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211004 -- Marie-Anne Mousseau-Holland -- Campaign Finance ReportCANDIDATE I OFFICEHOLDER FORM C /OH CAMPAIGN FINANCE REPORT COVER SHEET PG 1 1 F ile r ID (Eth ics Commission Filers) 2 Tota l pages fil ed : The C/OH In struction Guide expl ain s how to compl ete thi s form. 3 C ANDI DATE / MS / MRS I MR FIRST Ml OFFICEHOLDER Ms »lo.If~ e · OFFICE USE ONLY C.V\o-e.. NAM E Da te Rece ived . . . . . . . . . . . . . . . . . . . . ....... . . . . . NICKNAME LAST SUFFIX N\O\.~\e.. \'"\c!>V?<:. .(l c;. v r \..\ C) l\ c..v'\ A - Lf ..... ;;j..:"l~'j»A..a 4 C AN D I D ATE / ADDRESS I PO BOX; APT I SU IT E #; CITY; STAT E; ZIP CODE lZOZ 1, n lJO OFFICE HOL D ER MAILING ~ 6 C AN D I DATE/ AREA CODE PHONE NUMBER EXT ENSION OFFICEHOLDER ( <)~~ Da te Hand-de li vered or Date Post marked P HONE 6 C AM PAI G N MS/ MRS I MR FIRST M l Rece ipt# I Amount $ TREA S U RER . . M'f . .Llj ... NAM E ..... . ........ . . . . Da te Processed NICKNAME LAST SUFFIX Ii I I o.n .J Date Imaged 7 C AM PAIG N STREET ADDRESS (NO PO BOX PLE ASE); APT I SU ITE #; CITY; STATE; ZIP CODE T REA S U RER 8 C AM PAI G N AREA CO DE PHO NE NUM BER EXTENS IO N TREA S U RER ( P H O N E 9 REPORT T Y PE d 3oth day before election D January 15 D Ru noff D . 5th day after campaig n treasurer appointment (Offi ce holde r On ly) D July 15 D Bth day before election D Exceeded Modified D Fi nal Report (Attach C/OH -FR) Reporting Limit 10 PERIOD Mon th Day Yea r Mon th Day Yea r COV ERED /1s / 2.Pt.{ / o'l / 'l.-0 2-/ OS T HROUGH I cl 11 ELECTIO N ELECT ION DATE ELECT ION TYPE Mo nth Day Yea r D Primary D Runoff D Othe r Description ll / CJZ./2oi.( !QI' General D Specia l 12 OFF ICE OFF ICE HELD (if any) 13 OFFICE SOUGHT (if known) C~+l Covnc~ \ ~ 1Xttc e. 0 GO TO PAGE 2 Forms pro v ide d by Texas Ethi cs Commiss ion www.et h1 cs.stat e .t x.us Re vi sed 11112020 CANDIDATE I OFFICEHOLDER FORM C/OH CAMPAIGN FINANCE REPORT COVER SHEET PG 2 14 C /OH NAM E MA.<,·~ . ~l'\\f\ .e. M. (') \) ~C:.-P ~\.,) - 116 Fil e r I D (Eth ics Comm ission Fil ers) l-\o \ I ev\() A 16 N OTI CE FROM TH IS BOX IS FOR NOTICE OF POL ITICAL CONTRIBUTIONS ACCEPTED OR POLITICAL EXPENDITURES MADE BY POLITICAL COMMITTEES TO POLITICAL SUPPORT THE CANDIDATE/ OFF ICEHOLDER . THESE EXPEND/TURES MAY HAVE BEEN MADE WITHOUT THE CANDIDATE 'S OR OFFICEHOLDER'S COM M ITTEE(S) KNOWLEDGE OR CONSENT. CANDIDATES AND OFFICEHOLDERS ARE REQUIRED TO REPORT TH IS INFORMATION ONLY IF THEY RECE IVE NOTICE OF SUCH EXPEND ITURES . COMMITTEE TYPE CO MMITTEE NAME DGENERAL COMM ITTEE ADDRESS OsPECIFIC CO MMITTEE CA MPAIGN TREASURER NAME D Additional Pages COMMITTEE CA MPAIGN TREASURER ADDRESS 17 CONTRIB U T ION 1 . TOTAL U N ITEMIZED POLITICAL CONTRIBUTI ONS (OTHER THAN TOTALS PLEDGES, LOANS , OR GUARANTEES OF LOANS, OR $ 0 CONTRIBUTIONS MADE ELECTRONICALLY) 2. TOTAL POLITI CAL CONTRIBUTIONS $ 0 (OTHER THAN PLEDGES, LOANS, OR GUARANTEES OF LOANS) .. . . . . . . . . . . EXPENDITURE 3. TOTALS TOTAL UNITEMIZED POLITI CAL EXPENDITURE. $ 0 4. TOTAL POLITICAL EXPENDITURES $ 0 . . .......... CONTRIBUTION 5. TOTAL POLITICAL CONTR IBUTIONS MAINTAINED AS OF THE LAST DAY 0 BALANCE OF REPORTING PER I OD $ .. . . . . . . . . . . . OUTSTAND ING 6. TOTAL PRINCIPAL AMOUNT OF ALL OUTSTAND I NG LOANS AS OF THE 0 LOAN TOTALS LAST DAY OF THE REPORTING PER I OD $ 18 AFF I DAVI T I swear, or affirm, under penalty of perjury, that the accompanying report is ~~VP(I~ JACKIE RANGEL true and correct and inc ludes all information required to be reported by me ?~. Notary Public • State of Texas under Title 15, Election Code . IOI 13268326-5 R?;_-~ ~~ -~ My Comm. Expires 09-1&-2024 Signature of Candidate or Officeholder AFFIX NOTARY STAMP I SEALABOVE Sworn to and subscribed before me, by the sai d Ha~n'e ..... ~ J10 USS et(./,,(.. .. Hui/~ this the day of ae:1obu , 20 /)1 , to certify which , witness my hand and seal of office . 1~ ( r---\ ' M?P ( ;aeta~ fM4.1_,A Ard-full PtJ?t,l /,~,t~# ~i! nature of officer a< ~ini stering oath '-,) Pri nted name of officer ad~i ni stering oath Title of o~cer administering oath Form s provided by Texas Ethics Comm iss ion www .ethics.state .tx.us Revised 1/1/2020 SUBTOTALS -C/OH FORM C/OH COVER SHEET PG 3 19 FILER NAME 20 Filer ID (Ethics Commission Filers) 21 SCHEDULE SUBTOTALS SUBTOTAL NAME OF SCHEDULE AMOUNT 1. D SCHEDULEA1: MONETARY POLITICAL CONTRIBUTIONS $ 2. D SCHEDULEA2: NON-MONETARY (IN-KIND) POLITICAL CONTRIBUTIONS $ 3. D SCHEDULE B: PLEDGED CONTRIBUTIONS $ 4. D SCHEDULE E: LOANS $ 5. D SCHEDULE F1: POLITICAL EXPENDITURES MADE FROM POLITICAL CONTRIBUTIONS $ 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 I: 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.eth1cs.state.tx.us Revised 1 /1 /2020 MONETARY POLITICAL CONTRIBUTIONS SCHEDULE A1 The Instruction Guide explains how to complete this form. 1 Total pages Schedule A1: 2 FILER NAME 3 Filer ID (Ethics Commission Filers) 4 Date 6 Full name of contributor D out-of-state PAC (ID#: ) 7 Amount of contribution ($) 6 Contributor address; City; State; Zip Code 8 Principal occupation I Job title (See Instructions) 9 Employer (See Instructions) Date Full name of contributor D out-of-state PAC (ID#: ) Amount of contribution ($) Contributor address; City; State; Zip Code Principal occupation I Job title (See Instructions) Employer (See Instructions) Date Full name of contributor D out-of-state PAC (ID#: ) Amount of contribution ($) Contributor address; City; State; Zip Code Principal occupation I Job title (See Instructions) Employer (See Instructions) Date Full name of contributor D out-of-state PAC (ID#: __) Amount of contribution ($) Contributor address; City; State; Zip Code Principal 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.ethics.state.tx.us Revised 1/1/2020 NON-MONETARY (IN-KIND) POLITICAL A2 CONTRIBUTIONS SCHEDULE The Instruction Guide explains how to complete this form. 1 Total pages Schedule A2: 2 FILER NAME 3 Filer ID (Ethics Commission Filers) 4 TOTAL OF UNITEMIZED IN-KIND POLITICAL CONTRIBUTIONS $ 6 Date 6 Full name of contributor D out-of-state PAC (ID#: ) 8 Amount of 9 In-kind contribution Contribution $ description 7 Contributor address; City; State; Zip Code D Check if travel outside of Texas. Complete Schedule T. 10 Principal occupation I Job title (FOR NON-JUDICIAL)(See Instructions) 11 Employer (FOR NON-JUDICIAL)(See Instructions) 12 Contributor's principal occupation (FOR JUDICIAL) 13 Contributor's job title (FOR JUDICIAL) (See Instructions) 14 Contributor's employer/law firm (FOR JUDICIAL) 16 Law firm of contributor's spouse (if any) (FOR JUDICIAL) 16 If contributor is a child, law firm of parent(s) (if any) (FOR JUDICIAL) Date Full name of contributor D out-of-state PAC (ID#: ) Amount of In-kind contribution Contribution $ description Contributor address; City; State; Zip Code Ocheck if travel outside of Texas. Complete Schedule T. Principal occupation I Job title (FOR NON-JUDICIAL) (See Instructions) Employer (FOR NON-JUDICIAL)(See Instructions) Contributor's principal occupation (FOR JUDICIAL) Contributor's job title (FOR JUDICIAL) (See Instructions) Contributor's employer/law firm (FOR JUDICIAL) Law firm of contributor's spouse (if any) (FOR JUDICIAL) If contributor is a child, law firm of parent(s) (if any) (FOR JUDICIAL) ·--"-"' . ········-··--- 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.ethics.state.tx.us Revised 1/1/2020 PLEDGED CONTRIBUTIONS SCHEDULE B The Instruction Guide explains how to complete this form. 1 Total pages Schedule B: 2 FILER NAME 3 Filer ID (Ethics Commission Filers) 4 TOTAL OF UNITEMIZED PLEDGES $ 6 Date 6 Full name of pledgor D out-of-state PAC (ID#: l 8 Amount .9 In-kind contribution of Pledge$ description 7 Pledgor address; City; State; Zip Code D Check if travel outside of Texas. Complete Schedule T. 10 Principal occupation I Job title (See Instructions) 111 Employer (See Instructions) Date Full name of pledgor D out-of-state PAC (ID#: ) Amount In-kind contribution of Pledge$ description Pledgor address; City; State; Zip Code D Check if travel outsid.e of Texas. Complete Schedule T. Principal occupation I Job title (See Instructions) I Employer (See Instructions) Date Full name of pledgor D out-of-state PAC (ID#: ) Amount of In-kind contribution Pledge$ description Pledgor address; City; State; Zip Code D Check if travel outside of Texas. Complete Schedule T. Principal occupation I Job title (See Instructions) I Employer (See Instructions) Date Full name of pledgor D out-of-state PAC (ID#: ) Amount of In-kind contribution Pledge$ description Pledgor address; City; State; Zip Code Ocheck if travel outsid·e of Texas. Complete Schedule T. Principal occupation I Job title (See Instructions) I 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. rorms provld8d l;y Tt!xctl:I Elhicl:I Cornrnlsslon www.etlllcs.state.tx.us Revised 1/1/2020 LOANS SCHEDULE E The Instruction Guide explains how to complete this form. 1 Total pages Schedule E: 2 FILER NAME 3 Filer JD (Ethics Commission Filers) 4 TOTAL OF UNITEMIZED LOANS $ 6 Date of loan 7 Name of lender D out-of-state PAC (ID#: ) 9 Loan Amount($) 6 Is lender 8 Lender address; City; State; Zip Code 10 Interest rate a financial Institution? 11 Maturity date y N 12 Principal occupation I Job title (See Instructions) 13 Employer (See Instructions) 14 Description of Collateral 16 D Check if personal funds were deposited into political D none account (See Instructions) 16 GUARANTOR 17 Name of guarantor 19 Amount Guaranteed($) INFORMATION 18 Guarantor address; City; State; Zip Code D not applicable 20 Principal Occupation (See Instructions) 21 Employer (See Instructions) Date of loan Name of lender D out-of-state PAC (ID#: ) Loan Amount($) Is lender Lender address; City; State; Zip Code Interest rate a financial Institution? Maturity date y N Principal occupation I Job title (See lnstnmtiom;) Fmrl0y.;.r (See Instructions) Description of Collateral Check if personal funds were deposited into political D none D account (See Instructions) GUARANTOR Name of guarantor Amount Guaranteed($) INFORMATION Guarantor address; City; State; Zip Code D not applicable Principal Occupation (See Instructions) Employer (See Instructions) ATTACH ADDITIONAL COPIES OF THIS SCHEDULE AS NEEDED If lender is out-of-state PAC, please see Instruction guide for additional reporting requirements. Forms provided by Texas Ethics Commission www.ethics.state.tx.us Revised 1/1/2020 POLITICAL EXPENDITURES MADE F1 FROM POLITICAL CONTRIBUTIONS SCHEDULE EXPENDITURE CATEGORIES FOR BOXS(a) Advertising Expense 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 Gift/Awards/Memorials Expense Printing Expense Travel Out Of District Candidate/Officeholder/Political Committee Legal Services SalariesNVages/Contract Labor Other (enter a category not listed above) Credtt Card Payment The Instruction Gulde explains how to complete this form. 1 Total pages Schedule F1: 2 FILER NAME 13 Filer ID (Ethics Commission Filers) 4 Date 6 Payee name 6 Amount ($) 7 Payee address; City; State; Zip Code 8 (a) Category (See Categories listed at the top of this schedule) (b) Description PURPOSE OF EXPENDITURE (c) 0 Check if travel outside o!Texas. Complete Schedule T. 0 Check if Austin, TX, officeholder living expense 9 Complete ONLY if direct Candidate I Officeholder name Office sought Office held expenditure to benefit C/OH Date Payee name Amount ($) Payee address; City; State; Zip Code Category (See Categories listed at the top of this schedule) Description PURPOSE OF EXPENDITURE 0 Check if travel outside o!Texas. Complete Schedule T. 0 Check if Austin, TX, officeholder living expense Complete Qlli.Y 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 OF EXPENDITURE 0 Check if travel outside o!Texas. Complete Schedule T. 0 Check if Austin, TX, officeholder living expense Complete 00].Y 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 1/1/2020 UNPAID INCURRED OBLIGATIONS SCHEDULE F2 EXPENDITURE CATEGORIES FOR BOX 10(a) Advertising Expense 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 Gift/Awards/Memorials Expense Printing Expense Travel Out Of District Candidate/Officeholder/Political Committee Legal Services SalariesNVages/Contract Labor Other (enter a category not listed above) The Instruction Guide explains how to complete this form. 1 Total pages Schedule F2: 2 FILER NAME 3 Filer ID (Ethics Commission Filers) 4 TOTAL OF UNITEMIZED UNPAID INCURRED OBLIGATIONS $ 6 Date G Payee name 7 Amount ($) 8 Payee address; City; State; Zip Code 9 TYPE OF D 0 Non-Political EXPENDITURE Political 10 (a) Category (See Categories listed at the top of this schedule) (b) Description PURPOSE OF EXPENDITURE (c) D Check if travel outside of Texas. Complete Schedule T. D Check if Austin, TX, officeholder living expense 11 Complete ONLY if direct Candidate I Officeholder name Office sought Office held expenditure to benefit C/OH Date Payee name Amount ($) Payee address; City; State; Zip Code TYPE OF D D EXPENDITURE Political Non-Political Category (See Categories listed at the top of this schedule) Description PURPOSE OF EXPENDITURE D Check if travel outside of Texas. Complete Schedule T. D Check if Austin, TX, officeholder living expense 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 1/1/2020 PURCHASE OF INVESTMENTS MADE FROM POLITICAL CONTRIBUTIONS The Instruction Guide explains how to complete this form. SCHEDULE F3 1 Total pages Schedule F3: 2 FILER NAME 3 Filer ID (Ethics Commission Filers) 4 Date 6 Name of person from whom investment is purchased 6 Address of person from whom investment is purchased; City; State; Zip Code 7 Description of investment 8 Amount of investment($) Date Name of person from whom investment is purchased Address of person from whom investment is purchased; City; State; Zip Code Description of investment Amount of investment($) ATTACH ADDITIONAL COPIES OF THIS SCHEDULE AS NEEDED Forms provided by Texas Ethics Commission www.ethics.state.tx.us Revised 1 /1 /2020 EXPENDITURES MADE BY CREDIT CARD SCHEDULE F4 EXPENDITURE CATEGORIES FOR BOX 10(a) Advertising Expense 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 Gift/Awards/Memorials Expense Printing Expense Travel Out Of District Candidate/Officeholder/Political Committee Legal Services SalariesNVages/Contract Labor Other (enter a category not listed above) The Instruction Guide explains how to complete this form. 1 Total pages Schedule F4: 2 FILER NAME 3 Filer ID {Ethics Commission Filers) 4 TOTAL OF UNITEMIZED EXPENDITURES CHARGED TO A CREDIT CARD $ 6 Date 6 Payee name 7 Amount {$) 8 Payee address; City; State; Zip Code 9 TYPE OF D D Non-Political EXPENDITURE Political 10 (a) Category (See Categories listed at the top of this schedule) (b) Description PURPOSE OF EXPENDITURE (c) D Check if travel outside ofTexas. Complete Schedule T. D Check if Austin, TX, officeholder living expense 11 Candidate I Officeholder name Office sought Office held Complete ONLY if direct expenditure to benefit C/OH Date Payee name Amount ($) Payee address; City; State; Zip Code TYPE OF D D EXPENDITURE Political Non-Political Catagory (Soo Catogorioo liotod at tho top of thio oohcdule) Description PURPOSE OF EXPENDITURE 0 Check if travel outside ofTexas. Complete Schedule T. D Check if Austin, TX, officeholder living expense Candidate I Officeholder name Office sought Office held Complete QM.Y if direct 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 1 /1 /2020 POLITICAL EXPENDITURES SCHEDULE G MADE FROM PERSONAL FUNDS EXPENDITURE CATEGORIES FOR BOX 8(a) Advertising Expense 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 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 Gulde explains how to complete this form. 1 Total pages Schedule G: 2 FILER NAME I 3 Filer ID (Ethics Commission Filers) 4 Date 6 Payee name 6 Amount ($) 7 Payee address; City; State; Zip Code D Reimbursement from political contributions intended 8 (a) Category (See Categories listed at the top of this schedule) (b) Description PURPOSE OF EXPENDITURE (c) 0 Check if travel outside of Texas. Complete Schedule T. 0 Check if Austin, TX, officeholder living expense 9 Candidate I Officeholder name Office sought Office held Complete QM!.Y if direct expenditure to benefit C/OH Date Payee name Amount ($) Payee address; City; State; Zip Code Reimbursement from D political contributions intended Category (See Categories listed at the top of this schedule) Description PURPOSE OF EXPENDITURE 0 Check if travel outside ofTexas. Complete Schedule T. 0 Check if Austin, TX, officeholder living expense Candidate J Officeholder name Complete ONLY if direct Office sought Office held expenditure to benefit C/OH Date Payee name Amount($) Payee address; City; State; Zip Code Reimbursement from 0 political contributions intended Category (See Categories listed at the top of this schedule) Description PURPOSE OF EXPENDITURE 0 Check if travel outside ofTexas. Complete Schedule T. 0 Check if Austin, TX, officeholder living expense Complete QM!.Y if direct Candidate I Officeholder name Office sought Office held expenditure to benefit C/OH ATTACH ADDITIONAL COPIES OF THIS SCHEDULE AS NEEDED Forms provided by Texas Ethics Commission www.ethics.state.tx.us Revised 1 /1 /2020 PAYMENT MADE FROM POLITICAL CONTRIBUTIONS TO A BUSINESS OF C/OH SCHEDULE H EXPENDITURE CATEGORIES FOR BOX S(a) Advertising Expense Event Expense Loan Repayment/Reimbursement Solicit.ation/Fundraising Expense Accounting/Banking Fees Office Overhead/Rental Expense Transportation Equipment & Related Expense Consulting Expense Food/Beverage Expense Polling Expense Travel In District Contributions/Donations Made By Gift/Awards/Memorials Expense Printing Expense Travel Out Of District Candidate/Officeholder/Political Committee Legal Services Salaries/Wages/Contract Labor Other (enter a category not listed above) Credit Card Payment The Instruction Guide explains how to complete this form. 1 Total pages Schedule H: 2 FILER NAME 13 Filer ID (Ethics Commission Filers) 4 Date 5 Business name 6 Amount ($) 7 Business address: City; State; Zip Code 8 (a) Category (See Categories listed at the top of this schedule) (b) Description PURPOSE OF EXPENDITURE (c) D Check if travel outside ofTexas. Complete Schedule T. D Check if Austin, TX, officeholder living expense 9 Complete ONLY if direct Candidate I Officeholder name Office sought Office held expenditure to benefit C/OH Date Business name Amount ($) Business address; City: State; Zip Code Category (See Categories listed at the top of this schedule) Description PURPOSE OF EXPENDITURE D Check if travel outside of Texas. Complete Schedule T. D Check if Austin, TX, officeholder living expense Complete ONLY if direct Candidate I Officeholder name Office sought Office held expenditure to benefit C/OH Date Business name Arnou11l ($) Business address; City; State; Zip Code Category (See Categories listed at the top of this schedule) Description PURPOSE OF EXPENDITURE D Check if travel outside of Texas. Complete Schedule T. D Check if Austin, TX, officeholder living expense 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 1 /1 /2020 NON-POLITICAL EXPENDITURES MADE FROM POLITICAL CONTRIBUTIONS SCHEDULE I The Instruction Guide explains how to complete this form. 1 Total pages Schedule I: 2 FILER NAME 3 Filer ID (Ethics Commission Filers) 4 Date 6 Payee name 6 Amount ($) 7 Payee address; City State Zip Code 8 (a) Category (See instructions for examples of acceptable (b) Description (See instructions regarding type of information PURPOSE categories.) required.) OF EXPENDITURE Date Payee name Amount ($) Payee address; City State Zip Code PURPOSE Category (See instructions for examples of acceptable Description (See instructions regarding type of information OF categories.) required.) EXPENDITURE Date Payee name Amount ($) Payee address; City State Zip Code PURPOSE Category (See instructions for examples of acceptable Description (See instructions regarding type of information OF caiegories.) required.) EXPENDITURE ------------·---·--· -- Date Payee name Amount ($) Payee address: City State Zip Code PURPOSE Category (See instructions for examples of acceptable Description (See instructions regarding type of information OF categories.) required.) EXPENDITURE ATTACH ADDITIONAL COPIES OF THIS SCHEDULE AS NEEDED Forms provided by Texas Ethics Commission www.ethics.state.tx.us Revised 1 /1 /2020 INTEREST, CREDITS, GAINS, REFUNDS, AND CONTRIBUTIONS RETURNED TO FILER SCHEDULE K The Instruction Guide explains how to complete this form. 1 Total pages Schedule K: 2 FILER NAME 3 Filer JD (Ethics Commission Filers) 4 Date 6 Name of person from whom amount is received 8 Amount($) 6 Address of person from whom amount is received; City; State; Zip Code 7 Purpose for which amount is received D Check if political contribution returned to filer Date Name of person from whom amount is received Amount($) Address of person from whom amount is received; City; State; Zip Code Purpose for which amount is received D Check if political contribution returned to filer Date Name of person from whom amount is received Amount($) Address of person from whom amount is received; City; State; Zip Code Purpose for which amount is received D Check if political contribution returned to filer ---~-·· --··--~·-·~· - Date Name of person from whom amount is received Amount($) Address of person from whom amount is received; City; State; Zip Code Purpose for which amount is received D Check if political contribution returned to filer ATTACH ADDITIONAL COPIES OF THIS SCHEDULE AS NEEDED Forms provided by Texas Ethics Commission www.ethtcs.state.tx.us Revised 1 /1 /2020 IN-KIND CONTRIBUTIONS OR POLITICAL EXPENDITURES SCHEDULET FOR TRAVEL OUTSIDE OF TEXAS The Instruction Guide explains how to complete this form. 1 Total pages Schedule T: 2 FILER NAME 3 Flier ID (Ethics Commission Filers} 4 Name of Contributor I Corporation or Labor Organization I Pledger I Payee 5 Contribution I Expenditure reported on: D Schedule A2 D Schedule B D Schedule B(J) D Schedule C2 D Schedule D D Schedule F1 D Schedule F2 D Schedule F4 D Schedule G D Schedule H D Schedule COH-UC D Schedule B-SS 6 Dates of travel 7 Name of person(s) traveling 8 Departure city or name of departure location 9 Destination city or name of destination location 10 Means of transportation 11 Purpose of travel (including name of conference, seminar, or other event) Name of Contributor I Corporation or Labor Organization I Pledgor I Payee Contribution I Expenditure reported on: D Schedule A2 D Schedule B D Schedule B(J) D Schedule C2 D Schedule D D Schedule F1 D Schedule F2 D Schedule F4 D Schedule G D Schedule H D Schedule COH-UC D Schedule B-SS Dates of travel Name of person(s) traveling Departure city or name of departure location Destination city or name of destination location Means of transportation Purpose of travel (includlng name of conference, seminar, or other event} Name of Contributor I Corporation or Labor Organization I Pledger I Payee Contribution I Expenditure reported on: D Schedule A2 D Schedule B D Schedule B(J) D Schedule C2 D Schedule D D Schedule F1 D Schedule F2 D Schedule F4 D Schedule G D Schedule H D Schedule COH-UC D Schedule B-SS Dates of travel Name of person(s) traveling Departure city or name of departure location Destination city or name of destination location Means of transportation Purpose of travel (including name of conference, seminar, or other event) ATTACH ADDITIONAL COPIES OF THIS SCHEDULE AS NEEDED Forms provided by Texas Ethics Commission www.ethics.state.tx.us Revised 1 /1 /2020 CANDIDATE I OFFICEHOLDER REPORT: DESIGNATION OF FINAL REPORT FORM C/OH -FR The Instruction Guide explains how to complete this fonn. ••Complete only if "Report Type" on page 1 is marked "Final Report"•• 1 C/OH NAME 2 Filer ID (Ethics Commission Filers) 3 SIGNA11JRE I do not expect any further political contributions or political expenditures in connection with my candidacy. I understand that designat- ing a report as a final report terminates my campaign treasurer appointment. I also understand that I may not accept any campaign contributions or make any campaign expenditures without a campaign treasurer appointment on file. -·--------------------------- Signature of Candidate I Officeholder 4 FILER WHO IS NOT AN OFFICEHOLDER •• Complete A & B below only if you are not an officeholder. •• A. CAMPAIGN FUNDS Check only one: D I do not have unexpended contributions or unexpended interest or income earned from political contributions. D I have unexpended contributions or unexpended interest or income earned from political contributions. I understand that I may not convert unexpended political contributions or unexpended interest or income earned on political contributions to personal use. I also understand that I must file an annual report of unexpended contributions and that I may not retain unexpended contributions or unexpended interest or income earned on political contributions longer than six years after filing this final report. Further, I understand that I must dispose of unexpended political contributions and unexpended interest or income earned on political contributions in accordance with the requirements of Election Code, § 254.204. B. ASSETS Check only one: D I do not retain assets purchased with political contributions or interest or other income from political contributions. D I do retain assets purchased with political contributions or interest or other income from political contributions. I understand that I may not convert assets purchased with political contributions or interest or other income from political contributions to personal use. I also understand that I must dispose of assets purchased with political contributions in accordance with the requirements of Election Code, § 254.204. Signature of Candidate 6 OFFICEHOLDER •• Complete this section only if you are an officeholder •• D I am aware that I remain subject to filing requirements applicable to an officeholder who does not have a campaign treasurer on file. I am also aware that I will be required to file reports of unexpended contributions if, after filing the last required report as an officeholder, I retain political contributions, interest or other income from political contributions, or assets purchased with politi- cal contributions or interest or other income from political contributions. Signature of Officeholder Forms provided by Texas Ethics Commission www.eth1cs.state.tx.us Revised 1 /1 /2020