3
SPECIFIC-PURPOSE COMMITTEE FORM SPAC CAMPAIGN FINANCE REPORT COVER SHEET PG 1 1 Fit. to {Emics Commaision Filint) 2 Total pages bled· Th. SPAC Instruction Guldi explaln, how to complete thls form. 3 COMMITTEE NAME OFFICE USE ONLY '63 1& 04 Arl# 14 X Ft Date Received 4 COMMITTEE ADDRESS j PO BOX APT , SUITE crn¢ STATE ZIP CODE ADDRESS 30 9 E /)4 9 7 1 OCC RECEIVED f -Tr- [?] Change of Address JUL 6 '20 AM11:3' A-,6-72 789-0 l Date Hand douverld or Date Poilman,?d 5 CAMPAIGN Ms/hol?,MA FIRST U1 TREASURER 14 Amount $ Roe•,pi ' NAME -4 NICKNAME Dat® Procissid LAST SUFFIX Dam Imag?d 6 CAMPAIGN STREET ADDRESS (NO PO BOX PLEASE} APT / SUITE CITY. STATE- ZIP CODE TREASURER STREETADDRESS (Res,dence of Bus,ness) 3 8 9 E. ))0 9 41 1 Au stu 74 71 70 1 7 CAMPAIGN STREET ADDRESS OR PO BOX STATE, ZLP CODE TREASURER MAILINGADDRESS 30 9 t I lIE51- fi ? Chang. of Address taA-, 7% 76 70 f 8 CAMPAIGN AREA COOE P•ONE NUMBER EXTENSION TREASURER PHONE 0-11, 6 36 - 827 9 REPORT TYPE 0 J?nuary 15 El 300, day b?for, ?1,611on 0 EK=.4 Mod- Reponing L- l ? Aly 15 ? Blh day b-re ?licoon G,s_: (Alt.ch PAC.OR) ? RunoM 0 100 d,y ?n. c?mp??n t,ea,u,v -?n•I,on 10 PERIOD Month D. ¥*af Month COVERED Day Year I ./ £ 10 THROUGH 6 23.10 11 ELECTION ELECTION DATE ELEg?N TYPE Month v.- O P'-ry O Auno• 100- 0 0-• 0 Spec,al ???6/12/ GO TO PAGE 2 Forms prov,ded by Texas Ethts Commission www ethics.state.tx.us Revised 1/1/2020

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Page 1: 1& 04 Arl# Ft

SPECIFIC-PURPOSE COMMITTEE FORM SPACCAMPAIGN FINANCE REPORT COVER SHEET PG 1

1 Fit. to {Emics Commaision Filint) 2 Total pages bled·Th. SPAC Instruction Guldi explaln, how to complete thls form.

3 COMMITTEE NAMEOFFICE USE ONLY

'63 1& 04 Arl# 14X Ft Date Received

4 COMMITTEE ADDRESS j PO BOX APT , SUITE • crn¢ STATE ZIP CODEADDRESS

309 E /)49 71 OCC RECEIVED f -Tr-

[?] Change of Address JUL 6 '20 AM11:3'

A-,6-72 789-0 l Date Hand douverld or Date Poilman,?d

5 CAMPAIGN Ms/hol?,MA FIRST U1TREASURER 14 Amount $Roe•,pi 'NAME -4

NICKNAME Dat® ProcissidLAST SUFFIX

Dam Imag?d

6 CAMPAIGN STREET ADDRESS (NO PO BOX PLEASE} APT / SUITE • CITY. STATE- ZIP CODETREASURERSTREETADDRESS(Res,dence of Bus,ness) 38 9 E. ))09 41 1

Austu 74 7170 17 CAMPAIGN STREET ADDRESS OR PO BOX STATE, ZLP CODE

TREASURERMAILINGADDRESS 309 t IlIE51-fi? Chang. of Address taA-, 7% 76 70 f

8 CAMPAIGN AREA COOE P•ONE NUMBER EXTENSIONTREASURERPHONE 0-11, 6 36 - 827

9 REPORT TYPE 0 J?nuary 15 El 300, day b?for, ?1,611on 0 EK=.4 Mod- ReponingL-

l ? Aly 15 ? Blh day b-re ?licoon G,s_: (Alt.ch PAC.OR)? RunoM 0 100 d,y ?n. c?mp??n t,ea,u,v -?n•I,on

10 PERIOD Month D. ¥*af MonthCOVERED Day Year

I ./ £ 10 THROUGH 6 23.1011 ELECTION ELECTION DATE ELEg?N TYPE

Month v.- O P'-ry O Auno• 100-0 0-• 0 Spec,al ???6/12/GO TO PAGE 2

Forms prov,ded by Texas Ethts Commission www ethics.state.tx.us Revised 1/1/2020

Page 2: 1& 04 Arl# Ft

SPECIFIC-PURPOSE COMMITTEE REPORT: FORM SPACPURPOSE AND TOTALS COVER SHEET PG 2

12 COMMITTEE NAME llc 114 4»-n PAC 13 1 ?0,r ic, f 1 ?tj* 9 ti,m«

14 COMM;TTE E r.NAL,43*11 <f *,11 In{*TABhM,44

PURPOSE89•48 6,1* on pow,P.P.f /0 f»¢¥*tele 1/1 . CA#?>tOLA'*yet>011 •' 110€***ar,, 0

4/ SU?'PORI OFf-!Cr SOUGHT (C?t¥?lulf)FLE UND{ome,hu»#C•nd'dat• or U••,0,•, 0 €*Fit*O?DIR

E.3 OPPOSEIC,/,4,4- W U/asuf/]

BAUOT?DENT!11(LAT?ON'" FLECTIONDATE.

ma> 18[? ASSIST CMAAto#ic,notowl DESCRIPTION A

1 No<*15 CONTRIBUTION 1. TOTAL UNITEMIZED POLITICAL CONTRIBUTIONS fOTHER THAN

TOTALS PLEDGES. LOANS. OR GUARANTEES OF LOANS OR %OCONTRIBUTIONS MADE ELECTRONICALLY)

2. TOTAL POLITICAL CONTRIBUTIONS{OTHER THAN PLEDGES. LOANS. OR GUARANTEES OF LOANS) %0

EXPENDITURE TOTAL UNITE*ZED POLITICAL EXPENDITURESTOTALS $O4 TOTAL POLITICAL EXPENDITURES %O

CONTRIBUTION 5 TOTAL POLITICAL CONTRIBUTIONS MAINTAINED AS OF THE LAST DAYBALANCE OF THE REPORTING PERIOD $ 11*¥/7OUTSTANDING 8 TOTAL PRINCIPAL AMOUNT OF ALL OUTSTANDING LOANS AS OF THE

LAST DAY OF THE REPORTING PERIOD $LOAN TOTALS 0

16 AFFIDAVIT I swear. or affirm, under penalty of perjury, that the accompany,ng/n»46 report Is true and correct and includes all Information required to

:Janet J Melton be reported by me u?jerT'l?3? Election Code.

1 4741 I .2 ID NUMBER1010431-7

COMMISSION EXPIREStm444'"""?? 14 3-3 Fru*-Uck Ir,<?1 1-*wi

November 21.2022 S,gnatu,9 Of Campa,gn Trealuter

Notarized online using audio-video communicationAys,A **,101 *IMW,UALABOVE

Swain to and *ub?cribed belo,l me, by the,aid- Frederick Irving Lewis. thisthe 3Oth

day of *June , 20 20 to cerbly which. w,tness my hand and seal of office.

-- 4••4-U•u Janet J Melton Electronic NQtary Public?**, 81 0•Nt- adn?it)*Iblenne -h Pil-d f,sm® 01 Ofheer admcm#inng oath Tilll of OM,C- administinng Oath

Fo??n. p,ov,?i/a*T.1. Em<' Con"M/*10„ Wvm 001•Cs state 1% us Revised 1/1/2020

Page 3: 1& 04 Arl# Ft

POLITICAL COMMITTEEAFFIDAVIT OF DISSOLUTION FORM PAC - DR

The Instruction Guide explains how to complete this fonn-· Complete only 11 "Reporl Type" on page 1 Is marked 'Dissolution- ..

1 COMMITTEE NAME 2 Fige, *D {Ethics Commos,on Fit.rs*

b_4 *VAA«.?- fA0-3 Affidavit of Dissolution

1, the undersigned campaign treasurer, do not expect the occurrence of any further reportable activity bythis political committee for this or any other campaign or election for which reporting under the ElectionCode is required. I declare that all of the information required to be reported by me has been reported I

understand that designating a report as a dissolution report terminates the appointment of campaign trea-

surer. 1 further understand that a political committee may not make or authorize political expenditures or

accept political contributions without having an appointment of campaign treasurer on file.

S#gnature of Campaign Treasurer

DO NOT SIGN UNLESS POLITICALCOMMITTEE IS TO BE DISSOLVED

»UJ'We//*/..Y '4.7-14%>/ Janet J MeltonA

*2 ID NUMBER1010431-7

040, 1 , COMMISSION EXPIRES

441/,fliTW«* November 21, 2022

Notarized online using audio-video communication

AFFIX NOTARY STAMP/ SEAL ABOVE

Sworn to and subscribed before me, by the said Frederick Irving Lewis, this the 30th day 01

June , 20_20 , to certify which, witness my hand and seal of office.

4-*A1.-0.1. Janet J Melton Electronic Notary Public_Sionatur*of off:86, administifing oith Printed name of officer administering oath Title of officer adrninistering oath

Fofins p,ov,ded by Texas Ethics Commussion w.*.ethics state tx.us Revised 1/1,9020