Texas Ethics Commission P.O. Box Austin, Texas (512) TDD PAGE # 1 of 12 3 COMMITTEE NAME OFFICE USE ONLY
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1 Texas Ethics Commission P.O. Box Austin, Texas (512) TDD GENERAL-PURPOSE 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 12 3 COMMITTEE NAME OFFICE USE ONLY. Political Action Committee Date Received 4 COMMITTEE ADDRESS Change of Address ADDRESS / PO BOX; APT / SUITE #; CITY; STATE; ZIP CODE 5205 N. O'Connor Blvd Suite 200 Irving, TX Date Hand-delivered or Date Postmarked 5 CAMPAIGN TREASURER NAME MS / MRS / MR FIRST MI Roger W NICKNAME LAST SUFFIX Wallace Receipt # Date Processed Date Imaged Amount 6 CAMPAIGN TREASURER'S STREET ADDRESS (Residence or business) 7 CAMPAIGN TREASURER'S MAILING ADDRESS Change of Address STREET ADDRESS (NO PO BOX PLEASE); APT / SUITE #; CITY; STATE; ZIP CODE 5205 N. O'Connor Blvd Suite 200 Irving, TX STREET OR PO BOX; APT/SUITE#; CITY; STATE; ZIP CODE 5205 N. O'Connor Blvd Suite 200 Irving, TX CAMPAIGN TREASURER PHONE AREA CODE PHONE NUMBER EXTENSION (972) REPORT TYPE January 15 X 30th day before election Dissolution (attach PAC-DR) July 15 8th day before election Runoff 10th day after campaign treasurer termination 10 PERIOD COVERED Month Day Year Month Day Year THROUGH 01/01/ /23/ ELECTION ELECTION DATE ELECTION TYPE Month Day Year X Primary Runoff General Special 03/04/2014 GO TO PAGE 2
2 GENERAL-PURPOSE COMMITTEE REPORT: F ORM GPAC COVER SHEET PG PURPOSE AND TOTALS 2 12 COMMITTEE NAME 13 COMMITTEE ACTIVITY (Attach lists on plain paper to complete this report if necessary.). Political Action Committee 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 James L. Keffer ACCOUNT # 14 CONTRIBUTION TOTALS EXPENDITURE TOTALS 3. Officeholders Assisted (identify by name or, if applicable, classify by party) 1. TOTAL OF $50 OR LESS (OTHER THAN PLEDGES, LOANS, OR GUARANTEES OF LOANS), UNLESS ITEMIZED (OR $100 OR LESS IF QUALIFIED FOR HIGHER THRESHOLD) Check here if this report qualifies for the higher itemization threshold. 2. TOTAL (OTHER THAN PLEDGES, LOANS, OR GUARANTEES OF LOANS) $ 3. TOTAL POLITICAL EXPENDITURES OF $100 OR LESS, UNLESS ITEMIZED $ $ , CONTRIBUTION BALANCE OUTSTANDING LOAN TOTALS 4. TOTAL POLITICAL EXPENDITURES 5. TOTAL MAINTAINED AS OF THE LAST DAY OF THE REPORTING PERIOD $ 6. TOTAL PRINCIPAL AMOUNT OF ALL OUTSTANDING LOANS AS OF THE LAST DAY OF THE REPORTING PERIOD $ $ 3, , 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. 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 GENERAL-PURPOSE COMMITTEE REPORT: F ORM GPAC PURPOSE ADDENDUM Page 3 of COMMITTEE NAME COMMITTEE ACTIVITY (Attach lists on plain paper to complete this report if necessary.). Political Action Committee 1. Candidates (identify by name or, if applicable, classify by party) 2. Measures A. Supported B. Opposed A. Supported Rep. Doug Lamborn for U.S. HOUSE ACCOUNT # (describe by date and location of election and nature of issue) B. Opposed 3. Officeholders Assisted (identify by name or, if applicable, classify by party)
4 Schedule: 1/8 Report: 4/12 2 FILER NAME. Political Action Committee 3 ACCOUNT # (Ethics Commission filers) Bengtson, Mark E. 6 Flower Mound, TX $ Vice Pres-Barnett Asset Team Bengtson, Mark E. Flower Mound, TX $30.00 Vice Pres-Barnett Asset Team Cheatwood, Chris J. Southlake, TX EVP Bus Develop & Tech Cheatwood, Chris J. Southlake, TX EVP Bus Develop & Tech Dealy, Richard P. Argyle, TX $75.00 EVP & CFO
5 Schedule: 2/8 Report: 5/12 2 FILER NAME. Political Action Committee 3 ACCOUNT # (Ethics Commission filers) Dealy, Richard P. 6 Argyle, TX $ EVP & CFO Dove, Timothy L. Frisco, TX $70.00 Dove, Timothy L. Frisco, TX $70.00 Giovinco Jr, Sam Irving, TX Engineer Giovinco Jr, Sam Irving, TX Engineer
6 Schedule: 3/8 Report: 6/12 2 FILER NAME. Political Action Committee 3 ACCOUNT # (Ethics Commission filers) Hall, Frank W. 6 Irving, TX Accountant Hall, Frank W. Irving, TX Accountant Hall, Jerome D. Keller, TX $ Hall, Jerome D. Keller, TX $ Hannes, William F. Irving, TX EVP
7 Schedule: 4/8 Report: 7/12 2 FILER NAME. Political Action Committee 3 ACCOUNT # (Ethics Commission filers) Hannes, William F. 6 Irving, TX EVP Holmes, Dave Lewisville, TX Director Operational Training Holmes, Dave Lewisville, TX Director Operational Training Kellum, Danny Southlake, TX $31.25 Kellum, Danny Southlake, TX $31.25
8 Schedule: 5/8 Report: 8/12 2 FILER NAME. Political Action Committee 3 ACCOUNT # (Ethics Commission filers) Kleinman, Mark H. 6 Dallas, TX $ Attorney Kleinman, Mark H. Dallas, TX $60.00 Attorney Montemayor, Margaret M. Murphy, TX $35.00 Accountant Montemayor, Margaret M. Murphy, TX $35.00 Accountant Owens, Thaddeus Keller, TX 76262
9 Schedule: 6/8 Report: 9/12 2 FILER NAME. Political Action Committee 3 ACCOUNT # (Ethics Commission filers) Pierson, Weldon 6 Flower Mound, TX $ Reservoir Engr. Mgr. Pierson, Weldon Flower Mound, TX $75.00 Reservoir Engr. Mgr. Piper, Laura A. Irving, TX $60.00 Corporate Communications Piper, Laura A. Irving, TX $60.00 Corporate Communications Richmond, Perry L Flower Mound, TX Engineer
10 Schedule: 7/8 Report: 10/12 2 FILER NAME. Political Action Committee 3 ACCOUNT # (Ethics Commission filers) Richmond, Perry L 6 Flower Mound, TX Engineer Spratlen, Susan A. Argyle, TX VP Corporate Communications Spratlen, Susan A. Argyle, TX VP Corporate Communications Tessier, Carol Coppell, TX $30.00 IT Director Tessier, Carol Coppell, TX $30.00 IT Director
11 Schedule: 8/8 Report: 11/12 2 FILER NAME. Political Action Committee 3 ACCOUNT # (Ethics Commission filers) Wallace, Roger W. 6 Dallas, TX VP - Government Affairs Wallace, Roger W. Dallas, TX VP - Government Affairs
12 POLITICAL EXPENDITURES SCHEDULE F Advertising Expense Accounting/Banking Consulting Expense Event Expense Fees EXPENDITURE CATEGORIES Gifts/Awards/Memorial Expense Salaries/Wages/Contract Labor Legal Services Solicitation/Fundraising Expense Food/Beverage Expense Travel In District Polling Expense Travel Out Of District Printing Expense Office Overhead/Rental Expense The INSTRUCTION GUIDE explains how to complete this form. Loan Repayment/Reimbursement Transportation Equipment & Related Expense Contributions/Donations Made By Candidate/Officeholder/Political Committee OTHER (enter a category not listed above) 1 PAGE # 2 FILER NAME 3 ACCOUNT # (TEC filers) Schedule: 1/1 Report: 12/12. Political Action Committee 4 Date 5 Payee name 01/10/2014 Jim Keffer Campaign 6 Amount ($) 7 Payee address City; State; Zip Code $2, P.O. Box 857 Expenditure from Eastland, TX corporate funds 8 (a) Category (See Categories listed at the top of this schedule) (b) Description PURPOSE Contributions/Donations Made By James L. Keffer STATE HOUSE 60th TX OF Candidate/Officeholder/Political Committee EXPENDITURE 9 Complete ONLY if direct expenditure to benefit C/OH Candidate / Officeholder name Office sought: Office held: Date Payee name 01/23/2014 Lamborn For Congress Amount ($) Payee address City; State; Zip Code $1, P.O. Box Expenditure from Colorado Springs, CO corporate funds PURPOSE OF EXPENDITURE Complete ONLY if direct expenditure to benefit C/OH Category (See Categories listed at the top of this schedule) Description Contributions/Donations Made By Fundraiser Candidate/Officeholder/Political Committee Candidate / Officeholder name Office sought: Office held:
Texas Ethics Commission P.O.Box 12070 Austin, Texas 78711-2070 (512)463-5800 TDD 1-800-735-2989 ADDRESS / PO BOX; APT/SUITE #; CITY; STATE ZIP CODE
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Texas Ethics Commission P.O. Box 12070 Austin, Texas 78711-2070 (512)463-5800 1-800-325-8506 GENERAL- COMMITTEE CAMPAIGN FINANCE REPORT GPAC FORM COVER SHEET PG 1 The GPAC INSTRUCTION GUIDE explains how
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