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
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www.ethics.state.tx.us
Version V1.1.83d66148