| (a) An annual report of unexpended contributions shall include the following information: (1) the officeholder's full name; (2) the officeholder's address; (3) for each payment made by the officeholder from unexpended political contributions, unexpended interest or other income earned from political contributions, or assets purchased with political contributions or interest or other income earned from political contributions during the previous year: (A) the full name of each person to whom a payment was made; (B) the address of each person to whom a payment was made; (C) the date of each payment; (D) the nature of the goods or services for which the payment was made; and (E) the amount of the payment; (4) the total amount of unexpended political contributions as of December 31 of the
previous year; (5) the total amount of interest and other income earned on unexpended political contributions during the previous year; and (6) an affidavit, executed by the former officeholder, stating: "I swear, or affirm, that the accompanying report is true and correct and includes all information required to be reported by me under Title 15, Election Code."
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