Stephen Dillenberg January 2023 Semi-Annual CANDIDATE I OFFICEHOLDER FORM C/OH
CAMPAIGN FINANCE REPORT COVER SHEET PG 1
The C/OH Instruction Guide explains how to complete this form. 1 Filer ID(Ethics Commission Filers) 2 Total pages filed:3
3 CANDIDATE/ MS/MRS/MR FIRST MI
OFFICE USE ONLY
OFFICEHOLDER MV, -T-��'
NAME ................................ . ..................... ..............
Date Received
NICKNAME LAST SUFFIX
ptu-" ►2ig, RECEIVED
4 CANDIDATE/ ADDRESS /PO BOX; APT/SUITE#; CITY; STATE; ZIP CODE
OFFICEHOLDER
MAILINGMM./3 / `' P64.rC),-\f J� 7 jp7{� JAN 17 2023
ADDRESS ✓ l.ly �"✓
Change of Address City Managers/City
Secretary's Office
5 CANDIDATE/ AREA CODE PHONE NUMBER EXTENSION Date Hand-delivered or Date Postmarked
OFFICEHOLDER PHONE (Q) ��� _ •,l� I
` (_1j
Receipt# Amount$
6 CAMPAIGN MS/MRS/MR FIRST MI
TREASURER
NAME Date Processed
NICKN E LAST SUFFIX
Date Imaged
7 CAMPAIGN STREET ADDRESS (NO PO BOX PLEASE); APT/SUITE#; CITY; STATE; ZIP CODE
TREASURER R i '� 1 ^� n
ADDRESS , Ob t -'13(310T 13 b. P _ IT"' `3 -FY 7 ,2Z-5
(Residence or Business) �1�
8 CAMPAIGN AREA CODE PHONE NUMBER EXTENSION
TREASURER
PHONE `
9 REPORT TYPE Inuary 15 30th day before election Runoff m s 15th day after campaign
treasurer appointment
(Officeholder Only)
July 15 8th day before election Exceeded IModified �� Final Report(Attach C/OH-FIR)Reporting
10 PERIOD Month Day Year Month..f E'/may Year ail
COVERED 10 /0 7/ 7_022. THROUGH 4 / 8 I/ 2oz�
11 ELECTION ELECTION DATE ELECTION TYPE
Month Day Year Primary Runoff Other
Description 1
2.2 General Special
12 OFFICE OFFICE HELD (if any) J 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 I 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(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)
. . . . . . . . . . . . . . . . . . .
EXPENDITURE 3. TOTAL UNITEMIZED POLITICAL EXPENDITURE. O
TOTALS $
4. TOTAL POLITICAL EXPENDITURES $ / J
. . . . . . . . . . . . . . . . . . . v
CONTRIBUTION 5. TOTAL POLITICAL CONTRIBUTIONS MAINTAINED AS OF THE LAST DAY
BALANCE OF REPORTING PERIOD $
. . . . . . . . . . . . . . . . . .
OUTSTANDING 6. TOTAL PRINCIPAL AMOUNT OF ALL OUTSTANDING LOANS AS OF THE i\
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.
Signa"Candidai of er
Please complete either option below:
�0141 p1", ROSA A. RIOS
(1)Affidavit sl%RR•�e:1
�; :Notary Public,State of Texas
9: }c Comm.Expires 05-23-2024
Notary ID 8760780
NOTARY STAMP /
Sworn to and subscribed before me by /i/J _ /� J i 1 f%,-��1 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 itle of officer 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 8/17/2020
SUBTOTALS - C/OH FORM C/OH
COVER SHEET PG 3
19 FILER NAME 20 Filer ID(Ethics Commission Filers)
21 SCHEDULE SUBTOTALS SUBTOTAL
NAME OF SCHEDULE AMOUNT
1. SCHEDULEAI: MONETARY POLITICAL CONTRIBUTIONS $
2. SCHEDULEA2: NON-MONETARY(IN-KIND)POLITICAL CONTRIBUTIONS $
3. SCHEDULE B: PLEDGED CONTRIBUTIONS $
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 I: 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