JAIN RISHABH_APRIL 29 2022_CAMPAIGN FINANCE REPORTCANDIDATE / OFFICEHOLDER FORM C/OH
CAMPAIGN FINANCE REPORT COVER SHEET PG 1
The
C/OH
Instruction
Guide
explains
how
to
complete
this
form.
I
Filer
ID
(Ethics
Commission
Filers)
2
Total
pages
filed:
MS
/
MRS
/
MR
FIRST
MI
3
CANDIDATE
/
MR
OFFICEHOLDER
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NICKNAME
LAST
SUFFIX
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APR
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4
CANDIDATE
/
ADDRESS
/
PO
BOX;
APT
/
SUITE
if; CITY;
STATE;
ZIP
CODE
OFFICEHOLDER
CITY
OF
PEARLAND
MAILING
CITY
SECRETARY'S
ADDRESS
OFFICE
Change
of
Address
AREA
CODE
PHONE
NUMBER
EXTENSION
5
CANDIDATE/
Date
Hand
-delivered
or Date
Postmarked
OFFICEHOLDER
)
Receipt
#
6
CAMPAIGN
MS
/ MRS
/
MR
FIRST
MI
Amount
$
TREASURER
M
ire
r
Date
Processed
NAME
NICKNAME
LAST
SUFFIX
Wagers
Date
Imaged
7
CAMPAIGN
STREET
ADDRESS
(NO
PO
BOX
PLEASE);
APT
/ SUITE
#;
CITY;
STATE;
ZIP
CODE
TREASURER
ADDRESS
(Residence
or
Business)
8
CAMPAIGN
AREA
CODE
PHONE
NUMBER
EXTENSION
TREASURER
PHONE
9
REPORT
TYPE
January
15
30th
day
before
election
Runoff
15th
day
after
campaign
treasurer
(Officeholder
appointment
Only)
July
15
el
8th
day
before
election
[
Exceeded
Modified
Final
Report
(Attach
C/OH
-
FR)
Reporting
Limit
10
PERIOD
Month
Day
Year
Month
Day
Year
COVERED
04
/
07
/
2022
THROUGH
04
/
29
/ 2022
ELECTION
DATE
ELECTION
TYPE
11
ELECTION
Month
Day
Year
Primary
Runoff
Other
Description
N
General
Special
/
05
07�2022
12
OFFICE
HELD
(if
any)
13
OFFICE
SOUGHT
(if
known)
OFFICE
THIS
BOX
IS
FOR
NOTICE
OF
POLITICAL
CONTRIBUTIONS
ACCEPTED
OR
POLITICAL
EXPENDITURES
MADE
BY
POLITICAL
COMMITTEES
TO SUPPORT
14
NOTICE
FROM
THE
CANDIDATE
! OFFICEHOLDER.
THESE
EXPENDITURES
MAY
HAVE BEEN
MADE
WITHOUT
THE
CANDIDATE'S
OR
OFFICEHOLDER'S
KNOWLEDGE
OR
POLITICAL
CONSENT.
CANDIDATES
AND
OFFICEHOLDERS
ARE
REQUIRED
TO
REPORT
THIS
INFORMATION
ONLY
IF
THEY
RECEIVE
NOTICE
OF
SUCH
EXPENDITURES.
COMMITTEE(S)
COMMITTEE
TYPE
COMMITTEE
NAME
GENERAL
COMMITTEE
ADDRESS
Additional
Pages
SPECIFIC
COMMITTEE
CAMPAIGN
TREASURER
NAME
COMMITTEE
CAMPAIGN
TREASURER
ADDRESS
GO
TO
PAGE
2
Forms provided by Texas Ethics Commission
www.ethics.state.tx.us
Revised 8/17/2020
CANDIDATE / OFFICEHOLDER
CAMPAIGN FINANCE REPORT
FORM C/OH
COVER SHEET PG 2
15 C/OH NAME 16 Filer ID (Ethics Commission Filers)
17 CONTRIBUTION
TOTALS
1.TOTAL UNITEMIZED POLITICAL CONTRIBUTIONS (OTHER THAN
PLEDGES, LOANS, OR GUARANTEES OF LOANS, OR
CONTRIBUTIONS MADE ELECTRONICALLY)
$
2.TOTAL POLITICAL CONTRIBUTIONS
(OTHER THAN PLEDGES, LOANS, OR GUARANTEES OF LOANS)$
EXPENDITURE
TOTALS 3.TOTAL UNITEMIZED POLITICAL EXPENDITURE.$
4.TOTAL POLITICAL EXPENDITURES $
5.TOTAL POLITICAL CONTRIBUTIONS MAINTAINED AS OF THE LAST DAY
OF REPORTING PERIOD $
6.TOTAL PRINCIPAL AMOUNT OF ALL OUTSTANDING LOANS AS OF THE
LAST DAY OF THE REPORTING PERIOD $
18 SIGNATURE 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.
Signature of Candidate or Officeholder
Forms provided by Texas Ethics Commission www.ethics.state.tx.us
. . . . . . . . . . . . . . . . . . .
CONTRIBUTION
BALANCE
. . . . . . . . . . . . . . . . . .
OUTSTANDING
LOAN TOTALS
Revised 8/17/2020
Please complete either option below:
(1) Affidavit
NOTARY STAMP / SEAL
Sworn to and subscribed before me by _______________________________________________ this the ________ day of __________________,
20 ___________, to certify which, witness my hand and seal of office.
Signature of officer administering oath Printed name of officer administering oath Title of officer administering oath
(2)Unsworn Declaration
My name is _____________________________________________________, and my date of birth
Pearland TX 77584 USA
Brazoria TX 29 April 22
Forms provided by Texas Ethics Commission www.ethics.state.tx.us
SUBTOTALS - C/OH FORM C/OH
COVER SHEET PG 3
19 FILER NAME 20 Filer ID (Ethics Commission Filers)
21 SCHEDULE SUBTOTALS
NAME OF SCHEDULE
SUBTOTAL
AMOUNT
1.SCHEDULE A1: MONETARY POLITICAL CONTRIBUTIONS $
2.SCHEDULE A2: NON-MONETARY (IN-KIND) POLITICAL CONTRIBUTIONS $
3.SCHEDULE B: PLEDGED CONTRIBUTIONS $
4.SCHEDULE E: LOANS $
5.SCHEDULE F1: POLITICAL EXPENDITURES MADE FROM POLITICAL CONTRIBUTIONS $
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/O $
11.SCHEDULE I: NON-POLITICAL EXPENDITURES MADE FROM POLITICAL CONTRIBUTIONS $
12.SCHEDULE K: INTEREST, CREDITS, GAINS, REFUNDS, AND CONTRIBUTIONS RETURNED
TO FILER
H
$
Revised 8/17/2020
Rishabh Jain
47.63