Loll, Clyde, 8-day prior, 10-31-16CANDIDATE / 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:
i
3 CANDIDATE /
OFFICEHOLDER
NAME
MS / MRS MR FIRST
Ml
OFFICE USE ONLY
NICKNAME LAS
Lol!
SUFFIX
Date
Received
'D 31)(c)
4 CANDIDATE /
OFFICEHOLDER
MAILING
ADDRESS
❑ Change of Address
ADDRESS / PO BOX: APT / SUITE #; CITY; STATE; ZIP CODE,/
� /� �%
3T
113 S / ✓'� ---;7
f �I77
/
5 CANDIDATE/
AREA CODE PHONE NUMBER EXTENSION 1
OFFICEHOLDER
PHONE
(� /� �J /, / D= d- IivereQ or Dat Post ark/ed
� 156 ) 2q 1 - vU10 %V 3) )�ed
6 CAMPAIGN
TREASURER
MS / MRS / FIRST MI R eipt # mount $
n.
WWt ( jt2ijQ._
NAME
D. e oc ss d 1
NICKNAME LAST SUFFIX �� '���11 icp
Da 1 aged )01-31 t
Sitoiril
7 CAMPAIGN
AD
ADDDRESSRESS
(Residence or Business)
STREET ADDRESS (NO PO BOX PLEASE); APT / SUITE #; CITY; STATE; ofODE
9s J` L4' 5 LAO, a 1sv1 k I /\ 773�d
J
8 CAMPAIGN
TREAS
PHO EURER
AREA CODE PHONE NUMBER EXTENSION
( q%` ) I 4 - d/ /_ 3
9 REPORT TYPE
January 15 30th day before election 1 Runoff
July 15 8th day before election n Exceeded $500 limit
❑ 15th day after campaign
treasurer appointment
(Officeholder Only)
® Final Report (Attach C/OH - FR)
10 PERIOD
COVERED
Month Day Year Month Day Year
01 /0/<-
v THROUGH A / o? 9 /-26/6
11 ELECTION
ELECTION DATE
Month Day Year
f Y j /
/ / / 0 " / OC &v
ELECTION TYPE
❑ Primary Runoff ❑ Other
Description
General ❑ Special
12 OFFICE
OFFICE HELD (if any)
13 OFFICE SOUGHT (it Known)
6:6) W W cc-
di-f-k
f
As 3
GO TO PAGE 2
rovlded oy 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
Cel L 4) /1
at/
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 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 TYPE
GENERAL
COMMITTEE NAME
SPECIFIC
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
$ 5D IA)
2. TOTAL POLITICAL CONTRIBUTIONS
(OTHER THAN PLEDGES, LOANS, OR GUARANTEES OF LOANS)
1,4)
$ ) •
EXPENDITURE
TOTALS
3. TOTAL POLITICAL EXPENDITURES OF $100 OR LESS,
UNLESS ITEMIZED
$ .-e'
4. TOTAL POLITICAL EXPENDITURES
$ rn g 3J
,
CONTRIBUTION
BALANCE
5. TOTAL POLITICAL CONTRIBUTIONS MAINTAINED AS OF THE LAST DAY
OF REPORTING PERIOD
$ Jv C , 0 1
OUTSTANDING
LOAN TOTALS
6. TOTAL PRINCIPAL AMOUNT OF ALL OUTSTANDING LOANS AS OF THE
LAST DAY OF THE REPORTING PERIOD
$
0
18 AFFIDAVIT
T_ ... —..._......�.--. —_�
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.
�s6"" DONNA L. STORY
:. '' 11-` x = Notary Public
' w.'
1
I = ; r , STATE OF TEXAS
�,„,`. ,;
I 0" My Comm. Exp.03-14-2019
—�
ignature of Candidate or Officeholder
-�-•=--..r
AFFIX NOTARY STAMP / SEALABOVE
Sworn t ani su'scribed before me, by the said Cl Ie D, Lc
` ) , this the
of� !) 2
• =y��. 0, to certify which, witness my hand and seal of office.
,i 1 .fi 0
ay) i
rU
`,��+�"'►`J
L�.
� 4i�.�
is
Signature of officer admini.
g oath Printed name of officer administering
oath Title of officer)administering oath
orms provided by Texas Ethics Commission
www.ethics.state.tx.us
Revised 9/8/2015
orms 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
FILER NAMECi Ch I /I
20 Filer ID (Ethics Commission Filers)
21
SCHEDULE SUBTOTALS
NAME OF SCHEDULE
SUBTOTAL
AMOUNT
1.
1 1 SCHEDULE A1: MONETARY POLITICAL CONTRIBUTIONS
$
2.
SCHEDULE A2: NON-MONETARY (IN-KIND) POLITICAL CONTRIBUTIONS
$
3.
1 1 SCHEDULE B: PLEDGED CONTRIBUTIONS
$
4.
SCHEDULE E: LOANS
$
5.
SCHEDULE F1: POLITICAL EXPENDITURES MADE FROM POLITICAL CONTRIBUTIONS
$ 3a
6.
1 SCHEDULE F2: UNPAID INCURRED OBLIGATIONS
$
7.
SCHEDULE F3: PURCHASE OF INVESTMENTS MADE FROM POLITICAL CONTRIBUTIONS
$
8.
SCHEDULE F4: EXPENDITURES MADE BY CREDIT CARD
$
9.
SCHEDULE G: POLITICAL EXPENDITURES MADE FROM PERSONAL FUNDS
$
10.
SCHEDULE H: PAYMENT MADE FROM POLITICAL CONTRIBUTIONS TO A BUSINESS OF C/OH
$
11.
1 1 SCHEDULE I: NON -POLITICAL EXPENDITURES MADE FROM POLITICAL CONTRIBUTIONS
$
12.
SCHEDULE K: INTEREST, CREDITS, GAINS, REFUNDS, AND CONTRIBUTIONS
RETURNED TO FILER
$
orms provided by Texas Ethics Commission
www.ethics.state.tx.us
Revised 9/8/2015
POLITICAL EXPENDITURES MADE
FROM POLITICAL CONTRIBUTIONS SCHEDULE F1
EXPENDITURE CATEGORIES FOR BOX 8(a)
Advertising Expense Event Expense Loan Repayment/Reimbursement Solicitation/Fundraising
Accounting/Banking Fees9 Expense
Office Overense/RentalExpsnse Transportation Equipment & Related Expense
Consulting Expense Food/Beverage Expense Polling Expense Travelel In In District
Contributions/Donations Made By Gift/Awards/Memorials Expense Printing Expense Travel Out Of District
Candidate/Officeholder/Political Committee Legal Services Salaries/Wages/Contract Labor Other (enter a category not listed above)
Credit Card Payment
The Instruction Guide explains how to complete this form.
1 Total pages Schedule F1:
2 FILER NAME A ----
1 I'
C� `►J\ L
j)
3 Filer ID (Ethics Commission Filers)
4 Date
1()/.26II
5 Payee nameII)�(!
uiIle 14-e tri
6 Amount ($)
3°
$2-ri (4°1
7 Payee address; City; State; Zip Code
r'
)11091 I S+ is ��,lle ---7 3 Z
8
PURPOSE
OF
EXPENDITURE
(a) Category (See Categories listed at the top of this schedule)
ill61 ve. t7 -(2 S � t `J y 97 C
(b) Description
1-1Checkif Chetravel outside of Texas. Complete Schedule T.
I Check if Austin, TX, officeholder living expense
9 Complete ONLY if direct
Candidate / Officeholder name Office sought Office held
expenditure to benefit C/OH
DatePayee
)6/020 I16
name
K/rr7
Amount ($)
3- `�
Payee address; City; State; Zip Code
) 2 l l� �s 5 } ryifs �r, Ile 3 0
PURPOSE
OFCheck
EXPENDITURE
Category (See Categories listed at the top of this schedule)
Ha e ( a
j 504 j
Description
nI Check it travel outside of Texas. Complete Schedule T.
I I if Austin, TX, officeholder living expense
Complete ONLY if direct
Candidate / Officeholder name Office sought Office held
expenditure to benefit C/OH
Date
Payee name
Amount ($)
Payee address; City; State; Zip Code
PURPOSE
OF
EXPENDITURE
Category (See Categories listed at the top of this schedule)
Description
1 I Check if travel outside of Texas. Complete Schedule T.
1 I Check if Austin, TX, officeholder living expense
Complete ONLY if direct
Candidate / Officeholder name Office sought Office held
expenditure to benefit C/OH
ATTACH ADDITIONAL COPIES OF THIS SCHEDULE AS NEEDED
Gnrmc nrn..iv1...J L.., T........ car.:._ n_�.v,__,__ •
www. et h l c s. s tat e. t x. u s
Revised 9/8/2015