Olson, Keith, semi-annual, 1-15-16CANDIDATE / 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:
3 CANDIDATE /
OFFICEHOLDER
NAME
MS/MRS/MR FIRS MI
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e 1
NICKNAME T SUFFIX
OFFICE USE ONLY
Date
i
.;
Received
4 CANDIDATE /
OFFICEHOLDER
MAILING
ADDRESS
n Change of Address
ADDRESS
/ PO BOX; APT / SUITE #; CITY; STATE; ZIP CODE
2 1
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CANDIDATE/
OFFICEHOLDER
PHONE
AREA CODE PHONE NUMBER EXTENSION
O N
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d -deli red r Date ostmarked
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6 CAMPAIGN
TREASURER
NAME
MS / MRS / MR FIRST MI
Rec ipt #
jjjj
Amount $
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NICKNAME LA T SUFFIX 16/t.1 ..
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7 CAMPAIGN
TREASURER
ADDRESS
(Residence or Business)
STREET ADDRESS (NO PO
j �r
l Il
BOX PLEASE); APT / SUITE #; CITY; STATE; ZIP ' ODE
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Skil_
(C -e'e i4NA4 c.i-1) �( l'neqs T*
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8 CAMPAIGN
TREASURER
PHONE
AREA CODE PHONE NUMBER EXTENSION
S (e ) Z9� (?) ^ 2_ L
V'G
9 REPORT TYPE
15 30th day before election Runoff I 1 15th day after campaign
y....January 1 treasurer appointment
(Officeholder Only)
July 15 I 1 8th day before election I 1 Exceeded $500 limit Final Report (Attach C /OH - FR)
10 PERIOD
COVERED
Month Day Year Month
n 2
1 / /D > /�^ ) C THROUGH 11] /2
V t >
` LLLELL-ECTION
Day Year
1
Cr
( ZO 1 S-
11 ELECTION
DATE
Month Day Year
I2/ I 2 / -- /r
ELECTION TYPE
❑ Primary Runoff n Other
Description
❑ General I-I Special
12 OFFICE
OFFICE HELD (if any)
(� l- co,,,,,„,_;
�-F- AA--- V t 1l� C.,i l{�j 1
Vbes ii-t-ni b'1/4-1 ck.--)- - 1_ 00-3-e_
13 OFFICE
SOUGHT (if known) i
c7" 0 c 1.. Y
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GO TO PAGE 2
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 C /OH NAME
WO `t�, D. Ot S
15 Filer ID (Ethics Commission Filers)
16 NOTICE FROM
POLITICAL
COMMITTEE(S)
Additional Pages
THIS BOX IS FOR NOTICE OF POLITICAL CONTRIBUTIONS ACCEPTED OR POLITICAL EXPENDITURES MADE BY POLITICAL COMMITTEES TO
SUPPORT THE CANDIDATE / OFFICEHOLDER. THESE EXPENDITURES MAY HAVE BEEN MADE WITHOUT THE CANDIDATES OR OFFICEHOLDER'S
KNOWLEDGE OR CONSENT. CANDIDATES AND OFFICEHOLDERS ARE REQUIRED TO REPORT THIS INFORMATION ONLY IF THEY RECEIVE NOTICE
OF SUCH EXPENDITURES.
COMMITTEE TYPE
GENERAL
❑SPECIFIC
COMMITTEE NAME
COMMITTEE ADDRESS
COMMITTEE CAMPAIGN TREASURER NAME
COMMITTEE CAMPAIGN TREASURER ADDRESS
17 CONTRIBUTION
TOTALS
1. TOTAL POLITICAL CONTRIBUTIONS OF $50 OR LESS (OTHER THAN
PLEDGES, LOANS, OR GUARANTEES OF LOANS), UNLESS ITEMIZED
$ .---9.----
2. TOTAL POLITICAL CONTRIBUTIONS
(OTHER THAN PLEDGES, LOANS, OR GUARANTEES OF LOANS)
$
TOTANS ITURE
3. TOTAL POLITICAL EXPENDITURES OF $100 OR LESS,
UNLESS ITEMIZED
$
4. TOTAL POLITICAL EXPENDITURES
$F--
�/
CONTRIBUTION
BALANCE
5. TOTAL POLITICAL CONTRIBUTIONS MAINTAINED AS OF THE LAST DAY
OF REPORTING PERIOD
$ Z 3� Q2
U J
OUTSTANDING
LOAN TOTALS
6. TOTAL PRINCIPAL AMOUNT OF ALL OUTSTANDING LOANS AS OF THE
LAST DAY OF THE REPORTING PERIOD
$
18 AFFIDAVIT
I swear, or affirm, under penalty of perjury, that the accompanying report is
— — —
"aY Pte„—
At - - Poi:§ LEE WOODWARD
_ +. , j `,� s Notary Public
.= �., /(.; *1 STATE OF TEXAS
' -.,"*”,,,r- +� ;E+, My Comm. Exp. Feb. 19, 2017
Y
true and correct and includes all information r- . wired to be reported by me
under Title 15, El: lion Cod . /
-
.-- ���
Signature of Candidate or Officeholder
AFFIX NOTARY STAMP / SEALABOVE
-t-J\
Sworn to and ubscribed before me, by the said 11, 1 ► ` DIJ011 , this the I
day o A.J _ �� _ , 20 1 L y.to certify which, witness my hand and seal of office.
I rf
1 ����(,ii���
-Jt 0:Akifrc
i nature of officer administering oath Printed name of officer administering oath 1111e-e) officer administering oat
Forms provided by Texas Ethics Commission
www.ethics.state.tx.us
Revised 9/8/2015
Forms provided by Texas Ethics Commission
www.ethics.state.tx.us
Revised 9/8/2015
SUBTOTALS - C /OH FORM C /OH
COVER SHEET PG 3
19 FILE
NA �' Ot
20 Filer ID (Ethics Commission Filers)
21
SCHEDULE SUBTOTALS
NAME OF SCHEDULE
SUBTOTAL
AMOUNT
1.
SCHEDULE A1: MONETARY POLITICAL CONTRIBUTIONS
$
2.
SCHEDULE A2: NON - MONETARY (IN -KIND) POLITICAL CONTRIBUTIONS
$
3.
SCHEDULE B: PLEDGED CONTRIBUTIONS
$ ..e---
4.
l
SCHEDULE E: LOANS
$ LY
5.
(
SCHEDULE F1: POLITICAL EXPENDITURES MADE FROM POLITICAL CONTRIBUTIONS
$ ,--'
6.
SCHEDULE F2: UNPAID INCURRED OBLIGATIONS
$ ,--}!
7.
SCHEDULE F3: PURCHASE OF INVESTMENTS MADE FROM POLITICAL CONTRIBUTIONS
$ ,-
8.
I SCHEDULE F4: EXPENDITURES MADE BY CREDIT CARD
$ _��
9.
SCHEDULE G: POLITICAL EXPENDITURES MADE FROM PERSONAL FUNDS
...19----
$ ��"
V�"---
10.
SCHEDULE H: PAYMENT MADE FROM POLITICAL CONTRIBUTIONS TO A BUSINESS OF C /OH
$
11.
SCHEDULE I: NON - POLITICAL EXPENDITURES MADE FROM POLITICAL CONTRIBUTIONS
$
12.
I I SCHEDULE K: INTEREST, CREDITS, GAINS, REFUNDS, AND CONTRIBUTIONS
RETURNED TO FILER
$
Forms provided by Texas Ethics Commission
www.ethics.state.tx.us
Revised 9/8/2015