TexasEth::3Commi55won PO 50312079 gusnn, Fexas 7e7n,2o7o (mL>1--euo--7a5--29e9) PERSONAL FINANCIAL STATEMENT FORM PFS COVER SHEET PAGE 1 Fued accordance chapter 572 cfme Government (Dude Farmings veqmred in 2013' ccveing caIendav year ending December 31, 2012 'mm use FORM PFS--INSTRUCTION GUIDE when Liarrmetmg (ms Iorm 57 1 NAME NW OFFICE use ONLY am cf . .. RECENED Do>> /9194: 2 ADDRESS .mm,max snfizz/vcauz JAN 3 2013 Texas Ethics mm . mm 3 Amcong Pxmsuums JAN 3 1 2m REASON FOR FILING cmmams STATEMENT 7- . . 1-L. 3mmsuo;=m 4. . I:wo.mmomcER . . . . .w.c.m5m' Exacmve HEAD mm on mass sum 4 \wuwcvz>=Awm I: own: (wmar: mam>>, Famfly iv: Inserting (see mm emu: 2 3., In Parts I Waugh we, you wm dismcse your lwnanciai aclivily uurmg the precedmg calendar year In Par'.s1 through you are required In not my your own Ihaf I71 spouse or a dependentchiw (see instruchons). 8 COPY AND ATTACH ADDITIONAL PAGES AS SIQEHEL: elmcs stale (X .s Revfsadfli/11/2013 Texas Ethics Commission FEO. 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 which parts of Form PPS are not applicable to you. if you place a check in the box next to a Part below, then no pages for that Part should be inctuded in the report. If you do not place a check in the box, then pages for that Part must be included in the report. Li /31 El [Ill 6 PARTS NOT APPLICABLE TO FILER Part 1A -- Sources of Occupational Income Part 1B -- Retainers Part 2 -- Stock Part 3 -- Bonds, Notes Other Commercial Paper Part 4 -- Mutual Funds Part 5 -- Income from Interest, Dividends, Royalties Rents Part 6 - Personal Notes and Lease Agreements Part 7A - Interests in Reai Property Part 7B - Interests in Business Entities A Part 8 - Gifts Part 9 -- Trust income Part 10A - Blind Trusts Part 1GB -- Trustee Statement Part 11A -- Assets of Business Associations Part 11 -- Liabilities of Business Associations Part 12 - Boards and Executive Positions Part 13 - Expenses Accepted Under l-tonorarium Exception Part 14 -- Interest in Business in Commom with Lobbyist Part 15 -- Fees Received for Services Rendered to a Lobbyist or Lobbyists Employer Part 16 - Representation by Legislator Before State Agency Part 17 - Benefits Derived from Functions Honoring Public Servant Part 18 -- Legislative Continuances Revised 01/11/2013 Texas Ethics Commission PO. Box 12070 Austin, Texas 78711-2070 (512) 463-5800 (TDD 1-800-735-2989) SOURCES OF OCCUPATIONAL INCOME If the requested information is not appiicable, indicate that on Page 2 of the Cover Sheet. PART 1A When reporting information about a dependent child's activity, indicate the child aboutwhom you are reporting by providing the number under which the child is listed on the Cover Sheet. 1 INFORMATION RELATES TO FELER CI SPOUSE DEPENDENT CHILD 2 EMPLOYMENT EMPLOYED BYANOTH SELF-EMPLOYED I 6 fix" .4351-' . T2. I. . NAM ANDADDRESS OF EMPLOYER HELD fl (Check if FiIer's Home Address) NATURE OFOCCUPATION INFORMATION RELATES TO I spouse DEPENDENT CHILD NAMEANDADDRESSOF HELD EMPLOYMENT EMPLOYED BY ANOTHER SELF-EMPLOYED 7r4az._ cg-r4=. (Check If FiIer's Home Address) I rd 9 I I EMPLOYED BY ANOTHER NATURE OF OCCUPATION INFORMATION RELATES TO CI FILER - m'sPousE [3 DEPENDENT CHILD NAME AND ADDRESS OF EMPLOYER I POSITION HELD EMPLOYMENT COPY AND ATTACH ADDITIONAL PAGES AS NECESSARY :5 W2. 4-5 "7J'2z(Check If Fiiers Home Address) /fig; 1.1.494 NATURE OF OCCUPATION Revised 01/11/2013 Texas Ethics Commission PO. Box 12070 Austin, Texas 78711-ZOTO (512) 463-5800 (TDD 1-800-735-2989) BONDS, NOTES OTHER COMMERCIAL PAPER PART 3 lfthe requested information is not applicable, indicate that on Page 2 ofthe Cover Sheet. 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 underwhich the child is listed on the Cover Sheet. 1 DESCRIPTION OF INSTRUMENT 4-I?s o-A 2 HELD OR ACQUIRED BY CI DEPENDENT CHILD Cl sPoUsE 3 IF SOLD NET GAIN CI NET LOSS LESS THAN $5,000 CI [3 MORE DESCRIPTION OF INSTRUMENT HELD OR ACQUIRED BY IF SOLD CI NET GAIN NET LOSS FILER SPOUSE DEPENDENT CHILD [3 LESS THAN $5.000 MORE DESCRIPTION OF INSTRUMENT HELD OR ACQUIRED BY FILER SPOUSE DEPENDENT CHILD -. IF SOLD NET GAIN NET LOSS Cl LESS THAN $5,000 CI CI MORE COPY AND ATTACH ADDITIONAL PAGES AS NECESSARY Revised 01/11/2013 Texas Ethics Commission Box 12070 Austin, Texas 78711-2070 (512) 463-5800 (TDD 1-800-735-2989) MUTUAL FUNDS lfthe requested information is not applicable, indicate that on Page 2 ofthe Cover Sheet. PART 4 List each mutual fund and the number of shares in that mutual fund that you, your spouse, or a dependent child hetd or acquired during the calendar year and indicate the category ofthe number of shares of mutual funds held or acquired. If some or all ofthe shares of a mutual fund were sold, also indicate the category of the amount ofthe net gain or loss realized from the sale. 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 under which the child is listed on the Cover Sheet. NAME OF MUTUAL FUND 1 MUTUAL FUND 7" 04-v 2 8.3 FILER SPOUSE DEPENDENT CHILD 3 NUMBER OF SHARES lj LESS THAN 100 100 TO 499 500 To 999 1,000 To 4,999 5,000 To 9,999 E10000 OR MORE HELD OR ACQUIRED BY 4 . . IF SOLD NET GNN LESS THAN $5,000 MORE NET LOSS fl 3. mm 73 MUTUAL FUND NAME [(513 fl (/05 I-.4149-o 7 SHARES OF MUTUAL FUND [3 FILER QSROUSE Cl DEPENDENTCHILD NUMBER OF SHARES LESS THAN 100 [3 100 TO 499 500 To 999 1.000 TO 4.999 OF MUTUAL FUND El 5.000 TO 9.999 [$10,000 oR MORE SOLD NET i_j LESS THAN $5,000 MORE NET Loss MUTUAL FUND 9:/49. wwuuwv-nu NAME SHARES OF MUTUAL FUND HELD OR ACQUIRED BY El spouse FILER DEPENDENT CHILD NUMBER OF SHARES LESS THAN 100 [3 100 TO 499 R500 T0 999 El 1,000 TO 4,999 OF MUTUAL FUND 5,000 To 9,999 10,000 OR MORE IF SOLD NET i__l LESS THAN $5,000 El MORE NET Loss Revised 01/11/2013 Texas Ethics Commission Box 12070 Austin, Texas 78711-2070 (512) 463-5800 (TDD 1-800-735-2989) INCOME FROM INTEREST, DIVIDENDS, ROYALTIES RENTS lfthe requested information is not appiicable, indicate that on Page 2 of the Cover Sheet. 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 ofthe amount ofthe income. For more information, see FORM GUIDE. When reporting information about a dependent child's activity, indicate the ohiid about whom you are reporting by providing the number under which the child is iisted on the Cover Sheet. 1 SOURCE OF NAME AND ADDRESS 49- A 2 RECENED BY 1] FILER ij seouse El DEPENDENT CHILD 3 AMOUNT Cl MORE Mm SOURCE OF INCOME RECEIVED BY FILER sr-rouse DEPENDENT CHILD AMOUNT E3 El MORE SOURCE OF INCOME NAME AND ADDRESS RECEIVED BY FILER AMOUNT COPY AND ATTACH ADDITIONAL PAGES AS NECESSARY sPousE [Ii DEPENDENT CHILD MORE .us Revised 01/11l2013 Texas Ethics Commission BOX 12070 Austin, Texas 7871'l~207O (512) 463-5800 '1-800-735-2969) INTERESTS IN REAL PROPERTY PART 7A lfthe requested information is not applicable, indicate that on Page 2 ofthe Cover Sheet. Describe all beneficial interests in reai property held or acquired by you, your spouse, or a dependent child during the calendar year. lfthe interest was sold, also indicate the category ofthe amount Ofthe net gain or loss realized from the sale. For an explanation of "beneficial interest" and other specific directions for completing this section, see FORM INSTRUCTION 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 iisted on the Cover Sheet. 1 HELD OR ACQUIRED BY KFILER spouse CI DEPENDENT CHILD 2 STREETADDRESS NOTAVAILABLE CHECK IF HOME ADDRESS 3 DESCRIPTION LOTS ACRES 4 NAMES OF PERSONS RETAINING AN INTEREST NOT APPLICABLE (SEVERED MINERAL INTEREST) 5 IF SOLD CI NET GAIN LESS THAN $5,000 [3 MORE NET LOSS HELD OR ACQUIRED BY FILER SPOUSE El DEPENDENT CHILD STREET ADDRESS, INCLUDING CITY, COUNTY, AND STATE STREET ADDRESS NOTAVAILABLE CHECK IF HOME ADDRESS NUMBER OF LOTS OR ACRES AND NAM OF COUNTY WHERE LOCATED DESCRIPTION El LOTS ACRES NAMES OF PERSONS RETAINING AN INTEREST NOTAPPLICABLE (SEVERED MINERAL INTEREST) IF SOLD lj NET GAIN El LESS THAN $5,000 El [3 MORE NET LOSS COPY AND ATTACH ADDITIONAL PAGES AS NECESSARY Revised 01/11/2013 Texas Ethics Commission Box '?2070 Austin, Texas 78711-2070 (512) 463-5800 'i-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 fiie the persona! 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 31, 2012, and is true and correct and includes all lnfor ion required to be reported by me under hapter pa,- aw Signature of Filer AFFIX NOTARY STAMP I SEAL ABOVE Sworn to and subscribed before me. by the said this the 2 day of W4 20 to certify which, witness my hand and seal of office. Signature of officer administering oath Print name of officer administering oath Title of officer administering oath ROBIN w. soLoMoN Notary Public STATE cs rams Nlynomm. Exp. 309.02. 2015 Revised 01/11/2013