CANDIDATE / OFFICEHOLDER FORM C/ OH

CAMPAIGN FINANCE REPORT COVER SHEET PG 1

1 Filer ID ( Ethics Commission Filers) 2 Total pages filed:The C/ OH Instruction Guide explains how to complete this form.

3 CANDIDATE/ MS/ MRS/ MR FIRST MI

OFFICEHOLDER TOFF Y

NAME n/)-AO/ VDate Re •

1"0•"". q!

NICKNAME LAST SUFFIX fO

4 CANDIDATE/ ADDRESS / PO BOX; APT/ SUITE#; CITY; STATE; ZIP CODE A t Mr ,

OFFICEHOLDER l ,I/ / Al 7

s,, y

MAILING d-'7 / V l 1V/ l(14/ /9Ve' 01 40 7/Wt

ADDRESS lijv i

n Change of Address is

I20 Jjl

JAN 1 45 CANDIDATE/ AREA CODE PHONE NUMBER EXTENSION

OFFICEHOLDER / 3(( 59// / 3 / Date Idndideliv d o arked

PHONE V l " "

6 CAMPAIGN MS/ MRS/ MR FIRST MI Receipt# Amount$

TREASURER Stlaq. 2NAMEI Date Processed

NICKNAME LAAST SUFFIX

sti Date Imaged

7 CAMPAIGN STREET ADDRESS ( NO PO BOX PLEASE); APT/ SUITE#; CITY; STATE; ZIP CODE

f - I J i I, o

i

ADDRESS 1L// I/ aAICAIC` e/./ 0 c Vl a / 1 77! fResidence or Business)

8 CAMPAIGN AREA CODE PHONE NUMBER EXTENSION

TREASURER 3k 5 2/ / o 3 qPHONE

9 REPORT TYPE 15th dayafter campaign

n January 15 n 30th day before election n Runoff n treasurer appointment

Officeholder Only)

ri July 15 n 8th day before election n Exceeded$ 500 limit n Final Report( Attach C/ OH- FR)

10 PERIOD Month Day Year Month Day Year

COVEREDTHROUGH

11 ELECTION ELECTION DATE

IELECTIONTYPE

IMonth Day Year X Primary 0 Runoff 1 Other

7Description

0 1 / G )/ Lt2 0 General 0 Special

12 OFFICE OFFICE HELD ( if any)

7

13 OFFICE SOUGHT ( if known)

ti ; ce Atc3Q4h Pc+ i-1 U/ c

Co.

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Forms provided by Texas Ethics Commission www.ethics. state. tx. us Revised 9/ 8/ 2015

CANDIDATE / OFFICEHOLDER FORM C/ OH

CAMPAIGN FINANCE REPORT COVER SHEET PG 2

14 C/ OH NAME 15 Filer ID ( Ethics Commission Filers)

16 NOTICE FROM THIS BOX IS FOR NOTICE OF POLITICAL CONTRIBUTIONS ACCEPTED OR POLITICAL EXPENDITURES MADE BY POLITICAL COMMITTEES TO

POLITICAL SUPPORT THE CANDIDATE/ OFFICEHOLDER. THESE EXPENDITURES MAY HAVE BEEN MADE WITHOUT THE CANDIDATE' S OR OFFICEHOLDER' S

COMM ITTEE( S) KNOWLEDGE OR CONSENT. CANDIDATES AND OFFICEHOLDERS ARE REQUIRED TO REPORT THIS INFORMATION ONLY IF THEY RECEIVE NOTICE

OF SUCH EXPENDITURES.

COMMITTEE TYPE COMMITTEE NAME

GENERAL

COMMITTEE ADDRESS

SPECIFIC

COMMITTEE CAMPAIGN TREASURER NAME

n Additional PagesCOMMITTEE CAMPAIGN TREASURER ADDRESS

1

17 CONTRIBUTION 1. TOTAL POLITICAL CONTRIBUTIONS OF$ 50 OR LESS ( OTHER THAN $ TOTALS PLEDGES, LOANS, OR GUARANTEES OF LOANS), UNLESS ITEMIZED

2. TOTAL POLITICAL CONTRIBUTIONSOTHER THAN PLEDGES, LOANS, OR GUARANTEES OF LOANS)

EXPENDITURE3 TOTAL POLITICAL EXPENDITURES OF $ 100 OR LESS,

TOTALS UNLESS ITEMIZED

4. TOTAL POLITICAL EXPENDITURES

CONTRIBUTION5 TOTAL POLITICAL CONTRIBUTIONS MAINTAINED AS OF THE LAST DAY $

BALANCE OF REPORTING PERIOD

OUTSTANDING 6. TOTAL PRINCIPAL AMOUNT OF ALL OUTSTANDING LOANS AS OF THE $LOAN TOTALS LAST DAY OF THE REPORTING PERIOD

18 AFFIDAVIT

I swear, or affirm, under penalty of perjury, that the accompanying report istrue and correct and includes all information required to be reported by me

JARED A LUCASunder Ti Election e.

el" k' NOTARY PUBLIC

STATE OF TEXAS

44.0,., MY COMM. EXP. 6/27/ 22NOTARY ID 13162142- 2 Signature of Candidate or Officeholder

AFFIX NOTARY STAMP/ SEALABOVE

well( 4 L c& this the / V1'1

Sworn to and subscribed before me, by the said ... JJJ

day of : AN 20 to certify which, witness my hand and seal of office.

Sign to of officer administering oath Printed name of officer administering oath Title of officer administering oath

Forms provided by Texas Ethics Commission www. ethics. state. tx. usRevised 9/ 8/ 2015