Robbin 8 Day 2021CANDIDATE
/ OFFICEHOLDER FORM C1OH
CAMPAIGN
FINANCE REPORT COVER SHEET PG 1
The C10H Instruction Guide
— — -- -------
explains how to complete this form. I Filer ID (Ethics Commission F 2 Total pages filed:
3 CANDIDATE/
OFFICEHOLDER
MS MR
/)P<� ��IRST
('1 - L OFFICE USE ONLY
NAME....
... --- .......... I ... .. - .......
Date Re.77=0- VMT—
NICKNAME ST SUFFIX
4 CANDIDATE/
ADDRESS / PO BOX; APT I SUITE #; CITY; STATE: ZIP CODE
APR 2 3 2021
OFFICEHOLDER
MAILING
ADDRESS
CJ Change of Address
OFFICE OF CITY SECRETAI`�
Y
5 CANDIDATE/
OFFICEHOLDER
PHONE
--a----'-'— ------- - - -------- ----- - -
AREA CODE PHONE NUMBER EXTENSION
Date Gde.1-W1Vre4.or D P I k d
a a
6 CAMPAIGN
Receipt # Amount $
MS / MRS / MR FIRST MI
TREASURER
In 4S
NAME....
Date
....... ........... ...... Date Processed
NICKNAME LAST SUFFIX
elmaged
7 CAMPAIGN
TREASURER
STREETADDRESS ((NO PO BOX PLEASE); APT / SUITE # , CITY; STATE; ZIP CODE
--/V
wl" Lk\� I A
ADDRESS
(Residence or Business)
8 CAMPAIGN
AREA CODE PHONE NUMBER EXTENSION
TREASURER
PHONE
9 REPORT TYPE
January 15 30th day before election Runoff 15th day after campaign
treasurer appointment
(Officeholder Only)
July 15 8th day before election Exceeded Modified Final Report (Attach C/OH - FR)
Reporting Limit
----------
10 PERIOD
Month Day Year Month Day Year
COVERED
THROUGH 1.2
11 ELECTION
ELECTION DATE ELECTION TYPE
Month Day Year Primary Runoff El Other
Description
General Special
C, /
12 OFFICE
---- — ----- -
OFFICE HELD (if any) 13 OFFICE SOUGHT (if known)
14 NOTICE FROM
THIS BOX IS FOR NOTICE OF POLITICAL CONTRIBUTIONS ACCEPTED OR POLITICAL EXPENDITURES MADE BY POLITICAL COMMITTEES TO SUPPORT
POLITICAL
THE CANDIDATE / 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
USPECIFIC COMMITTEE CAMPAIGN TREASURER NAME
COMMITTEE CAMPAIGN TREASURER ADDRESS
— - --------
GO TO PAGE 2
Forms provided by Texas Ethics
Commission www.ethics.state.tx.us Revised 8/17/2020
CANDIDATE / OFFICEHOLDER FORM C/OH
CAMPAIGN FINANCE REPORT COVER SHEET PG 2
15 C/OH NAME 16 Filer ID (Ethics Commission Filers)
17 CONTRIBUTION
1. TOTAL UNITEMIZED POLITICAL CONTRIBUTIONS (OTHER THAN
TOTALS
PLEDGES, LOANS, OR GUARANTEES OF LOANS, OR
$
------
CONTRIBUTIONS MADE ELECTRONICALLY)
2. TOTAL POLITICAL CONTRIBUTIONS
(OTHER THAN PLEDGES, LOANS, OR GUARANTEES OF LOANS)
$
'I
-- -- - - ---------
XPENDITURE
EOTALS
T
3� TOTAL UNITEMIZED POLITICAL EXPENDITURE.
$
4. TOTAL POLITICAL EXPENDITURES
$
...........
CONTRIBUTION
5. TOTAL POLITICAL CONTRIBUTIONS MAINTAINED AS OF THE LAST DAY
$
BALANCE
OF REPORTING PERIOD
Vial
..........
OUTSTANDING
6. TOTAL PRINCIPAL AMOUNT OF ALL OUTSTANDING LOANS AS OF THE
$
LOAN TOTALS
LAST DAY OF THE REPORTING PERIOD
ow
18 SIGNATURE
I swear, or affirm, under penalty of perjury, that the accompanying rep correct
and includes all
information
required to be reported by me under Title 15, Election Code. 7��
Signature of Candidate or Officeholder
Please complete either option below:
AMY SHELLEY
S,,,-No (if Texas
i:NotaiyP,anii,
(1) Pkffidavit y4q Comm, Expires 12-02-2023
of
Notary ID 12476110-5
NOTARY STAMP/ SEAL
t7
Sworn to and subscribed before me by vw b ----this the day ofA_,
2 to certify which, witness my hand anA seal of office.
Signature Wfficer a4&istering oath PrInte&-ifame of officer admirNtering oath Title of officer admini,steling oath
BZMEZMIZI=s
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 120
(month) (year)
Signature of Candidate/Officeholder (Declarant)
Forms provided by Texas Ethics Commission www,ethics.state.tx.us Revised 8/17/2020
SHEETCOVER PG 3
19
FILER NAME20 Filer ID (Ethics Commission Filers)
Q
21
SCHEDULE SUBTOTALS
SUBTOTAL
NAME OF SCHEDULE
AMOUNT
1
SCHEDULEA1: MONETARY POLITICAL CONTRIBUTIONS
i
$
2.
SCHEDULE A2: NON -MONETARY (IN -KIND) POLITICAL CONTRIBUTIONS
$
v �1
0 �'"0
3,
SCHEDULE B: PLEDGED CONTRIBUTIONS
$
4.
e-------------- -------.__._.___
SCHEDULE E: LOANS
$
5.
Cl SCHEDULE F1: POLITICAL EXPENDITURES MADE FROM POLITICAL CONTRIBUTIONS
$
6.
El SCHEDULE F2: UNPAID INCURRED OBLIGATIONS
$
7.
El SCHEDULE F3: PURCHASE OF INVESTMENTS MADE FROM POLITICAL CONTRIBUTIONS
$
--
8.
�) SCHEDULE F4: EXPENDITURES MADE BY CREDIT CARD
$
9•
SCHEDULE G: POLITICAL EXPENDITURES MADE FROM PERSONAL FUNDS
$
10.
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 8/17/2020
MONETARY POLITICAL 1 SCHEDULE Al
If the requested information is not applicable, ®® NOT include this page in the report.
The Instruction Guide explains howl to complete this form. 1 Total pages Schedule Al:
2 FILER NAME 3 Filer ID (Ethics Commission Filers)
--
4 Late 5 Fu11 me of contributor El out-of-state PAC tID# __._...._ ) % Amount of contribution ($)
i�C'4 -e
....— .. ............ 4' ........ ........ 1
6 Contributor address; City; State; Zip Code
8 Y Principal occupation / Job title (See Instructions) g Employer (See Instructions)
Date Full name of contributor ❑ out-of-state PAC (ID#: } Amount of contribution ($)
..................................................................... — ..........
Contributor address; City; State; Zip Code
kF
Principal occupation I 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 8/17/2020
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1 I POLITICAL
CONTRIBUTIONS
If the requested information is not applicable, DO NOT include this page in the report.
1 Total pages Schedule A2:
1"he instruction Guide explains how to complete this form.
- - --- ----_ _.- - — _— - -----
Y- - - — -- - -
FILER NAME Zg �j 3 Filer to (Ethics Commission Filers)
^J
4 TOTAL OF UNITEMIZED IN -KIND POLITICAL CONTRIBUTIONS
Date 6 Full name of contributor out-of-state PAC (Ia#:_ __,--
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10 Princip I occ pation / Job title (FOR NON-JUDICIAL)(See Instructions)
11 Em I yer (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) �—
16 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)
Date Full name of contributor ❑ out-of-state PAC (io#:-
f
—�) Amount of i In -kind contribution
Contribution $ I description
............. . .. . .............!s .
Contributor address; City„ State;
............. jt f I
Zip Code
I F�°C
-]Check if travel outside of Texas. Complete S 7a ale T.
Pri al occupation / Job title (FOR NON JUDICIAL) (See Instructions)
mployer (FOR NON-JUDICIAL)(See Instructions)
Contributor's principal occupation (FOR JUDICIAL)
Cor r tor's job title (FOR JUDICIAL) (See instructions)Am
Contributor's employer/law firm (FOR JUDICIAL) —
Law firm of contributor's „spouse (if any) (FOR JUDICIAL)
If contributor is a child, law firin 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 8/17/2020
LOANS 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 E:
2 FILER NAME
3 Filer ID (Ethics Commission Filers)
4 TOTAL OF UNITEMIZED LOANS
$
--. - - -- -- - __ --- __ _ ___.. -
5 Date of loan 7 N of lender ❑ out-of-state PAC (to#: )
_ -------..__� --
9 Loan Amount($)
Oro
6 Is lender 8 Lender address; City; State; Zip Code
a financial
10 Interest rate
'
Institution? j �
11 Maturity date
Y N
12 princippi occupation / Job title (See Instructions)
13 Employer (See Instructions)
14 Description of Collateral
15
� /` Check if personal funds were deposited into political
none
L�, account (See Instructions)
16 GUARANTOR
17 Name of guarantor
19 Amount Guaranteed ($)
INFORMATION
18 Guarantor address; City; State; Zip Code
not applicable
20 Principal Occupation (See Instructions)
21 Employer (See Instructions)
--
Date of loan
❑ out-of-state PAC (ID#: )
Name of lender k';')
Loan Amount
Ii
{�
Lender address; City; State; Zip Code
0 ti 0,.............1.......................................................
Is lender
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!
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Y N
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01 t (:
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Description of Collateral
Check if personal funds were deposited into political
none
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GUARANTOR
Name of guarantor
Amount Guaranteed ($) T _
INFORMATION
..................................................................................
Guarantor address; City; State; Zip Code
[� not applicable
Principal Occupation (See Instructions)
Employer (See Instructions)
ATTACH ADDITIONAL COPIES OF THIS SCHEDULE AS NEEDED
If lender is out-of-state PAC, please see Instruction guide for additional reporting requirements.
Forms provided by Texas Ethics Commission www.ethies.state.tx.us Revised 8/17/2020
POLITICAL EXPENDITURES MADE SCHEDULE F1
FROM POLITICAL CONTRIBUTIONS
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 SalarjesWages/Contract Labor Other (enter a category not listed above)
Credit Card Payment The Instruction Guide explains how to complete this form.
File, ID (Ethics Commission Filers)
1 Total page;(Shedule Fl: 2 FILER NAME
A'>�.
4 Date Payee name
— — — -- — ---------
6 Amount 7 Payeeress; 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 Scheduler 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
-- - - -------
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
Date Payee name
--- - ---- ---
Amount Payee address; City; State; Zip Code
Category (See Categories listed at the top of this schedule) Description
PURPOSE
OF
EXPENDITURE
El Check iftravel outside ofTexas. Complete Schedule T. J 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 8/17/2020
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