Koza Joseph-January 15-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. 4
3 CANDIDATE/ MS/MRS/MR FIRST MI
OFFICEHOLDERINN.' Jc � OFFICE
NAME •
' Date Received
NICKNAME LAST SUFFIX
Itto-'` RECEIVED
4 CANDIDATE/ ADDRESS /PO BOX; APT/SUITE#; CITY* STATE; ZIP CODE
OFFICEHOLDER JAN 12 2024 15:41
MAILING D
ADDRESS P&cz-tads), "-ic -1-751` CITY OF PEARI,AN
I I Change of Address CITY SECRETARY'S OFFICE
5 CANDIDATE/ AREA CODE PHONE NUMBER EXTENSION Date Hand-delivered or Date Postmarked
OFFICEHOLDER //
PHONE
Receipt# Amount$
6 CAMPAIGN MS/MRS/MR FIRST MI
TREASURER Np 0
NAME • '' "^• J�' Date Processed
NICKNAME LAST SUFFIX
CS
Date Imaged
v�tN�
7 CAMPAIGN STREET ADDRESS (NO PO BOX PLEASE); APT/SUITE#; CITY• STATE; ZIP CODE
TREASURER
ADDRESS
8 CAMPAIGN AREA CODE PHONE NUMBER EXTENSION
TREASURER
PHONE (
9 REPORT TYPE srJanuary 15 n 30th day before election n Runoff 7 15th day after campaign
I treasurer appointment
(Officeholder Only)
n July 15 n 8th day before election ❑ Exceeded Modified ❑ Final Report(Attach C/OH FR)
Reporting Limit
10 PERIOD Month Day Year Month Day Year
COVERED
—1 / 1 /a^1J THROUGH M. /3 e /a3
11 ELECTION ELECTION DATE ELECTION TYPE
Month Day Year ❑ Primary ❑ Runoff ElOther
Description
/ / ❑ General ❑ Special
12 OFFICE OFFICE HELD (If any) 13 OFFICE SOUGHT (if known)
C CCJn4CO— i p OS to‘al�l ,
14 NOTICE FROM THIS BOX IS FOR NOTICE OF POLITICAL CONTRIBUTIONS ACCEPTED OR POLITICAL EXPENDITURES MADE BY POLITICAL COMMITTEES TO SUPPORT
POLITICAL THE CANDIDATE I 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
GENERAL COMMITTEE ADDRESS
❑ 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 11/15/2022
CANDIDATE / OFFICEHOLDER FORM C/OH
CAMPAIGN FINANCE REPORT COVER SHEET PG 2
15 C/OH NAME 16 Filer ID (Ethics Commission Filers)
.. �o
17 CONTRIBUTION 1 TOTAL UNITEMIZED POLITICAL CONTRIBUTIONS (OTHER THAN
TOTALS PLEDGES, LOANS OR GUARANTEES OF LOANS,OR $
CONTRIBUTIONS MADE ELECTRONICALLY)
2. TOTAL POLITICAL CONTRIBUTIONS
(OTHER THAN PLEDGES LOANS, OR GUARANTEES OF LOANS) !Do.ao
TOTANS ITURE 3 TOTAL UNITEMIZED POLITICAL EXPENDITURE. $
4 TOTAL POLITICAL EXPENDITURES $
CONTRIBUTION 5 TOTAL POLITICAL CONTRIBUTIONS MAINTAINED AS OF THE LAST DAY
BALANCE OF REPORTING PERIOD $ .c3l�� %a
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.
Si ature of Candidate or Officeholder
Please complete either option below.
(1)Affidavit
� i GLADIS SANCHEZ
.`
�P�••!;m'.
r°t...Notary Public,State of Texas
.• Comm.Expires 02-24-2024
Notary ID 130553701
NOTARY STAMP/SE/ G�, V; /�
444
Sworn to and subscribed before me by �1 i e� /4 • KV vu this the 1
Tr, x day of {
20 2./4 ,to certify which,witness my hand and seal of office.
ign� u4, ' C-�' tgci>,S Sav>!.chte� 099 �'i Iry GYe'�c�yy�
ig re of officer administering oath Printed name of officer administering oath Title of officer&dministering oat
OR
(2) Unsworn Declaration
My name is , and my date of birth Is
My address is ,
(street) (city) (state) (zip code) (country)
Executed in County,State of ,on the day of ,20
(month) (year)
Signature of Candidate/Officeholder (Declarant)
Forms provided by Texas Ethics Commission www.ethics.state.tx.us Revised 11/15/2022
SUBTOTALS - C/OH FORM C/OH
COVER SHEET PG 3
19 FILER NAME r 20 Filer ID(Ethics Commission Filers)
�oPA . t
21 SCHEDULE SUBTOTALS SUBTOTAL
NAME OF SCHEDULE AMOUNT
1 Nr.SCHEDULEA1 MONETARY POLITICAL CONTRIBUTIONS $ /t Q oo
2. ❑ SCHEDULE A2: NON-MONETARY(IN-KIND)POLITICAL CONTRIBUTIONS $
3 n SCHEDULE B. PLEDGED CONTRIBUTIONS $
4 n SCHEDULE E. LOANS $
5. I I SCHEDULE F1 POLITICAL EXPENDITURES MADE FROM POLITICAL CONTRIBUTIONS $
6 n SCHEDULE F2: UNPAID INCURRED OBLIGATIONS $
7 n SCHEDULE F3. PURCHASE OF INVESTMENTS MADE FROM POLITICAL CONTRIBUTIONS $
8. SCHEDULE F4 EXPENDITURES MADE BY CREDIT CARD $
9. Ei SCHEDULE G. POLITICAL EXPENDITURES MADE FROM PERSONAL FUNDS $
10. n SCHEDULE H: PAYMENT MADE FROM POLITICAL CONTRIBUTIONS TO A BUSINESS OF C/OH $
11 n SCHEDULE I: NON-POLITICAL EXPENDITURES MADE FROM POLITICAL CONTRIBUTIONS $
12. SCHEDULE K. INTEREST CREDITS, GAINS, REFUNDS,AND CONTRIBUTIONS RETURNED $
TO FILER
Forms provided by Texas Ethics Commission www.ethics.state.tx.us Revised 11/15/2022
MONETARY POLITICAL CONTRIBUTIONS SCHEDULE Al
If the requested information is not applicable, DO NOT include this page in the report.
The Instruction Guide explains how to complete this form. 1 Total pages Schedule Al
2 FILER NAME 3 Filer ID (Ethics Commission Filers)
iL
4 Date 5 Full name of contributor 0 out-of-state PAC(ID#• ) 7 Amount of contribution ($)
k •
JD I 13 1Z3 6 Contributor address; City; State, Zip Code t 00.0
1�\3
Z350 A E-st Z 1406 , 1\45roiJ
8 Principal occupation/Job title(See Instructions) g Employer(See Instructions)
Date Full name of contributor 0 out-of-state PAC(ID#• ) Amount of contribution ($)
Contributor address; City- State; Zip Code
Principal occupation/Job title(See Instructions) Employer (See Instructions)
Date Full name of contributor 0 out-of-state PAC(ID#• ) Amount of contribution ($)
Contributor address; City State; Zip Code
Principal occupation/Job title (See Instructions) Employer(See Instructions)
Date Full name of contributor 0 out-of-state PAC(ID#• ) Amount of contribution ($)
Contributor address; City• State; Zip Code
Principal occupation/Job title(See Instructions) Employer(See Instructions)
ATTACH ADDITIONAL COPIES OF THIS SCHEDULE AS 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 11/15/2022