Lane, Leo 03.01.2019LOCAL GOVERNMENT OFFICER $
CONFLICTS DISCLOSURE 1STATEMENT!
(instructions for completing and filing this form are provided on the next page.) � 1
This questionnaire reflects changes made to the law by H.B. 23, 841h Leg., Regular Session. OF ICE USE 11 ONO
This is the notice to the appropriate local governmental entity that the following local
government officer has become aware of facts that require the officer to file this statement Date Fla eiv U
in accordance with Chapter 176, Local Government Code. 0
1 1 Name of Local Government Officer O
Leo Lane ? Y
UJ W
— .
2 Office Held 0
WFEDC board member, president ¢ r a,
U D m
3 Name of vendor described by Sections 176.001(7) and 176.003(a), Local Government Code
Trinity Hughes Construction Co
42 Oescrlptlon of the nature and extent of each employment or other business relationship and each family relationship
with vendor named in item 3. James Lane Air Conditioning Co of which Lea Lane is a an owner occaisionaly
Performs work as a subcontractor for Trinity Hughes Construction Co
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 „ NA Description of Gift _
Date Gift Accepted N.A _,.. Description of Gift
Date Gift Accepted NA Description of Gift
(attach additional forms as necessary)
6 AFFIDAVIT
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
Government Code) of this local government officer. I also acknowledge that this statement
covers the 12-month period described by Section 176.003(a)(2)(B), Local Government Code.
VICKIE LYNN WHITE
:• ►= INy Notery iD # 12553WO
Expires December 282021 Signature of Local Government Officer
AFFIX NOTARY STAMP / SEAL ABOVE `1 /�
Sworn to and subscribed before md
' e, by the said L. o � I� 1 this theday
of &)acuov , 20 1 to certkly which, witness my hand and seal of office.
0'-�4 C" C' L
Signature of officer administering oath Printed name of officer administering oath Title of officer administering oath
Form provided by Texas Ethics Commission www.ethlcs.state.tx.us Rev sed 11/3012015