Texas PO Enx12U70 Auslln' Texas 75711-2070 {512)4e3>>5eoo PERSONAL FINANCIAL STATEMENT FORM PFS COVER SHEET PAGE 1 mm mamas Fxled in acconiance chap1er572 Mme Government Code FOTNIHQS Iequ wed in 2013, covenng ca\endar year ending Decernbet 31 2012 Use FORM PFSVINSTRUCTION GUIDE when completing form NAME gflerf/0; or USEONLY mm 2 usv sumx 2 ADDRESS muses: rPoaux.AvvrsuNEA cm zvvcouz HDVVIA Amm:v\l> 3 TELEPHONE mg was mm <>: owsa mow: Posmom 5 Fanuxy membevs whose Tinnitus! acwuly yuu ave uepmmg [see ms1nmmans), svouss usvswaem emu) In Fans 1 Ihmugh Ia. you wm aismuse your fmanaa) ounna me preoedmg calendar year ln Parts 1 mrough 14, you are requived to not only your own financial but also Ihal ofyour spouse or a uepenaem mun (see mslrucuons). COPY AND ATTACH ADDITIONAL PAGES AS NECESSARY uaxeqx us Remszanme/zma 1 Texas Ethics Commission P.O. Box 12070 Austin, Texas 78711-2070 (512) 463-5800 (TDD 1-800-735-2989) PERSONAL FINANCIAL STATEMENT COVER SHEET PAGE 2 On this page, indicate any Parts of Form PFS that are not applicable to you. If you do not place a check in a box, then pages for that Part must be included in the report. If you place a check in a box, do NOTincIude pages for that Part in the report. 6 PARTS NOT APPLICABLE TO FILER Cl Part 1A -- Sources of Occupational lncome Part 1B -- Retainers Part 2 - Stock Cl Part 3 -- Bonds, Notes Other Commercial Paper Part 4 - Mutual Funds Part 5 - lncome from Interest, Dividends, Royalties Rents Cl Part 6 - Personal Notes and Lease Agreements Cl Part 7A - Interests in Real Property Part 7B -- interests in Business Entities Part 8 - Gifts Part 9 - Trust lncome Part 10A - Blind Trusts Part 108 -- Trustee Statement Part 11A - Assets of Business Associations Part 11B - Liabilities of Business Associations Part 12 - Boards and Executive Positions Part 13 - Expenses Accepted Under Honorarium Exception Part 14 - Interest in Business in Common with Lobbyist Part 15 - Fees Received for Services Rendered to a Lobbyist or Lobbyist's Employer Part 16 -- Representation by Legislator Before State Agency Part 17 -- Benefits Derived from Functions Honoring Public Servant Part 18 -- Legislative Continuances Revised 04/19/2013 I Texas Ethics Commission P.O. Box 12070 Austin, Texas 78711-2070 (512) 463-5800 (TDD 1-800-735-2989) page in the report. SOURCES OF OCCUPATIONAL INCOME If the requested information is not applicable, indicate that on Page 2 of the Cover Sheet, and do NOT include this PART 1A When reporting information about a dependent child's activity, indicate the child about whom you are reporting by providing the number under which the child is listed on the Cover Sheet. 1 INFORMATION RELATES TO spouse DEPENDENT CHILD 2 EMPLOYMENT BYANOTHER CI NAME AND ADDRESS OF EMPLOYER I POSITION HELD (Check if iler's Home Address) - . rd 7x NATURE OF OCCUPATION EMPLOYED BY ANOTHER INFORMATION RELATES T0 FILER Ifirsfiouse El DEPENDENT CHILD NAME AND ADDRESS OF EMPLOYER IPOSITION HELD EMPLOYMENT (Check if Filer's Home Address) /77 /77/2 /09915 /774r/e/ 6- fl; fly.//If .0759?/NATURE OF OCCUPATION INFORMATION RELATES TO SPOUSE DEPENDENT CHILD EMPLOYMENT BY ANOTHER CI SELF--EMPLOYED NAME AND ADDRESS OF EMPLOYER I POSITION HELD fi/ /$44 (Check If Fi|er's Home Addressfla I/"Jfl COPY A ND ATTACH ADDITIONAL PAGES AS NECESSARY Revised 04/ 1 9/201 3 Texas Ethics Commission I P.O. Box 12070 Austin, Texas 78711-2070 (512) 463-5800 (TDD 1-800-735-2989) RETAINERS PART 1B If the requested information is not applicable, indicate that on Page 2 of the Cover Sheet, and do NOT include this page in the report. This section concerns fees received as a retainer by you, your spouse, or a dependent child (or by a business in which you, your spouse, or a dependent child have a "substantial interest") for a claim on future services in case of need, rather than for services on a matter specified at the time of contracting for or receiving the fee. Report information here only if the value of the work actually performed during the calendar year did not equal or exceed the value of the retainer. For more information, see FORM GUIDE. When report information about a dependent child's activity, indicate the child about whom you are reporting by providing thexqber under which the child is listed on the Cover Sheet. 1 NAME AND ADDRESS FEE RECEIVED OM 2 FEE RECEIVED BY El FILER OR Ines OR us 's Bu Ine CI DEPEN NT CHILD OR CHILD BUSINESS 3 FEE AMOUNT NAME OF BUSINESS CI LESS THAN $5,000 MORE NAME AND ADDRESS FEE RECEIVED FROM NAME BUSINESS FEE RECEIVED BY CI FILER on BUSINESS CI SPOUSE OR spouses BUSINESS CI DEPENDENT CHILD OR BUSINESS FEE AMOUNT Less THAN $5,000 CI El MORE COPY AND ATTACH ADDITIONAL PAGES AS NECESSARY Revised 04/1 9/201 3 Texas Ethics Commission P.O. Box 12070 Austin, Texas 78711-2070 (512) 463-5800 (TDD 1-800-735-2989) STOCK PART 2 If the requested information is not applicable, indicate that on Page 2 of the Cover Sheet, and do NOTincIude this page in the report. List each business entity in which you, your spouse, or a dependent child held or acquired stock during the calendar year and indicate the category of the number of shares held or acquired. If some or all of the stock was sold, also indicate the category of the amount of the net gain or loss realized from the sale. For more information, see FORM PFS-- INSTRUCTION When reporting information about a dependent child's activity, indicate the child about whom you are reporting by providing the number under which the child is listed on the Cover Sheet. 1 BUSINESS ENTITY NAME fig //744 i 4 2 STOCK HELD OR ACQUIRED BY SPOUSE El DEPENDENT CHILD 3 NUMBER OF SHARES Efss THAN 100 1,000 To 4999 CI 5,000 To 9,999 10000 OR MORE 4 IF SOLD NET GAIN CI LESS THAN $5,000 CI CI MORE CI NET LOSS BUSINESS ENTITY NAME STOCK HELD OR ACQUIRED BY FILER SPOUSE DEPENDENT CHILD NUMBER OF SHARES CI LESS THAN 100 100 To 499 CI 500 To 999 1,000 To 4.999 5,000 To 9,999 CI 10000 oR MORE IF SOI-D I3 NET GAIN El LESS THAN $5,000 CI El MORE NET Loss BUSINESS ENTITY NAME STOCK HELD OR ACQUIRED BY FILER CI SPOUSE CI DEPENDENT CHILD NUMBER OF SHARES LESS THAN 100 1.000 TO 4,999 I3 5,000 TO 9.999 CI 10000 OR MORE IF SCI-D I3 NET GAIN LESS THAN $5,000 CI Cl MORE El NET LOSS E-I FT BUSINESS ENTITY NAME STOCK HELD OR ACQUIRED BY El FILER El SPOUSE l:l DEPENDENT CHILD NUMBER OF SHARES [3 LESS THAN 100 100 To 499 El 500 To 999 1,000 T0 4,999 5,000 To 9999 El 10,000 oR MORE IF SOLD [3 NET GAIN LESS THAN $5.000 CI El El MORE El NET Loss BUSINESS ENTITY NAME STOCK HELD OR ACQUIRED BY FILER SPOUSE lj DEPENDENT CHILD NUMBER OF SHARES El LESS THAN 100 999 1,000 To 4,999 5,000 TO 9,999 El 10,000 oR MORE IF I3 NET GAIN LEss THAN $5,000 CI El MORE NET LOSS COPY AND ATTACH ADDITIONAL PAGES AS NECESSARY Revised 04/19/2013 Texas Ethics Commission P.O. Box 12070 Austin, Texas 78711-2070 (512) 463-5800 (TDD 1-800-735-2989) BONDS, NOTES OTHER COMMERCIAL PAPER If the requested information is not applicable, indicate that on Page 2 of the Cover Sheet, and do NOT include this page in the report. PART 3 List all bonds, notes, and other commercial paper held or acquired by you, your spouse, or a dependent child during the calendar year. If sold, indicate the category Of the amount Of the net gain or loss realized from the sale. For more information, See FORM GUIDE. When reporting information about a dependent child's activity, indicate the child about whom you are reporting by providing the number under which the child is listed on the Cover Sheet. 1 DESCRIPTION OF INSTRUMENT HELD OR ACQUIRED BY El DEPENDENT CHILD IF SOLD El LESS THAN $5,000 CI MORE El NET LOSS DESCRIPTION OF INSTRUMENT I HELD OR ACQUIRED BY MR ?2*?OusE DEPENDENT CHILD IF SOLD A GNN El LESS THAN $5,000 MORE El NET LOSS DESCRIPTION . - - OF INSTRUMENT 5 EC, fl HELD OR ACQUIRED BY DEPENDENT CHILD IF SOLD ET GAIN El LESS THAN $5,000 Cl CI MORE NET LOSS COPY AND ATTACH ADDITIONAL PAGES AS NECESSARY Revised 04/1 9/201 3 1 Texas Ethics Commission P.O. Box 12070 Austin, Texas 78711-2070 (512) 463-5800 (TDD 1-800-735-2989) MUTUAL FUNDS PART 4 If the requested information is not applicable, indicate that on Page 2 of the Cover Sheet, and do NOT include this page in the report. List each mutual fund and the number of shares in that mutual fund that you, your spouse, or a dependent child held or acquired during the calendar year and indicate the category of the number of shares of mutual funds held Or acquired. If some or all of the shares of a mutual fund were Soid, also indicate the category of the amount of the net gain or loss realized from the Sale. For more information, see FORM GUIDE. When reporting information about a dependent child's activity, indicate the child about whom you are reporting by providing the number under which the child is listed on the Cover Sheet. 1 MUTUAL FUND NAME 2 SHARES OF MUTUAL FUND HELD OR ACQUIRED BY ILER OUSE El DEPENDENT CHILD 3 NUMBER OF SHARES [1 LESS THAN 100 999 1,000 TO 4,999 OF MUTUAL FUND El 5,000 TO 9,999 Eflfio OR MORE 4 IF SOLD GAIN LESS THAN $5,000 El 0--OR MORE NET LOSS MUTUAL FUND NAME HAR ND SELD giacgguggo B8 El lj SPOUSE El DEPENDENT CHILD NUMBER OF SHARES LESS THAN 100 lj 100 To 499 500 TO 999 1,000 TO 4,999 OF MUTUAL FUND El 5,000 TO 9,999 El 10,000 OR MORE IF SOLD NET GAIN '3 LESS THAN $5,000 MORE NET LOSS MUTUAL FUND NAME I SHARES OF MUTUAL FUND HELD OR ACQURED BY FILER SPOUSE DEPENDENT NUMBER OF SHARES lj LESS THAN 100 100 TO 499 El 500 TO 999 1,000 TO 4,999 OF MUTUAL FUND 5000 TO 9,999 CI 10000 OR MORE IF SOLD NET (3 A LESS THAN $5,000 El El MORE Cl NET Loss COPY AND ATTACH ADDITIONAL PAGES AS NECESSARY wvvw.ethics.State.tx.us Revised 04/19/2013 Texas Ethics Commission P.O. Box 12070 Austin, Texas 78711-2070 (512) 463-5800 (TDD 1-800-735-2989) INCOME FROM INTEREST, DIVIDENDS, ROYALTIES RENTS If the requested information is not applicable, indicate that on Page 2 of the Cover Sheet, and do NOT include this page in the report. PART 5 List each source of income you, your spouse, or a dependent child received in excess of $500 that was derived from interest, dividends, royalties, and rents during the calendar year and indicate the category of the amount of the income. For more information, see FORM PFS--INSTRUCTION GUIDE. When reporting information about a dependent child's activi providing the number under which the child is listed on the Cover Sheet. ty, indicate the child about whom you are reporting by 1 SOURCE OF INCOME NAME AND ADDRESS 2 RECEIVED BY 3 FILER El spouse l:l DEPENDENT CHILD AMOUNT CI El El MORE -if NAME AND ADDRESS SOURCE OF INCOME RECEIVED BY FILER SPOUSE CI DEPENDENT CHILD AMOUNT CI CI MORE NAME AND ADDRESS SOURCE OF INCOME RECEIVED BY FILER SPOUSE CI DEPENDENT CHILD AMOUNT CI CI CI MORE COPY AND ATTACH ADDITIONAL PAGES AS NECESSARY wvvw.ethics.state.tx.us Revised 04/ 1 9/201 3 Texas Ethics Commission P.O. Box 12070 Austin, Texas 78711-2070 (512) 463-5800 (TDD 1-800-735-2989) PERSONAL NOTES AND LEASE AGREEMENTS PART 6 If the requested information is not applicable, indicate that on Page 2 of the Cover Sheet, and do NOT include this page in the report. Identify each guarantor of a loan and each person or financial institution to whom you, your spouse, or a dependent child had a total financial liability of more than $1,000 in the form of a personal note or notes or lease agreement at any time during the calendar year and indicate the category of the amount of the liability. For more informa- tion, see FOR GUIDE. When reporting formation about a dependent child's activity, indicate the child about whom you are reporting by providing the numb under which the child is listed on the Cover Sheet. 1 PERSON OR INSTIT ON HOLDING NOTE OR LEASE AGREEMENT 2 LIABILITY OF FILER SPOUSE El DEPENDENT CHILD 3 I . GUARANTOR 4 . AMOUNT .000 El MORE PERSON OR INSTITUTION HOLDING NOTE OR LEASE AGREEMENT LIABILITY OF FILER Cl SPOUSE DEPENDENT CHILD GUARANTOR AMOUNT Ij Cl $1o,%24,999 MORE PERSON OR INSTITUTION HOLDING NOTE OR LEASE AGREEMENT LIABILITY OF FILER Cl SPOUSE DEPENDENT CHILD GUARANTOR AMOUNT Cl Cl Cl El MORE -- COPY AND ATTACH ADDITIONAL PAGES AS NECESSARY Revised 04/19/2013 Texas Ethics Commission P.O. Box 12070 Austin, Texas 78711-2070 (512) 463-5800 (TDD 1-800-735-2989) page in the report. INTERESTS IN REAL PROPERTY If the requested information is not applicable, indicate that on Page 2 of the Cover Sheet, and do NOT include this PART 7A INSTRUCTION GUIDE. Describe all beneficial interests in real property held or acquired by you, your spouse, or a dependent child during the calendar year. If the interest was sold, also indicate the category of the amount of the net gain or loss realized from the sale. For an explanation of "beneficial interest" and other specific directions for completing this section, See FORM When reporting information about a dependent child's activity, indicate the child about whom you are reporting by providing the number under which the child is listed on the Cover Sheet. 1 HELD oR ACQUIRED BY 2 STREETADDRESS CI CHECK IF HOME ADDRESS CI DEPENDENT CHILD flF/ll.ER USE STREET ADDRESS, INCLUDING CITY. COUNTY, AND STATE 3 OTS ACRES 4 NAMES OF PERSONS RETAINING AN INTEREST NOTAPPLICABLE (SEVERED MINERAL INTEREST) 5 lF SOL NET GAIN CI NOTAVAILABLE CHECK IF HOME ADDRESS NET LOSS HELD OR ACQUIRED BY SPOUSE [3 DEPENDENT CHILD STREET ADDRESS, INCLUDING CITY. COUNTY, AND STATE LESS THAN $5,000 MORE RETAINING AN INTEREST NOT APPLICABLE (SEVERED MINERAL INTEREST) NUM ROFL SOR ACRESAND NAMEOFC UNTY WHE (LOCATED 5/ /77 57/ LOTS I . 0' in IICIJG NAMES OF PERSONS /efl W. IF So NET GAIN lj NET LOSS LESS THAN $5,000 MORE COPY AND ATTACH ADDITIONAL PAGES AS NECESSARY - Revised 04/19/2013 I Texas Ethics Commission P.O. Box 12070 Austin, Texas 78711-2070 (512) 463-5800 (TDD 1-800-735-2989) INTERESTS IN BUSINESS ENTITIES PART 7B If the requested information is not applicable, indicate that on Page 2 of the Cover Sheet, and do NOT include this page in the report. Describe all beneficial interests in business entities held or acquired by you, your spouse, or a dependent child during the calendar year. If the interest was sold, also indicate the category ofthe amount of the net gain or loss realized from the sale. For an explanation of "beneficial interest" and other specific directions for completing this section, see FORM PFS-- lN RUCTION GUIDE. orting information about a dependent child's activity, indicate the child about whom you are reporting by providing number under which the child is listed on the Cover Sheet. 1 HELD OR AC BY El SPOUSE El DEPENDENT CHILD 2 NAME AND ADDRESS (Check if Filer's Home Address) 3 lF SOLD I [3 NET GAIN El LESS AN $5,000 El El MORE El NET LOSS HELD OR ACQUIRED BY FILER Excuse Cl DEPENDENT CHILD NAME AND ADDRESS heck if Filer's Home Address) lF SOLD NET GAW LESS THAN $5,000 El El $10, CI $25,000--on MORE CI NET LOSS HELD OR ACQUIRED BY 1] FILER El SPOUSE El DEPENDENTN NAME AND ADDRESS DESCRIPTION (Check if FileI's Home Address) IF SOLD NET GNN El LESS THAN $5,000 CI MORE NET LOSS COPY AND ATTACH ADDITI ONAL PAGES AS NECESSARY Revised 04/19/2013 Texas Ethics Commission P.O. Box 12070 Austin, Texas 78711 -2070 (512) 463-5800 (TDD 1-800-735-2989) GIFTS PART 8 If the requested information is not applicable, indicate that on Page 2 of the Cover Sheet, and do NOT include this page in the report. Identify any person or organization that has given a gift worth more than $250 to you, your spouse, or a dependent child, and describe the gift. The description of a gift of cash or a cash equivalent, such as a negotiable instrument or gift certificate, must include a statement of the value of the gift. Do not include: 1) expenditures required to be reported by a person required to be registered as a lobbyist under chapter 305 of the Government Code; 2) political contributions reported as required by law; or 3) gifts given by a person related to the recipient within the second degree by consanguinity or affinity. For more information, see FORM PFS--INSTRUCTION GUIDE. When reporting information about a dependent Child's activity, indicate the child about whom you are reporting by providing the number finger which the child is listed on the Cover Sheet. NAME AND ADDRESS 1 DONOR RECIPIENT FILER SPOUSE El DEPENDENT CHILD /l 3 DESCRIPTION OF GIFT /4 NAME AND ADDRESS DONOR RECIPIENT [3 FILER spouse CI DEPENDENT CHILD DESCRIPTION OF GIFT NAME AND ADDRESS DONOR RECIPIENT FILER El SPOUSE El DEPENDENT CHILD DESCRIPTION OF GIFT If -- E. COPY AND ATTACH ADDITIONAL PAGES AS NECESSARY Revised 04/19/2013 Texas Ethics Commission P.O. Box 12070 Austin, Texas 78711-2070 (512) 463-5800 (TDD 1-800-735-2989) TRUST INCOME PART 9 If the requested information is not applicable, indicate that on Page 2 of the Cover Sheet, and do NOT include this page in the report. identify each source of income received by you, your spouse, or a dependent child as beneficiary of a trust and indicate the category of the amount of income received. Also identify each asset of the trust from which the beneficiary received more than $500 in inco e, if the identity of the asset is known. For more information, see FORM PFS--INSTRUCTION GUIDE. When reporting infor ation about a dependent child's activity, indicate the child about whom you are reporting by providing the number un rwhich the child is listed on the Cover Sheet. 1 NAME OF TRUST SOURCE 2 BENEFICIARY aw: Cl spouse El DEPENDENT CHILD INCOME El LESS TH $5,000 CI El MORE 4 ASSETS FROM WHICH OVER $500 WAS RECEIVED UNKNOWN NAME OF TRUST SOURCE BENEFICIARY Cl FILER El SPOUSE \I:l DEPENDENT CHILD INCOME El LESS THAN $5,000 El El $10, El MORE ASSETS FROM WHICH OVER $500 WAS RECEIVED UNKNOWN NAME OF TRUST SOURCE BENEFICIARY El FILER El spouse El DEPENDENT CHILD INCOME LESS THAN $5,000 MORE ASSETS FROM WHICH OVER $500 WAS RECEIVED El UNKNOWN COPY AND ATTACH ADDITIONAL PAGES AS NECESSARY Revised 04/19/2013 Texas Ethics Commission PO. Box 12070 Austin, Texas 78711-2070 (512) 463-5800 (TDD 1-800-735-2989) BLIND TRUSTS PART 10A If the requested information is not applicable, indicate that on Page 2 of the Cover Sheet, and do NOT include this page in the report. identify each blind trust that complies with section 572.023(c) of the Government Code. See FORM PFS--INSTRUCTION GUIDE. hen reporting information about a dependent child's activity, indicate the child about whom you are reporting by pr 'ding the number under which the child is listed on the Cover Sheet. 1 2 NAME AND ADDRESS TRUSTEE 3 BENEFICIARY El FILER SPOUSE El DEPENDENT CHILD 4 FAIR MAR TV KE A UE LESS THAN $5,000 CI El MORE 5 DATE CREATED NAME OF TRUST NAME AND ADDRESS TRUSTEE BENEFICIARY FILER El DEPENDENT CHILD FAIR MARKET VALUE LESS THAN $5,000 CI MORE DATE CREATED NAME OF TRUST NAME AND ADDRESS TRUSTEE BENEFICIARY FILER El SPOUSE El DEPENDENT CHILD FAIR MARKET VALUE Ci LESS THAN $5,000 El CI MORE DATE CREATED COPY AND ATTACH ADDITIONAL PAGES AS NECESSARY Revised 04/19/2013 Texas Ethics Commission P.O. Box 12070 Austin, Texas 78711-2070 (512) 463-5800 (TDD 1-800-735-2989) TRUSTEE TEMENT PART 10B if the requested inform 'on is not applicable, indicate that on Page 2 of the Cover Sheet, and do NOT include this page in the report. An individual who is required identify a blind trust on Part 10A of the Personal Financial Statement must submit a statement signed by the trustee each blind trust listed on Part 10A. The portions of section 572.023 ofthe Government Code that relate to blind trusts are 1 NAME OF TRUST 2 TRUSTEE NAME 3 ON WHOSE BEHALF STATEMENT IS BEING FILED 4 TRUSTEE STATEMENT I affirm, under penalty of perju trust except information that ma Code and that to the best of my Government Code. that have not revealed any information to the beneficiary of this disclosed un act' 572.023 of the Government owledge, th tr st plies with section 572.023 of the Vrustee Signature 1 572.023. Contents of Financial Statement in General The account of financial activity consists of: (8) identification of the source and the category of the amount of all income rece ed as beneficiary of a trust, other than a blind trust that complies with Subsection and identification of each trust set, if known to the beneficiary, from which income was received by the beneficiary in excess of $500; (14) identification of each blind trust that complies with Subsection including: (A) the category of the fair market value of the trust; (8) the date the trust was created; (C) the name and address of the trustee; and (D) a statement signed by the trustee, under penalty of perjury, stating that: the trustee has not revealed any information to the individual, except information that ma disclosed under Subdivision and (ii) to the best of the trustee's knowledge, the trust complies with this section. For purposes of Subsections and (14), a blind trust is a trust as to which: (1) the trustee: (A) is a disinterested party; (B) is not the individual; (C) is not required to register as a lobbyist under Chapter 305; (D) is not a public officer or public employee; and (E) was not appointed to public office by the individual or by a public officer or public employee the individual supervises; and (2) the trustee has complete discretion to manage the trust. including the power to dispose of and acquire trust assets without consulting or notifying the individual. If a blind trust under Subsection is revoked while the individual is subject to this subchapter, the individual must file an amendment to the individual's most recent financial statement, disclosing the date of revocation and the previously unreported value by category of each asset and the income derived from each asset. .state.tx.us Revised 04/19/2013 Texas Ethics Commission P.O. Box 12070 Austin, Texas 78711-2070 (512) 463-5800 (TDD 1-800-735-2989) ASSETS OF BUSINESS ASSOCIATIONS If the requested information is not applicable, indicate that on Page 2 of the Cover Sheet, and do NOT include this page in the report. PART 11A Describe all assets of each corporation, firm, partnership, limited partnership, limited liability partnership, professional corporation, professional association, joint venture, or other business association in which you, your spouse, or a depen- dent child held, acquired, or sold 50 percent or more of the outstanding ownership and indicate the category of the amount of the assets. For more information, see FORM GUIDE. When reporting information about a dependent child's activity, indicate the child about whom you are reporting by providing the number under which the child is listed on the Cover Sheet. BUSINESS ASS NAME AND ADDRESS (Check if Filer's Home Address) 2 BusiNEssT%~E\ 3 HELD, ACQUIRED, OR SOLD BY 4 ASSETS El FILER "Cl ipoflfl DESCRIPTI I DEPENDENT CHILD CATEGORY LESS THAN $5,000 I CI MORE LESS THAN $5,000 I3 Cl MORE El LESS THAN $5,000 CI El El MORE THAN $5.000 CI $25,000--on MORE Cl LESS THAN $5,000 MORE LESS THAN $5,000 I3 MORE El LESS THAN $5,000 CI MORE El LESS THAN $5.000 CI MORE COPY AND ATTACH ADDITIONAL PAGES AS NECESSARY Revised 04/19/201 3 Texas Ethics Commission P.O. Box 12070 Austin, Texas 78711-2070 (512) 463-5800 (TDD 1-800-735-2989) LIABILITIES OF BUSINESS ASSOCIATIONS PART 11 If the requested information is not applicable, indicate that on Page 2 of the Cover Sheet, and do NOT include this page in the report. Describe all liabilities of each corporation, firm, partnership, limited partnership, limited liability partnership, professional corporation, professional association, joint venture, or other business association in which you, your spouse, or a depen- dent child held, acquired, Or sold 50 percent or more of the outstanding ownership and indicate the category of the amount of the assets. For more information, see FORM PFS-INSTRUCTION GUIDE. Whe reporting information about a dependent child's activity, indicate the child about whom you are reporting by provi the number under which the child is listed on the Cover Sheet. 1 BUSINE ASSOCIATI NAME AND ADDRESS (Check If Filer's Home Address) 2 BUSINESS TYPE OR SOLD BY 4 LIABILITIES 3 \lj FILER El SPOUSE DESCRIPTION DEPENDENT CHILD CATEGORY LESS THAN $5,000 CI Cl LESS THAN $5,000 LESS THAN $5,000 El LESS THAN $5.000 LES THAN $5,000 CI 4999 LESS THAN $5.0 CI El LESS THAN $5,000 Cl El LESS THAN 55,000 El El CI MORE MORE CI Cl MORE El MORE [3 Cl MORE El Cl MORE CI MORE CI MORE COPY AND ATTACH ADDITIONAL PAGES AS NECESSARY wvvw.ethics.state.tx.us Revised 04/ 1 9/201 3 Texas Ethics Commission P.O. Box 12070 Austin, Texas 78711-2070 (512) 463-5800 (TDD 1-800-735-2989) BOARDS AND EXECUTIVE POSITIONS If the requested information is not applicable, indicate that on Page 2 of the Cover Sheet, and do NOT include this page in the report. PART 12 List all boards of directors of which you, your spouse, or a dependent child are a member and ali executive positions you, your spouse, or a dependent Child hold in corporations, firms, partnerships, limited partnerships, limited liability partner- ships, professional corporations, professional associations, joint ventures, other business associations, or proprietorships, stating the name of the organization and the position held. For more information, see FORM GUIDE. When reporting information about a dependent child's activity, indicate the child about whom you are reporting by providing the number under which the child is listed on the Cover Sheet. . /y I I I /mgr>> I Si/mdv I. Ni I /dd POSITION HELD /ff gag Mb (A/an 'pa It POSITION HELD BY ILER spouse DEPENDENT CHILD ORGANIZATION - HELD POSITION HELD BY El El SPOUSE El DEPENDENT CHILD ORGANIZATION 3* fr - POSITION HELD POSITION HELD BY El FILER Cl SPOUSE Cl DEPENDENT CHILD ORGANIZATION POSITION HELD POSITION HELD BY El FILER Ci SPOUSE Cl DEPENDENT CHILD POSITION HELD POSITION HELD BY FILER SPOUSE DEPENDENT CHILD COPY AND ATTACH ADDITIONAL PAGES AS NECESSARY Revised 04/19/2013 I Texas Ethics Commission P.O. Box 12070 Austin, Texas 78711-2070 (512) 463-5800 (TDD 1-800-735-2989) EXPENSES ACCEPTED UNDER HONORARIUM EXCEPTION PART 13 If the requested information is not applicable, indicate that on Page 2 of the Cover Sheet, and do NOT include this page in the report. Identify any person who provided you with necessary transportation, meals, or lodging, as permitted under section 36.07(b) of the Penal Code, in connection with a conference or similar event in which you rendered services, such as addressing an udience or participating in a seminar, that were more than perfunctory. Also provide the amount of the expenditures on nsportation, meals, or lodging. You are not required to include items you have already reported as political contributio on a campaign finance report, or expenditures required to be reported by a lobbyist under the lobby law (chapter 305 ofthe overnment Code). For more information, see FORM PFS--INSTRUCTION GUIDE. 1 NAME AND ADDRESS PROVIDER 2 AMOUNT PROVIDER AMOUNT PROVIDER NAME AND ADDRESS AMOUNT NAME AND ADDRESS i PROVIDER AMOUNT -- COPY AND ATTACH ADDITIONAL PAGES AS NECESSARY Revised 04/19/2013 Texas Ethics Commission P.O. Box 12070 Austin, Texas 78711-2070 (512) 463-5800 (TDD 1-800-735-2989) INTEREST IN BUSINESS IN COMMON WITH LOBBYIST PART 14 If the requested information is not applicable, indicate that on Page 2 of the Cover Sheet, and do NOT include this page in the report. Identify each corporation, firm, partnership, limited partnership, limited liability partnership, professional corporation, profes- sional association, joint venture, or other business association, other than a publicly-held corporation, in which you, your spouse, or a dependent child, and a person registered as a lobbyist under chapter 305 of the Government Code that both have an interest. For more information, see FORM PFS--INSTRUCTION GUIDE. 1 NAME AND ADDRESS BUSIN ENTITY 2 INTEREST HELDN El FILER CI SPOUSE El DEPENDENT CHILD NAME AND ADDRESS BUSINESS ENTITY INTEREST HELD BY POUSE CI DEPENDENT CHILD BUSINESS ENTITY NAME AND ADDRESS INTEREST HELD BY =5 BUSINESS ENTITY INTEREST HELD BY FILER El SPOUSE DEPENDEN NAME AND ADDRESS BUSINESS ENTITY INTEREST HELD BY El FILER El SPOUSE El DEPENDENT CHILD COPY AND ATTACH ADDITIONAL PAGES AS NECESSARY Revised 04/19/2013 Texas Ethics Commission P.O. Box 12070 Austin, Texas 78711-2070 (512) 463-5800 (TDD 1-800-735-2989) FEES RECEIVED FOR SERVICES RENDERED PART 15 TO A LOBBYIST OR EMPLOYER If the requested information is not applicable, indicate that On Page 2 of the Cover Sheet, and do NOT include this page in the report. Report any fee you received for providing services to or On behalf of a person required to be registered as a lobbyist under chapter 305 of the Govemment Code, Or for providing senrices to or on behalf of a person you actually know directly compen- sates Or reimburses a person required to be registered as a lobbyist. Report the name Of each person Or entity for which the serv' es were provided, and indicate the category of the amount Of each fee. For more information, see FORM PF S-- GUIDE. 1 WERE PROVI FEE CATEGORY LESS THAN $5.000 MORE PERSON OR ENTITY FOR WHOM SERVICES WEREPROVIDED I FEE CATEGORY 35% 00 000550999 El MORE 1 PERSON OR ENTITY FOR WHOM SERVICES WERE PROVIDED FEE CATEGORY lj LESS THAN $5,000 El MORE PERSON OR ENTITY FOR WHOM SERVICES WERE PROVIDED FEE CATEGORY LESS THAN $5,000 CI MORE PERSON OR ENTITY FOR WHOM SERVICES WERE PROVIDED FEE CATEGORY El LESS THAN $5,000 CI CI MORE PERSON OR ENTITY FOR WHOM SERVICES WERE PROVIDED FEE CATEGORY El LESS THAN $5,000 CI El CI MORE T7 4- COPY AND ATTACH ADDITIONAL PAGES AS NECESSARY Revised 04/19/2013 Texas Ethics Commission P.O. Box 12070 Austin, Texas 78711-2070 (512) 463-5800 (TDD 1-800-735-2989) STATE AGENCY page in the report. REPRESENTATION BY LEGISLATOR BEFORE If the requested information is not applicable, indicate that on Page 2 of the Cover Sheet, and do NOT include this PART 16 September 1, 2003. 1 STATE AGENCY This section applies only to members of the Texas Legislature. A member of the Texas Legislature who represents a person for compensation before a state agency in the executive branch must provide the name of the agency, the name of the person represented, and the category of the amount of the fee received for the representation. For more information, see FORM PFS--INSTRUCTION GUIDE. Note: Beginning September 1, 2003, iegislators may not, for compensation, represent another person before a state agency in the executive branch. The prohibition does not apply if: (1) the representation is pursuant to an attorney/client relationship in a riminal law matter; (2) the representation involves the filing of documents that involve only ministerial acts on the part of th agency; or (3) the representation is in regard to a matter for which the legislator was hired before 2 PERSON REPRESENTED 3 FEE CATEGORY Cl LESS AN $5,000 CI 5 Cl El MORE STATE AGENCY PERSON REPRESENTED FEE CATEGORY El LESS THAN $5,000 Cl STATE AGENCY MORE PERSON REPRESENTED FEE CATEGORY El LESS THAN $5,000 Cl CI MORE STATE AGENCY PERSON REPRESENTED FEE CATEGORY LESS THAN $5,000 Cl MORE COPY AND ATTACH ADDITIONAL PAGES AS NECESSARY wvvw.ethics.state.tx.us Revised 04/ 9/201 3 Texas Ethics Commission P.O. Box 12070 Austin, Texas 78711-2070 (512) 463-5800 (TDD 1-800-735-2989) BENEFITS DERIVED FROM FUNCTIONS HONORING PART 17 PUBLIC SERVANT If the requested information is not applicable, indicate that on Page 2 of the Cover Sheet, and do NOT include this page in the report. Section 36.10 of the Penal Code provides that the gift prohibitions set out in section 36.08 of the Penal Code do not apply to a benefit derived from a function in honor or appreciation of a public servant required to file a statement under chapter 572 of the Government Code or titte 15 of the Election Code if the benefit and the source of any benefit over $50 in value are: 1) reported in th statement and 2) the benefit is used solely to defray expenses that accrue in the performance of duties or activities in co ection with the office which are nonreimbursable by the state or a politicai subdivision. If such a benefit is received and is reported by the public servant undertitle 15 ofthe Election Code, the benefit is reportable here. For more information, see F0 GUIDE. NAME AND ADDRESS 1 SOURCE OF BENEFIT NAME AND ADDRESS SOURCE OF BENEFIT BENEFIT NAME AND ADDRESS SOURCE OF BENEFIT BENEFIT NAME AND ADDRESS SOURCE OF BENEFIT BENEFIT COPY AND ATTACH ADDITIONAL PAGES AS NECESSARY wvvw.ethics.state.tx.us Revised 04/19/2013 Al Texas Ethics Commission P.O. Box 12070 Austin, Texas 7871 1-2070 (51 2) 463-5800 (TDD 1-800-735-2989) LEGISLATIVE CONTINUANCES If the requested information is not applicable, indicate that on Page 2 of the Cover Sheet, and do NOT include this page in the report. PART 18 Identify any legislative continuance that you have applied for or obtained under section 30003 of the Civil Practice and Remedies Code, or under another law or rule that requires or permits a court to grant continuances on the grounds that an attorney for a party is a member or member-elect of the legislature. 1 NAME OF PARTY 2 DATE INED STYLE, CAUSE NUM R, COURT JURISDICTION DATE OF CONTINUANCE APPLICATION WAS CONTINUANCE El YES NAME OF PARTY REPRESENTED DATE RETAINED STYLE, CAUSE NUMBER, COURT, JURISDICTION DATE OF CONTINUANCE APPLICATION WAS CONTINUANCE YES ljno COPY AND ATTACH ADDITIONAL PAGES AS NECESSARY Revised 04/ 1 9/201 3 In Texas Ethics Commission P.O. Box 12070 Austin, Texas 78711-2070 (512) 463-5800 (TDD 1-800-735-2989) PERSONAL FINANCIAL STATEMENT AFFIDAVIT The law requires the personal financial statement to be verified. The verification page must have the signature of the individual required to file the personal financial statement, as well as the signature and stamp or seal of office of a notary public or other person authorized by law to administer oaths and affirmations. Without proper verification, the statement is not considered filed. I swear, or affirm, under penalty of perjury, that this financial statement covers calendar year ending December I 2012, and is true and correct reported by me under chapter Signature of Filer AFFIX NOTARY STAMP SEAL ABOVE Z. LOCKE Notary Public STATE OF TEXAS My Comm Exp. Jul. 05, 2014 before me, by the said day of 20 to certify which, witness my hand and seal of office. re A zltoate, A/mm gnature of oft'-leg administering Print name of officer administering oath Title of oath Z. LOCKE LEWIS Notary Public STATE OF TEXAS My Comm. Exp. Jul. 05, 2014 Revised 04/19/2013