DAILY-C PAC FORM POLITICAL COMMITTEE DAILY PRE-ELECTION REPORT OF CONTRIBUTIONS COMMITTEE NAME Clubs in Action, PAC 3 2 Total pages filed: 1 00086887 4 CAMPAIGN TREASURER NAME 5 CAMPAIGN TREASURER MAILING ADDRESS Date Received Date Imaged OFFICE USE ONLY Date Processed Amount Date Hand-delivered or Date Postmarked Receipt # Houston, TX 77003 2504 Rusk Street #110 Ingram 1 of 2 ADDRESS / PO BOX; APT / SUITE #; CITY; STATE; ZIP CODE MS/MRS/MR MI FIRST Tania K. LAST SUFFIX NICKNAME ELECTRONICALLY FILED 11/04/2022 Filer ID (Ethics Commission Filers) V3.5.1.d1b92728 www.ethics.state.tx.us Forms provided by Texas Ethics Commission
MONETARY POLITICAL CONTRIBUTIONS SCHEDULE A1 The Instruction Guide explains how to complete this form. FILER NAME Clubs in Action, PAC 2
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8 Employer (See Instructions) Date Full name of contributor 6 7 Houston, TX 77003 9 11/04/2022 Principal occupation / Job title (See Instructions) Contributor address; City; State; Zip Code 5 4 TKG Strategies Amount of Contribution ($) out-of-state PAC (ID#:_________________________) $35,000.00 Version V3.5.1.d1b92728 Forms provided by Texas Ethics Commission www.ethics.state.tx.us
1 Total pages Schedule A1:
00086887 (Ethics Commission Filers) Sch: 1/1 Rpt: 2/2 Filer ID