Candidate/Officeholder Campaign Finance Final Report
Candidate/Officeholder Campaign Finance Final Report
Womble Final Report ADA for Web CANDIDATE / OFFICEHOLDER CAMPAIGN FINANCE REPORT
FORM C/OH COVER SHEET PG 1
The C/OH Instruction Guide explains how to complete this form.
1 Filer ID (Ethics CommtSSI0/1 F,ers)
NIA
7 2 Total pages flied:
3 CANOIOArE/ OFFICEHOLDER NAME
MS(MRStMR
FIRST
Ml
Mr
Matthew
F
.......··················································.....··················
NICKNAME
LAST
Womble
SUFFIX
OFFICE USE ONLY
Date Rece1vert
4 CANDIDATE / OFFICEHOLDER MAILING ADDRESS
CMnge or Address
6 CANDIDATE/ OFFICEHOLDER PHONE
6 CAMPAIGN TREASURER NAME
CITY. APT I SUITE It.
STATE
ZIP CODE
JUN 1 5 2021
AREA CODE
(
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PHONE NUMBER
EXTENSION
MS/ MRS/ MR
FIRST
Ml
Mrs ......
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Mona
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NICKNAME
LAST
Bailey
SUFFIX
Date Hand0dehvered or Date Postmarked
Receipt U Dale Processed Date lmagoa
Amounl S I
7 CAMPAIGN TREASURER
STREET ADDRESS (NO PO BOX PLEASE), APT/ SUITE e,
6200 Lake Way
CITY,
ADDRESS
North Richland Hills, TX 76180
\Rllt.ldlll\CI} ()\ Sl>ll -\1\<l,\\lo)
8 CAMPAIGN TREASURER P HONE
9 REPORT TYPE
10 PERIOD COVERED
AREA CODE
( 817 )
C January 15
July 15
Month
04
PHONE NUMBER
EXTENSION
542-4486
C
r-=
O.,y
21
3oth day before elec11on
I Runoff
8111 clay t>et01e elect>0n
L Exceeded Modtfred Reporting L1md
Vea,
M onlh
21
06
THROUGH
STATE.
ZIP CODE
i
,5th day after campargn treasurer appointment (Qlf!Cf,hOlder Only)
Final Report (All.Och C/OH. FR)
Day
Year
11 21
11 ELECTION
ELECTION DATE
11.o<>\h
o,.,,
'l\'IM
05 01 21
Pnmary
Gor1orol
flunolf Spcc,ul
ELECTION TYPE
Other Doscnphon
12 OFFICE
14 NOTICE FROM POUT/CAL COMMITTEE(S)
OFF ICE HELO ( any)
N/A
13 OFFICE SOUGHT (1! kn<>M1)
Birdville ISO Trustee, Place 4
TIHS BOX IS FOR NOTICE OF POLITICAL CONTRIBUTIONS ACCEPTED OR POLITICAL EXPENDITURES MAOE BY POLITICAL COMMITTEES TO SUPPORT THE CANDIDATE I OFFlCEHOl.OER. THESE EXPENDITURES MAY HAVE OEEH MADE "'fTHOUT THE CAHID OATE."S OR OFFICE.HOLDER'S KHOWI.EDGE OR
CONSENT. CANDIDATES ANO OFACEHOLOERS ARE REQUIRED TO REPORT ms INFORMATION ONLY IF THEY RECEIVE NOIT CE OF SUCH EXPENDITURES
COMMITTEE TYPE COMMITlEE Nio.ME
Addrtlonol Pages
GENERAL
COMMITTEE ADDRESS
SPECIFIC
COMMITTEE CAMPAIGN T REASURER NAME
COMM ITTEE CAMPAIGN TREASURER ADDFU:SS
GO TO PAGE 2
CANDIDATE/ OFFICEHOLDER CAMPAIGN FINANCE REPORT
FORM C/OH COVER SHEET PG 2
16 C/OH NAME Matthew Fred Womble
16 FilNJA (Ethics Commission Filors)
17 CONTRIBUTION
1
TOTAL UNITEMIZED POLITICAL CONTRIBUTIONS (OTHER THAN
TOTALS
PLEDGES. LOANS, OR GUARANTEES OF LOANS. OR
$
0
CONTRIBUTIONS MADE ELECTRONICALLY)
2. TOTAL POLITICAL CONTRIBUTIONS (OTHER THAN PLEDGES, LOANS, OR GUARANTEES OF LOANS)
$
0
EXPENDITURE TOTALS
3,
TOTAL UNITEMIZED POLITICAL EXPENDITURE.
$
0
4. TOTAL POLITICAL EXPENDITURES
$
825.00
... ' ........... - .. ·1----------------------------+------------i
CONTRIBUTION BALANCE
5.
TOTAL POLITICAL CONTRIBUTIONS MAINTAINED AS OF THE LAST DAY OF REPORTING PERIOD
$
1.59
O\JTSTANDlNG LOAN TOTALS
6.
TOTAL PRINCIPAL AMOUNT OF ALL OUTSTANDING LOANS AS OF THE
LAST DAY OF THE REPORTING PERIOD
$
0
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 Tille 15, Election Code.
Slgn11ture of Car,dldnte or Olficoholder
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, wi1 ness my hand and seal of office.
Slgriature of officer administering oalh
Printed name of officer administering 00t11
Title of officer administering oath
(2) Unsworn Declaration
. My name IS __;N_.,:..,.!,..!....:.,:'----"'--""-"="'-'.!.e=---------· and my date of birth is
My address is
' .
--r:; rt± Executed in
,cc,,
(street) County, State of /e.)(4$
(country)
SUBTOTALS - C/OH
FORM C/OH COVER SHEET PG 3
19 FILER NAME
Matthew Fred Womble
20 Flier ID (Ethics Commission Filers)
N/A
21 SCHEDULE SUBTOTALS NAME OF SCHEDULE
1.
SCHEDULEA1: MONETARY POLITICAL CONTRIBUTIONS
2.
SCHEDULE A2: 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
SUBTOTAL AMOUNT
$
0
$
0
$
0
$
500.00
$
325.00
$
0
$
0
$
0
$
500.00
$
0
$
0
$
0
LOANS
If the requested information is not applicable, DO NOT include this page in the report.
SCHEDULE E
The JnstructJon GuJde expJaJns how to compJale thJs torm.
2 FILER NAME
Matthew Fred Womble
1 1 Total pages Schedule E:
3 Filer ID (Ethics Commission Fliers)
N/A
4 TOTAL OF UNITEMIZED LOANS
$ 0
6 Date of loan
6/09/2021
Is lender a financial Institution?
[!) N
7 Name of lender
0 out-of-state PAC (10#.
)
Matthew F Womble ··················································································
8 Lender address:
City;
State: Zip Code
9 Loan Amount($)
500.00
10 lntere5arate
11 Maturity date
NIA
12 Principal occupation / Job title (See Instructions)
13 Employer (See Instructions)
14 Description of Collateral none
16 Check if personal funds were deposited into political account (See Instructions)
16 GUARAN'TOR INFORMATION
17
ff Arnoum Guaran'lmfo \$)
··················································································
18 Guarantor address;
City;
State: Zip Code
not applicable
20 Principal Occupation (See Instructions)
21 Employer (See Instructions)
Date of loan
Name of lender
0 out-of-slate PAC (10#
)
Is lender a financial
Dv Institution?
··················································································
Lender address;
City;
Slate; Zip Code
Principal occupation I Job title (See Instructions)
Employer (See Instructions)
Loan Amount ($) Interest rate Maturtty date
Description of Collateral
none
Check if personal funds were deposited into political account (See Instructions)
GUARANTOR INFORMATION
Name of guarantor
··················································································
Guarantor address:
City;
State: Zip Code
Amount Guaranteed($)
not applicable Principal Occupation (See lm.'\ruc\ions)
Employet \'3e-e \rmrua\)
ATTACH ADDITIONAL COPIES OF THIS SCHEDULE AS NEEDED
If lender is out-of-state PAC, please see Instruction guide for additional reporting requirements.
POLITICAL EXPENDITURES MADE FROM POLITICAL CONTRIBUTIONS
If the requested information is not applicable, DO NOT include this page in the report.
SCHEDULE F1
EXPENDITURE CATEGORIES FOR BOX8(a)
Ad...:Hlising E1tpense
Consula1g Expenoo Conlri>uns/Donalions Made By
Cancidate/Officholtlor/Poltical CommiUae CreddCard Payment
Ewnt&p.,m., Foes Foo6'Bewraoe Expense Git/Awards/Memorials Expense
Legal Services
(.&J;m
Office Owmoad/Renl Expense Polling Expense Prinling Expense SalariesNVagnlract Labor
The Instruction Gulde explains how to complete this form.
1 a ew red Womble 1 Total pages Schedule F1: Ft'tf,R NAE
4 Oa'IB
6/09/2021
& Payee name
Matthew F Womble
6 Amount($)
7 Payee address:
City:
315.00
soaataoon/Funarai:.mg Expunoo Transportation Equipment & Related Expense Travel In District Trawl Out or District Other (enter a category not listed abow)
13 Filer ID(Ethics Commission Filers) N/A
State:
Zip Code
8
PURPOSE OF
EXPENDITURE
(a) Category (See Categories hsted at the top of this sehodulo)
loan Repayment/Reimbursement
(c)
Chock iftravel outside ofTexas. Coll1)lele ScheduleT.
9 Complete Qlil.l if direct expenditure to benefit CfOH
Candidate I Officeholder name
(b) Description
loan Repayment of $500 Consulting expense from Personal Funds
Check if Austin, TX. officeholder living expense
Office sought
Office held
Date
4/28/2021
Payeename
Legend Bank
Amount($)
5.00
Payee address:
6851 NE Loop 820, Suite 100 North Richland Hills, TX 76180
PURPOSE OF
EXPENDITURE
Category (See Catogones listed at the top of 1h15 Gehedulo)
Fees
Complete QliLY if direct expenditure to benefit CfOH
Ched<iftravelOlllsidoc!Texas_ CompleteScheduleT Candidate I Officeholder name
City:
State:
Zip Code
Description
Monthly statement fee
Check if Austin, TX, offtceholder l,ving expense
Office sought
Office held
Date
5/28/2021
Payeenome
Legend Bank
Amount($)
5.00
Payee address;
6851 NE Loop 820, Suite 100 North Richland Hills, TX 76180
City:
State;
Zip Code
PURPOSE
OF
EXPENDITURE
Category (See Categarln listed 111 lhe tap cl this schedule)
Fees
Complete '21':11. if direct expendlluro to benefit C/OH
Clw:;k('ll'4""4,. Candldale I Officeholder name
Description
Monthly statement fee
i< 'HIRl.w., 't'Y,, ff"Y:.111 1/,1 eY.p!IIMA
Office sought
Office held
ATTACH ADDITIONAL COPIES OF THIS SCHEDULE AS NEEDED
POLITICAL EXPENDITURES MADE FROM PERSONAL FUNDS
If the requested information is not applicable, DO NOT include this page in the report.
SCHEDULE G
Adwrli&ing Exponne Accountlng.lBanlclng Consulling Expense Conlribulionsl'Donations Made By
Candidate/Officeholder/Political Committee
CrooJ!Card Payrront
EXPENDITURE CATEGORIES FOR BOX 8(a)
E11entExponse Fees Food/Beverage Expense Gift/Awards/Memorial& Expense
Legal Services
LoanRepayment/Relmbursement Office Overhead/Rental Expense Polling Expenoo Printing Expenoo SalarieslWageslContract Labor
The Instruction Gulde explalns how to complete this form.
1 Total pa9et. Sd¥ad\l~ G: 2 FILER NAME
1
Matthew Fred Womble
4 Date
6/09/2021
6 Payee name
Craig Ownby Consulting
Solicilation/Fundra!sing Expense Transportation Equipment & Related Expense Travel In District Travel Out Of District Other (enter a category not listed above)
NIA 3 f\~r \0 {E\~ ~ f~w.}
8 Amount($)
500.00
.,, ~ I m m politico! ccntributions lnlended
8
PURPOSE OF
EXPENDITURE
7 Payee address;
7106 Lighthouse Road
Arlington, TX 76002
<c Categor:v (See Categories listud althe top of this schedule) onsultmg Expense
(c)
CheckdtravoloutsldoClfTexas Co~leteSdteduleT
9 Complete QW.Y if direct
expendllure to benefit C/OH
Candidate I Officeholder name
City;
State:
Zip Code
~)eDeeroarrlpctloanmpaign consulting
Chock If Au11tin, TX. officeholder living expen&e
Office &Ought
Office held
Date
Payee name
Amount($)
Payee address;
City;
State;
Zip Code
Rcinlburoement from pol!tlcal ccntributlons
Intended
PURPOSE OF
EXPENDITURE
Category (See Categorlos listed 111 the top of this schedule)
Check Iftravel outslde ofTexas. Complete ScheduleT.
Complete QW.Y if direct
expendllure lo benefit C/OH
Candidate I Offiooholder name
Description
Chock ii Austin, TX. officeholder living expense
Office sought
Offioo held
Date
Payee name
Amount($)
Rleimbumermnt from politico I ccntrlbutlons lnlended
PURPOSE OF
EXPENDITURE
Complete QW.Y if direct expenditure lo benefit C/OH
Payee address;
Category (See Categories listed at the top Clf thitl schedule) Check dtraveloutsicle of Texas. Complete ScheduleT.
Candidate I Officeholder name
City;
state;
Zip Code
Description
Check If Austin, TX, officeholder living expense
Offioo &Ought
Office held
ATTACH ADDITIONAL COPIES OF THIS SCHEDULE AS NEEDED
CANDIDATE/ OFFICEHOLDER REPORT: DESIGNATION OF FINAL REPORT
FORM C/OH - FR
The Instruction Guide explains how to comploto this form.
.. Comple te only if "Re port T y pe" on page 1 is m arked " F ina l Re port'' ..
1 C/OHNAME
Matthew Fred Womble
2 Flier ID (Elhics Commission Fliers)
N/A
3 SIGNAlURE
I do not expect any further polibcal contributions or political expenditures in connection with my candidacy. I understand that designating a report as a fi nal report terminates my campaign treasurer appointment I also understand that I may not accept any
°' ,,mpaigo oootrib,tioos make aoy campaigo o,peodiru,e, withoot a campa,go treasuca, p p : t , n ~
fgnature of Can didate I Officeholder
4 FILER WHO IS NOTAN OFFICEHOLDER
·· Complete A & B below only if you are not an officeholder. ··
A.
CAMPAIGN FUNDS
C heck only o ne : I do not have unexpended contributions or unexpended interest or income earned from political contributions
fJ
I have unexpended contributions or unexpended interest or income earned from political contributions. I understand that I
may not convert unexpended political contributions or unexpended interest or income earned on political contnbutions to
personal use. I also understand that I must file an annual report of unexpended contributions and that I may not retain
unexpended contributions or unexpended interest or income earned on political contributions longer than six years after
filing this final report Further, I understand that JmusJ" dispose of une.vpendad political contriiw/ions and une.~pended
interest or income earned on political contributions in accordance with the requirements of Election Code,§ 254.204.
B.
ASSETS
C heck only one : I do not retain assets purchased with politJcal contributions or interest or other income from political contributions.
n
I do retain assets purchased with political contributions or interest or other income from political contributions. I understand
that I may not convert assets purchased with political contributions or interest or other income from political contributions to
personal use. I also understand that I must dispose of assets purchased with political contributions in accordance with the
requirements of Election Code. § 254.204.
Signa ture of Can did ate
6 OFFICEHOLDER
·· Complete this section only If yo u ar e an offic ehold e r ··
I am aware that I remain subject to filing requirements applicable to an officeholder who does not have a campaign treasurer on file . I am also aware that I will be required to file reports of unexpended contributions if, after filing the last required report as an officeholder, I retain political contn\:t.:tv.:.rr.., m\erest or o~er 1ntome from pl:}i,tta\ con'isibuoons. m assets 'P'\lr~ ·1,i~
pohti~I oootrib,tions o, iot,"'' o, '""' moomo from political o o o t n b ~ ~ .~
Sign a ture of Officehol der
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