GENERAL-PURPOSE COMMITTEE CAMPAIGN FINANCE REPORT
FORM
GPAC
COVER SHEET PG 1 1 Filer ID
The GPAC Instruction Guide explains how to complete this form.
2 Total pages filed:
(Ethics Commission Filers)
10
00084593 3 COMMITTEE NAME
OFFICE USE ONLY
Tarrant Texas Black Democrats PAC
Date Received
ELECTRONICALLY FILED 07/16/2021 4 COMMITTEE ADDRESS
ADDRESS / PO BOX;
APT / SUITE #;
CITY;
STATE;
ZIP CODE
PO Box 50764
Date Hand-delivered or Date Postmarked
Fort Worth, TX 76105
Receipt #
Change of Address Amount
Date Processed
Date Imaged
5 CAMPAIGN TREASURER NAME
MS / MRS / MR
FIRST
MI
Mrs.
Betty L.
NICKNAME
LAST
SUFFIX
Moore 6 CAMPAIGN TREASURER STREET ADDRESS (Residence or Business)
7 CAMPAIGN TREASURER MAILING ADDRESS Change of Address
8 CAMPAIGN TREASURER PHONE
STREET ADDRESS (NO PO BOX PLEASE);
CITY;
STATE;
ZIP CODE
9128 Garden Springs Dr. Fort Worth, TX 76123 STREET OR PO BOX;
APT / SUITE #;
CITY;
STATE;
ZIP CODE
9128 Garden Springs Dr. Fort Worth, TX 76123 AREA CODE
PHONE NUMBER
EXTENSION
(817) 294-4407
9 REPORT TYPE
January 15
X 10 PERIOD COVERED
APT / SUITE #;
30th day before election
Dissolution (Attach PAC-DR)
8th day before election
10th day after campaign treasurer termination
July 15 Runoff
Month
Day
Year
01/01/2021
11 ELECTION Month
ELECTION DATE Day Year
Month THROUGH
Day
Year
06/30/2021 ELECTION TYPE
Primary
Runoff
General
Special
Other
GO TO PAGE 2 Forms provided by Texas Ethics Commission
www.ethics.state.tx.us
Version V1.1.83d66148
GENERAL-PURPOSE COMMITTEE REPORT: PURPOSE AND TOTALS
FORM
COVER SHEET PG 2
12 COMMITTEE NAME
13 Filer ID
Tarrant Texas Black Democrats PAC 14 COMMITTEE ACTIVITY
1. Candidates
GPAC
(Ethics Commission Filers)
00084593 A. Supported
Democrat
(Identify by name or, if applicable, classify by party.)
(Attach lists on plain paper to complete this report if necessary.)
B. Opposed
2. Measures
A. Supported
(Describe by date and location of election and nature of issue.)
B. Opposed
3. Officeholders Assisted (Identify by name or, if applicable, classify by party.)
15 CONTRIBUTION TOTALS
1. TOTAL UNITEMIZED POLITICAL CONTRIBUTIONS (OTHER THAN PLEDGES, LOANS, OR GUARANTEES OF LOANS, OR CONTRIBUTIONS MADE ELECTRONICALLY)
$
0.00
$
900.00
$
0.00
check here if this report qualifies for the higher itemization threshold
2. TOTAL POLITICAL CONTRIBUTIONS (OTHER THAN PLEDGES, LOANS, OR GUARANTEES OF LOANS) EXPENDITURE TOTALS
3. TOTAL UNITEMIZED POLITICAL EXPENDITURES
4. TOTAL POLITICAL EXPENDITURES
$
CONTRIBUTION BALANCE
5. TOTAL POLITICAL CONTRIBUTIONS MAINTAINED AS OF THE LAST DAY OF THE REPORTING PERIOD
$
1,007.11
OUTSTANDING LOAN TOTALS
6. TOTAL PRINCIPAL AMOUNT OF ALL OUTSTANDING LOANS AS OF THE LAST DAY OF THE REPORTING PERIOD
$
0.00
368.32
16 AFFIDAVIT 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 Title 15, Election Code.
Mrs. Betty L. Moore Signature of Campaign Treasurer AFFIX NOTARY STAMP / SEAL ABOVE Sworn to and subscribed before me, by the said _________________________________________, this the ___________________ day of___________________, 20________, to certify which, witness my hand and seal of office.
Signature of officer administering oath
Forms provided by Texas Ethics Commission
Printed name of officer administering oath
www.ethics.state.tx.us
Title of officer administering oath
Version V1.1.83d66148
SUBTOTALS - GPAC
FORM
GPAC
COVER SHEET PG 3 3 of 10 17 COMMITTEE NAME
18 Filer ID
Tarrant Texas Black Democrats PAC
(Ethics Commission Filers)
00084593
19 SCHEDULE SUBTOTALS SUBTOTAL AMOUNT
NAME OF SCHEDULE 1.
SCHEDULE A1: MONETARY POLITICAL CONTRIBUTIONS
$
2.
SCHEDULE A2: NON-MONETARY (IN-KIND) POLITICAL CONTRIBUTIONS
$
3.
SCHEDULE B: PLEDGED CONTRIBUTIONS
$
4.
SCHEDULE C1: MONETARY CONTRIBUTIONS FROM CORPORATION OR LABOR ORGANIZATION
$
5.
SCHEDULE C2: NON-MONETARY (IN-KIND) CONTRIBUTIONS FROM CORPORATION OR LABOR ORGANIZATION
$
6.
SCHEDULE C3: MONETARY SUPPORT FROM CORPORATION OR LABOR ORGANIZATION
$
7.
SCHEDULE C4: NON-MONETARY SUPPORT FROM CORPORATION OR LABOR ORGANIZATION
$
8.
SCHEDULE D: PLEDGED CONTRIBUTIONS FROM CORPORATION OR LABOR ORGANIZATION
$
9.
SCHEDULE E: LOANS
$
SCHEDULE F1: POLITICAL EXPENDITURES FROM POLITICAL CONTRIBUTIONS
$
11.
SCHEDULE F2: UNPAID INCURRED OBLIGATIONS
$
12.
SCHEDULE F3: PURCHASE OF INVESTMENTS FROM POLITICAL CONTRIBUTIONS
$
13.
SCHEDULE F4: EXPENDITURES MADE BY CREDIT CARD
$
14.
SCHEDULE I: NON-POLITICAL EXPENDITURES FROM POLITICAL CONTRIBUTIONS
$
15.
SCHEDULE K: INTEREST, CREDITS, GAINS, REFUNDS, AND CONTRIBUTIONS RETURNED TO FILER
$
10.
X
X
Forms provided by Texas Ethics Commission
www.ethics.state.tx.us
900.00
368.32
Version V1.1.83d66148
MONETARY POLITICAL CONTRIBUTIONS
The Instruction Guide explains how to complete this form. 2 FILER NAME
SCHEDULE
1 Total pages Schedule A1:
Sch: 1/3 Rpt: 4/10 3 Filer ID
Tarrant Texas Black Democrats PAC 4 Date
5 Full name of contributor
02/27/2021
A1
(Ethics Commission Filers)
00084593 out-of-state PAC (ID#:_________________________)
7 Amount of Contribution ($)
Lee, Sandra
$500.00
6 Contributor address; City; State; Zip Code
Kennedale, TX 76060 8 Principal occupation / Job title (See Instructions)
9 Employer (See Instructions)
Constable
Tarrant Country
Date
Full name of contributor
01/22/2021
Scott, Tracy
out-of-state PAC (ID#:_________________________)
Amount of Contribution ($)
$50.00
Contributor address; City; State; Zip Code
Fort Worth, TX 76120 Principal occupation / Job title (See Instructions)
Employer (See Instructions)
Principal
POC Connect
Date
Full name of contributor
01/27/2021
Scott, Tracy
out-of-state PAC (ID#:_________________________)
Amount of Contribution ($)
$25.00
Contributor address; City; State; Zip Code
Fort Worth, TX 76120 Principal occupation / Job title (See Instructions)
Employer (See Instructions)
Administrative
City of Fort Worth
Date
Full name of contributor
02/22/2021
Scott, Tracy
out-of-state PAC (ID#:_________________________)
Amount of Contribution ($)
$50.00
Contributor address; City; State; Zip Code
Fort Worth, TX 76120 Principal occupation / Job title (See Instructions)
Employer (See Instructions)
Principal
POC Connect
Date
Full name of contributor
02/27/2021
Scott, Tracy
out-of-state PAC (ID#:_________________________)
Amount of Contribution ($)
$25.00
Contributor address; City; State; Zip Code
Fort Worth, TX 76120 Principal occupation / Job title (See Instructions)
Employer (See Instructions)
Administrative
City of Fort Worth
Forms provided by Texas Ethics Commission
www.ethics.state.tx.us
Version V1.1.83d66148
MONETARY POLITICAL CONTRIBUTIONS
The Instruction Guide explains how to complete this form. 2 FILER NAME
SCHEDULE
1 Total pages Schedule A1:
Sch: 2/3 Rpt: 5/10 3 Filer ID
Tarrant Texas Black Democrats PAC 4 Date
5 Full name of contributor
03/22/2021
A1
(Ethics Commission Filers)
00084593 out-of-state PAC (ID#:_________________________)
7 Amount of Contribution ($)
Scott, Tracy
$50.00
6 Contributor address; City; State; Zip Code
Fort Worth, TX 76120 8 Principal occupation / Job title (See Instructions)
9 Employer (See Instructions)
Principal
POC Connect
Date
Full name of contributor
03/27/2021
Scott, Tracy
out-of-state PAC (ID#:_________________________)
Amount of Contribution ($)
$25.00
Contributor address; City; State; Zip Code
Fort Worth, TX 76120 Principal occupation / Job title (See Instructions)
Employer (See Instructions)
Administrative
City of Fort Worth
Date
Full name of contributor
04/22/2021
Scott, Tracy
out-of-state PAC (ID#:_________________________)
Amount of Contribution ($)
$50.00
Contributor address; City; State; Zip Code
Fort Worth, TX 76120 Principal occupation / Job title (See Instructions)
Employer (See Instructions)
Principal
POC Connect
Date
Full name of contributor
04/27/2021
Scott, Tracy
out-of-state PAC (ID#:_________________________)
Amount of Contribution ($)
$25.00
Contributor address; City; State; Zip Code
Fort Worth, TX 76120 Principal occupation / Job title (See Instructions)
Employer (See Instructions)
Administrative
City of Fort Worth
Date
Full name of contributor
05/22/2021
Scott, Tracy
out-of-state PAC (ID#:_________________________)
Amount of Contribution ($)
$50.00
Contributor address; City; State; Zip Code
Fort Worth, TX 76120 Principal occupation / Job title (See Instructions)
Employer (See Instructions)
Principal
POC Connect
Forms provided by Texas Ethics Commission
www.ethics.state.tx.us
Version V1.1.83d66148
MONETARY POLITICAL CONTRIBUTIONS
The Instruction Guide explains how to complete this form. 2 FILER NAME
SCHEDULE
1 Total pages Schedule A1:
Sch: 3/3 Rpt: 6/10 3 Filer ID
Tarrant Texas Black Democrats PAC 4 Date
5 Full name of contributor
05/27/2021
A1
(Ethics Commission Filers)
00084593 out-of-state PAC (ID#:_________________________)
7 Amount of Contribution ($)
Scott, Tracy
$25.00
6 Contributor address; City; State; Zip Code
Fort Worth, TX 76120 8 Principal occupation / Job title (See Instructions)
9 Employer (See Instructions)
Administrative
City of Fort Worth
Date
Full name of contributor
06/27/2021
Scott, Tracy
out-of-state PAC (ID#:_________________________)
Amount of Contribution ($)
$25.00
Contributor address; City; State; Zip Code
Fort Worth, TX 76120 Principal occupation / Job title (See Instructions)
Employer (See Instructions)
Administrative
City of Fort Worth
Forms provided by Texas Ethics Commission
www.ethics.state.tx.us
Version V1.1.83d66148
POLITICAL EXPENDITURES FROM POLITICAL CONTRIBUTIONS
SCHEDULE
F1
EXPENDITURE CATEGORIES FOR BOX 8(a) Advertising Expense Accounting/Banking Consulting Expense Contributions/ Donations Made By Candidate/Officeholder/Political Committee Credit Card Payment
Event Expense Fees Food/Beverage Expense Gift/Awards/Memorials Expense Legal Services
Loan Repayment/Reimbursement Office Overhead/Rental Expense Polling Expense Printing Expense Salaries/Wages/Contract Labor
The Instruction Guide explains how to complete this form.
1 Total pages Schedule F1: 2 FILER NAME
Sch: 1/4 Rpt: 7/10 4 Date
3 Filer ID
Tarrant Texas Black Democrats PAC
(Ethics Commission Filers)
00084593
5 Payee name
01/04/2021
BANK OF AMERICA
6 Amount ($)
7 Payee address;
$17.99 Expenditure from corporate funds
8
Solicitation/Fundraising Expense Transportation Equipment & Related Expense Travel in District Travel Out of District OTHER (enter a category not listed above)
City;
State; Zip Code
100 North Tryon Street Charlotte, NC 28255
PURPOSE OF EXPENDITURE
(a) Category
(See Categories listed at the top of this schedule)
(b) Description Check if travel outside of Texas. Complete Schedule T.
Fees
Check if Austin, TX, officeholder living expense
FEES 9 Complete ONLY if direct Candidate/Officeholder name expenditure to benefit C/OH Date
Payee name
01/04/2021
BANK OF AMERICA
Amount ($)
Payee address;
$18.17 Expenditure from corporate funds
City;
Office sought
Office held
State; Zip Code
100 North Tryon Street Charlotte, NC 28255
PURPOSE OF EXPENDITURE
(a) Category
(See Categories listed at the top of this schedule)
(b) Description Check if travel outside of Texas. Complete Schedule T.
Fees
Check if Austin, TX, officeholder living expense
FEES Complete ONLY if direct Candidate/Officeholder name expenditure to benefit C/OH Date
Payee name
01/04/2021
BANK OF AMERICA
Amount ($)
Payee address;
$16.00 Expenditure from corporate funds
PURPOSE OF EXPENDITURE
City;
Office sought
Office held
State; Zip Code
100 North Tryon Street Charlotte, NC 28255 (a) Category
(See Categories listed at the top of this schedule)
(b) Description Check if travel outside of Texas. Complete Schedule T.
Fees
Check if Austin, TX, officeholder living expense
FEES Complete ONLY if direct Candidate/Officeholder name expenditure to benefit C/OH
Forms provided by Texas Ethics Commission
Office sought
www.ethics.state.tx.us
Office held
Version V1.1.83d66148
POLITICAL EXPENDITURES FROM POLITICAL CONTRIBUTIONS
SCHEDULE
F1
EXPENDITURE CATEGORIES FOR BOX 8(a) Advertising Expense Accounting/Banking Consulting Expense Contributions/ Donations Made By Candidate/Officeholder/Political Committee Credit Card Payment
Event Expense Fees Food/Beverage Expense Gift/Awards/Memorials Expense Legal Services
Loan Repayment/Reimbursement Office Overhead/Rental Expense Polling Expense Printing Expense Salaries/Wages/Contract Labor
The Instruction Guide explains how to complete this form.
1 Total pages Schedule F1: 2 FILER NAME
Sch: 2/4 Rpt: 8/10 4 Date
3 Filer ID
Tarrant Texas Black Democrats PAC
(Ethics Commission Filers)
00084593
5 Payee name
02/03/2021
BANK OF AMERICA
6 Amount ($)
7 Payee address;
$17.99 Expenditure from corporate funds
8
Solicitation/Fundraising Expense Transportation Equipment & Related Expense Travel in District Travel Out of District OTHER (enter a category not listed above)
City;
State; Zip Code
100 North Tryon Street Charlotte, NC 28255
PURPOSE OF EXPENDITURE
(a) Category
(See Categories listed at the top of this schedule)
(b) Description Check if travel outside of Texas. Complete Schedule T.
Fees
Check if Austin, TX, officeholder living expense
FEES 9 Complete ONLY if direct Candidate/Officeholder name expenditure to benefit C/OH Date
Payee name
02/01/2021
BANK OF AMERICA
Amount ($)
Payee address;
$18.17 Expenditure from corporate funds
City;
Office sought
Office held
State; Zip Code
100 North Tryon Street Charlotte, NC 28255
PURPOSE OF EXPENDITURE
(a) Category
(See Categories listed at the top of this schedule)
(b) Description Check if travel outside of Texas. Complete Schedule T.
Fees
Check if Austin, TX, officeholder living expense
FEES Complete ONLY if direct Candidate/Officeholder name expenditure to benefit C/OH Date
Payee name
02/01/2021
BANK OF AMERICA
Amount ($)
Payee address;
$16.00 Expenditure from corporate funds
PURPOSE OF EXPENDITURE
City;
Office sought
Office held
State; Zip Code
100 North Tryon Street Charlotte, NC 28255 (a) Category
(See Categories listed at the top of this schedule)
(b) Description Check if travel outside of Texas. Complete Schedule T.
Fees
Check if Austin, TX, officeholder living expense
FEES Complete ONLY if direct Candidate/Officeholder name expenditure to benefit C/OH
Forms provided by Texas Ethics Commission
Office sought
www.ethics.state.tx.us
Office held
Version V1.1.83d66148
POLITICAL EXPENDITURES FROM POLITICAL CONTRIBUTIONS
SCHEDULE
F1
EXPENDITURE CATEGORIES FOR BOX 8(a) Advertising Expense Accounting/Banking Consulting Expense Contributions/ Donations Made By Candidate/Officeholder/Political Committee Credit Card Payment
Event Expense Fees Food/Beverage Expense Gift/Awards/Memorials Expense Legal Services
Loan Repayment/Reimbursement Office Overhead/Rental Expense Polling Expense Printing Expense Salaries/Wages/Contract Labor
The Instruction Guide explains how to complete this form.
1 Total pages Schedule F1: 2 FILER NAME
Sch: 3/4 Rpt: 9/10 4 Date
3 Filer ID
Tarrant Texas Black Democrats PAC
(Ethics Commission Filers)
00084593
5 Payee name
03/01/2021
BANK OF AMERICA
6 Amount ($)
7 Payee address;
$16.00 Expenditure from corporate funds
8
Solicitation/Fundraising Expense Transportation Equipment & Related Expense Travel in District Travel Out of District OTHER (enter a category not listed above)
City;
State; Zip Code
100 North Tryon Street Charlotte, NC 28255
PURPOSE OF EXPENDITURE
(a) Category
(See Categories listed at the top of this schedule)
(b) Description Check if travel outside of Texas. Complete Schedule T.
Fees
Check if Austin, TX, officeholder living expense
FEES 9 Complete ONLY if direct Candidate/Officeholder name expenditure to benefit C/OH Date
Payee name
04/01/2021
BANK OF AMERICA
Amount ($)
Payee address;
$16.00 Expenditure from corporate funds
City;
Office sought
Office held
State; Zip Code
100 North Tryon Street Charlotte, NC 28255
PURPOSE OF EXPENDITURE
(a) Category
(See Categories listed at the top of this schedule)
(b) Description Check if travel outside of Texas. Complete Schedule T.
Fees
Check if Austin, TX, officeholder living expense
FEES Complete ONLY if direct Candidate/Officeholder name expenditure to benefit C/OH Date
Payee name
05/03/2021
BANK OF AMERICA
Amount ($)
Payee address;
$16.00 Expenditure from corporate funds
PURPOSE OF EXPENDITURE
City;
Office sought
Office held
State; Zip Code
100 North Tryon Street Charlotte, NC 28255 (a) Category
(See Categories listed at the top of this schedule)
(b) Description Check if travel outside of Texas. Complete Schedule T.
Fees
Check if Austin, TX, officeholder living expense
FEES Complete ONLY if direct Candidate/Officeholder name expenditure to benefit C/OH
Forms provided by Texas Ethics Commission
Office sought
www.ethics.state.tx.us
Office held
Version V1.1.83d66148
POLITICAL EXPENDITURES FROM POLITICAL CONTRIBUTIONS
SCHEDULE
F1
EXPENDITURE CATEGORIES FOR BOX 8(a) Advertising Expense Accounting/Banking Consulting Expense Contributions/ Donations Made By Candidate/Officeholder/Political Committee Credit Card Payment
Event Expense Fees Food/Beverage Expense Gift/Awards/Memorials Expense Legal Services
Loan Repayment/Reimbursement Office Overhead/Rental Expense Polling Expense Printing Expense Salaries/Wages/Contract Labor
The Instruction Guide explains how to complete this form.
1 Total pages Schedule F1: 2 FILER NAME
Sch: 4/4 Rpt: 10/10 4 Date
3 Filer ID
Tarrant Texas Black Democrats PAC
(Ethics Commission Filers)
00084593
5 Payee name
06/01/2021
BANK OF AMERICA
6 Amount ($)
7 Payee address;
$16.00 Expenditure from corporate funds
8
Solicitation/Fundraising Expense Transportation Equipment & Related Expense Travel in District Travel Out of District OTHER (enter a category not listed above)
PURPOSE OF EXPENDITURE
City;
State; Zip Code
100 North Tryon Street Charlotte, NC 28255 (a) Category
(See Categories listed at the top of this schedule)
(b) Description Check if travel outside of Texas. Complete Schedule T.
Fees
Check if Austin, TX, officeholder living expense
FEES 9 Complete ONLY if direct Candidate/Officeholder name expenditure to benefit C/OH
Office sought
Date
Payee name
05/17/2021
DEBORAH PEOPLES FOR MAYOR
Amount ($)
Payee address;
$200.00 Expenditure from corporate funds
PURPOSE OF EXPENDITURE
City;
Office held
State; Zip Code
PO Box 15921 FORT WORTH, TX 76119 (a) Category
(See Categories listed at the top of this schedule)
(b) Description
Contributions/Donations Made By Candidate/Officeholder/Political Committee
Check if travel outside of Texas. Complete Schedule T. Check if Austin, TX, officeholder living expense
DONATIONS Complete ONLY if direct Candidate/Officeholder name expenditure to benefit C/OH PEOPLES, DEBORAH
Forms provided by Texas Ethics Commission
Office sought
Office held
MAYOR
www.ethics.state.tx.us
Version V1.1.83d66148