specific-purpose committee form spac … · specific-purpose committee campaign finance report ......

SPECIFIC-PURPOSE COMMITTEE CAMPAIGN FINANCE REPORT

The SPAC Instruction Guide explains how to complete this form.

3 COMMITTEE NAME

Friends of North Shore Fire Department

1 Filer ID

8994 FORM SPAC

COVER SHEET PG 1

2 Total pages filed:

23

OFFICE USE ONLY Date R.,,;ell'ed

4 COMMITTEE ADDRESS

ADDRESS I PO BOX; APT I SUITE #; CITY;

1505 Jackie Robinson Pl

STATE; ZIP CODE

D Change o1 Address

5 CAMPAIGN TREASURER NAME

6 CAMPAIGN TREASURER STREET ADDRESS

(ResKleJJCe or Business)

7 CAMPAIGN TREASURER MAILING ADDRESS

D Char>Qe of Address

8 CAMPAIGN TREASURER PHONE

' REPORT TYPE

10 PERIOD COVERED

11 ELECTION

Date Hlihd-Oeltvered or oate-Postma!l<ed

Round Rock, TX 78665 Rece1p1 #

Date Processed

Date Imaged

MS/MRS/MR FIRST Ml

Michael c ........................................................................................................................................................................ NICKNAME LAST

Johnson STREET ADDRESS (NO PO BOX PLEASE);


APT I SUITE#;

STREET OR PO BOX; APT I SUITE#;


AREA CODE PHONE NUMBER EXTENSION

512-740-3108

0 January 15

o July 15

O 30th day before elechon

D 8th day before election

O Runoff

SUFFIX

CITY; STATE; ZIP CODE

Round Rock TX 7866

CITY; STATE; ZIP CODE

Round Rock TX 7866

D Exceeded $500 Limit

[Kl Dissolution (Attach PAC·DR)

0 10th_day alter campaign treasurer termination

Month Day Year Month Day Year

1110112016

ELECTION DATE

Month Day Year

11108/2016

THROUGH

GJ Primary

D General

GOTO PAGE2

ELECTION TYPE

D Runoff

O Special

1213112016

oacher

orms prov1aea oy 1 exas t:.tn1cs comm1ss1on www.etrucs.state.tx.us version V .

SPECIFIC-PURPOSE COMMITTEE REPORT: FORM SPAC PURPOSE AND TOTALS COVER SHEET PG 2

12 COMMITTEE NAME 13 Filer ID


14 COMMITTEE CANDIDATE I OFFICEHOLDER NAME PURPOSE

(Attach lists on plain D Candidate paper to complete this report if necessary.) D Officeholder OFFICE SOUGHT (candidate) I OFFICE HELD (officeholder)

[g] SUPPORT

(Candidate or Measure) BALLOT IDENTIFICATION f# ELECTION DATE

D OPPOSE Prop 1 Month Day Year

(Candidate or Measure) 11/08/2016

D ASSIST [!}Measure

DESCRIPTION (Officeholder)

Emergency Service District Overlay, ESD # 7 Fire Department

15 CONTRIBUTION 1. TOTAL POLITICAL CONTRIBUTIONS OF $50 OR LESS (OTHER THAN PLEDGES, TOTALS LOANS, OR GUARANTEES OF LOANS), UNLESS ITEMIZED $ $337.41

2. TOT AL POLITICAL CONTRIBUTIONS

(OTHER THAN PLEDGES, LOANS, OR GUARANTEES OF LOANS) $ $4,927.41

------------EXPENDITURE 3. TOT AL POLITICAL EXPENDITURES OF $100 OR LESS, UNLESS ITEMIZED TOTALS $ $0.00

4. TOTAL POLITICAL EXPENDITURES $ $4,927.41

i--------------CONTRIBUTION 5. TOTAL POLITICAL CONTRIBUTIONS MAINTAINED AS OF THE LAST DAY OF THE BALANCE REPORTING PERIOD $ $0.00

------------OUTSTANDING 6. TOTAL PRINCIPAL AMOUNT OF ALL OUTSTANDING LOANS AS OF THE LAST LOAN TOTALS DAY OF THE REPORTING PERIOD $ $0.00

16 AFFIDAVIT

"'"""• CHIRAG PATEL I swear, or affirm, under penalty of perjury, that the accompanying report is true

,•'~• "" '•,~ ! T and correct and includes all information required to be reported by me under

!J.*"!'~ -,., No101y Public. State o exos Title 15, Election Code . • "". •<' ~ %,;\_ )i] comm. Exp11es 01 JQ-2019

~Campaigo T"a"'"'

-,,::€·;,;1.'-~~ Nolorv 10 1 l008120l ''""""

AFFIX NOTARY STAMP I SEAL ABOVE

Sworn to and subscribed before me, by the said M;,h.,r (. John.SOo, , this the l7 .... day

of :i-... '"'ry ,20 17 , to certify which, witness my hand and seal of office.

C{Jj/ Ci.;,.. If),./ •" "'I:- ~/Jc. .,f ~-- -Signature of officer administering oath Printed name'bf officer administering oath Title' of officer administering oath

arms prov1aea oy 1 exas t:.tn1cs comm1ss1on www.etn1cs.state.tx.us version vl.0.L~.l

SUBTOTALS - SPAC FORM SPAC COVER SHEET PG 3

3 of 23



19 SCHEDULE SUBTOTALS

NAME OF SCHEDULE SUBTOTAL AMOUNT

1. 0 SCHEDULE Al: MONETARY POLITICAL CONTRIBUTIONS $ 4,927.41

2. D SCHEDULE A2: NON-MONETARY (IN-KIND) POLITICAL CONTRIBUTIONS $

3. D SCHEDULE B: PLEDGED CONTRIBUTIONS $

4. D SCHEDULE Cl: MONET ARY CONTRIBUTIONS FROM CORPORATION OR LABOR

$ ORGANIZATION

5 D SCHEDULE C2: NON-MONETARY (IN-KIND) CONTRIBUTIONS FROM CORPORATION OR

$ LABOR ORGANIZATION

6. D SCHEDULED: PLEDGED CONTRIBUTIONS FROM CORPORATION OR LABOR ORGANIZATION $

7. D SCHEDULE E: LOANS $

8. 0 SCHEDULE Fl: POLITICAL EXPENDITURES FROM POLITICAL CONTRIBUTIONS $ 4,927.41

9 D SCHEDULE F2: UNPAID INCURRED OBLIGATIONS $

10. D SCHEDULE F3: PURCHASE OF INVESTMENTS FROM POLITICAL CONTRIBUTIONS $

11. D SCHEDULE F4: EXPENDITURES MADE BY CREDIT CARD $

12. D SCHEDULE H: PAYMENT FROM POLITICAL CONTRIBUTIONS TO A BUSINESS OF C/OH $

13. D SCHEDULE I: NON-POLITICAL EXPENDITURES FROM POLITICAL CONTRIBUTIONS $

14. D SCHEDULE K: INTEREST, CREDITS, GAINS, REFUNDS, AND CONTRIBUTIONS RETURNED

$ TO FILER

orms prov1aeu uy 1 exas Ethics Comm1ss1on www.etn1cs.state.tx.us Version vl.U.L::>.1-v

MONETARY POLITICAL CONTRIBUTIONS SCHEDULE Al

The Instruction Guide explains how to complete this form. 1 Total pages Schedule Al:

Sch: 1/17 Rpt: 4/23

2 FILER NAME 3 Filer ID


4 Date 5 Full name of contributor D out-ot-state PAC (ID#: ' 7 Amount of Contribution {$)

12102/2016 Buck, Taylor $50.00 ................................................................................... ........................................................................ 6 Contributor address; City; State; Zip Code

12525 Enchanted Forest Dr

Austin, TX 78727

8 Principal occupation I Job title (See Instructions) 9 Employer (See Instructions)

Firefighter TCESDl

Date Full name of contributor D out-of-state PAC {ID#: ' Amount of Contribution ($)

11/1612016 Buck, Taylor $50.00 ................................................................ ................... .......................................................................

Contributor address; City; State; Zip Code


Austin, TX 78727

Principal occupation I Job title (See Instructions} Employer (See Instructions)

Firefighter TCESDl

Date Full name of contributor D OU(-of-state PAC (ID#: ' Amount of Contribution ($)

11/30/2016 Buck, Taylor $50.00 ................................................. .......................................................... ...............................................



Austin, TX 78727

Principal occupation I Job title (See Instructions) Employer (See Instructions)

Firefighter TCESDl

Date Full name of contributor D out-of-state PAC (10#: ' Amount of Contribution ($)

11/0212016 Buckley, Charles $50.00 ................................................................................................... ........................................................


21118 Highland Lake Dr

#2 Lago Vista, TX 78645


Firefighter TCESD 1

Date Full name of contributor D out-of-state PAC (ID#: ' Amount of Contribution ($)

11/16/2016 Buckley, Charles $50.00 .................................................... .............................................. ........................................................

Contributor address: City; State; Zip Code




Firefighter TCESD 1

arms prov1oeo oy 1 exas t:.tn1cs Comm1ss1on www.etn1cs.state.tx.us version v1.u."-".1

MONETARY POLITICAL CONTRIBUTIONS Al SCHEDULE

The Instruction Guide explains how to complete this form. 1 Total pages Schedule A1:

Sch: 2/17 Rpt: 5/23

2 FILER NAME 3 Filerro


4 Date 5 Full name of contributor D out-of-state PAC (10#: ' 7 Amount of Contribution ($)

11/30/2016 Buckley, Charles $50.00 ··················································· ................................ ....................................................................... 6 Contributor address; City; State; Zip Code



8 Principal occupation I Job title (See Instructions) 9 Employer {See Instructions)

Firefighter TCESD 1


11/02/2016 Campbell, Tim $50.00 ........................................ .................................. ........... .. ..................................................................


609 Highcrest Dr

# 112 Granite Shoals, TX 78654


Firefighter TCESD 1

Date Full name of contributor D out·Of·state PAC {ID#: ' Amount of Contribution ($)

11116/2016 Campbell, Tim $50.00 ...................................................................... ............. .. .....................................................................


609 Highcrest Dr


Principal occupation I Job title (See Instructions) Employer {See Instructions)

Firefighter TCESD 1

Date Full name of contributor D out.of.state PAC (ID#: ' Amount of Contribution {$)

11/30/2016 Campbell, Tim $50.00 .................................................... ................................ . ...................... ..............................................


609 Highcrest Dr



Firefighter TCESD 1

Date Full name of contributor D OLit·Of·state PAC (ID#: ' Amount of Contribution ($)

11102/2016 Condit. Dustin $25.00 .................................................................................... .......................................................................


13304 lvywood Cv

Austin, TX 78729

Principal occupation/ Job title {See Instructions) Employer (See Instructions)

Firefighter TCESDl

arms prov1aea ay 1 exas ttrncs 1...omm1ss1on www.etn1cs.state.tx.us Version v.1..U . .::::iJ


The Instruction Guide explains how to complete this form. l Total pages Schedule Al:

Sch: 3/17 Rpt: 6123



4 Date 5 Full name of contributor D out-of-state PAC (ID#: ' 7 Amount ol Contribution ($)

11116/2016 Condit, Dustin $25.00 .................................................... ..................................... ...................... ·········································· 6 Contributor address; City; State; Zip Code

13304 lvywood Cv

Austin, TX 78729


Firefighter TCESDl


11/3012016 Condit. Dustin $25.00 ........................................................................ ........... . ......................................................................


13304 lvywood Cv

Austin, TX 78729


Firefighter TCESDl

Date Full name of contributor D out-of-suue PAC (ID#: ' Amount of Contribution ($)

1110212016 Daigle, David $50.00 ................................................... .............................................................. .................. ······················


1007 Oak Hollow Dr

Leander, TX 78641


Fireifghter TCESDl


11116/2016 Daigle, David $50.00 .. ............................................................................................................ ············································


1007 Oak Hollow Dr

Leander, TX 78641


Fireifghter TCESDl

Date Full name of contributor D oui-ot-s!ate PAC (IDlt: ' Amount of Contribution ($)

1113012016 Daigle, David $50.00

················································· ............................... ........................ ................................................. Contributor address; City; State; Zip Code

1007 Oak Hollow Dr

Leander, TX 78641


Fireifghter TCESDl

arms rov1ueu u1 1 ex as Et~ 1cs comm1ss1on p y www.etn1cs.state.tx.us Version v ,1..v."-:0.1.


1 Total pages Schedule Al: The Instruction Guide explains how to complete this form.

Sch: 4/17 Rpt: 7/23



4 Date 5 Full name of contributor D out-of-state PAC (ID#: ' 7 Amount of Contribution ($)

1V02/2016 Davidson, Mark $75.00 ............................................................................................................. ...................... . ...................... 6 Contributor address; City; State; Zip Code

16920 Tidewater Cove

Austin, TX 78717

8 Principal occupation I Job trtle (See Instructions) 9 Employer (See Instructions)

Firefighter TCESDl

Date Full name of contributor D out-of-state PAC (ID#: ' Amount of Contribution {$)

11/16/2016 Davidson, Mark $75.00 ...................................................... ...................................... . .............................................................



Austin, TX 78717


Firefighter TCESDl


1113012016 Davidson, Mark $75.00 ................................................... ............................................ . ..........................................................



Austin, TX 78717

Principal occupation I Job title {See Instructions) Employer (See Instructions)

Firefighter TCESDl

Date Full name of contributor D out-of-state PAC (ID#; ' Amount of Contribution ($)

11/0212016 Dicks, Honri $50.00 ........................................................................................ .............. ··················································


2000 S Lakeline Blvd

Cedar Park, TX 78619

Principal occupation/ Job title {See Instructions) Employer (See Instructions)

Firefighter TCESDl


1111612016 Dicks, Honri $50.00 ·················································································· ................... ·····················································




Principal occupation/ Job title (See Instructions) Employer (See Instructions)

Firefighter TCESDl

orms prov1aea oy 1 exas i::.tr 1cs 1..-omm1ss1on www.etn1cs.state.tx.us Version Vl.U.£::rJ.v



Sch: 5/17 Rpt: 8123




11/30/2016 Dicks, Honri $50.00 ..................................................................................... ......................... . ....................... ................... 6 Contributor address; City; State; Zip Code




Firefighter TCESDl


11/02/2016 Gammon, Will $50.00 ...................................................................................................... ·····················································


2932 Angelina Dr

Round Rock, TX 78665


Firefighter TCESDl

Date Full name of contributor D OUt·of·slate PAC (10#; ' Amount of Contribution ($)

1111612016 Gammon, Will $50.00 ···················································· ·············································· ························································


2932 Angelina Dr



Firefighter TCESDl

Date Full name of contributor D OUt·of·sta!e PAC (ID#: ) Amount of Contribution ($)

11/30/2016 Gammon, Will $50.00 ................................................................................................... .......................................... ·············


2932 Angelina Dr



Firefighter TCESDl

Date Full name of contributor D OUt·of·slate PAC (ID#: ) Amount of Contribution ($)

1110212016 Garner, Britney $25.00 ................................................... ································ ·················· ·················· .................................

Contributor address; City; State: Zip Code

5405 Barcelona Ct

Georgetown, TX 78628


Firefighter TCESD 1

orms prov1aea oy 1 exas ~1111cs 1.....omm1ss1on www.etn1cs.state.tx.us version vl.U.L::>J.


The Instruction Guide explains how to complete this form. 1 Total pages Schedule Al:

Sch: 6/17 Rpt: 9123



4 Date 5 Full name of contributor D out·of-state PAC (ID#: ' 7 Amount of Contribution ($)

11/1612016 Garner, Britney $25.00 ················································· .................................................... ····················································· 6 Contributor address; City; State; Zip Code

5405 Barcelona Ct



Firefighter TCESD 1


11/3012016 Garner, Britney $25.00 ............................................................................................. ..... . ........................................ ·············· Contributor address; City; State: Zip Code

5405 Barcelona Ct



Firefighter TCESD 1

Date Full name of contributor D out.of-state PAC {ID#: ' Amount of Contribution ($)

1110212016 Garner, Charles $45.00 ............................................... ..... ............................ ··································· . ...................... ...........


25200 Ranch Rd

Leander, TX 78645


Firefighter TCESD 1


11/1612016 Garner, Charles $45.00 ..................................................... .................................. ······················· . ........... ····························

Contributor address; City: State; Zip Code

25200 Ranch Rd

Leander, TX 78645


Firefighter TCESD 1


1113012016 Garner, Charles $45.00 .................................................................... ........................ .............................. ...............................

Contributor address: City; State: Zip Code

25200 Ranch Rd

Leander, TX 78645


Firefighter TCESD 1

Forms provided oy 1 exas t:tn1cs comm1ss1on www.eh11cs.state.tx.us version Vl.u.~ .......



Sch: 7/17 Rpt: 10/23



4 Date 5 Full name of contributor D out-of-state PAC {ID#: ' 7 Amount of Contribution ($)

11/0212016 Gray, Devin $50.00 ............................................................................ ..................................... . ........................................ 6 Contributor address; City; State; Zip Code

9009 Great Hills Trail

# 1515

Austin, TX 78759

8 Principal occupation I Job title (See Instructions) 9 Employer (see Instructions)

Firefighter TCESDl

Date Full name of contributor D out-of-state PAC (1011: ' Amount of Contribution ($)

11/16/2016 Gray, Devin $50.00 ······················································· ········································· ..........................................................



# 1515 Austin, TX 78759


Firefighter TCESDl

Date Full name of contributor D OLil·Of·state PAC (ID#: l Amount of Contribution ($)

11/30/2016 Gray, Devin $50.00 ....................................................................................................... ......................................... ..........



# 1515 Austin, TX 78759


Firefighter TCESDl

Date Full name of contributor D out·Of·state PAC (ID#: l Amount of Contribution ($)

11/0212016 Hancock, Sammy $50.00 ................................................. ............................................... ........... .. ............... ······················· .. ..


7933 Mountain View Rd

Aubrey, TX 76227


Firefighter TCESD 1

Date Full name of contributor D out-of-state PAC (ID#: l Amount of Contribution ($)

11/16/2016 Hancock, Sammy $50.00 ... .............................................................. ................... ............ ............................. ..........................

Contributor address: City; State: Zip Code


Aubrey, TX 76227


Firefighter TCESD 1

;:arms prov1aea oy 1 exas t:.tr tcs 1.,,..omm1ss1on www.etn1cs.state.tx.us version v.1..U . .0:0.1.0


The Instruction Guide explains how to complete this form. l Total pages Schedule Al:

Sch: 8/17 Rpt: 11/23



4 Date 5 Full name of contributor D out-of-state PAC (ID#; ' 7 Amount of Contribution ($)

11/30/2016 Hancock, Sammy $50.00 ................................................................ ······································ . ................................................... 6 Contributor address: City: State; Zip Code


Aubrey, TX 76227

8 Principal occupation I Job title {See Instructions) 9 Employer (See Instructions)

Firefighter TCESD 1

Date Full name Of contributor D ou1-of-state PAC (ID#: ) Amount of Contribution{$)

1110212016 Hert, John $75.00 .................................................... .................................. ........... ···································· ....... ..... . ....


8001RR1869

Liberty Hill, TX 78642


Firefighter TCESDl

Date Full name of contributor D out-ot-state PAC (ID#: ) Amount of Contribution ($)

1111612016 Hert, John $75.00 .................................................................................... ··································· . .......... .......................


8001RR1869


Principal occupation I Job tide (See Instructions) Employer {See Instructions)

Firefighter TCESDl


1113012016 Hert, John $75.00 ............................................................... .......................... ························ . ......... .............................


8001RR1869



Firefighter TCESDl

Date Full name of contributor D out-o!-state PAC (ID#: ' Amount of Contribution ($)

1110212016 Jackson, Troy $100.00 .... ................................................. ....................................... ................................................ ............


12813 Wire Rd

Leander, TX 78641

Principal occupation I Job tide (See Instructions) Employer (See Instructions)

Firefighter TCESDl

::arms prov1aea oy 1 exas t:.tn1cs comm1ss1on www.eth1cs.state.tx.us version ..... u.~ .... 1



Sch: 9/17 Rpt: 12123




11/16/2016 Jackson, Troy $100.00 .................................................................................... ............................................ .......................... • Contributor address; City; State; Zip Code

12813 Wire Rd

Leander, TX 78641

8 Principal occupation I Job title (see Instructions) 9 Employer (See Instructions)

Firefighter TCESDl


11/30/2016 Jackson, Troy $100.00 ······························································· ·················· .........................................................................


12813 Wire Rd

Leander, TX 78641


Firefighter TCESDl

Date Full name of contributor D out-al-state PAC (ID#. ' Amount of Contribution{$)

11/02/2016 Johnson, Michael $50.00 .... ................................................. ··················································· ·················································




Principal occupation f Job title (See Instructions) Employer (see Instructions)

Firefighter TCESDl

Date Full name of contributor D out-of-state PAC {ID#: ' Amount of Contribution ($)

11116/2016 Johnson, Michael $50.00 ................................................... ······························· ..................................... ..................................





Firefighter TCESD1


11/30!2016 Johnson, Michael $50.00

······························································· .................. ......................................................................... Contributor address: City; State; Zip Code




Firefighter TCESDl

orms prov1aea oy 1 exas t:.t1 1cs L-Omm1ss1on www.etn1cs.state.bc.us version V1.u."":::1.1 .. v



Sch: 10/17 Rpt: 13/23




11102/2016 Kenny, Dylan $50.00 .................................................................................. ...................................... ······················· . ......... 6 Contributor address; City; State: Zip Code

305 Finn St

Hutto, TX 78634


Firefighter TCESDl

Date Full name of contributor D out-of-state PAC (ID#: ' Amount of Contnbut1on ($)

11/1612016 Kenny, Dylan $50.00 ...................................................... ··················································· ·················································


305 Finn St

Hutto, TX 78634


Firefighter TCESDl

Date Full name of contributor D DUt·of·state PAC (ID#: ' Amount of Contribution ($)

1113012016 Kenny, Dylan $50.00 ... ................................................ ............................................ ..........................................................


305 Finn St

Hutto, TX 78634

Principal occupation I Job title (see Instructions) Employer (See Instructions)

Firefighter TCESDl

Date Full name of contributor D out-of·state PAC (ID#: ' Amount of Contribution ($)

1110212016 Mcdonald, Chris $50.00 .......................................... ................................................................. ···············································


1203 North Crest

Granite Shoals, TX 78654


Firefighter TCESDl


1111612016 Mcdonald, Chris $50.00

······················································· ······························· .................................................................... Contributor address; City; State; Zip Code

1203 North Crest



Firefighter TCESDl

orms prov1aea ay 1 exas t:.trucs L.Omm1ss1on www.etn1cs.state.tx.us version vl.U.L:::oJ.



Sch: 11117 Rpt: 14123



4 Date 5 Full name of contributor D out-of-state PAC (ID#: , 7 Amount of Contribution ($)

11/3012016 Mcdonald, Chris $50.00 ...................................................................... .............. . ..................................................................... 6 Contributor address; City; State: Zip Code

1203 North Crest


• Principal occupation I Job title (See Instructions) 9 Employer (See Instructions}

Firefighter TCESDl


1110212016 Ming, Robert $50.00 ....................................................... ........... .............. .. ....................................................................... Contributor address; City; State; Zip Code

1745 CR 262

Geotgetown, TX 78633


Firefighter TCESDl

Date Full name of contributor D OUt·of·state PAC (ID#: ' Amount of Contribution ($)

11/16/2016 Ming, Robert $50.00 ...................................................... ······································ . .............................................................


1745 CR 262



Firefighter TCESDl

Date Full name of contributor D out-of-state PAC (ID#: , Amount of Contribution ($)

11/30/2016 Ming, Robert $50.00 ................................................................. .............. .. .......................................................................


1745 CR 262



Firefighter TCESDl

Date Full name of contributor 0 out-of-state PAC (ID#: ' Amount of Contribution ($)

1110212016 Norman, Donnie $50.00 ······················································· ......................... ..........................................................................


22109 Cross Timber Bend

Lago Vista, TX 78645-4812


Firefighter TCESD 1

arms prov1aea oy 1 exas t:trucs 1...omm1ss1on www.etn1cs.state.tx.us Version Vl.O . .i:::r.i



Sch: 12/17 Rpt: 15/23



4 Date 5 Full name of contributor D out·of-state PAC (ID#: ' 7 Amount of Contribution ($)

11/16/2016 Norman, Donnie $50.00 ···························································· ............................................. ················································· 6 Contributor address; City; State; Zip Code




Firefighter TCESD 1

Date Full name of contributor D out-of-state PAC (ID#; l Amount of Contribution ($)

11/30/2016 Norman, Donnie $50.00 ... .......................................................................................................... . ......... ··································




Principal occupation f Job title (See Instructions) Employer (See Instructions)

Firefighter TCESD 1


1110212016 Oliver, Asa $60.00 ······················································ ········································· ..... ·········································· ··········


PO Box 541

Marble Falls, TX 78654


Firefighter TCESDl

Date Full name of contributor D out-of-state PAC (ID#; ' Amount of Contribution ($)

11/1612016 Oliver, Asa $60.00 ................................................................................................ ...... . ............................. .....................


PO Box 541



Firefighter TCESDl


11/30/2016 Oliver, Asa $60.00

···························································· .................... ·························· ··············································· Contributor address; City; State; Zip Code

PO Box 541



Firefighter TCESDl

orms prov1aea oy 1 exas tln1cs 1...omm1ss1on www.etn1cs.state.tx.us version Vl.U . .::::iJ.o



Sch: 13117 Rpt: 16/23



4 Date 5 Full name of contributor D Out-of-state PAC {ID#: ' 7 Amount ol Contribution{$)

11/0212016 Pipkin, David $50.00 .......................................... ...... ................................ ......................................................................... • Contributor address; City: State: Zip Code

1018 Terrace Dr

Leander, TX 78641

8 Principal occupation I Job title (See Instructions) • Employer (See Instructions)

Firefighter TCESD 1


11/16/2016 Pipkin, David $50.00 ............................................................................................................... ....................... ···················· Contributor address; City; State; Zip Code

1018 Terrace Dr

Leander, TX 78641


Firefighter TCESD 1


11130/2016 Pipkin, David $50.00 ...................................................................................................... ······················· ····························· Contributor address; City; State; Zip Code

1018 Terrace Dr

Leander, TX 78641

Principal occupation I Job title (See Instructions) Employer (see Instructions)

Firefighter TCESD 1


11/0212016 Ringstaff, James $50.00 .................................................................................... ························ ..... ........................................


851CR177

Leander, TX 78641


Firefighter TCESD 1


11116/2016 Ringstaff, James $50.00 ................................................ ................................. ......................... ................................... ...........


851CR177

Leander, TX 78641


Firefighter TCESD 1

orms prov1aea oy 1 exas t:tn1cs t..omm1ss1on www.etn1cs.state.tx.us version ..... u.~~1



Sch: 14117 Rpt 17/23



4 Date 5 Full name of contributor D out-of-state PAC (ID#: l 7 Amount of Contribution ($)

11/30/2016 Ringstaff, James $50.00 ··········································· ············································ ................... ............... ............................... 6 Contributor address; City; State; Zip Code

851CR177

Leander, TX 78641


Firefighter TCESD 1

Date Full name of contributor D out-of-state PAC (10#; l Amount of Contribution ($)

11/0212016 Robeson, Tim $100.00 ................................................................................................................... ........... ···························· Contributor address: City; State; Zip Code

300 Terry Ln

Leander, TX 78641


Firefighter TCESDl

Date Full name of contributor D out-of·state PAC (ID#: l Amount of Contribution ($)

11/16/2016 Robeson, Tim $100.00 ······················································· ······································ ..... ····································· ............ . ...

Contributor address; City: State: Zip Code

300 Terry Ln

Leander, TX 78641


Firefighter TCESDl

Dale Full name of contributor D out-of-state PAC (10#: l Amount of Contribution ($)

11/3012016 Robeson, Tim $100.00 ........................................... ..... ................................ . ....................................................... ················


300 Terry Ln

Leander, TX 78641


Firefighter TCESDl


11/0212016 Stengel, Brannon $100.00 ............................................................ ························ ············································ .........................


25 Waters Edge Cir



Firefighter TCESD 1

orms prov1ued oy 1 exas t:.tr 1cs L:omm1ss1on www.etrucs.state.tx.us version ' .... u .... .., ...



Sch: 15117 Rpt: 18/23



4 Date 5 Full name of contributor D Ou!-ol-sta!e PAC (ID#: ' 7 Amount of Contribution ($)

11/16/2016 Stengel, Brannon $100.00 ··················································· ······························ ................... ..................................................... 6 Contributor address; City; State; Zip Code

25 Waters Edge Cir


8 Principal occupation f Job title (See Instructions) 9 Employer (See Instructions)

Firefighter TCESD 1


1113012016 Stengel, Brannon $100.00 ····························································· ························· ....................................................................


25 Waters Edge Cir



Firefighter TCESD 1

Date Full name of contributor D OUl·Of·state PAC (ID#: ' Amount of Contribution ($)

1110212016 Sukup, Chris $50.00 .................................................................. ·················· . ..................................................................... Contributor address; City; State; Zip Code

20706 Park Dr

Lago Vista, TX 78645


Firefighter TCESDl


11/1612016 Sukup, Chris $50.00 ................................................. ································ ································ ............. ..........................


20706 Park Dr


Principal occupation I Job title (See Instructions) Employer (see Instructions)

Firefighter TCESDl

Date Full name of contributor D out-of-state PAC (ID#: Amount of Contribution ($)

1113012016 Sukup, Chris $50.00 ················································ ...................................... ............ .......................................................


20706 Park Dr



Firefighter TCESDl

orms prov1oeo oy 1 exas 1::.tn1cs L.omm1ss1on www.etn1cs.state.tx.us Version vl.u . .::.~,.



Sch: 16/17 Rpt: 19/23




1110212016 Thomason, Ty $25.00 ............................................................................................. ······························································ 6 Contributor address; City; State; Zip Code

1101 Brushy Creek Rd

cedar Park, TX 78613

8 Principal occupation I Job title (See Instructions) • Employer (See Instructions)

Frefighter TCESD 1


11/16/2016 Thomason, Ty $25.00 ............................................................ ...... ................ . .......................... ···········································





Frefighter TCESD 1

Date Full name of contributor D out·of·state PAC {ID#: ' Amount of Contribution ($)

11/30/2016 Thomason, Ty $25.00 ............................................................................................................... ············································





Frefighter TCESD 1

Date Full name of contributor D out-Of·state PAC (ID#: ' Amount of Contribution ($)

11/0212016 Troxtell, Kyle $50.00 ...................................................... ····························· . .................... ·················································


13108 Country Trail

Austin, TX 78732


Firefighter TCESD 1

Date Full name of contributor D OUt·Of·state PAC (10#: ' Amount of Contribution ($)

11/16/2016 Troxtell, Kyle $50.00 ................................................................................................ ...........................................................


13108 Country Trail

Austin, TX 78732


Firefighter TCESD 1

orms prov1aea oy 1 exas t:.tn1cs .._.omm1ss1on www.eth1cs.state.tx.us version Vl.O . ..:~J.o



Sch: 17/17 Rpt: 20/23




11/30/2016 Troxtell, Kyle $50.00 ................................................... ....................................... ································································ 6 Contributor address: City; State; Zip Code

13108 Country Trail

Austin, TX 78732

• Principal occupation I Job title (See Instructions) 9 Employer (See Instructions)

Firefighter TCESD 1


11/02/2016 White, James $50.00 .... ··············································· ................................ ......................................................................


2737 Crimson Sky Ct



Firefighter TCESD 1


11116/2016 White, James $50.00 ······················································ ··················································· ..... ···········································


2737 Crimson Sky Ct


Principal occupation I Job tide (See Instructions) Employer (See Instructions)

Firefighter TCESD 1

Date Full name of contributor D out-of-state PAC (ID#. ) Amount of Contribution ($)

11/30/2016 White, James $50.00 .... ................................................................................ ................... ······························ ...................


2737 Crimson Sky Ct



Firefighter TCESD 1

Forms prov1aea oy 1 exas ctn1cs Lornm1ss1on www.etn1cs.state.tx.us version v..1..u.,_, ...

POLITICAL EXPENDITURES FROM POLITICAL SCHEDULE Fl

CONTRIBUTIONS

EXPENDITURE CATEGORIES FOR BOX S(a) Atlvert1s1ng Expense Event Expense Loan Repayment/Reimbursement Sol1c1cam1nlFoodraising Expense Accoon11ng/Bank•J111 '~' Office O>rerheOOIRencal Expense Transpoiiatoon Equipment & Related Expense Consultf1(1 Expense Food/Beverage Expense Poll1n11 Expense Travel in District Coombutionsl Dooanons Made By. G1ft/Awards1Memonals Expense Printing Expense Travel Out ot Dosmct

Candtdate/Oft1eeholder/Polnical Committee Legal 5ervoces Salanes/Wages/Contract Labor OTI-IER {enter a catego<y not listed atlove) Cre<lll Card Payment

The Instruction Guide explains how to complete this form.

1 Total pages Schedule Fl: 2 FILER NAME 3 Filer ID

Sch: 1/2 Rpt: 21123 Friends of North Shore Fire Department

4 Date 5 Payee name

11/02/2016 GCP Association Services

6 Amount($) 7 Payee address; City; State; Zip Code

$1,845.00 200WMain

Pflugerville, TX 78691

8 PURPOSE (a) Category (See CategOries listed at the cap ot lh•s schedule) (b) Description OF

Consulting Expense D Check 1f travel outside o1 Texas. Complete Schedule T EXPENDITURE D Check 1f Auston, TX. ot11ceh~der l1v1ng exp€1lse

Consulting Expense

9 Complete QNU if direct Candidate/Officeholder name Office sought Office held expenditure to benefit CIOH

Date Payee name

11/0512016 Miller Signs

Amount($) Payee address: City; State; Zip Code

$500.00 18400 FM 1431

Jonestown, TX 78645

PURPOSE (a) Category (~ Cacego«es listed at lhe top of this schedule) (b) Description OF Advertising Expense D Check~ travel oots1de of Te•as Complete Schedule T

EXPENDITURE D Check if Austin, TX, of11ceh0Kjer liv•Jll! expense

Payment for billtx:Jard

Complete QNU ii direct Candidate/Officeholder name Office sought Office held expenditure to benefit C/OH

Date Payee name

12/29/2016 Norman, Donnie

Amount($) Payee address; City; State: Zip Code

$2,082.41 22109 Cross Timbers Bend


PURPOSE {a) Category (~ Categones listed at the top of this schedule) {b) Description OF Advertising Expense D Check~ travel wts•de of Texas Complete Schedule T

EXPENDITURE D Chee~ 1t Austin, TX. oft>eehok!er IMr>g expense

Billboard Reservation Fee; Trifold Flyer for Townhall meetings

Complete QNl.l'. if direct Candidate/Officeholder name Office sought Office held

expenditure to benefit C/OH

orms prov1aea oy 1 exas t:tn1cs L-Omm1ss1on www.etn1cs.state.tx.us Version v .1..v . .<:.<>l

POLITICAL EXPENDITURES FROM POLITICAL SCHEDULE Fl

CONTRIBUTIONS

EXPENDITURE CATEGORIES FOR BOX B(a) Actven1s1ng Expense Event ExJl"nse Loan Repayme11t1Re1mbmsemem Solocotatoon/FlXldra1s1ng Expense Accoum1ng1Banku'I! >~ Olf1ce Dv<!rheadlRental Expense Transportation Equipment & Related Ellperise Consult1nq Expense Food/Beverage Expense Polling Expense Travel in Distnct Cootribunoris/ Donations Made By. G11t!Awards!Memorials Expense Pnnt1ng Expense Travel Out of D1slflct

Candida(e/OfftceholderlPolJtocal C001m1ttee Legal Services Salariesl'Wa(leslContract Labor OTHER (enter a category no1 l1sted above) Credit Card Pa,,,.,ent

The Instruction Gulde explains how to complete this form.

1 Total pages Schedule Fl: 2 FILER NAME 3 Filer ID

Sch: 2/2 Rpt: 22/23 Friends of North Shore Fire Department

4 Date 5 Payee name

11/2912016 vasara Photography

6 Amount($) 7 Payee address; City; State; Zip Code

$500.00 3961 Outpost Trace


8 PURPOSE (a) category (See ca1egones listed at the top ol this scheOOle) (b) Description OF Advertising Expense D Check~ travel outsKle of Texas Complete Sd1edule T.

EXPENDITURE D Checi< ~Austin, TX, oHiceholder IMr>g expense

Website creation and hosting registration.

9 Complete 00.LY. if direct Candidate/Officeholder name Office sought Office held expenditure to benefit CIOH

orms p rov1ciea oy r ex as 1::.tn1cs i..:omm1ss1on www.etn1cs.state.tx.us version v .... u .... _,1

POLITICAL COMMITTEE PAC-DR AFFIDAVIT OF DISSOLUTION

FORM

23 of 23

The Instruction Guide explains how to complete this form. **Complete only if "Report Type" on page 1 is marked "Dissolution"**



3 Affidavit of Dissolution

I, the undersigned campaign treasurer, do not expect the occurrence of any further reportable activity by this political committee for this or any other campaign or election for which reporting under the Election Code is required. I declare that all of the information required to be reported by me has been reported. I understand that designating a report as a dissolution report terminates the appointment of campaign treasurer. I further understand that a political committee may not make or authorize political expenditures or accept political contributions without having an appointment of campaign treasurer on file.

Signature of Campaign Treasurer

I DO NOT SIGN UNLESS POLITICAL COMMITTEE IS TO BE DISSOLVED I

AFFIX NOTARY STAMP I SEAL ABOVE

Sworn to and subscribed before me, by the said , 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

arms prov1aea oy 1 exas ctr 1cs i....omm1ss1on www.eu11cs.state.tx.us version v1.u . .:.::::i..1.

specific-purpose committee form spac … · specific-purpose committee campaign finance report ......

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