Wedgeworth Lucas 30th Day Before 2024 General Election CANDIDATE I 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 I MRS/MR FIRST MI OFFICE USE ONLY
OFFICEHOLDER M
NAME • Q
. ..�� .5........................................... Date
NICKNAME AST SUFFIX
7ECEIVED
o�
4 CANDIDATE/ ADDRESS /PO BOX; APaT/SUITE# CITY; STATE; ZIP CODE APR 2 2014
OFFICEHOLDER v / �\�� J, �r)�i V 17/ )v r�
MAILING J l' /� ((�-G
ADDRESS City Manager's]City
Secretary's Office
❑ Change of Address
5 CANDIDATE/ AREA CODE PHONE NUMBER EXTENSION Date Hand-delivered or Date Postmarked
OFFICEHOLDER
PHONE \ I 1 I
Receipt# I Amount$
6 CAMPAIGN MIS I MRS/MR FIRST MI
TREASURER /t� r Date Processed
NAME ..`I.`................�'••"` ..................................
NICKNAME LAST SUFFIX
1�4a ��\ Date Imaged
7 CAMPAIGN STREET ADDRESS (NO PO BOX P SE); APT/SUITE#; L 'jC�ITY; STATE; ZIP CODE
TREASURER �23,(� S{ ,J�cet I ( I Ok \�
ADDRESS
(Residence or Business)
8 CAMPAIGN AREA CODE PHONE NUMBER EXTENSION
TREASURER
PHONE G 0 1 '3 q 3 q 3
9 REPORT TYPE ❑ January 15 30th day before election El El treasurer
day after campaign
treasurer appointment
(Officeholder Only)
❑ July 15 ❑ 8th day before election ❑ Exceeded.Modified ❑ Final Report(Attach C/OH-FIR)
Reporting Limit
10 PERIOD Month Day Year Month Day Year
COVERED l i / [7 /"� I THROUGH 1 I / I-�- //) {'^ }�
11 ELECTION ELECTION DATE ELECTION TYPE
Month Da Year ❑ Primary ❑ Runoff ❑ Other
Y Description
/�•j� /�'r X General ❑ Special .
12 OFFICE OFFICE HELD) 13 OFFICE SOUGHT (if known)
a(e
14 NOTICE FROM THIS BOX IS FOR NOTICE OF POLITICAL CONTRIBUTIONS ACCEPTED OR POLITICAL EXPENDITURES MADE ,YIPO1 ITICAL COMMITTEES TO SUPPORT
POLITICAL THE CANDIDATE I OFFICEHOLDER. THESE EXPENDITURES MAY HAVE BEEN MADE WITHOUT THE CANDIDATE'S OR OFFICEHOLDER'S KNOWLEDGE OR
CONSENT. CANDIDATES AND OFFICEHOLDERS ARE REQUIRED TO REPORT THIS INFORMATION ONLY IF THEY RECEIVE NOTICE OF SUCH EXPENDITURES.
COMMITTEE(S)
COMMITTEE TYPE COMMITTEE NAME
❑GENERAL COMMITTEE ADDRESS
❑ Additional Pages
❑SPECIFIC COMMITTEE CAMPAIGN TREASURER NAME
COMMITTEE CAMPAIGN TREASURER ADDRESS
GO TO PAGE 2
Forms provided by Texas Ethics Commission www.ethics.state.tx.us Revised 1/1/2024
CANDIDATE / OFFICEHOLDER FORM C/OH
CAMPAIGN FINANCE REPORT COVER SHEET PG 2
15 C/OH NAME 1 ( }}�� 16 Filer ID (Ethics Commission Filers)
�G r IG\
17 CONTRIBUTION 1. TOTAL UNITEMIZED POLITICAL CONTRIBUTIONS (OTHER THAN
TOTALS PLEDGES, LOANS, OR GUARANTEES OF LOANS, OR
CONTRIBUTIONS MADE ELECTRONICALLY) �Q
2. TOTAL POLITICAL CONTRIBUTIONS
(OTHER THAN PLEDGES, LOANS, OR GUARANTEES OF LOANS)
EXPENDITURE 3. TOTAL UNITEMIZED POLITICAL EXPENDITURE.
TOTALS $
4. TOTAL POLITICAL EXPENDITURES $
CONTRIBUTION 5. 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 O
LOAN TOTALS LAST DAY OF THE REPORTING PERIOD
18 SIGNATURE 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.
Signatufe,6f Candidate or Officeholder
Please complete either option below:
,• '". JESUS J.SALAZAR
*` MY Notary ID#131W4291
(1)A v�i!" �'' Expk%March 21,2026
NOTARY STAMP/SEAL
Sworn to and subscribed before me by L 0ofs , {�VQ this the 40 day of�P23L
20 to ce ' hich,witness my hand and seal of office.
`TGSC,S a606-1yG�fyrG
Si nat er administering oath Printed name of officer administering oath Title of officer administering oath
(2)Unsworn Declaration
My name is and my date of birth is
My address is
(street) (city) (state) (zip code) (countr
y)
Executed in County,State of on the day of 20
(month) (year)
Signature of Candidate/Officeholder (Declarant)
Forms provided by Texas Ethics Commission www.ethics.state.tx.us Revised 1/1/2024
SUBTOTALS - C/OH FORM C/OH
COVER SHEET PG 3
19 FILER NAME 20 Filer ID(Ethics Commission Filers)
21 SCHEDULE SUBTOTALS SUBTOTAL
NAME OF SCHEDULE AMOUNT
1. SCHEDULEA1: MONETARY POLITICAL CONTRIBUTIONS $
2- El SCHEDULEA2: NON-MONETARY(IN-KIND)POLITICAL CONTRIBUTIONS $
3. SCHEDULE B: PLEDGED CONTRIBUTIONS $
4. ❑ SCHEDULE E: LOANS $
5. SCHEDULE F1: POLITICAL EXPENDITURES MADE FROM POLITICAL CONTRIBUTIONS $
6. El SCHEDULE F2: UNPAID INCURRED OBLIGATIONS $
7. ❑ SCHEDULE F3: PURCHASE OF INVESTMENTS MADE FROM POLITICAL CONTRIBUTIONS $
8. El SCHEDULE F4: EXPENDITURES MADE BY CREDIT CARD $
9. SCHEDULE G: POLITICAL EXPENDITURES MADE FROM PERSONAL FUNDS $
10. El SCHEDULE H: PAYMENT MADE FROM POLITICAL CONTRIBUTIONS TO A BUSINESS OF C/OH $
11. SCHEDULE I: NON-POLITICAL EXPENDITURES MADE FROM POLITICAL CONTRIBUTIONS $
12. SCHEDULE K: INTEREST, CREDITS, GAINS, REFUNDS,AND CONTRIBUTIONS RETURNED $
TO FILER
Forms provided by Texas Ethics Commission www.ethics.state.tx.us Revised 1/1/2024
MONETARY POLITICAL CONTRIBUTIONS SCHEDULE Al
If the requested information is not applicable, DO NOT include this page in the report.
The Instruction Guide explains how to complete this form. 1 Total pages Schedule Al:
2 FILER NAME 3 Filer ID (Ethics Commission Filers)
4 Date 5 Full name of contributor j ❑out-of-state PAC(ID#. ) 7 Amount of contribution ($)
t ... �. ..> C-.� h .................................................
/�� 6 Contributor address, City; State; Zip Code
r�
8 Principal occupation/Job title (See Instructions) 9 Employer(See Instructions)
Date Full name of contributor ❑out-of-state PAC(ID#: > Amount of contribution ($)
..................................................................................
Contributor address; City; State; Zip Code
Principal occupation/Job title(See Instructions) Employer (See Instructions)
Date Full name of contributor ❑out-of-state PAC(ID#. ) Amount of contribution ($)
..................................................................................
Contributor address; City; State; Zip Code
Principal occupation/Job title (See Instructions) Employer(See Instructions)
Date Full name of contributor ❑out-of-state PAC(ID#: ) Amount of contribution ($)
..................................................................................
Contributor address; City; State; Zip Code
Principal occupation/Job title(See Instructions) Employer(See Instructions)
ATTACH ADDITIONAL COPIES OF THIS SCHEDULE AS NEEDED
If contributor is out-of-state PAC,please see Instruction guide for additional reporting requirements.
Forms provided by Texas Ethics Commission www.ethics.state.tx.us Revised 1/1/2024
NON-MONETARY (IN-KIND) POLITICAL
CONTRIBUTIONS SCHEDULE A2
If the requested information is not applicable, DO NOT include this page in the report.
The Instruction Guide explains how to complete this form. 1 Total pages Schedule A2:
2 FILER NAME 3 Filer ID (Ethics Commission Filers)
4 TOTAL OF UNITEMIZED IN-KIND POLITICAL CONTRIBUTIONS $
5 Date 6 Full name of contributor ❑out-of-state PAC(ID#: ) 8 Amount of I g In-kind contribution
Contribution $ I description
I
7 Contributor address; City; State; Zip Code
❑Check if travel outside of Texas. Complete Schedule T.
10 Principal occupation/Job title(FOR NON-JUDICIAL)(See Instructions) 11 Employer(FOR NON-JUDICIAL)(See Instructions)
12 Contributor's principal occupation (FOR JUDICIAL) 13 Contributor's job title(FOR JUDICIAL)(See Instructions)
14 Contributor's employer/law firm(FOR JUDICIAL) 15 Law firm of contributor's spouse(if any) (FOR JUDICIAL)
16 If contributor is a child, law firm of parent(s)(if any)(FOR JUDICIAL)
Full name of contributor ❑out-of-state PAC(ID#: ) I
Date Amount of In-kind contribution
Contribution $ I description
I
............................................................................
Contributor address; City; State; Zip Code
Check if travel outside of Texas. Complete Schedule T.
Principal occupation/Job title(FOR NON-JUDICIAL)(See Instructions) Employer(FOR NON-JUDICIAL)(See Instructions)
Contributor's principal occupation (FOR JUDICIAL) Contributor's job title(FOR JUDICIAL)(See Instructions)
Contributor's employer/law firm(FOR JUDICIAL) Law firm of contributor's spouse (if any) (FOR JUDICIAL)
If contributor is a child, law firm of parent(s)(if any)(FOR JUDICIAL)
ATTACH ADDITIONAL COPIES OF THIS SCHEDULE AS NEEDED
If contributor is out-of-state PAC, please see Instruction guide for additional reporting requirements.
Forms provided by Texas Ethics Commission www.ethics.state.tx.us Revised 1/1/2024
PLEDGED CONTRIBUTIONS SCHEDULE B
If the requested information is not applicable, DO NOT include this page in the report.
The Instruction Guide explains how to complete this form. 1 Total pages Schedule B:
2 FILER NAME 3 Filer ID (Ethics Commission Filers)
4 TOTAL OF UNITEMIZED PLEDGES $
5 Date 6 Full name of pledgor ❑ out-of-state PAC(ID#: ) 8 Amount I 9 In-kind contribution
of Pledge$ I description
I
7 Pledgor address; City; State; Zip Code
I
❑Check if travel outside of Texas Complete Schedule T.
10 Principal occupation/Job title(See Instructions) 11 Employer(See Instructions)
Date Full name of pledgor ❑out-of-state PAC(ID#: ) Amount I In-kind contribution
of Pledge$ I description
...........................................................................
I
Pledgor address: City; State; Zip Code
I
❑Check if travel outside of Texas. Complete Schedule T.
Principal occupation/Job title(See Instructions) Employer(See Instructions)
Date Full name of pledgor ❑out-of-state PAC(ID#: ) Amount of I In-kind contribution
Pledge $ I description
I
Pledgor address; City; State; Zip Code
I
❑Check if travel outside of Texas.Complete Schedule T.
Principal occupation/Job title(See Instructions) Employer(See Instructions)
Date Full name of pledgor ❑out-of-state PAC(ID#: )
Amount of I In-kind contribution
Pledge$ I description
...........................................................................
Pledgor address; City; State; Zip Code
I
I
❑Check if travel outside of Texas. Complete Schedule T.
Principal occupation/Job title(See Instructions) Employer(See Instructions)
ATTACH ADDITIONAL COPIES OF THIS SCHEDULE AS NEEDED
If contributor is out-of-state PAC, please see Instruction guide for additional reporting requirements.
Forms provided by Texas Ethics Commission www.ethics.state.tx.us Revised 1/1/2024
LOANS SCHEDULE E
If the requested information is not applicable, DO NOT include this page in the report.
The Instruction Guide explains how to complete this form.
1 Total pages Schedule E:
2 FILER NAME 3 Filer ID (Ethics Commission Filers)
4 TOTAL OF UNITEMIZED LOANS $
5 Date of loan 7 Name of lender out-of-state PAC(ID#: ) 9 Loan Amount($)
...................................................................................
6 Is lender 8 Lender address; City; State; Zip Code 10 Interest rate
a financial
Institution?
11 Maturity date
Y N
12 Principal occupation /Job title (See Instructions) 13 Employer (See Instructions)
14 Description of Collateral 15
El account
if personal funds were deposited into political
El none account (See Instructions)
16 GUARANTOR 17 Nameofguarantor 19 Amount Guaranteed($)
INFORMATION
..................................................................................
18 Guarantor address; City; State; Zip Code
❑ not applicable
20 Principal Occupation (See Instructions) 21 Employer (See Instructions)
Date of loan Name of lender ❑out-of-state PAC(ID#: ) Loan Amount($)
..................................................................................
Is lender Lender address; City; State; Zip Code Interest rate
a financial
Institution? _
Maturity date
Y N
Principal occupation / Job title (See Instructions) Employer (See Instructions)
Description of Collateral
❑ Check if personal funds were deposited into political
❑ none account (See Instructions)
GUARANTOR Name of guarantor Amount Guaranteed($)
INFORMATION
..................................................................................
Guarantor address; City; State; Zip Code
❑ not applicable
Principal Occupation (See Instructions) Employer (See Instructions)
ATTACH ADDITIONAL COPIES OF THIS SCHEDULEAS NEEDED
If lender is out-of-state PAC, please see Instruction guide for additional reporting requirements.
Forms provided by Texas Ethics Commission www.ethics.state.tx.us Revised 1/1/2024
POLITICAL EXPENDITURES MADE
FROM POLITICAL CONTRIBUTIONS SCHEDULE F1
If the requested information is not applicable, DO NOT include this page in the report.
EXPENDITURE CATEGORIES FOR BOX 8(a)
Advertising Expense Event Expense Loan Repayment/Reimbursement Solicitation/Fundraising Expense
Accounting/Banking Fees Office Overhead/Rental Expense Transportation Equipment&Related Expense
Consulting Expense Food/Beverage Expense Polling Expense Travel In District
Contributions/Donations Made By Gift/Awards/Memorials Expense Printing Expense Travel Out Of District
Candidate/Officeholder/Political Committee Legal Services Salaries/Wages/Contract Labor Other(enter a category not listed above)
Credit Card Payment
The Instruction Guide explains how to complete this form.
1 Total pages Schedule F1: 2 FILER NAME 3 Filer ID (Ethics Commission Filers)
4 Date 5 Payee name
6 Amount ($) 7 Payee address; City; State; Zip Code
8 (a) Category (See Categories listed at the top of this schedule) (b) Description
PURPOSE
OF
EXPENDITURE
(C) Check if travel outside ofTexas.Complete Schedule T Check if Austin,TX,officeholder living expense
9 Complete ONLY if direct Candidate/Officeholder name Office sought Office held
expenditure to benefit C/OH
Date Payee name
Amount ($) Payee address; City; State; Zip Code
Category (See Categories listed at the top of this schedule) Description
PURPOSE
OF
EXPENDITURE
ElCheck iftravel outside ofTexas.Complete ScheduleT. Check if Austin,TX, officeholder living expense
Complete ONLY if direct Candidate/Officeholder name Office sought Office held
expenditure to benefit C/OH
Date Payee name
Amount ($) Payee address; City; State; Zip Code
Category (See Categories listed at the top of this schedule) Description
PURPOSE
OF
EXPENDITURE
ElCheck iftravel outside ofTexas.Complete ScheduleT Check if Austin,TX, officeholder living expense
Complete ONLY if direct Candidate/Officeholder name Office sought Office held
expenditure to benefit C/OH
ATTACH ADDITIONAL COPIES OF THIS SCHEDULE AS N EEDED
Forms provided by Texas Ethics Commission www.ethics.state.tx.us Revised 1/1/2024
UNPAID INCURRED OBLIGATIONS SCHEDULE F2
If the requested information is not applicable, DO NOT include this page in the report.
EXPENDITURE CATEGORIES FOR BOX 10(a)
Advertising Expense Event Expense Loan Repayment/Reimbursement Solicitation/Fundraising Expense
Accounting/Banking Fees Office Overhead/Rental Expense Transportation Equipment&Related Expense
Consulting Expense Food/Beverage Expense Polling Expense Travel In District
Contributions/Donations Made By Gift/Awards/Memorials Expense Printing Expense Travel Out Of District
Candidate/Officeholder/Political Committee Legal Services Salaries/Wages/Contract Labor Other(enter a category not listed above)
The Instruction Guide explains how to complete this form.
1 Total pages Schedule F2: 2 FILERNAME 3 Filer ID (Ethics Commission Filers)
4 TOTAL OF UNITEMIZED UNPAID INCURRED OBLIGATIONS $
5 Date 6 Payee name
7 Amount ($) 8 Payee address; City; State; Zip Code
9 TYPE OF
EXPENDITURE PoIItIC81 Non-Political
10 (a) Category (See Categories listed at the top of this schedule) (b) Description
PURPOSE
OF
EXPENDITURE
(C) Check if travel outside of Texas.Complete Schedule ❑ Check if Austin,TX, officeholder living expense
11 Complete ONLY if direct Candidate/Officeholder name Office sought Office held
expenditure to benefit C/OH
Date Payee name
Amount {$) Payee address; City; State; Zip Code
TYPE OF
EXPENDITURE Political Non-Political
Category (See Categories listed at the top of this schedule) Description
PURPOSE
OF
EXPENDITURE
Check iftravel outsideofTexas.Complete ScheduleT Check if Austin,TX, officeholder living expense
Complete ONLY if direct Candidate/Officeholder name Office sought Office held
expenditure to benefit C/OH
ATTACH ADDITIONAL COPIES OF THIS SCHEDULE AS NEEDED
Forms provided by Texas Ethics Commission www.ethics.state.tx.us Revised 1/1/2024
PURCHASE OF INVESTMENTS MADE
SCHEDULE F3
FROM POLITICAL CONTRIBUTIONS
If the requested information is not applicable, DO NOT include this page in the report.
1 Total pages Schedule F3
The Instruction Guide explains how to complete this form.
2 FILER NAME 3 Filer ID (Ethics Commission Filers)
4 Date 5 Name of person from whom investment is purchased
................................................................................................................................
6 Address of person from whom investment is purchased; City; State; Zip Code
7 Description of investment
8 Amount of investment($)
Date Name of person from whom investment is purchased
................................................................................................................................
Address of person from whom investment is purchased; City; State; Zip Code
Description of investment
Amount of investment($)
ATTACH ADDITIONAL COPIES OF THIS SCHEDULE AS NEEDED
Forms provided by Texas Ethics Commission www.ethics.state.tx.us Revised 1/1/2024
EXPENDITURES MADE BY CREDIT CARD SCHEDULE F4
If the requested information is not applicable, DO NOT include this page in the report.
EXPENDITURE CATEGORIES FOR BOX 10(a)
Advertising Expense Event Expense Loan Repayment/Reimbursement Solicitation/Fundraising Expense
Accounting/Banking Fees Office Overhead/Rental Expense Transportation Equipment&Related Expense
Consulting Expense Food/Beverage Expense Polling Expense Travel In District
contributions/Donations Made By Gift/Awards/Memorials Expense Printing Expense Travel Out Of District
Candidate/Officeholder/Political Committee Legal Services Salaries/4Vages/Contract Labor Other(enter a category not listed above)
The Instruction Guide explains how to complete this form. USE A NEW PAGE FOR EACH CREDIT CARD ISSUER
1 TOTAL PAGES 2 FILER NAME 3 FILER ID (Ethics Commission Filers)
SCHEDULE F4:
4 TOTAL OF UNITEMIZED EXPENDITURES CHARGED TO A CREDIT CARD $
5 CREDIT CARD Name of financial institution
ISSUER
6 PAYMENT (a)Amount Charged (b)Date Expenditure Charged (c)Date(s)Credit Card Issuer Paid
7 PAYEE (a)Payee name (b)Payee address; City, State, Zip Code
8 PURPOSE OF (a)Category(see Categories listed at the top ofthis schedule) (b)Description
EXPENDITURE
❑ Political
❑ Non-Political (c) ❑ Check if travel outside of Texas.Complete Schedule T. ❑ Check if Austin,TX,officeholder living expense
9 Complete ONLY if direct Candidate/Officeholder name Office Sought Office Held
expenditure to benefit C/OH
PAYMENT (a)Amount Charged (b)Date Expenditure Charged (c)Date(s)Credit Card Issuer Paid
PAYEE (a)Payee name (b)Payee address; City, State, Zip Code
PURPOSEOF (a)Category(see Categories listed at the top of this schedule) (b)Description
EXPENDITURE
❑ Political
❑ Non-Political (c) ❑ Check iftravel outside of Texas.Complete Schedule T. ❑ Check if Austin,TX,officeholder living expense
Complete ONLY if direct Candidate/Officeholder name Office Sought Office Held
expenditure to benefit C/OH
PAYMENT (a)Amount Charged (b)Date Expenditure Charged (c)Date(s)Credit Card Issuer Paid
$
PAYEE (a)Payee name (b)Payee address; City, State, Zip Code
PURPOSE OF (a)Category(See Categories listed at the top of this schedule) (b)Description
EXPENDITURE
❑ Political
❑ Non-Political (C) ❑ Check if travel outside of Texas.Complete Schedule T. ❑ Check if Austin,TX,officeholder living expense
Complete ONLY if direct Candidate/Officeholder name Office Sought Office Held
expenditure to benefit C/OH
ATTACH ADDITIONAL COPIES OF THIS SCHEDULE AS NEEDED
Forms provided by Texas Ethics Commission www.ethics.state.tx.us Revised 1/1/2024
POLITICAL EXPENDITURES MADE FROM
PERSONAL FUNDS SCHEDULE G
If the requested information is not applicable, DO NOT include this page in the report.
EXPENDITURE CATEGORIES FOR BOX 8(a)
Advertising Expense Event Expense Loan Repayment/Reimbursement Solicitation/Fundraising Expense
Accounting/Banking Fees Office Overhead/Rental Expense Transportation Equipment&Related Expense
Consulting Expense Food/Beverage Expense Polling Expense Travel In District
contributions/Donations Made By Gift/Awards/Memorials Expense Printing Expense Travel Out Of District
Candidate/Officeholder/Political Committee Legal Services Salaries/Wages/Contract Labor Other(entera category not listed above)
Credit Card Payment
The Instruction Guide explains how to complete this form.
1 Total pages Schedule G: 2 FILER NAME 3 Filer ID (Ethics Commission Filers)
4 Date 5 Payee name
6 Amount ($) 7 Payee address; City; State; Zip Code
Reimbursement from❑
political contributions
intended
8 (a) Category (See Categories listed at the top of this schedule) (b) Description
PURPOSE
OF
EXPENDITURE
(c) Check if travel outside of Texas.Complete Schedule Check if Austin,TX,officeholder living expense
g Candidate/Officeholder name Office sought Office held
Complete ONLY if direct
expenditure to benefit C/OH
Date Payee name
Amount ($) Payee address; City; State; Zip Code
Reimbursement from
Elpolitical contributions
intended
Category (See Categories listed at the top of this schedule) Description
PURPOSE
OF
EXPENDITURE
Check iftravel outside ofTexas.Complete ScheduleT Ej Check if Austin,TX,officeholder living expense
Candidate/Officeholder name Office sought Office held
Complete ONLY if direct
expenditure to benefit C/OH
Date Payee name
Amount ($) Payee address; City: State: Zip Code
Reimbursement from
❑ political contributions
intended
Category (See Categories listed at the top of this schedule) Description
PURPOSE
OF
EXPENDITURE
Check iftravel outside ofTexas.Complete ScheduleT. Check if Austin,TX,officeholder living expense
Candidate/Officeholder name Office sought Office held
Complete ONLY if direct
expenditure to benefit C/OH
ATTACH ADDITIONAL COPIES OF THIS SCHEDULE AS N EEDED
Forms provided by Texas Ethics Commission www.ethics.state.tx.us Revised 1/1/2024
PAYMENT MADE FROM POLITICAL CONTRIBUTIONS
TO A BUSINESS OF CJOH SCHEDULE H
If the requested information is not applicable, DO NOT include this page in the report.
EXPENDITURE CATEGORIES FOR BOX 8(a)
Advertising Expense Event Expense Loan Repayment/Reimbursement Solicitation/Fundraising Expense
Accounting/Banking Fees Office Overhead/Rental Expense Transportation Equipment&Related Expense
Consulting Expense Food/Beverage Expense Polling Expense Travel In District
contributions/Donations Made By Gift/Awards/Memorials Expense Printing Expense Travel Out Of District
Candidate/Officeholder/Political Committee Legal Services SalariesANages/Contract Labor Other(enter a category not listed above)
Credit Card Payment
The Instruction Guide explains how to complete this form.
1 Total pages Schedule H: 2 FILER NAME 3 Filer ID (Ethics Commission Filers)
4 Date 5 Business name
6 Amount ($) 7 Business address; City; State; Zip Code
8 (a) Category (See Categories listed at the top of this schedule) (b) DesCription
PURPOSE
OF
EXPENDITURE
(c) Check if travel outside of Texas.Complete Schedule Check if Austin.TX, officeholder living expense
9 Complete ONLY if direct Candidate/Officeholder name Office sought Office held
expenditure to benefit C/OH
Date Business name
Amount ($) Business address; City; State; Zip Code
Category (See Categories listed at the top of this schedule) Description
PURPOSE
OF
EXPENDITURE
❑ Check if travel outside of Texas.Complete Schedule ❑ Check if Austin,TX, officeholder living expense
Complete ONLY if direct Candidate/Officeholder name Office sought Office held
expenditure to benefit C/OH
Date Business name
Amount ($) Business address; City; State; Zip Code
Category (See Categories listed at the top of this schedule) D2scrlption
PURPOSE
OF
EXPENDITURE
ElCheck if travel outside of Texas.Complete ScheduleT Check if Austin,TX, officeholder living expense
Complete ONLY if direct Candidate/Officeholder name Office sought Office held
expenditure to benefit C/OH
ATTACH ADDITIONAL COPIES OF THIS SCHEDULE AS NEEDED
Forms provided by Texas Ethics Commission www.ethics.state.tx.us Revised 1/1/2024
NON-POLITICAL EXPENDITURES
MADE FROM POLITICAL CONTRIBUTIONS SCHEDULE
If the requested information is not applicable, DO NOT include this page in the report.
The Instruction Guide explains how to complete this form.
1 Total pages Schedule I: 2 FILER NAME 3 Filer ID (Ethics Commission Filers)
4 Date 6 Payee name
6 Amount ($) 7 Payee address; City State Zip Code
8 (a)Category (See instructions for examples of acceptable (b)Description (See instructions regarding type of information
PURPOSE categories.) required.)
OF
EXPENDITURE
Date Payee name
Amount ($) Payee address; City State Zip Code
PURPOSE Category (See instructions for examples of acceptable Description (See instructions regarding type of information
categories.) required.)
OF
EXPENDITURE
Date Payee name
Amount ($) Payee address; City State Zip Code
PURPOSE Category (See instructions for examples of acceptable Description (See instructions regarding type of information
OF categories.) required.)
EXPENDITURE
Date Payee name
Amount ($) Payee address; City State Zip Code
Category (See instructions for examples of acceptable Description (See instructions regarding type of information
PURPOSE categories.) required.)
OF
EXPENDITURE
ATTACH ADDITIONAL COPIES OF THIS SCHEDULE AS NEEDED
Forms provided by Texas Ethics Commission www.ethics.state.tx.us Revised 1/1/2024
INTEREST, CREDITS, GAINS, REFUNDS, AND
CONTRIBUTIONS RETURNED TO FILER SCHEDULE K
If the requested information is not applicable, DO NOT include this page in the report.
The Instruction Guide explains how to complete this form. 1 Total pages Schedule K:
2 FILER NAME 3 Filer ID (Ethics Commission Filers)
4 Date 5 Name of person from whom amount is received 8 Amount($)
........................................................................ ........................
6 Address of person from whom amount is received; City; State; Zip Code
7 Purpose for which amount is received ❑ Check if political contribution returned to filer
Date Name of person from whom amount is received Amount($)
........................................................................ ........................
Address of person from whom amount is received; City; State; Zip Code
Purpose for which amount is received ❑ Check if political contribution returned to filer
Date Name of person from whom amount is received Amount($)
........................................................................ ........................
Address of person from whom amount is received; City; State; Zip Code
Purpose for which amount is received ❑ Check if political contribution returned to filer
Date Name of person from whom amount is received Amount($)
........................................................................ ........................
Address of person from whom amount is received; City; State; Zip Code
Purpose for which amount is received ❑ Check if political contribution returned to filer
ATTACH ADDITIONAL COPIES OF THIS SCHEDULE AS NEEDED
Forms provided by Texas Ethics Commission www.ethics.state.tx.us Revised 1/1/2024
IN-KIND CONTRIBUTIONS OR POLITICAL EXPENDITURES SCHEDULE T
FOR TRAVEL OUTSIDE OF TEXAS
If the requested information is not applicable, DO NOT include this page in the report.
i Total pages Schedule T:
The Instruction Guide explains how to complete this form.
2 FILER NAME 3 Filer ID (Ethics Commission Filers)
4 Name of Contributor/Corporation or Labor Organization/Pledgor/Payee
5 Contribution/Expenditure reported on:
❑ Schedule A2 ❑ Schedule B ❑ Schedule B(J) ❑ Schedule C2 ❑ Schedule D ❑ Schedule F1
❑ Schedule F2 ❑ Schedule F4 ❑ Schedule G ❑ Schedule H ❑ Schedule COWLIC ❑ Schedule B-SS
6 Dates of travel 7 Name of person(s)traveling
8 Departure city or name of departure location
9 Destination city or name of destination location
10 Means of transportation 11 Purpose of travel(including name of conference,seminar,or other event)
Name of Contributor/Corporation or Labor Organization/Pledgor/Payee
Contribution/Expenditure reported on:
❑ Schedule A2 ❑ Schedule B ❑ Schedule B(J) ❑ Schedule C2 ❑ Schedule D ❑ Schedule F1
❑ Schedule F2 ❑ Schedule F4 ❑ Schedule G ❑ Schedule H ❑ Schedule COWLIC ❑ Schedule B-SS
Dates of travel Name of person(s)traveling
Departure city or name of departure location
Destination city or name of destination location
Means of transportation Purpose of travel(including name of conference,seminar,or other event)
Name of Contributor/Corporation or Labor Organization/Pledgor/Payee
Contribution/Expenditure reported on:
❑ Schedule A2 ❑ Schedule B ❑ Schedule B(J) ❑ Schedule C2 ❑ Schedule D ❑ Schedule F1
❑ Schedule F2 ❑ Schedule F4 ❑ Schedule G ❑ Schedule H ❑ Schedule COH-UC ❑ Schedule B-SS
Dates of travel Name of person(s)traveling
Departure city or name of departure location
Destination city or name of destination location
Means of transportation Purpose of travel(including name of conference,seminar,or other event)
ATTACH ADDITIONAL COPIES OF THIS SCHEDULEAS NEEDED
Forms provided by Texas Ethics Commission www.ethics.state.tx.us Revised 1/1/2024
CANDIDATE / OFFICEHOLDER REPORT:
DESIGNATION OF FINAL REPORT FORM C/OH - FR
The Instruction Guide explains howto complete this form.
-• Complete only if 'Report Type" on page 1 is marked "Final Report" •-
1 C/OH NAME 2 Filer ID (Ethics Commission Filers)
3 SIGNATURE
I do not expect any further political contributions or political expenditures in connection with my candidacy. I understand that
designating a report as a final report terminates my campaign treasurer appointment. I also understand that I may not accept any
campaign contributions or make any campaign expenditures without a campaign treasurer appointment on file.
Signature of Candidate/Officeholder
4 FILER WHO IS NOT AN OFFICEHOLDER
•• Complete A& B below only if you are not an officeholder. ••
A. CAMPAIGN FUNDS
Check only one:
F-1 I do not have unexpended contributions or unexpended interest or income earned from political contributions.
F-1 I have unexpended contributions or unexpended interest or income earned from political contributions. I understand that I
may not convert unexpended political contributions or unexpended interest or income earned on political contributions to
personal use. I also understand that I must file an annual report of unexpended contributions and that I may not retain
unexpended contributions or unexpended interest or income earned on political contributions longer than six years after
filing this final report. Further, I understand that I must dispose of unexpended political contributions and unexpended
interest or income earned on political contributions in accordance with the requirements of Election Code, §254.204.
B. ASSETS
Check only one:
F7 I do not retain assets purchased with political contributions or interest or other income from political contributions.
0 I do retain assets purchased with political contributions or interest or other income from political contributions. I understand
that I may not convert assets purchased with political contributions or interest or other income from political contributions to
personal use. I also understand that I must dispose of assets purchased with political contributions in accordance with the
requirements of Election Code, §254.204.
Signature of Candidate
5 OFFICEHOLDER
•- Complete this section only if you are an officeholder ••
I am aware that I remain subject to filing requirements applicable to an officeholder who does not have a campaign treasurer on
file. I am also aware that I will be required to file reports of unexpended contributions if,after filing the last required report as
an officeholder, I retain political contributions, interest or other income from political contributions,or assets purchased with
political contributions or interest or other income from political contributions.
Signature of Officeholder
Forms provided by Texas Ethics Commission www.ethics.state.tx.us Revised 1/1/2024
OFFICE USE ONLY
�T>r, Off. Date Received
AFFIDAVIT FOR
CANDIDATE OR OFFICEHOLDER:
ELECTRONIC FILING EXEMPTION
An exemption affidavit must be submitted with each paper report. Date Hand-delivered or Date Postmarked
Beginning on January 1, 2024, a candidate or officehol'ifer who has accepted more than
$32,810 in political contributions or made more than $32,810 in political expenditures Receipt# Amount$
'in any calendar year must file all subsequent reports electronically.
Date Processed
Filer name Filer ID# Date Imaged
1. I swear or affirm that I have not accepted more than $32,810 in political contributions or made
more than $32,810 in political expenditures in a calendar year.
2. 1 further swear or affirm that I do not use computer equipment to keep current records of political
contributions, political expenditures, or persons making political contributions to me.
3. 1 further swear or affirm that no person acting as my agent or consultant, and no person with whom I
contract, uses computer equipment to keep current records of political contributions, political
expenditures, or persons making political contributions to me.
4. 1 further swear or affirm that I understand that I am required to file my campaign finance reports
electronically if 1, my agent or consultant, or a person with whom I contract exceeds $32,810 in political
contributions or political expenditures in a calendar year, or uses computer equipment to keep current
records of political contributions, political expenditures, or persons making political contributions to me.
5. 1 am filing this affidavit with the report due on
I understand that this affidavit is required to be filed with each campaign finance report for which I am
claiming an exemption from electronic filing.
Please complete either option below:
(1)Affidavit
Signature of Filer
NOTARY STAMP/SEAL
Sworn to and subscribed before me by this the day of
20 , to certify which,witness my hand and seal of office.
Signature of officer administering oath Printed name of officer administering oath Title of officer administering oath
(2)Unsworn Declaration
My name is and my date of birth is
My address is ,
(street) (city) -(state)' (zip code) ' (country)
Executed in County,State of on the day of 20
(month) (year)
Signature of Filer(Declarant)
FILERS WHO ARE EXEMPT FROM THE ELECTRONIC FILING REQUIREMENT
ARE STILL REQUIRED TO FILE CAMPAIGN FINANCE REPORTS ON PAPER
Forms provided by Texas Ethics Commission www.ethics.state.tx.us Revised 1/1/2024