Connie Baker January 2022 Semi-Annual CANDIDATE / OFFICEHOLDER FORM C/OH
CAMPAIGN FINANCE REPORT COVER SHEET PG 7
1 Filer ID (Ethics Commission Filers) 2 Total pages filed:
The C/OH Instruction Guide explains how to complete this form.
3 CANDIDATE/ MS/MRS MR) FIRST MI
OFFICE USE ONLY
OFFICEHOLDER
NAME ---------- ...................rI/ f�.......
NICKNAME LAST- SUFFIX Dal RlklfbEIVED
�a e r l:
4 CANDIDATE/ ADDRESS /PO BOX; APT/SUITE#; CITY; STATE; ZIP CODE 1 A N I y 2022
OFFICEH
MAILING OLDER cc1 � �V `f(,, 7V , City Managers/City
ADDRESS 0 )3 �ll ilnQi��Cl.0 d7. /``
Secretary's Office
Change of Address
5 CANDIDATE/ AREA CODE PHONE NUMBER EXTENSION
Date Hand-delivered or Date Postmarked
OFFICEPHONE HOLDER 006
,`6 ` � n O /
/ I y
Receipt# Amount$
6 CAMPAIGN MS MRS MR FIRST Q MI
TREASURER V f ra n C L_ /J Date Processed
NAME .................................................................................
NICKNAME SUFFIX
/54A!) r Date Imaged
7 CAMPAIGN STREET ADDRESS (NO PO BOX PLEASE); APT/SUITE#; CITY; STATE; ZIP CODE
TREASURER �` {�Qm �dy;
ADDRESS 3613 "L�`�� r !J TC
(Residence or Business) 77
8 CAMPAIGN AREA CODE PHONE NUMBER EXTENSION
TREASURER
PHONE (11 L/U U 4
9 REPORT TYPE January 15 1 r30th day before election i Runoff 15th day after campaign
i I treasurer appointment
(� (Officeholder Only)
July 15 I 8th day before election Reporting Exceeded Modified Final Report(Attach C/OH-FR)
it
10 PERIOD Month Day Year Month Day Year
COVERED ,I/® � / ®� i THROUGH /a 131
11 ELECTION ELECTION DATE ELECTION TYPE
Month Day Year Primary Runoff Other
Description
General Special
12 OFFICE OFFICE HELD (if any) 13 OFFICE SOUGHT (if known)
14 NOTICE FROM THIS BOX IS FOR NOTICE OF POLITICAL CONTRIBUTIONS ACCEPTED OR POLITICAL EXPENDITURES MADE BY POLITICAL COMMITTEES TO SUPPORT
POLITICAL THE CANDIDATE/OFFICEHOLDER. THESE EXPENDITURES MAY HAVE BEEN MADE WITHOUT THE CANDIDATES OR OFFICEHOLDER'S KNOWLEDGE OR
CONSENT.CANDIDATES AND OFFICEHOLDERS ARE REQUIRED TO REPORT THIS INFORMATION ONLY IF THEY RECEIVE NOTICE OF SUCH EXPENDITURES.
COMMITTEE(S)
COMMITTEE TYPE COMMITTEE NAME
GENERAL COMMITTEE ADDRESS
Additional Pages
SPECIFIC COMMITTEE CAMPAIGN TREASURER NAME
COMMITTEE CAMPAIGN TREASURER ADDRESS
GO TO PAGE 2
Forms provided by Texas Ethics Commission www.ethics.state.tx.us Revised 8/17/2020
CANDIDATE / OFFICEHOLDER FORM C/OH
CAMPAIGN FINANCE REPORT COVER SHEET PG 2
15 C/OH NAME 16 Filer ID (Ethics Commission Filers)
17 CONTRIBUTION 1. TOTAL UNITEMIZED POLITICAL CONTRIBUTIONS (OTHER THAN
TOTALS PLEDGES,LOANS,OR GUARANTEES OF LOANS,OR
CONTRIBUTIONS MADE ELECTRONICALLY)
2. TOTAL POLITICAL CONTRIBUTIONS
(OTHER THAN PLEDGES, LOANS, OR GUARANTEES OF LOANS) .5 l"7
. . . . . . . . . . . . . . . . . . .
EXPENDITURE 3. TOTAL UNITEMIZED POLITICAL EXPENDITURE.
TOTALS
4. TOTAL POLITICAL EXPENDITURES
. . . . . . . . . . . . . . . . . . .
CONTRIBUTION 5. TOTAL POLITICAL CONTRIBUTIONS MAINTAINED AS OF THE LAST DAY
BALANCE OF REPORTING PERIOD s _3 7 q Qt l I
OUTSTANDING 6. TOTAL PRINCIPAL AMOUNT OF ALL OUTSTANDING LOANS AS OF THE
LOAN TOTALS LAST DAY OF THE REPORTING PERIOD
18 SIGNATURE 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 Candidate or Officeholder
Please complete either option below:
ROSA A. RIOS
1 Affidavit ��`PPY( ) ?z°:' ��Notary Public, State of Texas
Comm.Expires 05-23-2024
Notary ID 8760780
NOTARY ST /
Sworn to and subscribed before me by �lJ/;J/�l� �.�E'/2 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 fficer administering oath
(2)Unsworn Declaration
My name is and my date of birth is
My address is
(street) (city) (state) (zip code) (country)
Executed in County,State of on the day of 20
(month) (year)
Signature of Candidate/Officeholder(Declarant)
Forms provided by Texas Ethics Commission www.ethics.state.tx.us Revised 8117/2020
SUBTOTALS - C/OH FORM C/OH
COVER SHEET PG 3
19 FILER NAME 20 Filer ID(Ethics Commission Filers)
/ 62
21 SCHEDULE SUBTOTALS SUBTOTAL
NAME OF SCHEDULE AMOUNT
1- SCHEDULE All: MONETARY POLITICAL CONTRIBUTIONS $
2. SCHEDULE A2: NON-MONETARY(IN-KIND)POLITICAL CONTRIBUTIONS $ ✓ty
./
3. SCHEDULE B: PLEDGED CONTRIBUTIONS $ XJ
4. SCHEDULE E: LOANS $
5. SCHEDULE F1: POLITICAL EXPENDITURES MADE FROM POLITICAL CONTRIBUTIONS $
6. SCHEDULE F2: UNPAID INCURRED OBLIGATIONS $
7. SCHEDULE F3: PURCHASE OF INVESTMENTS MADE FROM POLITICAL CONTRIBUTIONS $
8. SCHEDULE F4: EXPENDITURES MADE BY CREDIT CARD $
9. SCHEDULE G: POLITICAL EXPENDITURES MADE FROM PERSONAL FUNDS $ ,/
10. SCHEDULE H: PAYMENT MADE FROM POLITICAL CONTRIBUTIONS TO A BUSINESS OF C/OH $
11. SCHEDULE 1: NON-POLITICAL EXPENDITURES MADE FROM POLITICAL CONTRIBUTIONS $
12. SCHEDULE K: INTEREST, CREDITS, GAINS, REFUNDS,AND CONTRIBUTIONS RETURNED $
TO FILER
Forms provided by Texas Ethics Commission www.ethics.state.tx.us Revised 8/17/2020