IVERY, MASHUNDA_OCTOBER 2 2020_CAMPAIGN FINANCE REPORTCANDIDATE/
1
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FORM
C/OH
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explains
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this
form.
1 Filer ID (Ethics Commission Filers)
2 Total pages filed:
3 CANDIDATE
OFFICEHOLDER
/
MS
FAR
! MR
FIRST
MI
OFFICE USE ONLY
NAME
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NICKNAME LAST
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CITY; STATE; ZIP CODE
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Change
of
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5 CANDIDATE/
AREA CODE PHONE NU Et
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OFFICEHOLDER
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63. D
6 CAMPAIGN
TREASURER
MS '{ MRS FIRST
MI
Receipt N
Amount $
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NAME
NICKNAME LAST
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SUFFIX
Date Processed
1
C-,��t���C�r<<
Date
Imaged
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7 CAMPAIGN
TREASURER
STREET ADDRESS (NO PO BOX PLEASE);
APT r SUITE it:
CITY; STATE; ZIP CODE
ADDRESS
/ *.
oo c6-1-01'17g
1-7 Use;
(Residence or Business)
8 CAMPAIGN
TREASURER
AREA CODE
/
9 REPORT
TYPE
January 15 i 30th
day before election I
I Runoff 1
(—
15th day after campaign
treasurer appointment
(Officeholder Only)
July 15
I
8th
day before election
Exceeded $500 limit
! Final Report (Attach CiOH - FR)
10 PERIOD
COVERED
Month Day
_..
I / G
Year Month Day Year
C) THROUGH /3/ CT /)Z71C}
11 ELECTION
ELECTION DATE
ELECTION TYPE
Mo llh Day Year
I Primary Runoff !
I Other
_I
/. Description
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General
Li Special
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12 OFFICE
OFFICE HELD frf annyy)
13 OFFICE SOUGHT (if known)
1
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PAGE
2
Forms provided by Texas Ethics Commission
www.ethics.state.tx.us
Revised 9/8/2015
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14 C/OH
NAME
15 Filer ID (Ethics Commission 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
OF SUCH EXPENDITURES.
AND OFFICEHOLDERS ARE REQUIRED TO REPORT THIS INFORMATION ONLY IF THEY RECEIVE NOTICE
COMMTTTE12 TYPE
COMMITTEE
NAME
GENERAL
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17 CONTRIBUTION
TOTALS
1, TOTAL POLITICAL CONTRIBUTIONS OF
PLEDGES, LOANS; OR GUARANTEES OF
$50 OR LESS (OTHER THAN
LOANS), UNLESS ITEMIZED
/
$ j\
2.
TOTAL
POLITICAL
CONTRIBUTIONS
(OTHER THAN
PLEDGES, LOANS, OR GUARANTEES OF LOANS)9\\?)13
TOTAEXPENLS
3. TOTAL POLITICAL
UNLESS ITEMIZED
EXPENDITURES OF $100 OR LESS.
$
0
4. TOTAL POLITICAL
EXPENDITURES
$
\
CONTRIBUTION
BALANCE
5. TOTAL POLITICAL CONTRIBUTIONS MAINTAINED AS OF THE LAST DAY
OF REPORTING PERIOD
OUTSTANDING
LOAN
TOTALS
6. TOTAL PRINCIPAL AMOUNT OF ALL OUTSTANDING LOANS AS OF THE
LAST DAY OF THE REPORTING PERIOD
$
18 AFFIDAVIT
I
penalty
that
the
is
S
swear,
_
or affirm, and
!
of
perjury,
accompanying
report
f
.``'gar
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............. CRYSTAL N ROAN '
"s Notary Public, State of Texas u der
correct
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and
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Code.
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information
required
to be reported
by me
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*I My Commission Expires
January
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NOTARY ID 1057222.1
AFFIX
NOTARY STAMPi SEALABOVE
Signature of Cand
date
or
Of iceholder
Sworn to
■d
subscribed
before me,
by the
AI
this
saidaoka
,
the
d
f
7U /2-- 20 to
hand
f
D20 certify
which,
witness my and
seal office.
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, sir
ignature of officer
administering oath
Pri
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name of officer administering oath Title of officer administering
oath
Forms provided by Texas Ethics Commission
wwvv.ethics.state.tx.us
Revised 9/8/2015
TMS
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FORM
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19 FILER NAME
1
k,
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20 Filer ID (Ethics Commission Filers)
21 SCHEDULE SUBTOTALS
SUBTOTAL
NAME OF SCHEDULE
AMOUNT
r
1
SCHEDULE Al: MONETARY POLITICAL CONTRIBUTIONS
$
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2.
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SCHEDULE A2: NON -MONETARY (IN -KIND) POLITICAL CONTRIBUTIONS
$
SCHEDULE B: PLEDGED CONTRIBUTIONS
$
9
4.
I
I SCHEDULE E: LOANS
$
J
SCHEDULE F1: POLITICAL EXPENDITURES MADE FROM POLITICAL CONTRIBUTIONS
$
L
6•
,
SCHEDULE F2: UNPAID INCURRED OBLIGATIONS
$
7.
(0,
I SCHEDULE F3: PURCHASE OF INVESTMENTS MADE FROM POLITICAL CONTRIBUTIONS
$
ISCHEDULE
F4: EXPENDITURES MADE BY CREDIT CARD
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9.
SCHEDULE G: POLITICAL EXPENDITURES MADE FROM PERSONAL FUNDS
7-
10.
SCHEDULE H: PAYMENT MADE FROM POLITICAL CONTRIBUTIONS TO A BUSINESS
$
OF C/OH
--V3
11.
I
SCHEDULE I: NON -POLITICAL EXPENDITURES MADE FROM POLITICAL CONTRIBUTIONS
$ ,-
12
I
—
SCHEDULE K: INTEREST, CREDITS, GAINS, REFUNDS. AND CONTRIBUTIONS
RETURNED TO FILER
$
Tj
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Forms provided by Texas Ethics Commission
www.ethics.state.Ix.us
Revised 9/8/2015
POLITICAL
-
UTIONS
SCHEDULE
C
TRI
ETARY
A1
The
Instruction
Guide explains
how to complete
this
form.
1 Total pages Schedule Al:
2
FILER NAME
LIIl
cat VCr—v
3 Her ID (Ethics Commission Filers)
4
8
Date
Principal occupation
5 Full
name
/ Job
of
address:
(See
contributor
Instructions)
out•ot-state P C
City; State;
(ID/
9
r
Zip
Employer
Code
i. )
(See Instructions)
7
Amount
of contribution
� ,�
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($)
6 Contributor
\
title
Date
Full
Contributor
name
of
address;
contributor
out
City;
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state PAC (IDP
State;
Zip
Code
Amount
(- 49\
It)
of
contribution
CM
' 0C-.)
($)
I...I
Principal occupation / Job title (See Instructions)
Employer
(See Instructions)
Date
Full name of contributor
Contributor address;
out-of-state PAC (IDrf:
City; State;
Code
Amount of contribution ($)
I
Zip
Principal occupation / Job title (See Instructions)
Employer (See Instructions)
Date
Full name of contributor
Contributor address;
[]
out -of -slate PAC (Off: )
City; State; Zip Code
Amount of contribution ($)
Principal occupation 1 Job title (See Instructions)
Employer (See Instructions)
If contributor
ATTACH
is
-of
ADDITIONAL
state
PAC,
please
COPIES
see
OF
instruction
THIS
SCHEDULE
guide
for
additional
AS
NEEDED
reporting
requirements.
out
Forms provided by Texas Ethics Commission
www. eth ics. state.Ix. us
Revised 902015
POLITICA
EXPEN
ITURES
_:
'-S
,..A
SCHEDULE
AtE
F
FUNDS
Advertising Expense
Accounting/Banking
Consulting Expense
Contributions/Donations Made
Candidate/Officeholder/Political
Credit Card Payment
7 Total pages Schedule G:
EXPENDITURE
Event Expense
Fees
Food/Beverage
By Gift/Awards/Memorials
Committee Legal Services
The Instruction
2 FILER NAME
CATEGORIES
Loan
Office
Expense Polling
Expense Printing
Salaries!Wages/Contract
Guide explains how
FOR BOX 8(a)
Repayment/Reimbursement
Overhead/Rental Expense
Expense
Expense
Labor
to complete this
form.
Solicitation/Fundraising Expense
Transportation Equipment & Related Expense
Travel In District
Travel Out Of District
Other (enter a category not listed above)
3 Filer ID (Ethics Commission Filers)
4 Date
5 Payee name
k\
r
6 Amount ($)
7 Payee address; City; State; Zip Code
o
Reimbursement from
political contributions
intended
8
(a) Category (See Categories listed at the top of this schedule)
(b) Description
PURPOSE
Check if travel outside of Texas. Complete Schedule T.
OF
EXPENDITURE
y ,-y.
I Check if Austin. TX, officeholder living expense
1)4
e
)ea_
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9 Complete ONLY if direct Candidate ; Officehol
expenditure to benefit C/OH
r nam Office sought Office held
Date
Payee name
(�1►Vllf\i`YI
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1 y�
1 5
Amount ($)
Payee
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i Reimbursement from
political contributions
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intended
Category (See Categories listed at the lop of this schedule)
(b) Description
PURPOSEL
OF
j t Check if hovel outside of Texas. Complete Schedule T.
EXPENDITURE
, tt
A
I Check if Austin, TX, officeholder living expense
a
`
p,
Complete ONLY if direct Candidate / Offi et
!der nahie Office sought Office held
expenditure to benefit C/OH
Date
Payee name
Amount ($)
Payee address; City; State; Zip Code
Reimbursement from
contributions
Political
intended
Category (See Categories fisted al the top of this schedule)
(b) Description
PURPOSE
OF
1 I Check it travel outside of Texas. Complete Schedule T.
EXPENDITURE
I i
Check it Austin. TX, officeholder living expense
Complete ONLY
expenditure to
if direct Candidate / Officeholder name Office sought Office held
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