Texas Ethics Commission P.O. Box 12070 Austin, Texas 78711-2070 (512) 463-5800 (TDD 1 -800-735-2989)
Eo AFFIDAVIT FOR
DIRECT CAMPAIGN EXPENDITURE REPORT:
ELECTRONIC FILING EXEMPTION - INDIVIDUAL
*An exemption affidavit must be submitted with each paper report.
An individual not acting in concert with another person who makes one or more direct
campaign expenditures that exceed $100 in an election from the individual's own property
must file campaign finance reports as if the individual were the campaign treasurer of a
general purpose committee. These reports are required to be filed electronically unless
the person is eligible to claim the statutory exemption.
An individual filing a direct campaign expenditure report who has made more than $20,000
in direct campaign expenditures in any calendar year must file all subsequent reports
electronically.
Filer name Account #
1. I swear or affirm that I have not made more than $20,000 in direct campaign expenditures in a
calendar year.
2. I further swear or affirm that I do not use computer equipment to keep current records of direct
campaign expenditures.
3. I further swear or affirm that no person acting as my agent or consultant, and no person with whom I
contract, uses computer equipment to keep current records of direct campaign expenditures.
4. I further swear or affirm that I understand that I am required to file my campaign finance reports
electronically if I, my agent or consultant, or a person with whom I contract exceeds $20,000 in direct
campaign expenditures in a calendar year, or uses computer equipment to keep current records of
direct campaign expenditures.
5 I m filin this affi1\/it with the
rennrt li iue on
I understand that this affidavit is required to be filed with each campaign finance report for which I am
claiming an exemption from electronic filing.
Signature of Filer
NOTARY STAMP / SEAL
Sworn to and subscribed before me by
this the
day of
_, 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
FILERS WHO ARE EXEMPT FROM THE ELECTRONIC FILING REQUIREMENT
ARE STILL REQUIRED TO FILE CAMPAIGN FINANCE REPORTS ON PAPER
OFFICE USE ONLY
Date Received
Date Hand-delivered or Date Postmarked
Date Processed
Date Imaged
20
Texas Ethics Commission
P.O. Box 12070 Austin, Texas 78711-2070
(512) 463-5800 (TDD 1-800-735-2989)
v.
www.ethics.state.tx.us
Revised 05/29/2012