HomeMy WebLinkAboutVaughn, Blake Correction/Amendment Affidavit July 15th Semi Annual Report 2024 CORRECTION/AMENDMENT AFFIDAVIT
FOR CANDIDATE/OFFICEHOLDER FORM COR-C/OH
1 Filer ID(Ethics Commission Filers) 2 Total pages filed: F
R
3 CANDIDATE/ MS/MRSrMR FIRST MI Date Received
OFFICEHOLDER f7( 63(in l�C JUL 24 2024 L`IJ
NAME D0"
NICKNAME LftsT SUFFIX
VC^l ,5111.VI CITY SECRETARY
4 ORIGINAL REPORT ❑ January 15 ❑ Runoff ❑ Final report Date Hand-delivered or Date Postmarked
TYPE Zuly 15 0 Exceeded modified reporting V I A £M�1 A t L 5 n
limit 30th day before election Other(specify) Receipt# Amount S T
❑ 15th day after treasurer
❑ 8th day before election appointment(officeholder only)
Date Processed
5 ORIGINAL PERIOD Month Day Year Month Day Year
COVERED /1 / I / /,. PI THROUGH ( / 3C/ !7 ;2‘,r1
Date imaged
6 EXPLANATION OF CORRECTION Cam /
041119
/ce&if-r r7( C c....) re/40J cc✓1(cl do 0'1t icit,1 .c.'t:y1) fri✓v--1.
7 SIGNATURE I swear,or affirm, under penalty of perjury,that this corrected report is true and correct.
Check ONLY if applicable:
Semiannual reports: I swear, or affirm,that the original report was made in good faith and without an intent to
mislead or to misrepre-sent the information contained in the report.
❑ 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 fa' .
J ignature of Candidate/Officeholder
Please complete either option below:
(1)Affidavit
NOTARY STAMP/SEAL
Sworn to and subscribed before me by 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
OR
(2)Unworn Declaration
My name is 1.5 `cA. :-t5 L'`-- , and my date of birth is
My address is 9101 Gal�t,,, Na ri/ , ?d 1{�f Z, ` ,,,/. 4,-1
(street) (city) (state) (zip code) (country)
Executed in fa��" County,State of I '-' - ,on the 7- day of .a t^ ,20 7`f
(month (year)
Signatu Candidate/Officeholder(Declarant)
Remember To Attach Any Part Of The Campaign Finance Report Form Needed To Report And Explain Corrections
Forms provided by Texas Ethics Commission www.ethics.state.tx.us Revised 4/16/2021
CANDIDATE / OFFICEHOLDER FORM Cloth
CAMPAIGN FINANCE REPORT COVER SHEET PG 1
1 Filer ID(Ethics Commission Filers) 2 Total pages filed: G
The C/OH Instruction Guide explains how to complete this form. V
3 CANDIDATE/ MS/MRS/MR FIRST MI OFFICE USE ONLY
OFFICEHOLDER Mr Blake J
NAME
Date Received
NICKNAME LAST SUFFIX
Vaughn
4 CANDIDATE/ ADDRESS /PO BOX; APT/SUITE#; CITY; STATE; ZIP CODE
OFFICEHOLDER 8109 Belmont Ct North Richland Hills, TX 76182
MAILING
ADDRESS
Change of Address
5 CANDIDATE/ AREA CODE PHONE NUMBER EXTENSION
Date Hand-delivered or Date Postmarked
OFFICEHOLDER 682 334-4076
PHONE
Receipt# Amount 3
6 CAMPAIGN MS/MRS/MR FIRST MI
TREASURER Mr Jeffrey L
NAME Date Processed
NICKNAME LAST SUFFIX
LottDate Imaged
7 CAMPAIGN STREET ADDRESS (NO PO BOX PLEASE): APT!SUITE#; CITY: STATE; ZIP CODE
TREASURER 1709 Signet Dr. Euless, TX 76040
ADDRESS
(Residence or Business)
8 CAMPAIGN AREA CODE PHONE NUMBER EXTENSION
TREASURER
PHONE (469 236-9785
9 REPORT TYPE January 15 30th day before election Runoff 15th day after campaign
treasurer appointment
g (Officeholder Only)
1■ July 15 8th day before election f Exceeded Mod Reporting
Report(Attach VON-FR)
ttt ! 9 Reporting Limit
10 PERIOD Month Day Year Month Day Year
COVERED 01 / 01 / 24 THROUGH 06 / 30 /24
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)
City Council Place 5
14 NOTICE FROM THIS BOX IS FOR NOTICE OF POLmCAL CONTRIBUTIONS ACCEPTED OR POLITICAL EXPENDITURES MADE BY POLITICAL COMMITTEES TO SUPPORT
POLITICAL THE CANDIDATE I OFFICEHOLDER. THESE EXPENDITURES MAY HAVE BEEN MADE WITfOUT 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
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Forms provided by Texas Ethics Corn Reset Form cs•$ Re5et Page Revised 8/17/2020