j, ~ COnirtbuior add're~; • 'city: · ........ · ., ~ . .. . . . ., - J
Slate; ZIp Code
I
I
.rlf travel oulside 01 Texas colTIDlete Schedule T)
Prinolpal oooupalion , Job title (See In&lructlol1&) 1 Employer (See inslrudlons)
ATTACH ADDITIONAL COPIES OF THIS SCHEDULE AS NEEDED
If contributor Is out-or-state PAC, please see instruction guide roraddltlonal reporting requirements, www.athlcs.stata.lx.us

RevIsed 0<1'2112010

972 -721-2384

04:15:05 p.rn,

04-14-2011

Texas Ethics Commission

Austin, Texas 78711-2070

(TDO 1-800-735-2989)

PO. Box 12070

(S12) 463-5800

PLEDGED CONTRIBUTIONS SCHEDULE B
The Instruction Guide explains how to complete Ihls form. 1 Tolal pages Schedule B:
2 FILER NAME 3 ACCOUNT 1# (EthiC!! Comml991on Filers)
4 TOTAL OF UN ITEMIZED PLEDGES: t:> t:> t:> t:> Q Q 1$
5 Dall! 6 Full name of pledgor o OUI-o'-.Ial. PAC (Ilk ) B Amouniof 19 In-kind deacrlpllon
pledge ($) I (If applicable)
.. · ........ · - · . . ~ . . .... · ~ . . . . . . - , I
7 Pledgor address; City; Siale; Zip Code
I
I
(II lravel outside gf Texas, CQmplo~ Schedule-T}
10 Principal occupation I Job Illle (See Illstruclions) 111 Employer (See Instructions)
Oela Full name of pledgor o oul-o'-lllloPAC(IDII: I Amount of I In-kind d8:Sgrtpllo~
pledge ($) I (If appllceble)
. , · . , ...... , - · ..... - ~ . . • • • I • • • ~ · . I
Pledgor address; City; State; Zip Code
I-
I
(il !ravel oUlllide of TIllIB8, complete Schedule -TI
Principal occupation I Job title (See Inljtrucllolls) I Employer (Sea Instructlona)
Dale Full name of pledgor o out-.!-Ilate PACOOl, I Amounlof I In-kind descrlpllon
pledge ($) I (If eppflCllbla)
- . • •• t ••••• · , ~ ~ . . . . , ... • • • * * • ~ • · '. I
Pledgor address; City; State; Zip Code
I
I
, (If travel Dullide 0' TSlIlIS, campllilo Schedule Tl
Principal occupaUon I Job title (See Inatnlllllons) -, Employer (See Inslructlons)
Data Full name of pledgor o o.l-o~.tatBPAC(IOI: I Amount of I In-kind description
pledge ($) I (if applicable)
, . ~ ~ • • • * • • • · . * •••• .., . ~ ~ ~ • • * • ~ • • • · . I
Pledgor address; City; state; ZJpCode
I
I
til travel outside of Texas, comRlole Schedule n
Principal occupallon I Job tKle (See Instructlona) I Employer (Sea InslructJons)
Dale Full name of pledgor o OUI-o!"tall PAC nOlI: I Amounlof I In-kind description
pledge ($) I (If applicable)
, . • ~ i • , .. ~ • • , . • * • , •• •. . . . · ........ , . I
Pledgor address; City; State; ZJpCoda
I
I
,(ff travel outside III Texas, CQm~lelO Schedulll T)
Principal eeeupatlcn I Job mle (See Instructions) I Employer (See Instructlona)
ATTACH ADDITIONAL COPIES OFTHIS SCHEDULE AS NEEDED
If cDntrlbutDr '11 out-ef-state PAC, pleass Bse .nstructlon guide for additional reporting requlremenla. www.elhlcs.slate.lx.us

RevIsed 0412tf2010

55/64

972-721-2384

04: 15:28 p.m.

04-14-2011

56/64

Texas Ethics Commission

PO. BOK 12070

Austin. Texaa 78711-2070

(512) 463-5800

(TOO 1-800-735-2969)

LOANS SCHEDULE E
Tha Instruction Guida axplalns how to complata thIs term, 1 Total pllGes Schedule E;
l
2 FtLER NAME 3 ACCOUNT # (Ethh:s Commlaalon fliers)
:r...J\\~ ~~~ Cs,~
4
TOTAL OF UN ITEMIZED LOANS: ~ Q Q ~ Q t;> $
5 ;i:~rfnl 7 Name oflender o oul-ol·.lala PAC II[JII" I ;. LoanAmounl ($)
~",-,\\-t._ q).PJ. ~Q.',,""" \.)~UU.~
I. I • I ••• • I •••• . . . . . . . . ••• I I • · ... . .. , ....
6 Is lender B Lender address; City; State; Zip Code 10 Initrate
efinBnclBI 'l..o 2-lp ~u'("ho.-.-. :t\'Lv,,~ '\jl
Ill5lJtullcn? 7S-0,," 1.-
11 Mo\urll>, dale
y ®
12 Prlnclpel occupation I Job title (See In~lructl(lnB) 13 Employer (See lnstructlons)
14 ZiOn of COllateral
15 GUARANTOR 16 Name of guaranlor 18 Amount Guaranteed (:jI)
INFORMATION
• • • I I ••••••• . . . • t I • i •• 0' .. " ... • • • • I ~. • •• .. • • •
~ llppIidlb'e 17 GUarantor address; City; State; Zip Code
19 Principal Occupation (See Instructlons) 20 Employer (See Instructions)
Dale of Joan Nama of lender o oul·ol·olllia PAC garl; ,I Loan Amount ($)
~ 11.."?/i \ :t~\\~ ~"Q,. b~m-r1 i- 51rO. crO
~ • ~ I • • I • . . . . . . • I ••• . .. ..... , ..............
Is lender Lender addre6ll; City; Slate; Zip Cede Ij51rale
aftnandal "LU'l-.\o ~u-('-~~ h" \"'~ '\ ~ "'1 ~l}' 1-
Inslltullon?
@) MatUrity date
y
PrinCipal eccupauen I Job tHla (See Inslrucllons) Employer (See Instructions)
~(Oll of Collaterel
GUARANTOR Name of guarantor Amount Guaranteed ($)
INFORMATION
. . . . . . . . . . . . . . . . . . . . . . . ...... • •• t .........
~apPlc3iIe GuarantDr address; City; State; Zip Code
Principal Occupallon (Saa Instructions) EmplDyer (Sea InstructlDns)
ATTACH ADOmONAL COPIES OF THIS SCHEDULE AS NEEDED
If lender Is out-o'·state PAC, please sea Instruction gulda fDr addltlDnal reporting requirements. www.ethics.Btale.hc.us

Revised 04/2112010

972 - 721-2384

04:15:51 p.m.

04-14-2011

57164

Texas Ethics Commission

P.o. 80)( 12070

Austin, Texas 78711-2070

(512)~5BOO

CTDD 1-800-735-2989)

POLITICAL EXPENDITURES SCHEDULE F
EXPENDITURE CATEGORIES FOR BOX 8(a)
Advertising Expens., GIlUAwards/Memorlala Expense SaianestW8ges/Contract Labor Loan Repaymenl/Relmburlsment
Accaunllng/Banklng Legal SeNlce8 SollcltalionlFundralslng Expenae Tranapanatian Equipment & Ratatad Expense
conauiling Expanse Food/Beverage ExpanlB Tr811111 In Dlslrlcl ContribuUons/Donations Made By
Event Expanse Polling Expense Travel Out Of District Candldale/Officeholdsr/PollUcal CommlUes
Files Prlnllng Expense Office Overhead/Rental E.pense OTHER (enter e category not listed above)
The Instruction Guida eltplalna how to complete this lorm.
1 Total pages Schedule F: 2 FILER NAME 13 ACCOUNT II (Ethics Commission Filers)
)_ ~\\~ ~kiQ), G;. o(l_ 'f>n,.. '\
4 Date Ei Pllyeename
l.J/,'2-/ t \ . ~. 'Pt-'-I...O 0 .,.-,. O-L~ 'JIA.,:,'1I..Jl.
Ei ~ount'($) 7 E'l,Iy"a HdQre9~; Clly; State; Zip fade
9,'10 lJ.~+-~
'J..0.0!;' ~ 'C) \ ,1:.1\-'" \ ~ ~ 7~o(. 1
8 PURPOSE (a) Calagory (5 •• catogo,t .. II,tod .llholap of Ihl' Idled"I.1 (bl Deaa1pUon (1I1nI •• 1 oulJld. ofTo""s. """'pl.l. Sdl.dul. TI
OF ~J.\t4I\~~ ~ ~V\L1..1.y\._ Co..w..;p , ~\ \\ltJ~>
EXPENDITURE -
"I,Y
9 Con1'lete.tN.Y II dlrect C~ndldate I Officeholder name' Office sought Officehetd
expenditure 10 benefll ClOH
~aA_iL\\ Payee name (;.~~ ~ 4.-r-(" e \.~
C)-k. rJA-Oc'1It.
I t1"0'S,1 (') ~ -- I Payee IIQdress; City; State; Zip Code
').. .~ ~.~, I D\S'\:) 1: b S" G , I.J\!) ~V'f"'\!)"~
~~~Iat..~~
T""''_''''_
PURPOSE Category (S •• ""tegDIf.llllted at Iholcp of Ihil Idledule) Description (II inval o~e crT'I"a •• completo SdI.dul. T)
OF Ptd.'/'eA.~"'" ~ 6v:~y... c..CJ...w--~to..t"l0" O\)R.\~~ClG1t->
EXPENDITURE
~ele w.y If direct Oandldate I Officeholder name Office sought Office held
expendIlure 10 benefit CIOH
Date Payee name Q(\~~\
_y I_"I \ \ \}oJ • t'1. \}oJ e, \" l? SVVIoV:;J
Amount ($) Payee address; Clly; State; Zip Code ).
~ ~W~ ~~~b~
'1 a~() \ ...J \'\'0.( \'.,c:. ''"'' r.,. 0
PURPOSE Category (s •• ...?ego,I",lIlled.t Ihalop .,lhludledulo) DeScription (II inVOIDUlild. ollO •••. complllt. Schedule T)
OF r\-o._~~t~ ~~ c_ Cl..~ ;) o-J t..rv.... ~'A-r-r1v l?1--
EXPENDmJRE
CorrflIetew...ylfdlred Candidate I Officeholdel name , Office 8ou~ht -" Offir:e held
expendlure to beneftI CIOH
~7o\)~'\ Payee name ~ ('e.~ '>
(,M.'NJ~
Amount (IS) 1l..C."- Payee address; Clly: Slate; Zip Code
$~t ll~~ q<'h) N. ~~ <t."" ~-.s-. t ,~~
A c:t c .. ti tt' rk...'" ~ \~ '7 ,;;:b ~ J
PURPOSE Category (s .... CI~.'IO.II'll!d II Ih. lap .11hI .. dl.dul.) OII5cnptlDn (II invll oUIIlde oIT ..... campl.,. SclildulHj
OF ~.:_~ &,-"n_ ,oJ Q ... ~~ C{>n...\)S
EXPENDITURE
Complele J:llil.Y: il dlr"cl Candidate I O'~~hold~r nLme Office Bought Office held
BKpendlture to benefit C/OH
ATTACH ADDITIONAL COPIES OF THIS SCHEDULE AS NEEDED www.elhlcs.state.lx.us

Revised 0412112010

972-721-2384

04: 16:23 p.m.

04-14-2011

58/64

Texas Ethics Commission

..
POLITICAL EXPENDITURES SCHEDULE F
EXPENDITURE CATEGORIES FOR BOX 8(s)
AdvBrtlslng Expanse GIIUAwBrdafM6ma~als Expense SalarlBstWalJSBfConlrect Labor Loan RepavmenlfRelmbunlemenl
Accounllng/Banklng Legal ServlCIIG SollcllaUonlFundralslng ElcpenslI TranaportaUoJl E.quJprnonl & ReJllled Elcpen~e
Consuiling Expense Filed/Beverage Elcpense TfaVllI In DI&lrtci CenlnbullonlfOol1ullons M'odll By
Evenl Elcpen8s Polling Expenas Travel Oul or Dlslrict CandldalslOmCj!holder/PbUUcnl CommlUoe
Fees Prtnllng Expense Olnce Overhead/Renlal Expense OTHER (enler B category nol lilled above)
Tha Instruction Guide a_plains how to complete thla form.
1 Tolal pages Schedule F: 2 FILER NAME ~~, 13 ACCOUNT ~ (Elhlcs Commission Fllars)
'L- 'l' .v., ~ VI... DeN \""
43il--¥tl Ii Payee name
bL C-h.., t--O
6 AmllunL (5) 7{a~~a;resBli-\~I~ ~e:~\
{'-\<n, \ ~
J:w..v \. ~ \ '1" '7 s; "G "L.-
a PURPOSE (a) Calegory (5 •• cs(ogorla.llitod pi thllnp ofthl, ,tIt,dlll.1 ~=~O:;DU~:::\~~:I~UI.;veJ-
OF ~'7~ "-yL ~~
EXPENDITURE
9 Ccln1lIe!e.cN..Y If dlred Candidate I Officeholder nama Office sought Offil:e held
expenditure to benefit ClOH
Daz / paYllena\e s: ~
~ '.1";- " V,<-. ~"'\ . c_VVV'"
Amounl ($) Payee address: I City: Stale~ Coda ~
6 tJS'ql.,).L~ SL~ ~w- 'i, l)t ~.
'\)~«"~' \A- S1....b"t.l 1-

PURPOSE Irp:~~(Bc:t.n~he: ofthl •• tltedulel Oeacrlpl!lln ,II 11"1 .. 1 OUllldo OITIUI. comple(e Stltadul. T)
OF ii+tM~ G. AAA,,'J OJ' ~ C;. yr--'
EXPENDITURE
CaJll'eIe w.Y If dired Candidate I Officeholder nlm;" Office sought Office held
I!IIpI!ndllure to benefil CIOH
;J~/?-a\ \ Payee name
Lc.rw..'()MJ ~~L
Amotonl ($) Payee address; City; State: Zip Code
1!,'4,U~ r ~Il. -(S J)< c.. 7'l-V Q .... \
\:)~t...~ i'-'(
PURPOSE Category (SU callgo~"lIstod.1 tho top of this _tltedulo) Oeficrlpllon (lr (ravel oulJlde 011 ..... , campl.1II Stlt.dul. T)
OF r\c_c.uu-..- ~ / ~ ~ \c.t , ~e.~. \-- ~ Gh~~c. ()lL~
EXPENDITURE A
0:ln1:>Ie!e .cN..Y if direct Candidate I omcehol~r name \ OffIce.ought Offlceheld
m.pendllure to benefit CIOH
Oale I J~ Payee name
t.t \:, ';)...:1\\ o ~~-u_ W\ oA-"f.
Amount ($) PaYl'e lI<1dress: Clly; Slate; ZIp Olldl'
qiot ~ ~ ;.~SO Lu~\~ bJv~
'f1...J\~ lC_C\ t'7
PURPOSE Category (B •• ee(~~._ H_lod ~ha tap o1thll ItIt.dulo) Description (~,",vel o .... ld. oIT ..... camploto Stltodulor)
OF ry'(\.-\'~\"", ~...__ ...... _.. ,?d.~ ~~"'" J:..~ \<.._
EXPENDITURE
CQl11plele mIl:l if direct Can<ll<lale I Offl\eholder namb Offloeaoullhl I Office held
expenditure ID benent etOH
ATTACH ADDITIONAL COPIES OF THIS SCHEDULE AS NEEDED PO 801112070

Austin, Texas 78711-2070

(512) 463·5800

(TDD 1-80Q..735·29B9)

www.ethlcs.slste.11I.u5

Revised 04/2112010

972-721-2384

04:16:54p,m,

04-14-2011

Texas EthIcs CommIssion

P.o. Box 12070

(512) 463-5800

(rOD 1-800-735-2989)

Austin, Texas 78711-2070

POLITICAL EXPENDITURES SCHEDULE G
MADE FROM PERSONAL FUNDS
EXPENDITURE CATEGORIES FOR BOX 8(a)
Advertising Expeneo Glll/Awarde/Memoriala Expenee Saiarieu/WagaelConlract Labor Loan RepaymanURelmbursement
Accounting/Banking Legal Services SolicUallonlFundralslng EKpense Transportation Equipment & Rllialed Expense
Consulting Expense FoodlBeverage Expense Travel In DI&trlci Conlrlbutlon,/Oonallons Made By
Evenl Expanse Polling Expanse Travel OUI or Dlstrlcl Csndidsie/Olficehoider/Polilical CammiUee
Fees Prlnllng Expense Office Overhesd/Renlal Expense OTHER (enter a category not IIstad above)
The Instruction Guide explains how to complst!! this form.
1 Tolal pages Schedule G: 2 FILER NAME J 3 ACCOUNT II .(Elhlca Comml!tllon Fliers)
4 Date 5 Payee name
6 AmoLint ($) 7 Payee address; City; Stale; Zip Code
'0 RBimburllmonllrom
pDlIIlCIIl co"l~buUDn •
. Intended
B PURPOSE (a) Calegary IS •• cal.gDrI .. IIIIBd II the lOP Dr Ihll ,eII.dule) (b) 0 Bscrlptlon III !nIvel Dul'ide DIT ..... campl.lo Schedul. T)
OF
EXPENDITURE
Oalll Payeensme
Amount ($) Payee address; City; Stele; Zip Code
o Rolmuurtemenl ft'Dm
. pDIIlIca";'lnlribu~Dnl
lnIandod
PURPOSE Category (S ..... legon •• Ulled BLllle IDp .llhl. ach.duID) Description (1I'roWol ouilld. olT ..... campiSI. Schedtll. n
OF
EXPENDITURE
Dale Payee nama
Amount ($) Payee address; CIty; Slate; ZIp Code
o RalmlKnMm.nt Imm
pDlltJcol contrtlllilfDrII
lrlIonded
PURPOSE Category ISo. cologon •• II,'ed ellholDp DIIllis Ith.dulo) Description (II trauBI outslda 01 Tm ••• campl.t. SeIIedulo T)
OF
EXPENDITURE
Date PayeenBme
Amount ($) Payee addl1lBs; City; Stale; Zip Code
o RalmburHmoot Imm
pDlltJOIIt tcnlrlbuUDn.
1111_
PURPOSE Category IS •• cal.gon •• lilted allholap OIthl. Ich.dula) DescrlpUon III trauel Dullid. DfT ..... compille B~duto T)
OF
EXPENDITURE
ATTACH ADDITIONAL COPIES OF THIS SCHEDULE AS NEEDED wwW.elhlcs.slate.!lC.U5

Revised 0412112010

59/64

972-721-2384

04:17:17p.m.

04-14-2011

60/64

Texas Ethics Commission

PO Box 12070

Austin Texas 78711-2070

(512) 463-5800

(rOO 1-800-735-2989)

,
PAYMENT FROM POLITICAL CONTRIBUTIONS SCHEDULE H
TO A BUSINESS OF C/OH
EXPENDITURE CATEGORIES FOR BOX 8(a)
AdverllRlng ExpenRe GIIIJAWBld&lMemorlllis Expanee SalmleolWeaellConllD1II Labor Loan RJlP8rmentiR~lmburumenl
Accounting/Banking Lega! Servlcaa Sollellllllon/FundlDlllnll EKp8nae iranaporlnllon EqlilpllUlnl & RuIBted Expense
Coneuiling Expenee FODdlliuvarago Expense Trovel In DISlrict Conlrtbullons/Dol'lnllcna Mada BV
Event Expense Polling EJ:punse Trilvol Out or DIBI~cl CanlildilIBIOln""lliil~er/Fclrllc:a1 Committee
Fees Prlnllng Elcpense Office Overh8sdiRentai eKpenRe OTHER (enlll' a catego,V nolll&ted above)
Tha Instruction Guida axplalna how to completa Ihle form.
1 Tolal pages Schedule H: 2 FILER NAME 13 ACCOUNT '" (Ethics CommiSSion fliers)
4 Dale 6 Buslne8B name
6 Amount ($) 7 Business address; Clly; SlBte; Zip Code
B PURPOSE (e) Category IS •• <.I.gc~ .. lill.d at Iholcp aI thli ,chedule) (h) Description (II travel cUlold. cITe""l, compl.l. Sd1.dul. TI
OF
EXPENDITURE
9 Cartllele a!I.Y If direct Candidate / OffIceholder name Office sought Office held
expendllure 10 benefit etOH
Dale Business name
Amount ($) Business address; City; State; Zip Code
PURPOSE Calegory IS •• calegcrt.lnllod at Ihe top .llhl, ,c:h.dulel Description Ilf lraVel oullide DITO,...., compl.le Schedulo T)
OF
EXPENDITURE
~ele .w:llf direct Candidate / Officeholder name Officeaought Omce held
mcpenditure to benefit etOH
Date Buslne85 name
Amount ($) BUBlne811 address; City; Stale; Zip Code
PURPOSE Category (S.e colegcrlellill.d ollhe Icp allili. Ic:hedule) Description (II 11'11 vol cullide alT.""" CIlI!1plel6 Schedule Tl
OF
EXPENDITURE
~ete W.l:' If diJl3d Candidate / Officeholder name Office sought Office hald
expenditure to benefit etOH
Date Business name
Amount ($) Business address: City; Stale; Zip Code
PURPOSE Category (So. COI"1lDrtIIllillod IIlhe lop DllhllSthoduiol Description (1IInveloulIId. ofT,ns, c:umpl.lo SrJlldule TI
OF
EXPENDITURE
~!4ea!I.YlfdJ!Dd Candida Ie/ Officeholder name Office Boughl OffIce held
expendIlum to benefrt C'Q-t
ATTACH ADDITIONAL COPIES OF THIS SCHEDULE AS NEEDED www.ethlcs.slaIB,lx.U6

Revised 04/2112010

972 -721-2384

04: 17:43 p.m.

04-14-2011

61/64

Texas Ethics Commission

P.O. Box 12070

Austin, Texas 78711-2070

(512) 463-5800

(TOO 1-800-735-2989)

NON-POLITICAL EXPENDITURES SCHEDULE I
MADE FROM POLITICAL CONTRIBUTIONS
EXPENDITURE CATEGORIES FOR BOX 8(a)
Advertising E!cpenae G'fUAwams/Memollsls ElIpenae Salat1l1l11WaOllslConlract Labar Loan RepaymenURaimburaamenl
AccounllnglBanklng Legal Services Sollcllallon/Fundralslng EKpenBB Transportallon Equlpmenl & Related EXpense
Cons~llIng ElIpenall Food/Beverage Expense Travel In Dlslrlcl CQnl,Ibullon,/Ollnallonl Mada By
Evant Expenso PDlllng ElpBnsB Travel Oul or Olatnct Candldele/OniceholderlPolltical CDmmlll.e
Fees Pllntlng Expense Olnco Overhead/Renlal Elpense OTHER (enter B calegary nallisled above)
Tho Inatructlon Guide uptBlnB how to complete thle form.
1 Tola1 pagn SChedule I: 2 FILER NAME J 3 ACCOUNT # (Ethics Commlulon Alera)
4 Dille 6 Payee nama
6 Amount ($) 7 PaYlle address; City; Stale: Zip Code
8 PURPOSE (a) Category (s •• cIlsgonun.led .llh.tDp of Ihla sdtodull) (b) 0 BBcr)pllon (581 Inllrudton. regalding Iyfl'l 0' Inlorm.llon IlIQUllld.1
OF
EXPENDITURE
Dale PaYBename
Amount (91) Payee address; City; State; Zip Code
PURPOSE category (S •• ClII.gorl •• llllad pllh.lop o,lhill Ichedul.) Description (S __ lnltructlons ra9lrcllng IYpe 0' Infannallon ,oquirad.1
OF
EXPENDITURE
Dale Payeenllma
Amounl ($) Payee addnoss: City: State; Zip Code
PURPOSE Category (5ee cal.gart.III~I.d 11th. lop DllhJllCh.dul.) Description (Sue I.BIIIICllono regarding Iypo 01 InllIrmaticn ,.qui",d~)
OF
EXPENDITURE
Dale F'ayeename
Amount ($) Payee address; City; Slale: ZlpCllde
PURPOSE Calegory 15.e cal.ljDrlu UII.d .1 Ill. lap "'Ihl •• !;had"I.) 08acrlpUon (5 •• In.IIIICllan, regilding Iype onnformallon required.)
OF
EXPENDITURE
ATTACH ADDITIONAL COPIES OF THIS SCHEDULE AS NEEDED www.lllhlcB.Blate.tx.UB

Revised 0412112010

972-721-2384

04: 18:05 p.rn,

04-14-2011

62/64

Texas Ethics Commission

PO 80x12070

Austin, Texas 78711-2070

(512) 463·5800

(TDD 1-800.735-2989)

CREDITS (optional) SCHEDULE K
The Instruction Guida &xplalna how te complete this form. 1 Tolal pages Schedule K:
2 FILER NAME 3 ACCOUNT # (Elhlcs Commls&lDn Fliers)
4 Dale S Payor name 8 Amount
(51
6 Payor address; City; Slale; ZlpCade
7 RaaBon for credit
Date Payor name Amounl
($'
Pavor address; City; Stale; Z1pCocle
Rea Bon far credit
Dale Payor name Amount
($)
.
Payor address; City; SIBle; ZlpCade
Reason for credit
Dale Payor name Amount
(IS)
Payor acldress; City; State; Zip Code
Rsason for credll
Dale Payor name Amounl
($)
..
Payor address; City; Stale; Zip Code
Reason for cnsdll
.
ATTACH ADDITIONAL COPIES OF THIS SCHEDULE AS NEEDED www.elhlcs.slate.tX.U8

Revised 04121/2010

972-721-2384

04: 18:20 p.m.

04-14-2011

63/64

Texas elhlcs CommIssIon

P.O. 80l( 12070

Austin, Texas 78711·2070

(512) 463-5800

(TDD 1·800-735-2989)

IN-KIND CONTRIBUTION OR POLITICAL EXPENDITURE SCHEDULET
FOR TRAVEL OUTSIDE OF TEXAS
Tho Instruction Guide axplalns how to ~ete this fann 1 Total pages Schedule T:
2 FILER NAME 3 ACCOUNT # IElhlce Commission Fllsrt)
4 Name of Contributor I Corporation Dr Labor Organization I Pledgor I Payee
5 Contrfbution I Expendlturu reported on:
0 Schedule A 0 Schedule B 0 Schedule C 0 Schedule D 0 Schedule F 0 Schedule G
'0 Schedule H 0 Schedule N 0 COH·UC 0 COH-T 0 PAC-C 0 PAC-E
6 Oalea of travel 7 Name of person(s) traveling
B Departure city or nsme of departure locallon
9 Desllnatlon clly or name of deatinatlon location
10 MlIsns oftrensportation 11 PUrp05" ofiravel(lncludlng name of conference, seminar, or etner event)
Nome of Contributor I Corporallon or Lebar Organlzetlon I Pledgor I Payee
Contribution' EJcpendlluf8 r"ported on:
0 Schedule A 0 Schedute 8 o ScheduleC 0 Schedule 0 0 Schedule F o Schedule G
0 Sohedule H 0 Schedule N o COH-UC 0 COH-T 0 PAC-C o PAC·E
Oates oflravel Name of person(s) traveling
Oepartuns city Dr neme of departure location
De,lInstion city Dr name of destination locallon
Mesne or trsnaportatlon Purposa of travel (InclUding name of conference, seminar, or other event)
Name of Contrtbutor I Corporation Dr Lebar Orgenlzallon , Pledgor I Payee
Contrlbullon I Expenditure reported on:
0 Schedule A 0 Schedule B 0 Schedule C 0 Schedule 0 0 Schedule F 0 Schedule G
0 ScheduleH 0 Schedule N 0 COH-UC 0 COH-T' 0 PAC-C 0 PAC-E
Oatas of travel Name of person(s) traveling
DepartUre city Dr name of dapartura locallon
Dastlnetlon city or name of destination location
Means oftrsnsportaUon Purpose of travel (Including name of conference, semlnsr, or olher evenl)
ATTACH ADDITIONAL COPIES OF THIS SCHEDt,JLE AS NEEDED www.elhlcs.stale,lx.U6

Revlsed 0412112010

972-721-2384

04: 18:44 p.m 04-14-2011

Texas Ethics Commission

P.O. BOl< 12070

(612) 463-5600

(T001-SCJO.-735-29B9j

Austin, Texas 76711-2070

CANDIDATE I OFFICEHOLDER REPORT:

DESIGNATION OF FINAL REPORT

FORM etOH - FR

The Instruction Guide explains how to complete this form .

•• Complete only If "Report Type" on page 1 Is marked "Final Report" ••

2 ACCOUNT # (Elhlca CommissIon F1lersl

1 C/OHNAME

3 SIGNATURE

I do not expect any furthar political contributions or political expenditures In connection with my candidacy. I understand that designating a report as a final report tennlnates my campaign treasurer appointment. I also understand that I may not accept any campaign contributlons or make IIny campaign expenditures without a campaign treasurer appolnfment on file.

Signature of Candidate I Officeholder

4 FILER WHO IS NOT AN. OFFICEHOLDER

•• Complete A & B bulow only If you are notanofficahotdar ...

A. CAMPAIGN FUNDS

Chock only ono:

o I do not have unexpended contributions or unexpended Interest or Income earned from pol~lcal contributions.

o I have unelCpended contributions or unexpended Interest or Income earned Irompollllcal conlIlbullons. I understand that I may not convert unexpended polilh:al contributions or unexpended Interest or Income earnea on poliUcatconlrtbutlon~ to personal use. I also understand that I must file an annuel report of unexpended contrlbullons Bnd that I may not retain unexp,endea contributions or unexpended Interest or Income earned on p~IIIlCl81 contributions tongarthan six years after flllng lhlB linal' report. Further, I understand thai I must dispose of unexpended political conlribullona and tmal(pe,nded Inlaresl o-r inoome earned on political contributions In accordance with the requirements of Election Code, § 254.204.

B. ASSETS

Chack only Dna:

o I do not retain assets purchased with political contributions Dr Interest of other Income from political contributions.

o I do retain assets purchased wHh political contributions or Interest orotherlncome from political contributions. I understand that I may not convell 6llsets purchased wHh political contributlons or Interest or other Income from poliUcal contributions to personal use. I also underatand that 1 must dispose of assets purchased with political contributions In accordance with the IlIqui'rements ofEledionCode, § 254.204.

Signature of CandIdate

6 OFFICEHOLDER

•• Complota this aoellon only If you ara an officoholdor ••

o I am aware that I remain subject to filing requlrements applIcable loan oflicehol~l!Irwho does nm !lave a campaign treasurer on file.

I am also awara that I wlJJ be required IE) file reports of unexpended contrlbullons if, after fll1ng the last rsqulred report as an officeholder, I retain polHlcal contributions, Intenest or other lncome frompolillcal contribullons. or assets purchased with political contributions or Interest Dr other Income from political contrlbuUons.

Signature of Officeholder

www.elnlcs.slate.lx.us

Revised 04/2112010

64/64

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