Texas Ethics Commission P.O.Box Austin, Texas (512) A. Supported. B. Opposed. A. Supported. B.
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1 Texas Ethics Commission P.O. Box Austin, Texas (512) GENERAL- COMMITTEE CAMPAIGN FINANCE REPORT GPAC FORM COVER SHEET PG 1 The GPAC INSTRUCTION GUIDE explains how to complete this form. 1 ACCOUNT # (Ethics Commission filers) 2 PAGE # 1 of 6 3 COMMITTEE NAME FICE USE ONLY Pearland Area Republican Women PAC Received 4 COMMITTEE ADDRESS Change of Address ADDRESS / PO BOX; APT / SUITE #; CITY; STATE; ZIP CODE P.O. Box 1816 Pearland, TX Hand-delivered or Postmarked 5 CAMPAIGN TREASURER NAME MS / MRS / MR FIRST MI Mrs. Susan NICKNAME LAST SUFFIX Elam Receipt # Processed Imaged Amount 6 CAMPAIGN TREASURER'S STREET ADDRESS (Residence or business) STREET ADDRESS (NO PO BOX PLEASE); APT / SUITE #; CITY; STATE; ZIP CODE 2407 Anthony Pearland, TX CAMPAIGN TREASURER'S MAILING ADDRESS STREET OR PO BOX; APT/SUITE#; CITY; STATE; ZIP CODE P.O. Box 1816 Pearland, TX Change of Address 8 CAMPAIGN TREASURER PHONE AREA CODE PHONE NUMBER EXTENSION (281) REPORT TYPE January 15 30th day before election Dissolution (attach PAC-DR) X July 15 8th day before election Runoff 10th day after campaign treasurer termination 10 PERIOD COVERED Month Day Year Month Day Year THROUGH 04/04/ /30/ ELECTION ELECTION DATE ELECTION TYPE Month Day Year Primary Runoff General Special GO TO PAGE 2
2 GENERAL- COMMITTEE REPORT: F ORM GPAC COVER SHEET PG AND TOTALS 2 12 COMMITTEE NAME 13 COMMITTEE ACTIVITY (Attach lists on plain paper to complete this report if necessary.) Pearland Area Republican Women PAC 1. Candidates (identify by name or, if applicable, classify by party) 2. Measures (describe by date and location of election and nature of issue) A. Supported B. Opposed A. Supported B. Opposed ACCOUNT # 14 CONTRIBUTION TOTALS 3. Officeholders Assisted (identify by name or, if applicable, classify by party) 1. TOTAL POLITICAL CONTRIBUTIONS $50 OR LESS (OTHER THAN PLEDGES, LOANS, OR GUARANTEES LOANS), UNLESS ITEMIZED (OR $100 OR LESS IF QUALIFIED FOR HIGHER THRESHOLD) X Check here if this report qualifies for the higher itemization threshold. 2. TOTAL POLITICAL CONTRIBUTIONS (OTHER THAN PLEDGES, LOANS, OR GUARANTEES LOANS) $ $ TOTALS 3. TOTAL POLITICAL S $50 OR LESS, UNLESS ITEMIZED $ TOTAL POLITICAL S $ CONTRIBUTION BALANCE OUTSTANDING LOAN TOTALS 5. TOTAL POLITICAL CONTRIBUTIONS MAINTAINED AS THE LAST DAY THE REPORTING PERIOD $ 6. TOTAL PRINCIPAL AMOUNT ALL OUTSTANDING LOANS AS THE LAST DAY THE REPORTING PERIOD $ 5, AFFIDAVIT 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. Susan Elam Signature of Campaign Treasurer 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
3 POLITICAL CONTRIBUTIONS OTHER THAN PLEDGES OR LOANS SCHEDULE A The INSTRUCTION GUIDE explains how to complete this form. 1 PAGE # Schedule: 1/1 Report: 3/6 2 FILER NAME Pearland Area Republican Women PAC 3 ACCOUNT # (Ethics Commission filers) 4 5 Full name of contributor out-of-state PAC (ID# ) Adams, Michelle (Mrs.) /18/ Contributor address; City; State; Zip Code Pearland, TX Principal occupation / Job title (See Instructions) 10 Employer (See Instructions) Homemaker 7 Amount of 8 contribution ($) $27.97 In-kind contribution description (if applicable) Donation of food supplies for meeting (If travel outside of Texas, complete Schedule T) Full name of contributor out-of-state PAC (ID# ) Harris, Richard (Mr.) 05/18/ Contributor address; City; State; Zip Code Pearland, TX Amount of contribution ($) $90.00 In-kind contribution description (if applicable) Donation of food for meeting Principal occupation / Job title (See Instructions) Food Distributor Employer (See Instructions) Southwest Foods (If travel outside of Texas, complete Schedule T)
4 POLITICAL S SCHEDULE F Advertising Expense Accounting/Banking Consulting Expense Event Expense Fees CATEGORIES Gifts/Awards/Memorial Expense Salaries/Wages/Contract Labor Legal Services Solicitation/Fundraising Expense Food/Beverage Expense Travel In District Polling Expense Travel Out Of District Printing Expense Office Overhead/Rental Expense The INSTRUCTION GUIDE explains how to complete this form. Loan Repayment/Reimbursement Transportation Equipment & Related Expense Contributions/Donations Made By Candidate/Officeholder/Political Committee OTHER (enter a category not listed above) 1 PAGE # 2 FILER NAME 3 ACCOUNT # (TEC filers) Schedule: 1/3 Report: 4/6 Pearland Area Republican Women PAC /25/2010 Academy Sports & Outdoors 6 Amount ($) 7 Payee address City; State; Zip Code $ Business Center Expenditure from Pearland, TX (a) Category (See Categories listed at the top of this schedule) (b) Description (If travel outside of Texas, complete Schedule T) (not required for expenditures made before July 1, 2010) To reimburse Christina Moore for purchase of canopy 9 04/28/2010 Big Lots $ No. Main (not required for expenditures made before July 1, 2010) To reimburse Pat Smajstrla for purchase of two folding tables 05/12/2010 Dollar Tree $ Broadway (not required for expenditures made before July 1, 2010) To reimburse Pat Smajstrla for purchase of patriotic decorations 05/05/2010 Office Depot $ Main Street (not required for expenditures made before July 1, 2010) To reimburse Linda Starkenburg for purchase of labels
5 POLITICAL S SCHEDULE F Advertising Expense Accounting/Banking Consulting Expense Event Expense Fees CATEGORIES Gifts/Awards/Memorial Expense Salaries/Wages/Contract Labor Legal Services Solicitation/Fundraising Expense Food/Beverage Expense Travel In District Polling Expense Travel Out Of District Printing Expense Office Overhead/Rental Expense The INSTRUCTION GUIDE explains how to complete this form. Loan Repayment/Reimbursement Transportation Equipment & Related Expense Contributions/Donations Made By Candidate/Officeholder/Political Committee OTHER (enter a category not listed above) 1 PAGE # 2 FILER NAME 3 ACCOUNT # (TEC filers) Schedule: 2/3 Report: 5/6 Pearland Area Republican Women PAC /14/2010 Office Depot 6 Amount ($) 7 Payee address City; State; Zip Code $ Main Street 8 (a) Category (See Categories listed at the top of this schedule) (b) Description (If travel outside of Texas, complete Schedule T) (not required for expenditures made before July 1, 2010) To reimburse Janet Melcher for purchase of paper 9 06/04/2010 Texas Federation of Republican Women $ Lavaca Expenditure from Suite 505 Austin, TX (not required for expenditures made before July 1, 2010) To support Republican Party 05/10/2010 U. S. Post Office $28.00 Walnut Street (not required for expenditures made before July 1, 2010) To reimburse Linda Starkenburg for purchase of postage 06/14/2010 U. S. Postmaster $15.84 Walnut Street (not required for expenditures made before July 1, 2010) To reimburse Janet Melcher for purchase of postage
6 POLITICAL S SCHEDULE F Advertising Expense Accounting/Banking Consulting Expense Event Expense Fees CATEGORIES Gifts/Awards/Memorial Expense Salaries/Wages/Contract Labor Legal Services Solicitation/Fundraising Expense Food/Beverage Expense Travel In District Polling Expense Travel Out Of District Printing Expense Office Overhead/Rental Expense The INSTRUCTION GUIDE explains how to complete this form. Loan Repayment/Reimbursement Transportation Equipment & Related Expense Contributions/Donations Made By Candidate/Officeholder/Political Committee OTHER (enter a category not listed above) 1 PAGE # 2 FILER NAME 3 ACCOUNT # (TEC filers) Schedule: 3/3 Report: 6/6 Pearland Area Republican Women PAC /03/2010 Uniform School Supply 6 Amount ($) 7 Payee address City; State; Zip Code $ West Broadway 8 (a) Category (See Categories listed at the top of this schedule) (b) Description (If travel outside of Texas, complete Schedule T) (not required for expenditures made before July 1, 2010) Reimburse Susan Elam for printing 9 04/21/2010 Wal Mart $ Main Street (not required for expenditures made before July 1, 2010) To reimburse Pat Smajstrla for purchase of supplies
Texas Ethics Commission P.O. Box 12070 Austin, Texas 78711-2070 (512)463-5800 TDD 1-800-735-2989
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More informationTexas Ethics Commission P.O. Box 12070 Austin, Texas 78711-2070 (512)463-5800 TDD 1-800-735-2989
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