HERNANDEZ, ADRIAN_JANUARY 15 2020_CAMPAIGN FINANCE REPORT CANDIDATE / OFFICEHOLDER FORM C/OH
CAMPAIGN FINANCE REPORT COVER SHEET PG 1
1 Filer ID (Ethics Commission Filers) 2 Total pages filed:
The C/OH Instruction Guide explains how to complete this form.
8
3 CANDIDATE/ MS/MRS/MR FIRST MI
OFFICEHOLDER OFFICE USE ONLY
NAME Mr. Adrian M Date Received
NICKNAME LAST SUFFIX
Hernandez / / ô (f.CANDIDATE/ ADDRESS /PO BOX; APT/SUITE#; CITY; STATE; ZIP CODE �o
OFFICEHOLDER
MAILING
ADDRESS Pearland,TX 77581
n Change of Address
5 CANDIDATE/ AREA CODE PHONE NUMBER EXTENSION
OFFICEHOLDER \ Da a and-d ivered or Date Postmarked
PHONE 3 I/.aoaD
6 CAMPAIGN MS/MRS/MR FIRST MI
R ceipt# /// Amount$
TREASURER
NAME Mrs' Veronica K Date Processed
NICKNAME LAST SUFFIX
Date Imaged
Longoria
7 CAMPAIGN STREET ADDRESS (NO PO BOX PLEASE); APT/SUITE#; CITY; STATE; ZIP CODE
TREASURER
ADDRESS
Pearland,TX 77584
(Residence or Business)
8 CAMPAIGN AREA CODE PHONE NUMBER EXTENSION
TREASURER
PHONE (
9 REPORT TYPE
x I January 15 30th day before election Runoff 15th day after campaign
treasurer appointment
(Officeholder Only)
July 15 8th day before election Exceeded Modified I Final Report(Attach C/OH-FR)
Reporting Limit
10 PERIOD Month Day Year Month Day Year
COVERED
07 / 16 /2019 THROUGH 01 /14 /2020
11 ELECTION ELECTION DATE ELECTION TYPE
Month Day Year Primary n Runoff n Other
Description
/ / I I General n Special
12 OFFICE OFFICE HELD (if any) 13 OFFICE SOUGHT (if known)
Pearland City Council Position 4
GO TO PAGE 2
Forms provided by Texas Ethics Commission www.ethics.state.tx.us Revised 1/1/2020
CANDIDATE / OFFICEHOLDER FORM C/OH
CAMPAIGN FINANCE REPORT COVER SHEET PG 2
14 C/OH NAME 15 Filer ID (Ethics Commission Filers)
Allan M Hemartclee
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 OFRCEHOLDER'S
COMMITTEE(S) KNOWLEDGE OR CONSENT. CANDIDATES AND OFFICEHOLDERS ARE REQUIRED TO REPORT THIS INFORMATION ONLY IF THEY RECEIVE NOTICE
OF SUCH EXPENDITURES.
COMMITTEE TYPE COMMITTEE NAME
❑GENERAL
COMMITTEE ADDRESS
SPECIFIC
COMMITTEE CAMPAIGN TREASURER NAME
I I Additional Pages
COMMITTEE CAMPAIGN TREASURER ADDRESS
17 CONTRIBUTION 1. TOTAL UNITEMIZED POLITICAL CONTRIBUTIONS (OTHER THAN
TOTALS PLEDGES, LOANS, OR GUARANTEES OF LOANS, OR $ 0
CONTRIBUTIONS MADE ELECTRONICALLY)
2. TOTAL POLITICAL CONTRIBUTIONS $ 0
(OTHER THAN PLEDGES, LOANS, OR GUARANTEES OF LOANS)
TOTALS EXPENDITURE 3. TOTAL UNITEMIZED POLITICAL EXPENDITURE. $ 0
4. TOTAL POLITICAL EXPENDITURES $ 418.00
CONTRIBUTION 5. TOTAL POLITICAL CONTRIBUTIONS MAINTAINED AS OF THE LAST DAY
BALANCE $ 9.22
OF REPORTING PERIOD
OUTSTANDING 6. TOTAL PRINCIPAL AMOUNT OF ALL OUTSTANDING LOANS AS OF THE
LOAN TOTALS LAST DAY OF THE REPORTING PERIOD $ 60.00
18 AFFIDAVIT
I swear,or affirm,under penal. : •er ry,that the accompanying report is
true- d orrect and in .:e -II informa. required to be reported by me
un-•erTi,e 15, - 'ion•od:.
. ure of •- or Officeholder
AFFIX NOTARY STAMP I SEALABOVE dri /
Sworn to nd subscribed before me, by the said � aI- 4 Z , this the 5
da of 'Mat- ,20 c0 ,to certify hich,witness my hand and seal of office.
t r 1 60_ram— 5C re
Si ature of officer administering oath Print name of officer administering oath Title Icer administering ath
Forms provided by Texas Ethics Commission 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)
Adrian M Hernandez
21 SCHEDULE SUBTOTALS SUBTOTAL
NAME OF SCHEDULE AMOUNT
1. I I SCHEDULEA1: MONETARY POLITICAL CONTRIBUTIONS $
2. SCHEDULEA2: NON-MONETARY(IN-KIND)POLITICAL CONTRIBUTIONS $
3. SCHEDULE B: PLEDGED CONTRIBUTIONS $
4. X SCHEDULE E: LOANS $ 60.00
5. X SCHEDULE F1: POLITICAL EXPENDITURES MADE FROM POLITICAL CONTRIBUTIONS $ 418.00
6. 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. SCHEDULE I: NON-POLITICAL EXPENDITURES MADE FROM POLITICAL CONTRIBUTIONS $
12. X SCHEDULE K: INTEREST, CREDITS, GAINS, REFUNDS,AND CONTRIBUTIONS RETURNED $ 60.00
TO FILER
Forms provided by Texas Ethics Commission www.ethics.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 ID (Ethics Commission Filers)
Adrian M Hernandez
4 TOTAL OF UNITEMIZED LOANS $
5 Date of loan 7 Name of lender ❑out-of-state PAC(ID#: ) 9 Loan Amount($)
01/04/2020 Adrian M Hernandez 60.00
6 Is lender 8 Lender address; City; State; Zip Code 10 Interest rate
a financial 0
Institution?
1431 Crystal Lake Cir E Pearland, TX 77584 11 Maturity date
Y k
N/A
12 Principal occupation / Job title (See Instructions) 13 Employer (See Instructions)
Executive Director Keep Pearland Beautiful
14 Description of Collateral 15
12
Check if personal funds were deposited into political
none account (See Instructions)
16 GUARANTOR 17 Name of guarantor 19 Amount Guaranteed($)
INFORMATION
18 Guarantor address; City; State; Zip Code
[y� not applicable
20 Principal Occupation (See Instructions) 21 Employer (See Instructions)
Date of loan Name of lender 0 out-of-state PAC(ID#: ) Loan Amount($)
Is lender Lender address; City; State; Zip Code Interest rate
a financial
Institution?
Maturity date
Y N
Principal occupation / Job title (See Instructions) Employer (See Instructions)
Description of Collateral
❑ Check if personal funds were deposited into political
account (See Instructions)
❑ none
GUARANTOR Name of guarantor Amount Guaranteed($)
INFORMATION
Guarantor address; City; State; Zip Code
❑ not applicable
Principal Occupation (See Instructions) I 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 SCHEDULE F1
FROM POLITICAL CONTRIBUTIONS
EXPENDITURE CATEGORIES FOR BOX 8(a)
Advertising Expense Event Expense Loan Repayment/Reimbursement Solicitation/FundraisingExpense
AcoountingBanking 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 SalariesfNages/Contract Labor Other(enters category not listed above)
Credit Card Payment The Instruction Guide explains how to complete this form.
1 Total pages Schedule Fl: 2 FILER NAME 3 Filer ID (Ethics Commission Filers)
3 Adrian M Hernandez
4 Date 5 Payee name
01/07/2020 Cubesmart Storage
6 Amount ($) 7 Payee address; City; State; Zip Code
73.00 8206 Broadway St Pearland,TX 77581
8 (a)Category (See Categories listed at the top of this schedule) (b)Description
PURPOSE
OF
EXPENDITURE Rental Expense Storage Unit
(c) Check iif travel outside of Texas.Complete Schedule T. I I Check if Austin,TX,officeholder living expense
9 Complete ONLY if direct
Candidate/Officeholder name Office sought Office held
expenditure to benefit C/OH
Date Payee name
Amount ($) Payee address; City; State; Zip Code
Category (See Categories listed at the top of this schedule) Description
PURPOSE
OF
EXPENDITURE
I Check if ravel outside of Texas.Complete Schedule T. I I Check 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 ($) Payee address; City; State; Zip Code
Category (See Categories listed at the top of this schedule) Description
PURPOSE
OF
EXPENDITURE
I I Check if travel outside of Texas.Complete ScheduleT. I I Check if Austin,TX, officeholder living expense
Complete ONLY if direct
Candidate/Officeholder name Office sought Office held
expenditure to benefit C/OH
ATTACH ADDITIONAL COPIES OF THIS SCHEDULE AS NEEDED
Forms provided by Texas Ethics Commission
www.ethics.state.tx.us Revised 1/1/2020
POLITICAL EXPENDITURES MADE
FROM POLITICAL CONTRIBUTIONS SCHEDULE Fl
EXPENDITURE CATEGORIES FOR BOX 8(a)
Advertising Expense Event Expense Loan Repayment/Reimbursement Solicitation/Fundraising Expense
Accounting/Banking Fees Office Overhead/Rental Expense Transportation Equipment&Related Expense
Consulting Expense Food/Beverage Expense Polling Expense Travel In District
Contributions/Donations Made By Gift/Awards/Memorials Expense Printing Expense Travel Out Of District
Candidate/Officeholder/Political Committee Legal Services SalariesANages/Contract Labor Other(enter a category not listed above)
Credd Card Payment
The Instruction Guide explains how to complete this form.
1 Total pages Schedule Fl: 2 FILER NAME 3 Filer ID (Ethics Commission Filers)
3 Adrian M Hernandez
4 Date 5 Payee name
10/07/2019 Cubesmart Storage
6 Amount ($) 7 Payee address; City; State; Zip Code
65.00 8206 Broadway St Pearland,TX 77581
8 (a) Category (See Categories listed at the top of this schedule) (b)Description
PURPOSE
OF Rental Expense Storage Unit
EXPENDITURE
(c) I Check if travel outside of Texas.Complete ScheduleT. n Check if Austin, TX,officeholder living expense
9 Complete ONLY if direct Candidate/Officeholder name Office sought Office held
expenditure to benefit C/OH
Date Payee name
11/07/2019 Cubesmart Storage
Amount ($) Payee address; City; State; Zip Code
65.00 8206 Broadway St Pearland,TX 77581
Category (See Categories listed at the top of this schedule) Description
PURPOSE Rental Expense Store e Unit
OF P g
EXPENDITURE
ICheck if travel outside of Texas.Complete ScheduleT I Check ifAustin,TX,officeholder living expense
Complete ONLY if direct Candidate/Officeholder name Office sought Office held
expenditure to benefit C/OH
Date Payee name
12/07/2019 Cubesmart Storage
Amount ($) Payee address; City; State; Zip Code
65.00 8206 Broadway St Pearland,TX 77581
Category (See Categories listed at the top of this schedule) Description
PURPOSE
OF Rental Expense Storage Unit
EXPENDITURE
nCheck if travel outside of Texas.Complete ScheduleT. 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
Forms provided by Texas Ethics Commission www.ethics.state.tx.us Revised 1/1/2020
POLITICAL EXPENDITURES MADE
FROM POLITICAL CONTRIBUTIONS SCHEDULE F1
EXPENDITURE CATEGORIES FOR BOX 8(a)
Advertising Expense Event Expense Loan Repayment/Reimbursement Solidtation/FundraisingExpense
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)
Credit Card Payment
The Instruction Guide explains how to complete this form.
1 Total pages Schedule Ft: 2 FILER NAME 3 Filer ID (Ethics Commission Filers)
3 Adrian M Hernandez
4 Date 5 Payee name
08/07/2019 Cubesmart Storage
6 Amount ($) 7 Payee address; City; State; Zip Code
8206 Broaduvay St Pearland,TX 77581
65.00
8 (a) Category (See Categories listed at the top of this schedule) (b) Description
PURPOSE
OF Rental expense Storage Unit
EXPENDITURE
(C) n Check if travel outside of Texas.Complete Schedule T. Check if Austin, TX,officeholder living expense
9 Complete ONLY if direct Candidate/Officeholder name Office sought Office held
expenditure to benefit C/OH
Date Payee name
08/13/2019 Nature Conservancy
Amount ($) Payee address; City; State; Zip Code
20.00 4245 N Fairfax Dr Ste 100 Arlington,VA 22203
Category (See Categories listed at the top of this schedule) Description
PURPOSE
OF Donation
EXPENDITURE
Check if travel outside of Texas.Complete Schedule T. Check 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
09/07/2019 Cubesmart Storage
Amount ($) Payee address; City; State; Zip Code
65.00
8206 Boradway St Pearland,TX 77581
Category (See Categories listed at the top of this schedule) Description
PURPOSE
OF
EXPENDITURE Rental Expense Storage Unit
Check if travel outside of Texas.Complete Schedule T. n Check if Austin, TX,officeholder living expense
Complete ONLY if direct Candidate/Officeholder name Office sought Office held
expenditure to benefit C/OH
ATTACH ADDITIONAL COPIES OF THIS SCHEDULE AS NEEDED
Forms provided by Texas Ethics Commission www.ethics.state.tx.us Revised 1/1/2020
INTEREST, CREDITS, GAINS, REFUNDS, AND
CONTRIBUTIONS RETURNED TO FILER SCHEDULE K
The Instruction Guide explains how to complete this form. 1 Total pages Schedule K:
2 FILER NAME 3 Filer ID (Ethics Commission Filers)
Adrian M Hernandez
4 Date 5 Name of person from whom amount is received 8 Amount($)
Nature Conservancy
09/14/2019 6 Address of person from whom amount is received; City; State; Zip Code
60.00
4245 N Fairfax Dr Ste 100 Arlington, VA 22203
7 Purpose for which amount is received Check if political contribution returned to filer
Refund
Date Name of person from whom amount is received Amount($)
Address of person from whom amount is received; City; State; Zip Code
Purpose for which amount is received Check if political contribution returned to filer
Date Name of person from whom amount is received Amount($)
Address of person from whom amount is received; City; State; Zip Code
Purpose for which amount is received 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 I I Check if political contribution returned to filer
ATTACH ADDITIONAL COPIES OF THIS SCHEDULE AS NEEDED
Forms provided by Texas Ethics Commission www.ethics.state.tx.us Revised 1/1/2020