District 65: Ben Kissling, R-Lewisville

CORRECTION/AMENDMENT AFFIDAVIT FOR CANDIDATE/OFFICEHOLDER 1 Filer ID

(Ethics Commission Filers)

2 Total pages filed:

00080553 3 CANDIDATE / OFFICEHOLDER NAME

FORM

OFFICE USE ONLY

7 MS / MRS / MR

FIRST

Mr.

Benjamin

NICKNAME

LAST

Date Received

MI

ELECTRONICALLY FILED 01/26/2016

SUFFIX

Kissling 4 ORIGINAL REPORT TYPE

Date Hand-delivered or Date Postmarked

January 15

Runoff

July 15

Exceeded $500 limit

Receipt #

15th day after campaign treasurer appointment (officeholder only) Final Report (Attach C/OH-FR)

Date Processed

X 30th day before election 8th day before election

5 ORIGINAL PERIOD Month COVERED

Day

Other (specify)

Year

01/01/2016

COR-C/OH

Month THROUGH

Day

Year

Amount

Date Imaged

01/21/2016

6 EXPLANATION OF CORRECTION One expense was a credit card expense that was previously reported as a loan and political expense from political funds. The descriptions of expenses were also made more specific.

7 AFFIDAVIT I swear, or affirm, under penalty of perjury, that this corrected report is true and correct.

Check the box next to any and all applicable statements: Semiannual reports: I swear, or affirm that the original report was made in good faith and without an intent to mislead or to misrepresent the information contained in the report.

X

Other reports: I swear, or affirm, that I am filing this corrected report not later than the 14th business day after the date I learned that the report as originally filed is inaccurate or incomplete. I swear, or affirm, that any error or omission in the report as originally filed was made in good faith.

Mr. Benjamin Kissling Signature of Candidate or Officeholder AFFIX NOTARY STAMP / 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

Remember To Attach Any Part Of The Campaign Finance Report Form Needed To Report And Explain Corrections Forms provided by Texas Ethics Commission

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CANDIDATE / OFFICEHOLDER CAMPAIGN FINANCE REPORT

FORM

COVER SHEET PG 1 1

The C/OH Instruction Guide explains how to complete this form.

Filer ID

2

Total pages filed:

(Ethics Commission Filers)

7

00080553 3

CANDIDATE / OFFICEHOLDER NAME

C/OH

MS / MRS / MR

FIRST

MI

Mr.

Benjamin

OFFICE USE ONLY Date Received

ELECTRONICALLY FILED NICKNAME

LAST

SUFFIX

01/26/2016

Kissling 4

CANDIDATE / OFFICEHOLDER MAILING ADDRESS Change of Address

ADDRESS / PO BOX;

APT / SUITE #;

CITY;

ZIP CODE

Date Hand-delivered or Date Postmarked

Receipt #

Lewisville, TX 75057

Amount

Date Processed

Date Imaged

5

CAMPAIGN TREASURER NAME

MS / MRS / MR

FIRST

MI

Mr.

Benjamin D.

NICKNAME

LAST

SUFFIX

Kissling 6

CAMPAIGN TREASURER ADDRESS

STREET ADDRESS (NO PO BOX PLEASE);

APT / SUITE #;

CITY;

STATE;

ZIP CODE

(Residence or Business)

Lewisville, TX 75057

7

CAMPAIGN TREASURER PHONE

8

REPORT TYPE

AREA CODE

PHONE NUMBER

January 15

X

July 15

9

PERIOD COVERED

Month

Day

Month

ELECTION DATE Day Year

03/01/2016

11 OFFICE

30th day before election

Runoff

15th day after campaign treasurer appointment (officeholder only)

8th day before election

Exceeded $500 limit

Final Report (Attach C/OH-FR)

Year

01/01/2016

10 ELECTION

EXTENSION

Month THROUGH

Day

Year

01/21/2016 ELECTION TYPE

X Primary General

OFFICE HELD (if any)

Runoff

Other

Special

12 OFFICE SOUGHT (if known)

State Representative District 65

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Version V1.0.34538

FORM

CANDIDATE / OFFICEHOLDER REPORT: SUPPORT & TOTALS 13 C / OH NAME

C/OH

COVER SHEET PG 2 3 of 7 14 Filer ID

Kissling, Benjamin (Mr.)

(Ethics Commission Filers)

00080553 15 NOTICE FROM POLITICAL COMMITTEE(S) Additional Pages

This box is for notice of political contributions accepted or political expenditures made by political committees to support 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 TYPE

COMMITTEE NAME

GENERAL

COMMITTEE ADDRESS SPECIFIC

COMMITTEE CAMPAIGN TREASURER NAME

COMMITTEE CAMPAIGN TREASURER ADDRESS

16 CONTRIBUTION TOTALS

1.

TOTAL POLITICAL CONTRIBUTIONS OF $50 OR LESS (OTHER THAN PLEDGES, LOANS, OR GUARANTEES OF LOANS), UNLESS ITEMIZED

$

0.00

2.

TOTAL POLITICAL CONTRIBUTIONS (OTHER THAN PLEDGES, LOANS, OR GUARANTEES OF LOANS)

$

0.00

3.

TOTAL POLITICAL EXPENDITURES OF $100 OR LESS, UNLESS ITEMIZED

$

0.00

4.

TOTAL POLITICAL EXPENDITURES

$

16.22

CONTRIBUTION BALANCE

5.

TOTAL POLITICAL CONTRIBUTIONS MAINTAINED AS OF THE LAST DAY OF THE REPORTING PERIOD

$

0.00

OUTSTANDING LOAN TOTALS

6.

TOTAL PRINCIPAL AMOUNT OF ALL OUTSTANDING LOANS AS OF THE LAST DAY OF THE REPORTING PERIOD

$

751.07

EXPENDITURE TOTALS

17 AFFADAVIT

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.

Mr. Benjamin Kissling Signature of Candidate or Officeholder AFFIX NOTARY STAMP / 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

Forms provided by Texas Ethics Commission

Printed name of officer administering

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Title of officer administering oath

Version V1.0.34538

FORM

SUBTOTALS - C/OH

C/OH

COVER SHEET PG 3 4 of 7 18 FILER NAME

19 Filer ID

Kissling, Benjamin (Mr.)

(Ethics Commission Filers)

00080553

20 SCHEDULE SUBTOTALS SUBTOTAL AMOUNT

NAME OF SCHEDULE 1.

SCHEDULE A1: MONETARY POLITICAL CONTRIBUTIONS

$

2.

SCHEDULE A2: NON-MONETARY (IN-KIND) POLITICAL CONTRIBUTIONS

$

3.

SCHEDULE B: PLEDGED CONTRIBUTIONS

$

4.

X

SCHEDULE E: LOANS

$

1.07

5.

X

SCHEDULE F1: POLITICAL EXPENDITURES FROM POLITICAL CONTRIBUTIONS

$

1.07

6.

SCHEDULE F2: UNPAID INCURRED OBLIGATIONS

$

7.

SCHEDULE F3: PURCHASE OF INVESTMENTS FROM POLITICAL CONTRIBUTIONS

$

SCHEDULE F4: EXPENDITURES MADE BY CREDIT CARD

$

9.

SCHEDULE G: POLITICAL EXPENDITURES FROM PERSONAL FUNDS

$

10.

SCHEDULE H: PAYMENT FROM POLITICAL CONTRIBUTIONS TO A BUSINESS OF C/OH

$

11.

SCHEDULE I: NON-POLITICAL EXPENDITURES FROM POLITICAL CONTRIBUTIONS

$

12.

SCHEDULE K: INTEREST, CREDITS, GAINS, REFUNDS, AND CONTRIBUTIONS RETURNED TO FILER

$

8.

X

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LOANS

SCHEDULE

The Instruction Guide explains how to complete this form.

2 FILER NAME

1 Total pages Schedule E:

Sch: 1/1 Rpt: 5/7 3 Filer ID

Kissling, Benjamin (Mr.) 4

$

7 Name of lender

01/19/2016 6 Is lender a financial institution?

(Ethics Commission Filers)

00080553

TOTAL OF UNITEMIZED LOANS

5 Date of loan

out-of-state PAC (ID#:_________________________________) 9

Loan Amount ($)

Kissling, Benjamin 8 Lender address;

E

$1.07 City;

State;

Zip Code

10 Interest Rate

11 Maturity Date

No Lewisville, TX 75057 12 Principal occupation / Job title (See Instructions)

13 Employer (See Instructions)

Clinical Laboratory Specialist III

Creative Testing Solutions

14 Description of Collateral

15 Check if personal funds were deposited into political account (See Instructions)

X None 16 GUARANTOR INFORMATION

17 Name of guarantor

X not applicable

18 Guarantor address;

19 Amount Guaranteed ($)

City;

20 Principal occupation

Forms provided by Texas Ethics Commission

State;

Zip Code

21 Employer (See Instructions)

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POLITICAL EXPENDITURES FROM POLITICAL CONTRIBUTIONS

SCHEDULE

F1

EXPENDITURE CATEGORIES FOR BOX 8(a) Advertising Expense Accounting/Banking Consulting Expense Contributions/ Donations Made By Candidate/Officeholder/Political Committee Credit Card Payment

Event Expense Fees Food/Beverage Expense Gift/Awards/Memorials Expense Legal Services

Loan Repayment/Reimbursement Office Overhead/Rental Expense Polling Expense Printing Expense Salaries/Wages/Contract Labor

The Instruction Guide explains how to complete this form.

1 Total pages Schedule F1: 2 FILER NAME

Sch: 1/1 Rpt: 6/7 4 Date

Solicitation/Fundraising Expense Transportation Equipment & Related Expense Travel in District Travel Out of District OTHER (enter a category not listed above)

3 Filer ID

Kissling, Benjamin (Mr.)

(Ethics Commission Filers)

00080553

5 Payee name

01/19/2016

The UPS Store

6 Amount ($)

7 Payee address;

$1.07

City;

State; Zip Code

1565 W. Main St. Suite 208 Lewisville, TX 75067

8

PURPOSE OF EXPENDITURE

(a) Category

(See Categories listed at the top of this schedule)

(b) Description Check if travel outside of Texas. Complete Schedule T.

Fax

Check if Austin, TX, officeholder living expense

Fax document to TEC 9 Complete ONLY if direct Candidate/Officeholder name expenditure to benefit C/OH

Forms provided by Texas Ethics Commission

Office sought

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Office held

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EXPENDITURES MADE BY CREDIT CARD

SCHEDULE

F4

EXPENDITURE CATEGORIES FOR BOX 10(a) Advertising Expense Accounting/Banking Consulting Expense Contributions/ Donations Made By Candidate/Officeholder/Political Committee

Event Expense Fees Food/Beverage Expense Gift/Awards/Memorials Expense Legal Services

Loan Repayment/Reimbursement Office Overhead/Rental Expense Polling Expense Printing Expense Salaries/Wages/Contract Labor

Solicitation/Fundraising Expense Transportation Equipment & Related Expense Travel in District Travel Out of District OTHER (enter a category not listed above)

The Instruction Guide explains how to complete this form.

1 Total pages Schedule F4: 2 FILER NAME

Sch: 1/1 Rpt: 7/7 4

3 Filer ID

Kissling, Benjamin (Mr.)

00080553

TOTAL OF UNITEMIZED EXPENDITURES CHARGED TO A CREDIT CARD

5 Date

The UPS Store

7 Amount ($)

8 Payee address;

$15.15

TYPE OF EXPENDITURE

10

PURPOSE OF EXPENDITURE

$

6 Payee name

01/19/2016

9

(Ethics Commission Filers)

City;

State; Zip Code

1565 W. Main St. Suite 208 Lewisville, TX 75067 X (a) Category

Political

Non-Political

(See Categories listed at the top of this schedule)

(b) Description Check if travel outside of Texas. Complete Schedule T.

Postage

Check if Austin, TX, officeholder living expense

Postage for documents sent to TEC 11 Complete ONLY if direct Candidate/Officeholder name expenditure to benefit C/OH

Forms provided by Texas Ethics Commission

Office sought

www.ethics.state.tx.us

Office held

Version V1.0.34538