KOZA JOSEPH_JANUARY 15 2023_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 CIOH Instruction Guide explains how to complete this form. LI
3 CANDIDATE/ MS/MRS/MR FIRST MI OFFICE USE ONLY
OFFICEHOLDER (fi OSt ® E
NAME Date Received
NICKNAME �LA�SST��, SUFFIX
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4 CANDIDATE/ ADDRESS /PO BOX; APT/SUITE#; CITY; STATE; ZIP CODE •,.yt S ,+
OFFICEHOLDER �i '�n
MAILING ,:JAN 1 7?�0Z3 ✓�i V
ADDRESS .
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5 CANDIDATE/ AREA CODE PHONE NUMBER , EXTENSION p���}IaR�-c{e�yq�d-� [��,Pp�ry�
�� riTY OF PEARL/,;
OFFICEHOLDER
T 7 vJ
Receipt# Amount$
6 CAMPAIGN MS I MRS/MR FIRST MI
NAMEEASURER �/�, � P/ ,1•� Date Processed
! � � � r"'Ati/
NICKNAME LAST SUFFIX
Date Imaged
e°'S,Zot1E
7 CAMPAIGN STREET ADDRESS (NO PO BOX PLEASE); APT/SUITE#; CITY; STATE; ZIP CODE
TREASURER
ADDRESS A " `� �v
(Residence or Business) ,� P � g Q
8 CAMPAIGN AREA CODE PHONE NUMBER EXTENSION
TREASURER
PHONE `�
I I 30th daybefore election I I Runoff I 15th day after campaign
January 15 treasurer appointment
(Officeholder Only)
I I July 15 I I 8th day before election I I Exceeded Modified 1 J Final Report(Attach C/OH-FR)
Reporting Limit
10 PERIOD Month Day Year Month Day Year
COVERED 1 / 6 /.D.... THROUGH ta. /3 i / aD„.
11 ELECTION ELECTION DATE ELECTION TYPE
Year El Primary ❑ Runoff El Other
Month Day Description
/ / ❑ General ❑ Special
12 OFFICE OFFICE HELD (if any) 13 OFFICE SOUGHT (if known)
Crcq COACAL 9,0 1'vyai
14 NOTICE FROM THIS BOX IS FOR NOTICE OF POLITICAL CONTRIBUTIONS ACCEPTED OR POLITICAL EXPENDITURES MADE BY POLITICAL COMMITTEES TO SUPPORT
POLITICAL THE CANDIDATE/OFFICEHOLDER. THESE EXPENDITURES MAY HAVE BEEN MADE WITHOUT THE CANDIDATE'S OR OFFICEHOLDER'S KNOWLEDGE OR
CONSENT.CANDIDATES AND OFFICEHOLDERS ARE REQUIRED TO REPORT THIS INFORMATION ONLY IF THEY RECEIVE NOTICE OF SUCH EXPENDITURES,
COMMITTEE(S)
COMMITTEE TYPE COMMITTEE NAME
COMMITTEE ADDRESS
Ell GENERAL
❑ Additional Pages
El 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 FORM C/OH
CAMPAIGN FINANCEREPORT COVER SHEET PG 2
15 C/OH NAME 16 Filer ID (Ethics Commission Filers)
. Ey.6fq E.
17 CONTRIBUTION 1. TOTAL UNITEMIZED POLITICAL CONTRIBUTIONS (OTHER THAN $
TOTALS PLEDGES,LOANS,OR GUARANTEES OF LOANS,OR
CONTRIBUTIONS MADE ELECTRONICALLY)
2. TOTAL POLITICAL CONTRIBUTIONS $ I
(OTHER THAN PLEDGES, LOANS, OR GUARANTEES OF LOANS) ® 0
EXPENDITURE 3. TOTAL UNITEMIZED POLITICAL EXPENDITURE. $
TOTALS
4. TOTAL POLITICAL EXPENDITURES $
CONTRIBUTION 5. TOTAL POLITICAL.CONTRIBUTIONS MAINTAINED AS OF THE LAST DAY rip W
BALANCE OF REPORTING PERIOD $ ' 0
OUTSTANDING 6. TOTAL PRINCIPAL AMOUNT OF ALL OUTSTANDING LOANS AS OF THE $
LOAN TOTALS 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
Please complete either option below:
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(1)Affidavit TM m vvvww a.w ww vuv
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NOTARY STAMP/SEAL Sworn to and subscribed before me by U pplik,
I
V h this the 1 day of`-� II /
Ca)U�G
20 f ,i which,witness my hand an'IL eal of offiPtUVVL
1>( We
Signal •of officer adminis ring oath Printed name of officer administering oath
TjJe of offi administering oat
OR
(2)Unsworn Declaration
My name is , and my date of birth is
My address is
(street) (city) (state) (zip code) (country)
County,State of ,on the day of ,20 .
Executed in (month) (year)
Signature of Candidate/Officeholder(Declarant)
Forms provided by Texas Ethics Commission
www.ethics.state.tx.us Revised 8/17/2020
SUBTOTALS C/OH FORM C/OH
COVER SHEET PG 3
19 FILER NAME 20 Filer ID(Ethics Commission Filers)
O A t
21 SCHEDULE SUBTOTALS SUBTOTAL
NAME OF SCHEDULE AMOUNT
1. =r SCHEDULEA1: MONETARY POLITICAL CONTRIBUTIONS $ ‘951• 00
2. I I SCHEDULE A2: NON-MONETARY(IN-KIND)POLITICAL CONTRIBUTIONS $
3. I I SCHEDULE B: PLEDGED CONTRIBUTIONS $
4. I I SCHEDULE E: LOANS $
5. SCHEDULE F1: POLITICAL EXPENDITURES MADE FROM POLITICAL CONTRIBUTIONS $
6. I I SCHEDULE F2: UNPAID INCURRED OBLIGATIONS $
7. SCHEDULE F3: PURCHASE OF INVESTMENTS MADE FROM POLITICAL CONTRIBUTIONS $
8. I I SCHEDULE F4: EXPENDITURES MADE BY CREDIT CARD $
9. I I SCHEDULE G: POLITICAL EXPENDITURES MADE FROM PERSONAL FUNDS $
10. I I SCHEDULE H: PAYMENT MADE FROM POLITICAL CONTRIBUTIONS TO A BUSINESS OF C/OH $
11. l I SCHEDULE I: NON-POLITICAL EXPENDITURES MADE FROM POLITICAL CONTRIBUTIONS $
12. I I SCHEDULE K: INTEREST, CREDITS, GAINS, REFUNDS,AND CONTRIBUTIONS RETURNED $
TO FILER
Forms provided by Texas Ethics Commission www.ethics.state.tx.us Revised 8/17/2020
MONETARY POLITICAL CONTRIBUTIONS SCHEDULE Al
If the requested information is not applicable, DO NOT include this page in the report.
1 Total pages Schedule Al:
The Instruction Guide explains how to complete this form.
2 FILER NAME 3 Filer ID (Ethics Commission Filers)
..�®s6PVA . 1
4 Date 5 Full name of contributor 0 out-of-state PAC(ID#:_ ) 7 Amount of contribution ($)
1 115
leot 6 Contributor address; City; State; Zip Code 50\v 00
a AV3 ZSGMoNtic 14144C ,P ;�' 11S L
8 Principal occupation/Job title(See Instructions) 9 Employer(See Instructions)
Date Full name of contributor ❑out-of-state PAC(ID#: ) Amount of contribution ($)
` tt �yy �. ®I
1` i® O�� Contributor address; A.ta`, City; State; Zip Code G�� 00
e •
�35O E 5-Curl TA —nun
Principal occupation/Job title(See Instructions) Employer(See Instructions)
Date Full name of contributor ❑out-of-state PAC(ID#: I Amount of contribution ($)
Contributor address; City; State; Zip Code
Principal occupation/Job title(See Instructions) Employer (See Instructions)
Date Full name of contributor 0 out-of-state PAC(ID#: ) Amount of contribution ($)
Contributor address; City; State; Zip Code
Principal occupation/Job title(See Instructions) Employer(See Instructions)
ATTACH ADDITIONAL COPIES OF THIS SCHEDULEAS NEEDED
If contributor 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 8/17/2020