Document 6524033

Transcription

Document 6524033

exas Ethics Commission
CANDIDATE
P.O. Box 12070
Austin. Texas 787 40
(512)463-5800
I’
/ OFFICEHOLDER
FORM C/OH
CovER SHEET PG 1
CAMPAIGN FINANCE REPORT
The C!OH INsTRUCTIoN Gutoc explains
flow to complete this form.
-
CommIssion
2
PAGE#
1
3 CANDIDATE /
MS MRS MR
OFFICEHOLDER
NAME
1-800-325-8506
31
of
FIRST
Ms.
Erin Kathleen
ceivd
NICKNAME
LAST
SUFFIX
Hicks
4
CANDIDATE /
ADDRESS POBOX
APT!SUITE#,
CITY
OFFICEHOLDER
ZIPCOj
t
MAILING
AD DRESS
c:
STATE.
P.O. Box 15921
1
Fort Worth, TX 76119
-
Date Hand-delivered or Date Postmarked
ChangeofAddress
Receipt #
MS/MRS/MR
5 CAMPAIGN
TREASURER
FIRST
Dr.
MI
Clarence S.
Date Processed
NAME
NICKNAME
LAST
6 CAMPAIGN
TREASURER
ADDRESS
Date Imaged
SUFFIX
Brooks
STREET ADDRESS (NO P0 Box PLEASEI.
APT ‘SUITE 4.
CITY.
Amount
STATE:
ZIP CODE
2200 Evans Avenue
(Residence or busIness)
7 CAMPAIGN
TREASURER
PHONE
8
AREA CODE
PHONE NUMBER
EXTENSION
(817) 926-4693
REPORT TYPE
U
9 PERIOD
COVERED
January 15
30th day before election
Runoff
July
8th day before eiBctiOn
Exceeded S500
15
Month
Day
Year
10 ELECTION
Day
Year
ELECTION TYPE
Year
Dab
Primary
05/09/2009
-
-
04/29/2009
ELECrION DATE
Month
4j
I..,
Final report (Attach C/OH FR)
limit
Monin
1 5th day after campaIgn treasurer
appointment (officeholder only)
THROUGH
04/08/2009
11 OFFICE
Fl
1
QFF.I- HELL’
Runoff
,FF
Fort Worth City Counctl Dtstrtct 8
F SOUGH
General
t
Speoal
row-
ort Worth City Counctt Dtnct8
-
-
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-
t...AMF AVN
-Xt’ENDtRE
BY OTHER
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GO TO PAGE 2
—..-
U.
F..
I
—
Texas Ethics Commission
CANDIDATE
P.O. Box 12070
I
Austin, Texas 78711-2070
(512)463-5800
FORM CIOH
CovER SHEET PG 2
OFFICEHOLDER REPORT:
SUPPORT & TOTALS
14 C/OH NAME Hicks, Erin Kathleen (Ms.)
15 ACCOUNT # (Ethics Commission fliers)
00000001
.
This box is for notice of political expenditures by political committees to support the candidate officeholder.
/
These expenditures may
have been made without the candidates or officeholders knowledge or consent. Candidates and officeholders are required
to report this
information only if they receive notice of such expenditures.
16 NOTICE
FROM
POLITICAL
COMMITTEE(S)
COMMITTEE
[]
J
Q
1-800-325-8506
TYPE
GENERAL
COMMITTEE NAME
COMMITTEE ADDRESS
SPECIFIC
cOMMITTEE CAMPAIGN TREASURER NAME
additional pages
COMMITTEE CAMPAIGN TREASURER ADDRESS
17 CONTRIBUTION
TOTALS
TOTAL POLITICAL CONTRIBUTIONS OF $50 OR LESS (OTHER THAN
PLEDGES, LOANS. OR GUARANTEES OF LOANS), UNLESS ITEMIZED
1.
2.
EXPENDITURE
TOTALS
TOTAL POLITICAL CONTRIBUTIONS
(OTHER THAN PLEDGES, LOANS. OR GUARANTEES OF LOANS)
3.
OUTSTANDING
LOAN TOTALS
0.00
$
13,395.00
$
0.00
$
14,301.23
$
0.00
TOTAL POLITICAL EXPENDITURES OF $50 OR LESS, UNLESS ITEMIZED
4.
D A I A
‘L’
$
TOTAL POLITICAL EXPENDITURES
5.
TOTAL POLITICAL CONTRIBUTIONS MAINTAINED AS OF THE
LAST DAY OF THE REPORTING PERIOD
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 true and correct and includes all information required to be reported by
me under Title 15, Election Code.
,
/
i1
t
J
Signature of Candidate or Officeho)Ør
AFFIX NOTARY STAMP
SEAL ABOVE
).
.
Swrn to
of
nj a
.
20 C
i
j\
‘
Oefcre r bo e so
.
t
(
t
I
tooertifvw.Con. wness ma hand and sea of
/
I
Signature of officeministeri.ng oath
L
I
Print name of officer adminlstenng oath
Title of officer administert oath
P.O.Box 12070
Austin, Texas 7871 1-2070
(512)463-5800
POLITICAL CONTRIBUTIONS
OTHER THAN PLEDGES OR LOANS
The
1-800-325-8506
SCHEDULE
1
INsTRuciloN GuIDE explains how to complete this form.
A
PAGE #
Schedule: 1/11 Report: 3/31
2
FILER NAME
Hicks, Erin Kathleen (Ms.)
(Ethics Commission filers)
3 ACCOUNT #
00000001
4
Date
04/17/2009
5 Full name of contributor
Armstrong. Beatrice (Mrs.)
0
6 Contributor address;’
2913 Mansfield Hwy
City;
out-of-state PAC (1D4
7
( 8
Amount of
contribution (5)
State; ‘Zip Code
tn-kind contribution
description (if applicable)
$75.00
FortWorth, TX76119
(If travel outside of Texas, complete Schedule T)
9
Principal occupation / Job title (See Instructions)
Date
04/1 7/2009
10
Full name of contributor
Bass, Anne T (Ms.)
0
Contributor address;
201 Main Street
City;
out-of-state PAC (ID#
Amount of
In-kind contribution
contribution (5)
State;
Zip Code
$1 000.00
I
04/23/2009
D
Employer (See Instructions)
lnvester
Date
Q
Bell, Carl (Mr.)
0
Contributor address:
5834 Park Lane
Dallas, TX 75225
City;
State; Zip Code
)
I
Amount of
contribution ($)
$100.00
I
Date
04/09/2009
Benson, Johnnie
0
1704 Martel Aue
Fort WorTh. TX70,103
City;
out-of-state PAC (ID#,......
State;
Zip Code
Amount of
contribution (5)
I
$200.00
(If travel outside of Texas. complete Schedule T)
Princinal occupation / Job title (See instructions)
Date
Bewley. Jackie
0
Contributo.r address;
6.ity;
04/i 6/2009
2200 2. Riverside Dr
out-of-state PAC (lD#
State; Zip Code
Amount of
ln-kuid contribution
contribution (Si
500.00
Fort WorD TX 76104
.
(tt travel outside of Texas. Complete Schedule Tl
.incP:ai occupa6on/Job titie (See instructions)
Employer (See instructions)
Business Owner
Eectronc FSng Vereon 3.3.7
P.O.Box 12070
(512)463-5800
1-800-325-8506
SCHEDULE
A
2
4
The INsTRUCTION GUIDE explains how to complete this form.
I
FILER NAME
3 ACCOUNT #
00000001
Date
04/16/2009
Hicks, Erin Kathleen (Ms.>
Full name of contributor D out-of-state PAC (ID#_..
Bradbury, James (Attorney)
5
6 Contributor address;
2337 Mistletoe Ave
Fort Worth, TX76110
City;
State;
PAGE #
7
(Ethics Commission filers>
I
Amount of
contribution (S)
Zip Code
$250.00
8
I
I
Q
9
Principal occupation / Job title (See Instructions>
Date
04/16/2009
10 Employer (See Instructions)
Braka, Steven (Mr.)
Q
2521 Ryan Place Dr
Fort Worth, TX76110
City;
State;
I
Amount of
contribution ($)
Zip Code
$50.00
I
I
Q
Principal occupation I Job title (See Instructions)
Date
D
04/23/2009
3709 Santiago Ct.
Irving, TX 75062
City;
State;
I
Amount of
contribution ($)
)
Calhoun, Ross (Mr.)
Zip Code
$250.00
I
EJ
Date
Q
Amount of
contribution (3)
Carvey. Louise
04/27/2009
3601 Overton Park Dr E
Fort Worth
City;
State: Zip Code
I
$100.00
Ty 76109
I
Principal occupation/Job title (See instructions)
Date
04i1 Of2009
Full name of contributor D out-of-state PAC (ID#
Committee for Public Safety- FW Police Officers Assn
Gcnrcuror address:
‘W:
State
-
)
Amount of
contnbution S
Oorth
51
descnption uf applicable)
flflnQfl
1)2
(If
Pn:rcipai occupation / Job title
Q
(See instructions)
Employer
travel outside of Texas, complete Schedule T)
Q
(See Instructions)
Electronc FSng Version 5.3 8
P.O.Box
12070
Austin,
Texas 78711-2070
(512)463-5800
SCHEDULE A
The hsTRuc11oN GuIDE explains how to complete this form.
2
4
FILER NAME
Date
I
5
C
6
3501 Elm Creek Ct
7 Amount of
out-of-state PAC (lD#_
I 8
contribution (S)
Conservative Voters Forum
04/10/2009
PAGE #
3 ACCOUNT 4
00000001
City:
State;
1-800-325-8506
Zip Code
$50000
I
Q
9
Date
04/25/2009
Curley, Bevelia (Ms.)
C
7537 Madeira Dr
City;
State;
)
I
Amount of
contribution ($)
Zip Code
$5000
I
Date
04/23/2009
Fullnameofcontributor
Denny, Gretchen (Ms.)
C
2717 Museum Way
Fort Worth, TX76107
City;
out-of-state PAC(ID#
)
State; Zip Code
I
Amount of
contribution ($)
$100.00
I
I
Q
(If travel outside of Texas, complete ScheduleT)
Date
04/09/2009
First Southwest Properties
C
City:
State;
I
Amount of
contribution (S)
-
Zip Code
Sponsored fundraiser
$500.00
(If travel outside of Texas, complete Schedule T)•
Principal occupation / Job title (See instructionsi
Date
04123/2009
gull name ci corInbutor
Gideon. Randall (Mr.)
C
City;
3812 Montice.llo
Q
State:
Zip Code
i
Amount of
contribution (St
I
in-kind contribution
description hf applIcable)
$100.00
Fort Worth. T%. 76107
Of travel outside of Texas. complete Schedule T)
Principal occupation Job
titiC (See
nstructionsi
C
Emn:oy€r (See nstrucliorsj
E;eoronc FrIq Versol 3 3
Texas
Ethics
Commission
P.O.Box
12070
Austin,
Texas
(512)463-5800
78711-2070
The
2
4
INsTRucfloN GUIDE explains how to complete this
FILER NAME
Date
04/08/2009
SCHEDULE
I
form.
Q
201 Main St.
Suite 2500
City:
State;
)
A
PAGE #
3 ACCOUNT #
00000001
Good Government Fund
1-800-325-8506
7
Zip Code
I 8
Amount of
contribution ($)
$1 000.00
I
I
L1
9
Date
04/24/2009
Full name of contributor 0 out-of-state PAC (lD#
Greater Fort Worth Real Estate Council PAC
301 Commerce St.
Suite 2400
City;
State;
)
I
Amount of
contribution ($)
Zip Code
$1 000.00
I
I
D
Date
04/13/2009
Greenhill, William (Mr.)
0
1608 Ashland Ave
FortWorth, TX76107
City:
State; Zip Code
)
I
Amount of
contribution (5)
$250.00
I
Date
04/1 5/2009
Full name of contributor 0 out-of-state PAC (lD#
Hadley. Erma Johnson (Mrs.)
City:
Q
State:
)
Amount of
contribution ($)
Zip Code
$100.00
2362 Faett Ct
I
I
Fort Warth TX76119
(if travel outside of Texas, complete Schedule TI
Princloa.l occupation / Job title :5ee inst.ructions)
Date
04/21/2009
Full name of contributor 0 out-ofstate PAC (iD#
Hill Real Estate Development Inc
Conlributor address;
P.O. Bcm /53554
Arlington, TX 76015
City:
State;
)
Amount of
contribution $)
Zip Code
.‘
$250.00
(If
Pnncipai occupatIon Job title See r,structlors
Li
Employer See nstructons)
Eiectropc Fing ‘Jesy
7
POLITICAL
OTHER
P.Q.Box 12070
PLEDGES
OR
A
SCHEDULE
CONTRIBUTIONS
THAN
1-800-325-8506
(512)463-5800
LOANS
I
The INsTRucnoN Guioe explains how to complete this form.
PAGE #
2
4
FILER NAME
Hodges Ill, L. Allen (Mr.)
Q
6
City; State; Zip Code
5
Date
04/12/2009
3 ACCOUNT #
00000001
7
I 8
Amount of
contribution (S)
$100.00
115W Seventh St., Suite 1310
I
Q
9
Date
Q
)
Johnson, Karmen (Mrs.)
04/09/2009
6116 Forest Lane
City;
State;
I
Amount of
contribution ($)
Zip Code
$25.00
I
Date
04/25/2009
Johnson, Sheila B
Q
4636 Harley Ave
City;
out-of-state PAC (ID#__
State;
)
Zip Code
I
Amount of
contribution
$200.00
I
Q
Full name of contributor EJ out-of-state PAC (ID#
Kay Granger Campaign Fund
Date
715 Jones St. Ste 100
Port Worth TX 76102
04/27/2009
City:
State:
Zip Code
[
04/08/2009
Amount of
contribution ($)
I
$200.00
I
(If travel outside of Texas, complete Schedule Ti
Prnc,cai occupatonJot tOe rSee nstructionst
Date
)
Full name of conlhbutor
Kelly Hart PAC
Q
Contr(butor address;
City;
Employer See nstruct:ons)
Amount of
contribution iS)
State:
Zp Code
C
......
I
in-kind contribution
description (if applicablel
$500.00
201 Mad 1;tree
Suite2500
(if travel outside of Texas, complete Schedule
Prindpai cccupation / Job tide (See Instructions)
T)
Et’tp1oyer(See instructions)
Efectroec Fill oç Vereon 3.3 7
P.O.Box 12070
(512)463-5800
1-800-325-8506
SCHEDULE
A
The
2
4
INSTRUCTION
Guioe explains how to complete this form.
I
Hicks. Erin Kathleen (Ms.)
3 ACCOUNT #
00000001
FILER NAME
Date
5
0
out-of-state PAC (lD#_
)
Lamm, Sandra (Ms.)
04/09/2009
6
Oty;
PAGE #
7
Amount of
contribution
State; Zip Code
I
i
I
(If
Date
4200 S Hulen St., Ste 417
C
)
City;
I
Amount of
contribution ($)
State: Zip Code
I
(If
04/24/2009
C
Full name of contributor C out-of-state PAC (lD#
Law Offices of Gwinda Burns
P.O. Box 8704
$100.00
Fort Worth, TX76109
Date
r:i
Langston, Constance
04/09/2009
$100.00
Fort Worth. TX
9
8
City:
)
State; Zip Code
I
Amount of
contribution ($)
$250.00
I
I
Q
Date
Loftin. Jerry (Mr.)
C
out-of-state PAC(ID#
City:
State; Zip Code
04/08/2009
113 N Houston
Fort Worth. TX 76102
_)
Amount of
contribution (S)
I
description (it applicable)
$100.00
1
(If travel outside of Thxas, complete Schedule T)
Principal occupation / Job title (See Instructior.s)
Date
C
oubof-state PAC (ID#__
Lucas. Rebecca (Atty)
04/0912009
City;
P so 0
un So Sjbe 1021
FOrtWoith 1X76107
Q
Employer (See• Instructions)
State:
Zip Cod•e
Amount of
contribution (SI
I
i
$500.00
17
Itt travel outside of Texas. cornpete Schedule 1)
Prropa occupation Job tIle (See instructionsi
Employer See Instructions)
Eectrorc Fig Vesiciri 33
P.O.Box 12070
(512)463-5800
1-800-325-8506
SCHEDULE
The INSTRUcTION GuIDE explains how to complete this form.
I
A
PAGE #
2
FILER NAME
3 ACCOUNT #
00000001
4
Date
Full name of contributor D out-of-state PAC (ID#
Luther Cantrell, Patsy (Ms.)
5
04/22/2009
9
4954 FM 1187 Box 277
Cresson, TX 76035
City;
‘
I 8
Amount of
$150.00
I
I
Malone, Tom (Mr.)
04/24/2009
7
contribution (S)
State; Zip Code
Date
__)
10
EJ out-of-state PAC (lD#_)
City;
814 Pennsylvania Ave. Suite 100
State;
ci
Zip Code
Amount of
contribution ($)
I
$200.00
I
I
Q
Date
04/18/2009
Mayo Ill, Ted (Attorney)
C
3862 Tamworth Rd
FortWorth, TX76116
City;
out-of-state PAC (lD#__)
State;
Zip Code
I
Amount of
contribution ($)
$100.00
I
Q
Full name of contributor C out-of-state PAC (lD#_,.)
Mckenzie, Cynthia (Attorney)
Date
04/16/2009
1800 N Norwood Dr.
Se00
Hurts, TX 76054
City:
State;
Zip Code
I
Amount of
contribution ($)
$20000
(If travel Outside of Texas, complete Schedule T)
incipal occupation/Job title (See lnstructions)
Date
Means, Randell (Attorney)
04/162C159
C
‘.uTOj.-,S
‘441 F
e’
Z::Crce
)
Amount of
contribution ($)
I
i
In-kind contnbution
c1Ofl
44
(if travel outside of Texas, complete Schedule T)..
Principal
occupation /
Q
Employer (See istructons)
Job title (See ln.structions)
Q
Employer (See lnstructions)
Eciroia FWnq Verson 3 3 7
P.O.Box 12070
(512)463-5800
SCHEDULE A
OTHER THAN
1-800-325-8506
PLEDGES OR LOANS
1
The INSTRuCTiON GuIDE explains how to complete this form.
PAGE #
2
FILER NAME
3 ACCOUNT #
00000001
4
Date
Moayedi, Mehrdad (Mr.)
Q
6
City:
5
04/23/2009
3901 Airport Fwy
Ste 200
Bedford,
)
7
Amount of
I 8
contribution ($)
State; Zip Code
$500.00
I
/
TX 76021
Q
9
Developer
Date
04/20/2009
Nickleson, Gary (Attorney)
Q out-of-state PAC (lD#_..
5201 W Freeway, Ste 100
Fort Worth, TX76107
City;
State;
Amount of
)
I
contribution ($)
Zip Code
$100.00
I
Full name of contributor EJ out-of-state PAC (ID#
Nunneley Family Law Center
Date
04/09/2009
1845 Precinct Line Rd.
Suite 100
Hurst, TX 76054
City;
State;
I
Amount of
contribution
)
Zip Code
$50.00
I
Date
04/24/2009
Porter, David (Mr.)
Q
2100 Ross Ave. Ste 2900
Dallas, TX 75201
City:
State:
Amount of
contribution ($)
Zip Code
I
$100.00
rncia 0000pabon
Date
04/1 3/2009
Job nt!e iSee instructions)
Riley, Robery (Mr.)
Q
‘mekCt
Fort Wrih, TX 70137
City:
4j7
r
intOfl
job tcie See nstruc.bonrt
U
Emp;oyer (See instructions)
outof-state PAC (lD#
State:
)
Amount of
coqtribution ($)
I
$50 00
.p Code
(If
Pnnonal
U
travel outside of Texas. complete Schedule T)
U
Employer See nstructons,
E)ectrorc
Versu 3 3
P.O.Box 12070
(512)463-5800
1-800-325-8506
SCHEDULE
I
The INSrRucnoN GUIDE explains how to complete this form.
A
PAGE #
2
FILER NAME
3 ACCOUNT #
00000001
4
Date
04/09/2009
Ryan, Elaine (Atty)
Q
669 Airport Fwy, Suite 206
Hurst, TX 76053
City:
out-of-state PAC (ID#__
State:
)
7
8
Amount of
contribution ($)
Zip Code
$100.00
I
I
9
Date
04/25/2009
fl
Sadberry, Birdie (Ms.)
0
5625 Hensley Dr
City:
State;
)
Zip Code
I
Amount of
contribution ($)
$150.00
I
I
Date
04/1 6/2009
0
Sibbett, A.B.
City;
7620 Deaver Dr
North Richland Hills, TX 76180
State;
)
Amount of
contribution
Zip Code
I
$50.00
Date
Smith. Jason (Attorney)
0
City:
04/16/2009
State;
)
Amount of
contribution ($)
Zip Code
I
$5000
2257 Coilege Ave
(if travel outside of Texas, compete Schedule T)
PrhWp ocoupabon
Dote
Job titie lSae ins7rucdonsi
Full rame of contnbutor
Emrhoyer(Se•einstructions
0
out of state PAC (lD#
City:
State; Zip Code
Struhs, Tom (Mc)
04/08/2009
ContrIbutor address;
2801 BiedsoeSr
Fort Worth, CX 76107
Amount of
m kind contribution
contribution ($)
$2.5000
(if travel outside of Texas. complete Schedule Ti
‘
Proopa oocupai;.on Job tile See
rstructors
Employer ‘S/ nstrcOOnsi
EeOroOc Peiq Verspo 3 3 7
P.O.Box 12070
(512)463-5800
The
2
INSTRUCTioN GuIDE explains how to complete
FILER NAME
1-800-325-8506
SCHEDULE A
1
this form.
PAGE #
3 ACCOUNT # (Ethics Commission filers)
00000001
4
Date
04/21/2009
Sturns, Vernell (Mr.)
EJ
612 HighwoodsTr
City;
State;
7
_)
Zip Code
.
Amount of
contribution ($)
I
$100.00
I
I
8
Q
9
Principal occupation I Job title (See instructions)
Date
04/08/2009
Texas Progress Fund
LI
801 Cherry St- Unit #9
Fort Worth, TX76102
City;
State;
)
Zip Code
I
Amount of
contribution ($)
$1 ,000.00
1
I
Q
Date
04/21/2009
Tilley, Rice (Mr.)
LI
City;
State;
)
—_
I
Amount of
contribution ($)
Zip Code
$50.00
201 Main St.
Ste 2200
I
EJ
Date
04/1 9/2009
Tracy, J David (Mr.)
C
City:
State;
)
Amount of
contribution ($)
Zip Code
I
$50.00
2734 Colonial Pkwy
Fort Worth, TX76106
(If travel outside of Texas, complete Schedule 7)
Princical occupa.oE.Jbtite (See Instruct.ions)
Full name of contnbutor C out-of-state PAC (lD#
Turner. Patti Gearhart (Attorney)
Date
04/16/2009
2332 Wmton Terr 99
Fort WOrth, TX 76109
City;
Q
State;
Zip Code
-
-
--
-
Amount of
j
contribution (S)
sioooo
(If travel outside ot Texas. complete Schedule T
Pr,nela
ocou anon Job Pod (See netrucons
Employer ::See instructions;.
EOor Frwq Veron 3 3 7
Texas Ethics
Commission
P.O.Box
12070
Austin,
Texas 78711-2070
(512)463-5800
SCHEDULE
The NsTRuc’noN GLaDE explains how to complete this form.
2
4
FILER NAME
Date
04/23/2009
6 Contributor address:
2121 Kirby Dr
#19NE
Houston, TX 77019
3 ACCOUNT #
00000001
D
out-of-state
PAC (lD#
)
Van Riet, Cecilia
City:
State;
Zip Code
A
PAGE #
Schedule:_11/11_Report:_13/31
1
1-800-325-8506
7
I 8
Amount of
contribution (S)
$200.00
I
I
Q
9
Date
Rita
Q
out-of-state PAC (lD#__
__)
Vinson,
04/13/2009
1813 Lake Shore Court
City;
State;
I
i
Amount of
contribution
Zip Code
tn-kind contribution
$25.00
I
Date
04/08/2009
Waste Management PAC
D
City;
Q
)
State:
Zip Code
Amount of
contribution ($)
I
$250.00
Fort Worth. TX
I
Date
04/13/2009
Full name of contributor Q out-of-state PAC (ID#,
Young, Valerie Baston (Attorney)
City;
State:
-
)
Amount of
contribution (S)
Zip Code
I
$20.00
700 Nocona Dr
Mansfecj TX 70063
(If travel outside of Texas, complete schedule T)
Pri.ncipai occupation i Job title (See Instructions)
Q
En player (See instructions)
Eecronc F75g VerSon 3 3 7
P.O.Box 12070
(512)463-5800
POLITICAL EXPENDITURES
2
1-800-325-8506
SCHEDULE
The INsTRuCTIoN GuIDE explains how to complete this form.
I
PAGE #
FILER NAME
3
ACCOUNT #
F
00000001
4
Date
5
Payee name
Angelos Barbeque
7
04/20/2009
dit’’
Amount
(S)
$38.32
‘a;’ ‘‘boct
2533 White Settlement Rd
8
Purpose of payment (See instructions regarding type of information
required,>
9
Complete if direct expenditure to benefit Candidate/Officeholder
Candidate! Officeholder name:
*
Food for volunteers
Date
Office sought:
Office held:
D
Payee name
AT&T
04/13/2009
‘
Amount
($)
ejcjr
$200.00
Zidod
t’;
PC BOX 650553
Dallas, TX 75265
required.)
Campaign Phone
Date
Office sought:
Office held:
Q
Payee name
Amount
Baker, Ashley (Ms.)
04/11/2009
($)
dtr
‘‘
$200.00
‘a’ ‘ide
2744 S Jones St
required.)
Consulting
(If travei outside of Texas, complete Schedule T)
Date
[
Office S000f:t
Office hetd:
Payee name
Baker. Ashley Ms.
04/24/2009
Amount
fS)
City:
State:
$400.00
Zip Code
2744 S Jones St
Purpose of
req.utred.)
cemen1
(See Inrhructons
roe rrhng type.
of [nforniahon
Comekte if direct exoe.ndhure
Canddare / Officeholder name
fif 020didate/C:fhcehoidor
Consulting
(If travel outsIde of Texas complete Schedule T)
Q
Office sought:
Office held
OectraOc FSng
V,rsOfl 3.3.7
P.O.Box 12070
(512)463-5800
2
4
SCHEDULE
The INSTRucTioN Gutoc explains how to complete this form.
1
PAGE #
FILER NAME
3
ACCOUNT #
00000001
Date
5
04/24/2009
8
1-800-325-8506
Payee name
Cafe Modern
7
cir:
dt
3200 Darnell Ave
Amount
($)
$81.44
idoci
reqLlired.)
F
9” Complete if direct expenditure to benefit Candidate/Officeholder
—
Candidate / Officeholder name:
Volunteer Lunch
Q
Date
Office sought:
Office held:
Payee name
Cass, Wendell (Mr.)
04/23/2009
.
Amount
Cs)
eciir;
$450.00
ai idccie
2913 Ridgeview
required)
Consulting
Office sought:
Office held:
Date
Payee name
Central Market
04/27/2009
Amount
($)
Payee address:
t
4651 W Freeway, Ste A
a
$110.21
Ziod
required.)
•.
Campaign Materials & Food
Off:cesflut
(If trael outside of Texas, complete Schedule T
1
Date
Off cc hPd
Payee name
Amount
Churches Chicken
04/19/2009
Payee address:
(5)
dt:
State:
$5233
ziod
4224 Miller
Foil Worth, TX
PSce
t
Orrec
rv
Food for volunteers
(If travel outside of Texas complete Schedule 1)
Q
Office sougflt:
Office held
Eectrocc E3n9 Venon 33.7
P.O.Box 12070
(512)463-5800
SCHEDULE
I
FILER NAME
3 ACCOUNT #
00000001
Date
4
5
Payee name
Amount
7
Civic Strategies
04/11/2009
6
F
PAGE #
The INsTeuclioN GuIDE explains how to complete this form.
2
1-800-325-8506
(3)
dtn
eecir;
$750.00
iboci
1201 W Park Row Dr
Arlington, TX 76013
8
required.)
9
Consulting
Q
Date
Office sought:
Office held:
Payee name
Civic Strategies
04/18/2009
Amount
(3)
dit a:
le ccir;
$855.29
idcce
1201 W Park Row Dr
Arlington, TX 76013
required.)
—
Consulting
Date
Q
Office sought:
Office held:
Payee name
Amount
($)
Civic Strategies
04/23/2009
e are;
1201 W Park Row Dr
Arlington, TX 76013
t’;
a;
$2,368.12
Zi)Cod
required.)
Mailing
(lfravel outside of Texas complete Schedule T)
Date
04/24/2009
—
s
Q
Offic:e sought:
Oe nela
Payee name
CMc Strategies
Amount
Payee address:
City:
1201 W Park Row Dr
Arlington, TX 76013
St:
$1,253.12
Cod
S
—
r000:r01i.
Canddate I Oftic.ehoder name:
Mailing
Q
Office sought:
Office held:
Oectrorc Fang Vernnn 3 3
P.O.Box 12070
(512>463-5800
1-800-325-8506
SCHEDULE
I
The INsTRucTIoN GuIDE explains how to complete this form.
F
PAGE #
2
FILER NAME
3
ACCOUNT #
00000001
4
Date
5
04/25/2009
Payee name
Civic Strategies
6
7
Amount
Cs)
$600.00
icJe
t’;
1201 W Park Row Dr
Arlington, TX 76013
8
required.)
Consulting
Q
Date
Office sought:
Office held:
Payee name
Civic Strategies
04/29/2009
Amount
(5)
dt’;
ta;
$1,103.79
icce
1201 W Park Row Dr
Arlington, TX 76013
required.)
“
Mailing
Q
Date
Office sought:
Office held:
Payee name
Amount
Corner Bakery and Cafe
04/09/2009
cir;
dt’;
615 Main Street
($)
required.)
Constituent Lunch
(If travel outside of Texas. complete Schedule Ti
at
$12.97
ifcie
Q
“
Office
he(d
Pe rn
Amount
Edible Arangements
04/20/2009
Payee address:
(6)
dt;
$68.83
dod
2600 W 7th St
Pu::x.se of oayrne.nt (See mstructons• regerd(no t•ve of infomation
re.
“C omotete if direct e.rcendfiure to benefit Coed dOe/Officeholder
Caodida:e / Ofncehoide nanne
Hostess Gift
Q
Office sought
Office he(d:
Eecroee F-g Vrso, 3 3 7
P.O.Box 12070
(512)463-5800
SCHEDULE
1
The INSTRucTIoN GuiDE explains how to complete this form.
2
FILER NAME
1-800-325-8506
F
PAGE #
3 ACCOUNT #
00000001
4
Date
5
Payee name
Enterprise
04/13/2009
7
ccir
bt
a:
Amount
($)
$226.90
i dcje
8442 Camp Bowie W
8
required.)
9
Car Rental
Date
04/17/2009
0
Office sought:
Office held:
Payee name
Amount
Enterprise
($)
ai
cr;
$253.40
ide
1001 Jones St.
Suite 139
required.)
Car rental
Date
Q
Office sought:
Office held:
Amount
(5)
Payee name
Family Dollar
04/11/2009
r;
$16.51
dO
t
504 W Rosedale
required.)
Campaign Materials
( f travel outside of Texas complete Schedule T)
atr
F
av€
Q
Candidate / Officeholder name
cs gtt
if r € J
)if
Amo nt
$
aT €
Feast vities
04/16/2009
-
Payee address,
$324.75
ty tae
3637 W Vickery Blvd
FrtW rib
TX 76101
If
d’ff
f dt rfu dras
Q
Off € souglt
Off cc held
E ccJ’orc€
rgVErs3Y 33
P.O.Box 12070
(512)463-5800
The
INSTRUCTION
1-800-325-8506
SCHEDULE
I
Guioe explains how to complete this form,
F
PAGE #
2
FILER NAME
3
ACCOUNT #
00000001
4
Date
5
04/16/2009
Payee name
Graphics2
7
ccr;
6
ai;
Amount
($)
$270.63
idccie
507 S Main St
required.)
Envelopes
8
D
Date
Office sought:
Office held:
Payee name
Greater Meadowbrook News
04/12/2009
aee address;
City;
P.O. Box 24264
Amount
($)
State:
Q
Date
$548.00
Ziod
required.)
Advertisment
Office sought:
Office held:
Payee name
Haltom’s
04/09/2009
‘
Amount
($)
are;
317 Main St
State;
(If travel outsde
of Texas
$86.60
‘dod
required)
Hostess Gifts
Do e
9
Q
complete Schedule T)
Office sought:
Office helci
Paveename
Amount
Hobby Lobby
04,18/2009
Payee address;
City:
State:
S1886
Zip Code
900W 15th St
Plno, TX 75075
Purpose of payment (See instructions regard)ng type •of infucatlen
UirCd.
Cnfrt’ if direct expend)ture o beneift CandidateiOfficahoider
Candidate / Officeho;:der name:
Materials for invitations
LI
Office souoht:
Office held:
Eetrorc- F’g Vers.on 3 3 7
P.O.Box 12070
(512)463-5800
2
4
SCHEDULE
The lNS11ucTIoN GutoE explains how to complete this form.
I
FILER NAME
3 ACCOUNT #
00000001
Date
04/18/2009
6
Amount
(S)
7
‘a;’
‘‘‘‘‘
F
PAGE #
Payee name
Hobby Lobby
5
1-800-325-8506
$15.62
i’cicde
4220 Legacy Rd
Piano, TX 75024
required.)
8
Q
Date
Candidate I Officeholder name:
Office sought:
Office held:
Payee name
J & J Quick Mart
04/11/2009
‘‘
Amount
($)
bt’;’
‘cr;
4201 Lancaster Blvd
Fort Worth, TX
required.)
Gas for campaign
Q
Date
$30.28
‘a;’ ‘od
Office sought:
Office held:
Payee name
JoAnn Fabric
04/17/2009
‘
Amount
($)
Payee address
1400 Green Oaks Rd
$16.17
Ziod
required.)
Date
ayee.narre
fl
Office souqht:
Office held:
Amount
-
JoAnn Fabric
04/19/2009
yedr:
($)
City:
State:
$67.44
Zip Code
1439 W Pipeline Rd
Hurst, TX 76053
—
reu:red:
—-
c
c——
—
G.anOdate Officeholder name:
:
J
Q
Office so-ughh
Office held:
EectrOflC Fhng Verson 33
P.O.Box 12070
(512)463-5800
1-800-325-8506
SCHEDULE
The lNsTRucnoN Guos explains how to complete this form.
I
F
PAGE #
2
4
FILER NAME
Date
04/17/2009
Hicks, Erin Kathleen (Ms.>
5
Payee name
Kwik Kopy
6
le
3 ACCOUNT #
00000001
(Ethics Commission filersi
7
dtn
rs;
1850 Handley Dr
••••
Amount
($)
$139.64
idcie
FortWorth, TX76112
8
required.)
Door Knockers
r:
Date
Office sought:
Office held:
Payee name
Amount
LaVida News
04/21/2009
($)
diti; a;
icr;
$840.00
iccce
5601 Bridge St #300
FortWorth, TX76112
required.)
Advertisement
Q
Date
Office sought:
Office held:
Payee name
Mellow Mushroom
04/15/2009
ccr:
Amount
($>
dtc’: a;
$18.89
iccie
3455 Bluebonnet Circle
required.)
Candidate i Officeholder name:
Constituent Lunch
Of travel outside of Texas complete Schedule T)
Date
C’
Payee name
Mellow Mushroom
04/18/2009
Amount
(St
$22.14
ar
3455 Bluebonnet Circle
Fort Worth. TX 76.109
Purpose of oayment (See instructions regarding type of information
r5.cn red.)
Complete if direct expenditure to be n..e:tit Ca.nctdate/Officr...ho der
Can•dctate jff•cefde name:
Campacin Meetnq
Q
Office sought:
Office held:
EeOronc Firg Verson 337
P.O.Box 12070
(512)463-5800
SCHEDULE
I
The INSTRucTIoN GuIDE explains how to complete this form.
2
4
FILER NAME
Date
5
Payee name
F
PAGE #
3 ACCOUNT #
00000001
7
Office Depot
04/09/2009
1-800-325-8506
Amount
($)
$11.36
Payee address;
401 Carroll St
8
required.)
Copies
Q
Date
04/11/2009
9
Office sought:
Office held:
Payee name
Amount
Office Depot
($)
Payee address;
4810 Southwest Blvd
bit
$55.20
ai; ide
required.)
Copies for campaign invitation
Q
Date
Office sought:
Office held:
Payee name
Office Depot
04/17/2009
.
cr;
.
Amount
($)
dt’;
$183.12
ai;
6680 W Freeway
Fort Worth, TX76116
required.)
Office Supplies
Date
Q
Office sought:
Office held
Payee name
Onyx lnc
04/10/2009
Amount
($)
ty;
$200.00
0d
1301. Evans Ave
Purpose c.f payment (See instructioes. regarding type of information
requireci)
Complete f ffie/ exoenditure to benefit Candidate/Officeholder
Candi:date / Officeholder name:
Rental of Campaign FacUlty
Q
Office sought:
Office held
Eectronc FSng VerSon 3.3.7
PO.Box 12070
(512)463-5800
1-800-325-8506
SCHEDULE
I
F
PAGE #
2
FILER NAME
Date
4
ACCOUNT #
00000001
Payee name
Our Mother of Mercy School
5
04/15/2009
3
6
7
ty; ‘a;
Amount
($)
icci’e
$150.00
1005 E Terrell Ave
required.)
Donation
8
0
Date
9 Complete if direct expenditure to benefit Candidate/Officeholder
Office sought:
Office held:
Payee name
Paper Planet
04/17/2009
.
Amount
ie cir;
dt,;
6511 E Lancaster Ave
Fort Worth, TX76112
a;
zip’dod
required,)
Q
Date
$4.76
Office sought:
Office held:
Payee name
Amount
PF Chang’s China Bistro
04/09/2009
($)
dts a;
‘
‘
$43.89
Zip’cie
400 Throckmorton St
required.)
Campaign Meeting
Q
Date
Office souqht:
Office heki
Payee name
Amount
Cs)
Potbelly
/1 1/2009
‘
‘er;’” t:’ ‘t;’ ‘de””
2058 University Dr
Pj
o p en Se’
requkeci)
Lunch
a
ega ci og
g
ki amIon
Car
a Ia
xpena t
C.an:ctkiate / Offcehokier name:
a here
$14.25
ardiaae rhcehalct
tar Volunteers
U
Office sought:
Office held
Eecrorc F’ Versor 3 37
P.O.Box 12070
(512)463-5800
2
1-800-325-8506
SCHEDULE
The lNsTRucnoN Guoe explains how to complete this form.
I
FILER NAME
3 ACCOUNT #
F
PAGE #
Schedule: 11/18 Report: 24/3 1
00000001
4
Date
5
04/25/2009
Payee name
Potbelly
7
ie ccir;
Amount
()
$13.60
cicie
btti;
540 Throckmorton
required.)
Lunch for Volunteers
8
Q
Date
9 Complete if direct expenditure to benefit Candidate/Officeholder
Office sought:
Office held:
Payee name
Amount
Rosebud Cafe
04/26/2009
.
($)
bt
ir;
$9JclJ
ccce
1519 W Rosedale
required.)
Volunteer Breakfast
Q
Date
Office sought:
Office held:
Payee name
Amount
Saint Patrick
04/19/2009
($)
cr:
bt’:
1206 Throckmorton St
$513 00
icce
required.)
Donation
D
lf travel outstde of Texas complete Schedule T)
Date
04/25,2009
Office sounht
Off e cc
Payee name
Shannon, Keegan
Amount
($)
bt:
ers:
‘t;
$100.00
de
2019 Clinton
Fort Worth., 1X76164
Puroose of ovment (See scti.
rrjnc.
pre icfórmapor:
1
pc
(noft
r:anff:rjatr
if direc(
C
er:rfcjre
to beneft CandidsteiOfficehotder
r1cenOGer came:
Phone Bank
Q
Office sought:
Office held:
Electroec Fihog Vereon 3.31
P.O.Box 12070
(512)463-5800
2
4
SCHEDULE
The INSTRUC-noN GUIDE explains how to complete this form.
I
FILER NAME
3 ACCOUNT #
00000001
Date
Payee name
6
PAGE #
7
ccr;
Amount
($)
Shannon, Patrick
04/25/2009
F
5
1-800-325-8506
dit
$10000
idccie
2019 Clinton
8
required.)
9
*
Phone Bank
Q
Date
Office sought:
Office held:
Amount
Payee name
Shell
04/15/2009
€€
($)
Jr;
ti
ai;
$25.22
icce
1224 Oakland Blvd
required.)
Gas for campaign
Q
Office sought:
Office held:
Amount
($)
Payee name
Shell
Date
04/27/2009
eirs;
4429 Bellaire Dr
tt
$22.40
0
id
required.)
Gas for Campaign
lit travel outside of Texas. complete Schedule T)
fl
Qftrte souc:ht
Otice heid:
Amount
S
Payee namP
Date
SMIT nc.
04/10/2009
ayeer:
Cy: State:
$165.00
Ziod
3501 Williams Rd
FortWorth, TX7611$
Jrnosn c c
requred.)
Scr
gf
ons ega dng type o’ infcrmahon
crrr
c t ‘xer c ‘ure tc ceneft Candrtat&Offcaholde
CandIdate i Otf.ceholder nam:e:
Advertisement
(If travel outside of Texas complete Schedule T)
Q
Office sought:
Office held
Electronic Filing Version 3.3c
P.O.Box 12070
(512)463-5800
1-800-325-8506
SCHEDULE
The INsTRIJcnoN GuIDE explains how to complete this form.
‘
F
PAGE #
2
FILER NAME
3 ACCOUNT #
00000001
Date
4
Payee name
5
7
SMIT Inc.
04/17/2009
Amount
($)
6 ‘cr;
btc’;’
$165.00
‘ta;’ ‘i’dcce
3501 Williams Rd
required.)
Advertisement
8
Q
Date
9
Office sought:
Office held:
Payee name
Amount
SMIT Inc.
04/24/2009
‘
e’ drs;
($)
City:
‘
$165.00
State
3501 Williams Rd
required.)
Advertisement
Q
Date
Office sought:
Office held:
Payee name
Staples
04/08/2009
Amount
($)
dt’:
$93.86
a;’ ‘dcie
1600 S University Dr
required. 1
Copies
D
(if travel outsIde of Texas complete Schedule T)
Date
Office .sougm:
Office teld
Payee name
Thraet
04/08/2009
Amount
!S)
$26.66
eJr;
2600 W 7th St
Foci Worth, X 76107
Purpose c avrient (13cc. instructions regarding type. of information
reaui.red.f
Compiete if direct expend.iture ro benefit Candcta.te/Officehoider
Carctdate .1 Officehcder rurme:
Materia is for campaign
Q
Office sought:
Office held:
Eiecironc FWng Vereon 3 3 7
P.O.Box 12070
(512)463-5800
SCHEDULE
I
FILER NAME
F
PAGE #
Schedule: 14/18
2
1-800-325-8506
3 ACCOUNT #
Report: 27/3 1
00000001
4
Date
5
04/14/2009
•.
Payee name
Target
7
‘ccr;
dt;’ ‘a;’ ‘idod
2600 W 7th St
required.)
Materials for campaign fundraiser
8
$97.92
Office sought:
Office held:
Date
Payee name
Target
04/26/2009
‘
Amount
($)
$36.80
cir;
dti; ‘a;’ ‘i’bcct’e
2600 W 7th St
required.)
Food for campaign event
D
Date
Office sought:
Office held:
Payee name
Teresa’s Catering Service
04/16/2009
Amount
(S)
Amount
($)
$280.00
‘e ccir;
sit’;’ t;’ ‘iod
2709 Scott Ave
required.)
“
Catering Service
P travel outside of Texas complete Schedule Ti
Date
Drtce oem
Payee name
Tetco
04/11/2009
Paee dr:
700 E Berry
Fort Worth, TX
Amount
($)
y:
Sta
$23.20
Zip Cod
Pj.r.e of Doyment tSee ,rmtrucMns r:nc2 tone of nfcrmMon
renuned.)
Gas for c.ampamqn
(It travel outside of Texas complete Schedule T)
Q
Comoi,&e f rtr ::t expendture to benelit Candmdate./Offcehotd.er
u300roate .r 1iftlcenc.idec name:
‘‘
Office sought:
Office held
Emectrone FiHng Vereon 3:3.7
PO.Box 12070
(512)463-5800
2
4
SCHEDULE
The INsTRuclioN GuIDE explains how to complete this form.
1
FILER NAME
3 ACCOUNT #
00000001
Date
Hicks. Erin Kathleen (Ms.)
5
Payee name
7
dt;
‘a
F
PAGE #
Tom Thumb
04/12/2009
1-800-325-8506
Amount
($)
$36.96
i,dccte
3100 S Hulen
required.)
Food for Event
8
Q
Date
Office sought:
Office held:
Payee name
USPS
04/08/2009
Amount
($)
cicr;
dti;
$75.60
t; idod
5125 Wichita
FortWorth, TX76119
required.)
Postage
Q
Date
Office sought:
Office held:
Payee name
USPS
Amount
($)
04/13/2009
t’:
$42.00
icod
5125 Wichita St
Fort Worth, TX76119
required,)
Postage
Office soucht:
Office held.
Date
Payee name
Amount
USPS
04/16/2009
(5)
Payee address:
City:
5125 Wichita St
P
‘e of
reauded./
t O’ ‘ct y’
ec
tvp
State:
to
$84.00
Zip Cod
‘rr
nq
Candidate
e’ oer’
‘t’, be b Ca
OfficeOcider name:
ateOW ld€
Postace
Q
Office sought:
Office held:
Electroac ESog Version 331
P.O.Box 12070
(512)463-5800
The
2
lNSTRucnoN
FILER NAME
1-800-325-8506
SCHEDULE
Guioe explains how to complete this form.
I
3 ACCOUNT #
F
PAGE #
00000001
Date
4
Payee name
5
04/1 7/2 009
6
e
Amount
(S)
7
usps
City:
r
State;
$80.76
ie
400 N Retta
8
required.)
Postage
Q
Date
Office sought:
Office held:
Payee name
Amount
USPS
($)
04/18/2009
dt
a;
$168.00
idccte
4450 Oak Park Ln
required.)
Postage
Date
D
Office sought:
Office held:
Payee name
Amount
USPS
04/25/2009
.
()
ccr;
.
$6.15
dod
301 DarcySt
required.)
Postage
Q
Office sought:
Office heid:
Payee name
Dste
Amount
uSPS
04/27/2009
($)
Payee address:
5125 Wichita St
Otv:
State:
$51.10
Zip Cod
Fort Worth, TX 75:119
—
“
—“
.
—,,,
‘‘
requ:red:
‘
.--
‘U’
Cand-kiate / Officer other name:
Postage
Q
Office .sought:
Office held:
Eeetronc Eiing VerSon 3,3,
P.O.Box 12070
(512)463-5800
2
1-800-325-8506
SCHEDULE
The iNSTRUCTION GuIDE explains how to complete this form.
1
FILER NAME
3 ACCOUNT #
F
PAGE #
00000001
4
Date
5
Payee name
Walgreen’s
04/15/2009
7
Amount
($)
t ai;
bi
$12.48
921 Henderson
required.)
Campaign Materials
9
8
Date
Q
Office sought:
Office held:
Amount
Payee name
Walgreen’s
04/18/2009
•.
($)
dt
e
6346 Camp Bowie Blvd
$8.65
idcde
required.)
Campaign Materials
Date
Q
Amount
Payee name
Walgreen’s
04/23/2009
($)
r;
dt a;
921 Henderson
(If travel outside of Texas complete Schedule T)
—
04/12/2009
Candidate Officeholder name:
*
*
Q
Off es uqO
if
£d
Arr ount
a
Walmart
cres
3851 Airport Fwy
FortWorth 1X76111
$
Y.
1
d
State;
ty
t
$34.36
t
3
arrpaq
$28.55
idcJe
required)
Campaign Materials
Date
Office sought:
Office held:
—1—d
is
‘
s
t
if
Matsralsfo rurrt
Q
Off so sougft
Offlc,e held
Eectrorci1rgVcrscv
37
P.O.Box 12070
(512)463-5800
2
4
SCHEDULE
The lNsTRucnoN GUIDE explains how to complete this form.
I
FILER NAME
3 ACCOUNT #
00000001
Date
04/17/2009
5
Payee name
Xpedx
6
dty:
2017 White Settlement
1-800-325-8506
PAGE #
7
required.)
Paper
0
Amount
($)
$115.13
idccie
8
F
Office sought:
Office held:
EicrorC Fig Vets on 3 3 /

Document 6524033

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