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HERNANDEZ, ADRIAN_JANUARY 15 2022_CAMPAIGN FINANCE REPORTFORM C/OH CANDIDATE I OFFICEHOLDER COVER SHEET PG 1 CAMPAIGN FINANCE REPORT 1 Filer ID 2 Total pages filed: The CIOH Instruction Guide explains how to complete this form. 8 FIRST MI 3 CANDIDATE / MS /MRS / MR �� • i� Y r � OFFICEHOLDER Ad rian NAME NICKNAME' LAST SUFFIX Date CITY Received .I AN OF 1 PEARLAND 8 2;22 Hernandez CI�Y SECRETARY'S OFFICE 4 CANDIDATE / ADDRESS / PO BOX, APT / SUITE #; CITY; ZIP CODE Date Hand -delivered or Date Postmarked OFFICEHOLDER /n atom-- Receipt # Amount Change Address of Pearland, TX 77584 ❑ Date Processed Date Imaged 5 CAMPAIGN TREASURER NAME MS /MRS / MR FIRST MI Veronica NICKNAME LAST Longoria SUFFIX 6 CAMPAIGN STREET ADDRESS (NO PO BOX PLEASE); APT / SUITE #; CITY; STATE; ZIP CODE TREASURER ADDRESS Pearland, TX 77584 (Residence or Business) 7 CAMPAIGN AREA CODE PHONE NUMBER EXTENSION TREASURER PHONE ( 8 REPORT TYPE © January 15 30th day before election Runoff 15th day after campaign treasurer appointment (officeholder only) July 15 El 9th day before election Exceeded modified Final Report (Attach C/OH-FR) reporting limit 9 PERIOD Month Day Year Month Day Year COVERED 07/01/2021 THROUGH 12/31/2021 10 ELECTION ELECTION DATE ELECTION TYPE Month Day Year Primary ■ Runoff Other General 0 Special 11 OFFICE OFFICE Pearland HELD City (if any) Council Position 4 Brazona 12 OFFICE SOUGHT (if known) GO TO PAGE 2 Version V1.1.a Forms provided by Texas Ethics Commission www.ethics.state.tx. us C/OH FORM CANDIDATE 1 OFFICEHOLDER REPORT: COVER SHEET PG 2 SUPPORT & TOTALS 2of8 14 Filer ID 13 C / OH NAME Hernandez, Adrian 15 NOTICE FROM This box is for notice of political contributions accepted or candidate / officeholder. These expenditures may have been political made expenditures made by without he candidate political committees s or officeholder's to support knowledge the or POLITICAL COMMITTEE(S) consent. Candidates and officeholders are required to report this information only if they receive notice of such expenditures. ■ Additional Pages COMMITTEE TYPE COMMITTEE NAME Eli GENERAL COMMITTEE ADDRESS il SPECIFIC COMMITTEE CAMPAIGN TREASURER NAME COMMITTEE CAMPAIGN TREASURER ADDRESS 16 CONTRIBUTION 1. TOTAL UNITEMIZED POLITICAL CONTRIBUTIONS (OTHER THAN PLEDGES, LOANS, TOTALS OR GUARANTEES OF LOANS, OR CONTRIBUTIONS MADE ELECTRONICALLY) $ 0.00 2. TOTAL POLITICAL CONTRIBUTIONS 0.00 (OTHER THAN PLEDGES, LOANS, OR GUARANTEES OF LOANS) EXPENDITURE 3. TOTAL UNITEMIZED POLITICAL EXPENDITURES TOTALS 0.00 4. TOTAL POLITICAL EXPENDITURES 2,969.86 CONTRIBUTION BALANCE 5. TOTAL POLITICAL CONTRIBUTIONS MAINTAINED AS OF THE LAST DAY OF THE REPORTING PERIOD 65.99 OUTSTANDING 6. TOTAL PRINCIPAL AMOUNT OF ALL OUTSTANDING LOANS AS OF THE LAST DAY $ 0.00 LOAN TOTALS OF THE REPORTING PERIOD 17 AFFIDAVIT I swear, or affirm, under penalty true and correct and includes under Title 15, Election •d all of perjury, information that required the accompanying to be reported report is by me ate. A a-,� xe PY;�.,, JUDY D BROVVIN V i t �5 ;.,• _y "` January 03, 2025 NOTARY ID 680301-5 ... AFFIX NOTARY STAMP / SEAL ABOVE • i•-- . • :.. ass da or Officeholder 1-1._ dC'.. 1 S Sworn to and subscribed before me, by the said 4 Arian eC (e-t a n z , this the t- day J nc 22,_ a vl- to certify which, witness my hand and seal of office. of 120 , e -55 J tcc L own, e&ted"c'vE, 1,c ► Sit ire of offic adm rfis ` ring Panted name of officer ministering Title of officer administering oath Forms provided by Texas Ethics Commission www. eth i c s. state. tx. u s ersion v1.1.a CIOH SUBTOTALS - CIOH FORM COVER SHEET PG 3 3 of 8 18 FILER Hernandez, NAME Adrian 19 Filer ID 20 SCHEDULE SUBTOTALS NAME OF SCHEDULE SUBTOTAL AMOUNT 1. x SCHEDULE Al: MONETARY POLITICAL CONTRIBUTIONS $ 0.00 2. © SCHEDULE A2: NON -MONETARY (IN -KIND) POLITICAL CONTRIBUTIONS $ 0.00 3. X SCHEDULE B: PLEDGED CONTRIBUTIONS $ 0.00 4. © SCHEDULE E' LOANS $ 0.00 5. X SCHEDULE F1: POLITICAL EXPENDITURES FROM POLITICAL CONTRIBUTIONS $ 2,969.86 6. © SCHEDULE F2: UNPAID INCURRED OBLIGATIONS $ 0.00 7. x SCHEDULE F3: PURCHASE OF INVESTMENTS FROM POLITICAL CONTRIBUTIONS $ 0.00 8. © SCHEDULE F4' EXPENDITURES MADE BY CREDIT CARD $ 0.00 9. © SCHEDULE G: POLITICAL EXPENDITURES FROM PERSONAL FUNDS $ 0.00 10. ■ SCHEDULE H: PAYMENT FROM POLITICAL CONTRIBUTIONS TO A BUSINESS OF C/OH $ 11. � SCHEDULE I: NON -POLITICAL EXPENDITURES FROM POLITICAL CONTRIBUTIONS $ SCHEDULE K: INTEREST, CREDITS, GAINS, REFUNDS, AND CONTRIBUTIONS RETURNED 12. gi TO FILER $ 0.19 Forms provided by Texas Ethics Commission www. ethics.state.tx. us erslon Vl 1 a CONTRIBUTIONS SCHEDULE PLEDGED B Instruction Guide explains how to complete this form. 1 Total Sch: pages 1/1 Rpt: Schedule 4/8 B: The 2 FILER Hernandez, NAME Adrian 3 Filer ID meetadrian@live.com 4 TOTAL OF UNITEMIZED PLEDGES $ 0.00 5 Date 6 Full 7 Pledgor name of pledgor Address; out-of-state PAC State; Zip (ID#: Code ) 8 Amount pledge of ($) if 19 In -kind i (If travel outside of Texas. applicable) description Complete Schedule T. ❑ City; Check 10 Principal occupation / Job title (See Instructions) 11 Employer (See Instructions) Forms provided by Texas Ethics Commission www.ethics.state.tx.us ersion V1 1 a LOANS SCHEDULE E The Instruction Guide explains how to complete this form. 1 Total Sch: pages 1/1 Rpt: Schedule 5/8 E. 2 FILER Hernandez, NAME Adrian 3 Filer ID 4 TOTAL OF UNITEMIZED LOANS $ 0.00 5 Date of loan 7 Name of lender out-of-state PAC (ID#: ) 9 Loan Amount ($) IIII 6 Is financial institution? lender a 8 Lender address; City; State; Zip Code 10 Interest Rate 11 Maturity Date 12 Principal occupation / Job title (See Instructions) 13 Employer (See Instructions) 14 Description None of Collateral 15 Check if personal funds were deposited into political (See Instructions) account ■ 111 16 GUARANTOR INFORMATION not applicable 17 Name of guarantor 18 Guarantor address; City; State; Zip Code 19 Amount Guaranteed ($) II 20 Principal occupation 21 Employer (See Instructions) Forms provided by Texas Ethics Commission ersion a www. etnics.state.tx. us SCHEDULE POLITICAL POLITICAL EXPENDITURES FROM F1 CONTRIBUTIONS 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 Guide explains how to complete this form. 1 Total pages Schedule F1: 2 FILER NAME 3 Filer ID Sch: 1/2 Rpt: 6/8 Hernandez, Adrian 4 Date 5 Payee name 07/14/2021 Adrian, Hernandez 6 Amount ($) 7 Payee address; City; State; Zip Code $624.43 12501 Broadway St Pearland, TX 77584 8 PURPOSE (a) Category (See Categories listed at the top of this schedule) (b) Description OF Loan Repayment/Reimbursement Check if travel outside of Texas. Complete Schedule T. EXPENDITURE Check if Austin, TX, officeholde living expense Reimbursement for previous period expenditures made from personal funds. 9 Complete ONLY if direct Candidate/Officeholder name Office sought Office held expenditure to benefit C/OH Date Payee name 09/21/2021 Adrian, Hernandez Amount ($) Payee address; City; State; Zip Code $345.43 12501 Broadway St Pearland, TX 77584 PURPOSE (a) Category (see Categories listed at the top of this schedule) (b) Description OF Check if travel outside of Texas. Complete Schedule T. EXPENDITURE Loan Repayment/Reimbursement Check if Austin, TX, officeholder living expense Reimbursement from previous period expenditures made from personal funds. Complete ONLY if direct Candidate/Officeholder name Office sought Office held expenditure to benefit C/OH Date Payee name 10/14/2021 Greg, Rincon Amount ($) Payee address; City; State; Zip Code $200.00 2524 Westminister St Pearland, 77581 TX (a) Category (See Categories listed at the top of this schedule) (b) Description PURPOSE OF Contributions/Donations Made By a check if travel outside of Texas. Complete Schedule T. EXPENDITURE Candidate/Officeholder/Political Committee Check if Austin, TX, officeholder living expense a Donation to Greg Rincon for Judge Complete ONLY if direct Candidate/Officeholder name Office sought Office held expenditure to benefit C/OH Forms provided by Texas Ethics Commission ersion V1,1. www.etnics.state.tx.us SCHEDULE POLITICAL FROM POLITICAL EXPENDITURES F1 CONTRIBUTIONS EXPENDITURE Advertising Expense Event Expense Accounting/Banking Fees Consulting Expense Food/Beverage Contributions/ Donations Made By - Gift/Awards/Memorials Candidate/Officeholder/Political Committee Legal Services Credit Card Payment The Instruction CATEGORIES FOR BOX 8(a) Loan Repayment/Reimbursement Office Overhead/Rental Expense Polling Expense Expense Printing Expense Salaries/Wages/Contract Guide explains how to complete this Solicitation/Fundraising Expense Expense Transportation Equipment & Related Expense Travel in District Travel Out of District Labor OTHER (enter a category not listed above) form. 1 Total Sch: pages Schedule 2/2 Rpt: 7/8 F1: 2 FILER Hernandez, NAME Adrian 3 Filer ID 4 Date 09/22/2021 5 Payee Pearland name Entertainment and Beverage Coalition PAC 6 Amount ($) $400.00 7 Payee 13306 Pearaldn, address; ALDER GLEN 77584 City; LN State; Zip Code TX 8 PURPOSE EXPENDITURE OF (a) Category Contributions/Donations Candidate/Officeholder/Political (See Categories listed at Made the top of this schedule) By Committee (b) Description Check if travel outside if Austin, TX, made of Texas. officeholder to SPAC. Complete Schedule T. living expense ElCheck 0 Contribution 9 Complete expenditure ONLY if direct C/OH Candidate/Officeholder name Office sought Office held to benefit Date 09/05/2021 Payee name Bartending and Catering TLC Amount ($) $1,400.00 Payee 11102 Houston, address; Sage TX King 77089 City; State; Zip Code PURPOSE OF (a) Category Event Expense (See Categories listed at the top of this schedule) (b) Description Check if if travel Austin, outside TX, for campaign of officeholder Texas. Complete living volunteer Schedule expense appreciation T. party. 0Check EXPENDITURE Catering Complete expenditure ONLY if direct C/OH Candidate/Officeholder name Office sought Office held to benefit Forms provided by Texas Ethics Commission www. etnics.state.tx. us INTEREST, CREDITS, GAINS, REFUNDS, AND CONTRIBUTIONS RETURNED TO FILER SCHEDULE K The Instruction Guide explains how to complete this form. 1 Total pages Schedule K: Sch: 1/1 Rpt: 8/8 2 FILER NAME Hernandez, Adrian 3 Filer ID 4 Date 07/01/2021 5 Name of person from whom amount is received JSC Federal Credit Union 6 Address of person from whom amount is received; City; State; Zip Code 1330 Gemini Houston, TX 77058 8 Amount ($) $0.06 7 Purpose for which amount is received Check if political cont ibution returned to filer Interest Earned Date 08/01/2021 N ame of person from whom amount is received JSC Federal Credit Union Address of person from whom amount is received; City; State; Zip Code 1330 Gemini Houston, TX 77058 Amount ($) $0.07 P urpose for which amount is received U Check if political cont ibution returned to filer Interest Earned Date 09/01/2021 N ame of person from whom amount is received JSC Federal Credit Union Address of person from whom amount is received; City; State; Zip Code 1330 Gemini Houston, TX 77058 Amount ($) $0.05 P urpose for which amount is received U Check if political cont ibution returned to filer Interest Earned Date 10/01/2021 N ame of person from whom amount is received JSC Federal Credit Union Address of person from whom amount is received; City; State; Zip Code 1330 Gemini Houston, TX 77058 Amount ($) $0.01 P urpose for which amount is received EI Check if political cont ibution returned to filer Interest Earned Forms provided by Texas Ethics Commission www.ethics.state.tx.us Version V1.1.ab979f02