Lauren LaNeave LOCAL GOVERNMENT OFFICER CONFLICTS FORM CIS
DISCLOSURE STATEMENT
(Instructions for completing and filing this form are provided on the next page.)
This questionnaire reflects changes made to the law by H.B. 23, 84th Leg., Regular Session. OFFICE USE ONLY
This is the notice to the appropriate local governmental entity that the following local Date Received
government officer has become aware of facts that require the officer to file this statement
in accordance with Chapter 176,Local Government Code.
1 Name of Local Government Officer
LtikneM UtSki-t
2 Office Held
113-elcMlet 13t N itbr * t1)4 Q W V 5 —Acitim.iviStredo 311
3 Name of vendor described by Sections 176.001(7)and 176.003(a), Local Governmen
4.
Code
CA.-415: C4- foal^
4 Description of the nature and extent of each employment or other bus ess relationship'and each family relationship
with vendor named in item 3.
?t,9 CQ ce,. Svrt—[ vlv Si
5 List gifts accepted by the local government officer and any family member, if aggregate Value of the gifts accepted
from vendor named in item 3 exceeds$100 during the 12-month period described by Section 176.003(a)(2)(B).
Date Gift Accepted N 1 N Description of Gift
Date Gift Accepted Description of Gift _
Date Gift Accepted Description of Gift
(attach additional forms as necessary)
6 SIGNATURE I swear under penalty of perjury that the above statement is true and correct. I acknowledge that the disclosure applies
to each family member (as defined by Section 176.001(2), Local Governmep ••e) of this local government officer. I
also acknowledge that this statement covers the 12-mon :.'• ' '::d by Scction 176.003(a)(2)(B), Local
Government Code. 410,
.ture of Local Government Officer
Please complete either option below:
co Affidavit
VERONICA LOMAS
P<a°o
oc Notary Public,State of Texas
NOTARY STAMP/SEAL Co m.Expires 06-27-2028
Notary ID 1290 3128
Sworn to and subscribed before me bY' a this the Z7 day of v l CJ
20 Z i , to certify which,witness my hand and seeIPf office.
or Imp ft014.`CA I ,01414 29a/3 (.41S Meta
Signature of officer administering oath Printed name of officer administering oath Title of officer administering oath
OR
(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 Local Government Officer (Declarant)
Form provided by Texas Ethics Commission www.ethics.state.tx.us Revised 8/17/2020
LOCAL GOVERNMENT OFFICER CONFLICTS FORM CIS
DISCLOSURE STATEMENT
(Instructions for completing and filing this form are provided on the next page.)
This questionnaire reflects changes made to the law by H.B. 23, 84th Leg., Regular Session. OFFICE USE ONLY
This is the notice to the appropriate local governmental entity that the following local Date Received
government officer has become aware of facts that require the officer to file this statement
in accordance with Chapter 176,Local Government Code.
1 Name of Local Government Officer
l,CkLMJk ta .av&
2 Office Held
- S
4fit.N.Pr t Peute ki kkra — rsOkva Vlt tired1114
3 Name of vendor described by Sections 176.001(7)and 176.003(a), Local Government
Code
tevIfiv y\ cc -
4 Description of the nature and extent of each employment or other business relationship and each family relationship
with vendor named in item 3.
CKA' * titcAAt LOASSCOLat. _ t c_'--CO a uft crAjk0 GIN Y r
5 List gifts accepted by the local government officer and any family member, if aggregate value of the gifts accepted
from vendor named in item 3 exceeds$100 during the 12-month period described by Section 176.003(a)(2)(B).
Date Gift Accepted V/rS Description of Gift
Date Gift Accepted Description of Gift
Date Gift Accepted Description of Gift
(attach additional forms as necessary)
6 SIGNATURE I swear under penalty of perjury that the above statement is true and correct. I acknowledge that the disclosure applies
to each family member(as defined by Section 176.001(2), Local Governmen o•: of this local government officer. I
also acknowledge that this statement coy- -mo per•. described •y --•'•n 176.003(a)(2)(B), Local
Government Code.
� C
ature .f L:,cal government Officer
Please complete either option '•elovv:
(1)Affidavit
.‘ 41'% VERONICA LOMAS
�Pa 4,4,%
NOTARY STAMP/SEAL No' Ni Notary Public,State of Texas
a. •'e� Corn . Expires 06-27-2028
-74,°"'���`� Nt ,ID12901318
Sworn to and subscribed ber �'
��-�-�— -�- ��(/e this the Zz day of 1�
20 Z f , to certify which,witness my hand and seal of office.
U
] � P` - V.4 Vkro, /CO AA CJ(j letthr9
Signature of officer administering oath Printed name of officer administering oath Title of officer administering oath
OR
(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 Local Government Officer (Declarant)
Form provided by Texas Ethics Commission www.ethics.state.tx.us Revised 8/17/2020
LOCAL GOVERNMENT OFFICER CONFLICTS FORM CIS
DISCLOSURE STATEMENT
(Instructions for completing and filing this form are provided on the next page.)
This questionnaire reflects changes made to the law by H.B. 23, 84th Leg., Regular Session. OFFICE USE ONLY
This is the notice to the appropriate local governmental entity that the following local Date Received
government officer has become aware of facts that require the officer to file this statement
in accordance with Chapter 176, Local Government Code.
1 Name of Local Government Officer
'Albers L(nts e otve--
2 Office Held
)-er�c � � ,
� kw of Wo t
k b kivzheS-p6-14AxV Yatrem
3 Name of vendor described by Sections 176.001(7)and 176.003(a), Local Government
Code
4 Description of the nature and extent of each employment or other business relationship and each family relationship
with vendor named in item 3.
W'UI 044 (/X — (,c) n — CIC‘:,Y IM C
5 List gifts accepted by the local government officer and any family member, if aggregate value of thegis cepted
from vendor named in item 3 exceeds$100 during the 12-month period described by Section 176.003(a)(2)(B).
Date Gift Accepted Description of Gift
Date Gift Accepted Description of Gift
Date Gift Accepted Description of Gift
(attach additional forms as necessary)
6 SIGNATURE I swear under penalty of perjury that the above statement is true and correct. I acknowledge that the disclosure applies
to each family member (as defined by Section 176.001(2) • al Government Code) of this local government officer. I
also acknowledge that this statement covers the e-mo• h p- iod •-scr'•ed b, .1 n 176.003(a)(2)(B), Local
Government Code.
ig . • of Local Government Officer
l •- �o Im late either option below:
±;�;.s�'+ale
(1)Affidavit _2 .�=Notary Public,State of Texas
I ` " Comm.Expires 06-27-2028
%� ...• :
.,,�oe �. Notary ID 129013128
NOTARY STAMP/SEA ...:
Sworn to and subscribed before me by f1.0{'QU} 1, Maw this the Z Z day of ft;!y ,
20 Z7 , to certify which,witness my hand and seal of office.
U 6rY/(0 fie-roorcA Loma j, Ntoo-if, 033 Setre4.3
Signature of officer administering oath Printed name of officer administering oath Title of officer administering oath
OR
(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 Local Government Officer(Declarant)
Form provided by Texas Ethics Commission www.ethics.state.tx.us Revised 8/17/2020