CANDIDATE·/OFFICEHQLDER CAMPAIGN FINANCE REPORT
.·
The C/OH lnstructioll. G1Jide ~xplalns how to compl¢te this form. 3 CANDIDATE I OFF1cEHoLDER NAME
Mr.
.
4 CANDIDATE/ OFFICEHOLDER MAILING ADDRESS
D
Change of Address
5 CANDIDATE/ OFFICEHOLDER PHONE 6 CAMPAIGN TREASURER NAME
•
~
Mr.
.· ,. . • ·. : # . > •
NICKNAME
7 CAMPAIGN
STREET ADORES~ (NO PO BbX PLEASE):
TREASURER ADDRE:::SS {Residence
or. Business)
ij CAMPAIGN
TREASURER PHONE
·9 REPORT TYPE
10 PERIQD COVERED
Month.
t'I ELECTION
ELECTION !'.>ATE' Month
Oay
12 OFFJGE
Forms provided by Texas E:thics Coininission
APT/SUITE #;
FORM C/OH COVER SHEET l=i'G 1