6
,. CANDIDATE I OFFICEHOLDER FORM C/ OH CAMPAIGN FINANCE REPORT COVER SHEET PG 1 1 Filer 10 (Ethi cs Commission Filers) 2 Total pages filed: 0 The C/OH Instruction Guide explains how to complete this form. 3 CANDIDATE / MS I MRS I MR FIRST Mt OFFICEHOLDER J)}r Koh-er+o OFFICE USE ONLY NAME Date Received(.".) . . .. NICKNAME LAST SUFFIX =-·t r-.) s oaJJ,· - :: o-- <:n -:.-- :a l ;'l :-; 1 4 CANDIDATE / ADDRESS I PO BOX; APT I SUITE #; CITY; STATE; ZI P CODE · ··-1' ·- ,., ._. OFFICEHOLDER f •' - :1 ..:t:: MAILING ... :;·; ADDRESS - ., :7 (.) :.::: 'l 0 Ch a nge of Address -:; t:Y J '. 5 CANDIDATE/ AREA CODE PHONE NUMBER EXTENS ION - ;-:; !'-..) OFFICEHOLDER Date or C11lQ Postmarked PHONE ,. 6 CAMPAIGN MS I MRS I MR FIRST Ml Receipt # I Amount $ TREASURER rJ..s . C / Otuo!J ' Cj V. NAME . . . . Date Processed NICKNAME LAST SUFFI X Date Imaged 7 CAMPAIGN STREET ADDRESS (NO PO BOX PLEASE); APT I SUITE #; CITY; STATE; ZIP CODE TREASURER ADDRESS (R es idenc e or Business) 8 CAMPAIGN AREA CODE PHONE NUMBER EXTENSION TREASURER PHONE 9 REPORT TYPE IJ2( January 15 D 30th day before election D Runoff D 15th day after campaign tr easurer appointment (OIIiceholder On ly) D July 15 D 8th day before election D Exceeded $500 limit D Final Report (Attach CI OH- FR) 10 PERIOD Month Day Year Month Day Yea r COVERED ol / oJ / '2.0\5 12. / 31 / 20\5 THROUGH 11 ELECTION ELECTION DATE ELECTION TYPE Month Day Year D Primary D Runofl D Other Description / / D General D Special 12 OFFICE OFFI CE HELD (if any) 13 OFFI CE SOUGHT (if known) Lc:veo\o c;+y Counc.i\ J --:::[:) i <S + y i c.+ 8 GO TO PAGE 2 Forms provided by Texas Ethics Commission www.eth1cs .state.t x. us Rev1sed 9/8/ 20 15

J)}r Koh-er+o - Laredo, Texas...2016/01/14  · fl ,,~:1\to J\('l_f'VP"" 0 o-kvV) Signatu9e of officer administering oath PrintecTname of officer administering oath Title of officezJdministering

  • Upload
    others

  • View
    0

  • Download
    0

Embed Size (px)

Citation preview

Page 1: J)}r Koh-er+o - Laredo, Texas...2016/01/14  · fl ,,~:1\to J\('l_f'VP"" 0 o-kvV) Signatu9e of officer administering oath PrintecTname of officer administering oath Title of officezJdministering

,. CANDIDATE I OFFICEHOLDER FORM C /OH CAMPAIGN FINANCE REPORT COVER SHEET PG 1

1 Filer 10 (Ethics Commission Filers) 2 Total pages filed:

0 The C/OH Instruction Guide explains how to complete this form.

3 CANDIDATE / MS I MRS I MR FIRST Mt

OFFICEHOLDER J)}r Koh-er+o OFFICE USE ONLY

NAME Date Received(.".) . . . . NICKNAME LAST SUFFIX =-·t

r-.)

s oaJJ,· - :: o--

<:n -:.-- :a l ;'l :::~ :-;1 --~

4 CANDIDATE / ADDRESS I PO BOX; APT I SUITE #; CITY; STATE; ZIP CODE · ··-1' ·- ·~) ,.,._. OFFICEHOLDER f •' - :1

..:t:: MAILING ...

:;·; ~ ,.;~

ADDRESS - ., :7 ~

(.) :.::: ' l 0 Cha nge of Address -:; t:Y J '.

5 CANDIDATE/ AREA CODE PHONE NUMBER EXTENSION - ;-:; !'-..)

OFFICEHOLDER

Date Hand·de li vW~-~ or C11lQ Postmarked

PHONE , .

6 CAMPAIGN MS I MRS I MR FIRST Ml Receipt #

I Amount $

TREASURER rJ..s . C / Otuo!J ' Cj V . NAME . . . . Date Processed

NICKNAME LAST SUFFIX

b~/J,· Date Imaged

7 CAMPAIGN STREET ADDRESS (NO PO BOX PLEASE); APT I SUITE #; CITY; STATE; ZIP CODE

TREASURER ADDRESS

( Residence or Business)

8 CAMPAIGN AREA CODE PHONE NUMBER EXTENSION

TREASURER PHONE

9 REPORT TYPE IJ2( January 15 D 30th day before election D Runoff D 15th day after campaign

treasurer appointment (OIIiceholder On ly)

D July 15 D 8th day before election D Exceeded $500 limit D Final Report (Attach CIOH- FR)

10 PERIOD Month Day Year Month Day Year

COVERED ol / oJ / '2.0\5 12. / 31 / 20\5 THROUGH

11 ELECTION ELECTION DATE ELECTION TYPE

Month Day Year D Primary D Runofl D Other Description

/ / D General D Special

12 OFFICE OFFICE HELD (if any) 13 OFFICE SOUGHT (if known)

Lc:veo\o c;+y Counc.i\ J

--:::[:) i <S + y i c.+ 8

GO TO PAGE 2

Forms provided by Texas Ethics Commission www.eth1cs .state.tx. us Rev1sed 9/8/20 15

Page 2: J)}r Koh-er+o - Laredo, Texas...2016/01/14  · fl ,,~:1\to J\('l_f'VP"" 0 o-kvV) Signatu9e of officer administering oath PrintecTname of officer administering oath Title of officezJdministering

, CANDIDATE I OFFICEHOLDER FORM C/OH CAMPAIGN FINANCE REPORT COVER SHEET PG 2

14 C /OH NAME

Kola erm o~~\~· 15 Filer ID (Ethics Comm ission Filers)

16 NOTICE FROM THIS BOX IS FOR NOTICE OF POLITICAL CONTRIBUTIONS ACCEPTED OR POLITICAL EXPENDITURES MADE BY POLITICAL COMMITTEES TO POLITICAL SUPPORT THE CANDIDATE / OFFICEHOLDER. THESE EXPENDITURES MAY HAVE BEEN MADE WITHOUT THE CANDIDATE'S OR OFFICEHOLDER'S

COMMITTEE(S) KNOWLEDGE OR CONSENT. CANDIDATES AND OFFICEHOLDERS ARE REQUIRED TO REPORT THIS INFORMATION ONLY IF THEY RECEIVE NOTICE OF SUCH EXPENDITURES.

COMM ITTEE TYPE COMMITTEE NAME

~ENERAL I "12-..t.-p A c \ Tex.ru 'Assad o.·-hoV) ot \2-.-eCI \1-ov__s -:po\ ~ · -h ca.\ ~ c.-+1 o VI Col-v!Ml't\-ee..

COMMITTEE ADDRESS OsPEC JFJ C t'. Q . bo)C.. '2.'l.L\Lo

~u~-hV\, \~ \ <Q \to <D - LL...4(p COMMITTEE CAMPAIGN TREASURER NAME

0 Additional Pages K-cnjq ""b uvv~ l\- \lo..V\ WovYv!-e. r

COMM ITTEE CAM PAIGN TREASURER ADDRESS

t> .o. po 1\ 2.2.-t.\-lp ~us-\.· V\ \I)__ \ t?il. lo 0 - 1-:v-t \o

17 CONTRIBUTION 1. TOTAL POLIT ICAL CONTRIBUTIONS OF $50 OR LESS (OTHER THAN TOTALS PLEDGES , LOANS, OR GUARANTEES OF LOANS ), UNLESS ITEMIZED $

2. TOTAL POLITICAL CONTRIBUTIONS $ I,Ooo .oo (OTHER THAN PLEDGES , LOANS, OR GUARANTEES OF LOANS)

EXPENDITURE 3. TOTAL POL ITICAL EXPENDITURES OF $100 OR LESS,

TOTALS UNLESS ITEMIZED

$

4. TOTAL POLITICAL EXPENDITURES $ \lt.l'ol

CONTRIBUTION 5. TOTAL POLITICAL CONTRIBUTIONS MAINTAINED AS OF THE LAST DAY

$ ~) 12JS. ~i BALANCE OF REPORTING PERIOD

OUTSTANDING 6. TOTAL PRINCIPAL AMOUNT OF ALL OUTSTANDING LOANS AS OF THE LOAN TOTALS LAST DAY OF THE REPORTING PERIOD $ I, 5oo. oo

18 AFFIDAVIT

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

~-t:.t:Jf'~~,~ ANGELITA ACEVES oodecT~ ~~~[~ Notary Public. state or Texas \.,:·. .:~: My Commission Expires 'S>."'Jt"·· · ~• A 1101 2018 ~,,,,r;,~,~,,~... pr ,

\ signature of Candidate or Officeholder

AFFIX NOTARY STAMP I SEAL ABOVE

Sworn to and subscribed before me, by the said \2-ob.e. V' W b~ \ ~ i , this the t4-hL

day of Jb "". \lq ':] , 20 I lp , to certify which , witness my hand and seal of office .

~olAt".A ~o.~. fl ,,~:1\to J\('l_f'VP"" 0 o-kvV) Signatu9e of officer administering oath PrintecTname of officer administering oath Title of officezJdminis tering oath

Forms provided by Texas Ethics Commission www.ethJcs.state.tx. us Rev1sed 9/8/2015

Page 3: J)}r Koh-er+o - Laredo, Texas...2016/01/14  · fl ,,~:1\to J\('l_f'VP"" 0 o-kvV) Signatu9e of officer administering oath PrintecTname of officer administering oath Title of officezJdministering

SUBTOTALS - C/OH FORM C/OH COVER SHEET PG 3

19 FILER NAME 20 Filer ID (Ethics Commission Filers)

12--obe(+o oet\ L. 21 SCHEDULE SUBTOTALS SUBTOTAL

NAME OF SCHEDULE AMOUNT

1. 0' SCHEDULEA1: MONETARY POLITICAL CONTRIBUTIONS $ \1000 . QQ

2. D SCHEDULE A2: NON-MONETARY (IN-KIND) POLITICAL CONTRIBUTIONS $

3. D SCHEDULE B: PLEDGED CONTRIBUTIONS $

4. D SCHEDULE E: LOANS $

5. 0' SCHEDULE F1: POLITICAL EXPENDITURES MADE FROM POLITICAL CONTRIBUTIONS $ 4-\ l\ . Co\ 6. D SCHEDULE F2: UNPAID INCURRED OBLIGATIONS $

7. D SCHEDULE F3: PURCHASE OF INVESTMENTS MADE FROM POLITICAL CONTRIBUTIONS $

8. D SCHEDULE F4 : EXPENDITURES MADE BY CREDIT CARD $

9. D SCHEDULE G: POLITICAL EXPENDITURES MADE FROM PERSONAL FUNDS $

10. D SCHEDULE H: PAYMENT MADE FROM POLITICAL CONTRIBUTIONS TO A BUSINESS OF C/OH $

11 . D SCHEDULE 1: NON-POLITICAL EXPENDITURES MADE FROM POLITICAL CONTRIBUTIONS $

12. D SCHEDULE K: INTEREST, CREDITS, GAINS, REFUNDS, AND CONTRIBUTIONS $ RETURNED TO FILER

Forms provided by Texas Ethics Commission www.eth ics.state.tx.us Revised 9/8/2015

Page 4: J)}r Koh-er+o - Laredo, Texas...2016/01/14  · fl ,,~:1\to J\('l_f'VP"" 0 o-kvV) Signatu9e of officer administering oath PrintecTname of officer administering oath Title of officezJdministering

MONETARY POLITICAL CONTRIBUTIONS SCHEDULE A1

The Instruction Guide explains how to complete this form. 1 Total pages Schedu le A 1:

\ 2 FILER NAME 3 Fi ler ID (Ethics Commission Filers)

12 olo e v -\-o -n~lli 4 Date 5 Full name of contributor 0 out-of-state PAC (ID#: ) 7 Amount of contribution ($)

12-\ 2.1 I 15 Tf\EfAC/TNO.S ~6.SoGiCl ·hoV! ot Reol+ors

6 Contributor add ress; City; State; Zip Code \J ooo . 00

-:r.o. 'box 22.L\U> p IJ~hV)' T~ I B l(o ~- 224(p

8 Principal occupation I Job title (See Instructions) 9 Employer (See Instructions)

Date Full name of contributor 0 out-of-state PAC (ID#: ) Amount of contribution ($)

.. Contributor address; City; State; Z ip Code

Principal occupation I Job title (See Instructions) Employer (See Instructions)

Date Full name of contributor 0 out-of-state PAC (ID#: ) Amount of contribution ($)

Contributor address; City; State; Zip Code

Principal occupation I Job title (See Instructions) Employer (See Instructions)

Date Full name of contributor 0 out-of-state PAC (ID#: ) Amount of contribution ($)

Contributor address; C ity; State; Zip Code

Princ ipal occupation I Job title (See Instructions) Employer (See Instructions)

.

ATTACH ADDITIONAL COPIES OF THIS SCHEDULE AS NEEDED If contributor is out-of-state PAC, please see instruction guide for additional reporting requirements.

Forms provided by Texas Ethics Commission www.elhtcs.state.tx.us Rev1sed 9/8/2015

Page 5: J)}r Koh-er+o - Laredo, Texas...2016/01/14  · fl ,,~:1\to J\('l_f'VP"" 0 o-kvV) Signatu9e of officer administering oath PrintecTname of officer administering oath Title of officezJdministering

POLITICAL EXPENDITURES MADE FROM POLITICAL CONTRIBUT IONS SCHEDULE F1

EXPENDITURE CATEGORIES FOR BOX 8(a)

Adve rt is in g Expe nse Event Expense Loan Repayment/Reimbursement Solicitation/Fundraising Expense Accounting/Banking Fees Office Overhead/Rental Expense Transportation Equipment & Related Expense Consulting Expense Food/Beverage Expense Polling Expense Travel In District Contributions/Donations Made By GifVAwards/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 explai ns how t o complete this f o rm.

1 Total pages Schedule F1 : 2 F ILER N AME K Do.\\·, 13 F iler ID (Ethics Comm ission Fi lers)

2 I olo.ev-to 4 Date 5 Payee name -=p

0 '(+y

~ity Ol \1.0\ l5 6 Amount ($) 7 Payee address ; City; State; Z ip Code

j\,1~ . 5(p lLQ~\ SaY\ J)dri o ~ve, . lc;.v-cd.o 1

\'( \BoL\5 8 (a) Category (See Categories listed at the top ol this schedule) (b) Descript ion

PURPOSE

E v-evA- t. x~e-V\se. D Check if travel outside of Texas. Complete Schedule T.

OF D Check if Austin , TX, off iceholder living expense EXPENDITURE

bo.0.:s 9 Complete ONLY if di rect Candidate I Officeho lde r na m e O ffi ce sou g ht Office held

expenditure to benefit C/OH

Date Payee nam e

Ol\2o\\5 c.asa C,\r) vis lJVDVl M-evc.cuio Amount ($) Pay ee address; C ity ; State; Z ip Code

-1VF1 .lo5 1 1 20 :r ~ v, O.t~r.) -T L ~v.-cclo 1 T)( \§0 <-\0 Category (See Categories listed at the top of this schedule) D escri ption

PURPOSE Eve(/\+ Ex.t'eVlS~ D Check if travel outside of Texas. Complete Schedule T.

OF D Check if Austin, TX, off iceholder living expense EXPENDITURE

.S e-\-to o\ Gup-p\ le_s Complete ONLY if direct Candidate I Officeho lder na m e O ff ice sou g ht Office h e ld

expenditure to benefit C/OH

Date Payee name

\OlOStts 6 lOWOY\ivevse.. Amount ($) Payee address ; C ity; State; Z ip Code

4~'1 . 52. 12..1() :PC'\{\~ C..,ivG\.e.,vr . I S-\-e . ~

~V\ove.r-, M'D 2\ Ol.(o Category (See Categories listed at the top of this schedule) D escript ion

PURPOS E D Check if travel outside of Texas. Complete Schedule T.

OF :E:.veV\t 'Ex? e.V1se.. D Check if Austin, TX. off iceholder living expense EXPENDITURE

':J) e: cor Ct-\-\ CJ V\S

Complete ONLY if direct Cand idate I Officeho lder nam e O ffice soug ht O ff ice he ld expenditure to benefit C/OH

ATTACH ADDITIONAL COPIES OF THIS SCHEDULE AS NEEDED

Forms provided by Texas Eth ics Commission www.ethtcs.state.tx.us Revtsed 9/8/2015

Page 6: J)}r Koh-er+o - Laredo, Texas...2016/01/14  · fl ,,~:1\to J\('l_f'VP"" 0 o-kvV) Signatu9e of officer administering oath PrintecTname of officer administering oath Title of officezJdministering

POLITICAL EXPENDITURES MADE FROM POLITICAL CONTRIBUTIONS SCHEDULE F1

EXPENDITURE CATEGORIES FOR BOX 8(a)

Adve rti s ing Expe n s e Event Expense Loan RepaymenVReimbursement Solicitation/Fundraising Expense Accounting/Banking Fees Office Overhead/Rental Expense Transportation Equipment & Related Expense Consulting Expense Food/Beverage Expense Polling Expense Travel In District Contributions/Donations Made By Giff/Awards/Memorials Expense Printing Expe nse Trave l Out Of District

Candidate/Officeholder/Politica l Committee Legal Services Sala ries/Wages/Contract Labor Other (enter a category not lis ted above) Credit Card Payment

The Instruction Guide explains how to complete this form.

1 Total pages Schedule F1 : 2 FILER NAME 'K. 13 Filer ID (Ethics Commi ssion Filers)

2 aloe v-\-o by\\i 4 Date 5 Payee name

\0\2(&,\15 H-E"b 6 Amount ($) 7 Payee address; City ; State ; Zip Code

&t6 . B~ 2\0 W . :be\ Mo.r '"b\vd. . Loveclo) n 'l<QOL\ \

8 (a) Category (See Categories listed at the top ol this schedule) (b) Description

PURPOSE D Check il travel outside ol Texas. Complete Schedule T.

OF E\J-eVtt GA?eVlse D Check if Austin, TX, off iceholder living expense

EXPENDITURE

food }b-eve v4'\]e. Ex -p-eV'l s e

9 Complete ONLY if direct Candidate I Officeholder name Office sought Office held expenditure to benefit CIOH

Date Payee name

\\\o2.\\5 IbC Amount ($) Payee address ; City ; State ; Zip Code

$l5 .00 12..00 5otVl Oevrtav~O

L C\,Ye.M) \)( \€Jo'-\D Category (See Categories listed at the top of this schedule) Description

PURPOSE D Check if travel outside ol Texas. Complete Schedule T.

OF bo..nk fe_e_, D Check if Austin , TX, olficeholder living expense EXPENDITURE

Serv,·c.e ~r5e Complete ONLY if direct Candidate I Officeholder name Office sought Office held expenditure to benefit C/OH

Date Payee name

Amount ($) Payee address; City; State; Zip Code

Category (See Categories listed at the top of this schedule) Description

PURPOSE D Check if travel outside of Texas. Complete Schedule T.

OF D Check if. Austin , TX, olficeholder livi ng expense EXPENDITURE

Complete ONLY if direct Candidate I Officeholder name Office sought Office held expenditure to benefit C/OH

ATTACH ADDITIONAL COPIES OF THIS SCHEDULE AS NEEDED

Forms provided by Texas Ethics Commission www.ethics .state.tx. us Revised 9/8/2015