Robbins Semi July 2021 CANDIDATE / 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/MRS AMR/ zST MI
,y
OFFICEHOLDER � v OFFICE USE ONLY
NAME / /�
Da e Received RECEIVED
NICKNAME ZS2T SUFFIX
4 CANDIDATE/ ADDRESS /PO BOX; APT/SUITE#; CITY; STATE; ZIP CODE J U L 1 5 2021
OFFICEHOLDER
. , ? V y. 8Lo Pl.,,,
I Change of Address / ( LOFFICE OF CITY SECRETARY
5 CANDIDATE/ AREA CODE PHONE NUMBER EXTENSION
OFFICEHOLDER Date Ha d-delivered or Date Postmarked
PHONE ( 7/IS/Zi
Receipt# Amount $
6 CAMPAIGN MS/MRS I MR FIRST MI
TREASURER �
NAME frf 1�/ /A Date Processed
NICKNAME LAST SUFFIX
Date Imaged
7 CAMPAIGN STREET ADDRESS/ (NO PO BOX PLEASE); APT/SUITE#; CITY;I �/ STATE; ZIP CODE
TRDRESS
EASURER 42/� la11,)f//- h /
L L . , a/1./h,/141 �t/ �lv7
(Residence or Business)
8 CAMPAIGN AREA CODE PHONE NUMBER EXTENSION
TREASURER
PHONE (04- )
J?7-/ _ ?if(
9 REPORT TYPE January 15 I I 30th day before election I I Runoff I I 15th day after campaign
treasurer appointment
(Officeholder Only)
X July 15 8th day before election Exceeded Modified I Final Report(Attach C/OH-FR)
Reporting Limit
10 PERIOD Month Day Year Month Day Year
COVERED
V / a'/a/ THROUGH Z //t- /2/
11 ELECTION ELECTION DATE ELECTION TYPE
Month Day Year I I Primary I I Runoff I Other
I���/f Description
c/ / / , / r.�v General I Special
12 OFFICE OFFICE HELD (if any) / 13 OFFICE SOUGHT (if known)
, *( / /c1 Cd7 54k(,. / /'hCf
14 NOTICE FROM THIS BOX IS FOR NOTICE OF POLITICAL CONTRIBUTIONS ACCEPTED OR POLITICAL EXPENDITURES MADE BY POLITICAL COMMITTEES TO SUPPORT
POLITICAL THE CANDIDATE I OFFICEHOLDER. THESE EXPENDITURES MAY HAVE BEEN MADE WITHOUT THE CANDIDATE'S OR OFRCEHOLDER'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
I I 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 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)
41-
in,
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) $ 21 1/ l";(piS
TOTALS EXPENDITURE 3. TOTAL UNITEMIZED POLITICAL EXPENDITURE. $
4. TOTAL POLITICAL EXPENDITURES $ et 2�11. -��, p
/
CONTRIBUTION 5. TOTAL POLITICAL CONTRIBUTIONS MAINTAINED AS OF THE LAST DAY
BALANCE OF REPORTING PERIOD $ CI L ' I-1
OUTSTANDING 6. TOTAL PRINCIPAL AMOUNT OF ALL OUTSTANDING LOANS AS OF THE
LOAN TOTALS LAST DAY OF THE REPORTING PERIOD $ (,coo ou
18 SIGNATURE I swear, or affirm, under penalty of perjury, that the accompanying report is t and correct and includes all information
required to be reported by me under Title 15,Election Code.
Signature of Candidate or Officeholder
``�1'11�'', VERONICA LOMAS
6
t =° c,=Notary Public,State of Texas
"'r; +; Comm.Expires 06-27-2024
1 °;,;�`� Notary ID 129013128 Please complete either option below:
(1)Affidavit
NOTARY STAMP/SEAL
Swom to and subscribed before me by 61,4d1 ke k k K.S this the IS day of Sj4 ,
20 24 ,to certify which,witness my hand and seal of office.
�4i VtrorltcG La v ) /)epu l, di , Sear fatr7
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 Candidate/Officeholder (Declarant)
Forms provided by Texas Ethics Commission www.ethics.state.tx.us Revised 8/17/2020
SUBTOTALS - C/OH FORM C/OH
COVER SHEET PG 3
19 FILER NAME ` ✓�//�l 20 Filer ID(Ethics Commission Filers)
f
21 SCHEDULE SUBTOTALS SUBTOTAL
NAME OF SCHEDULE AMOUNT
1. SCHEDULE A1: MONETARY POLITICAL CONTRIBUTIONS $ ?/f7 63
2. I I SCHEDULE A2: NON-MONETARY(IN-KIND)POLITICAL CONTRIBUTIONS $
3. I J SCHEDULE B: PLEDGED CONTRIBUTIONS $
4. SCHEDULE E: LOANS $
5. SCHEDULE Fl: POLITICAL EXPENDITURES MADE FROM POLITICAL CONTRIBUTIONS $ / 7
6. SCHEDULE F2: UNPAID INCURRED OBLIGATIONS $
7. SCHEDULE F3: PURCHASE OF INVESTMENTS MADE FROM POLITICAL CONTRIBUTIONS $
8. SCHEDULE F4: EXPENDITURES MADE BY CREDIT CARD $ —.
9• I I SCHEDULE G: POLITICAL EXPENDITURES MADE FROM PERSONAL FUNDS $
10. I 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 CONTRIBUTIONS SCHEDULE Al
If the requested information is not applicable, DO NOT include this page in the report.
The Instruction uide explains how o complete this form. 1 Total pages Schedule Al:
2 FILER NAME / 3 Filer ID (Ethics Commission Filers)
4 Date 5 Full me of contributor ❑out tate PAC(ID ) 7 Amount of contribution ($)
[f ‘ Chi../( __Vie (--(5 LA,/
6 Contributor address; City; State; Zip Code
8 Principal occupation/Job title (See Instructions) 9 Employer(See Instructions)
Date Full name of contributor ❑out-of-state PAC(ID#: ) Amount of contribution ($)
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 8/17/2020
Filer Name: Randy Robbins
Donation Date First Name Last Name Address Line 1 City State Zip Occupation Employer Donation Amount
5/2/2021 Lori Palmer 921 Parkview Lane Southlake TX 76092 Retired Retired $300.00
4/28/2021 Stephen Gillett 670 S Peytonville Ave Southlake TX 76092 Technology ITSAINT $500.00
4/24/2021 Mark Grasmick 1208 Andre ct Southlake TX 76092 Retired Retired $100.00
5/17/2021 Craig&Leigh Huang 407 Indian Paintbrush Way Southlake TX 76092 Retired Retired $180.00
5/17/2021 James&Cyndy Dollar 101 Latrobe Ct Southlake TX 76092 Unknown Unknown $300.00
6/3/2021 David C Bryan 970 Ownby Ln Southlake TX 76092 Unknown Unknown $391.09
7/6/2021 Amy Torres-Lepp Title Officer Excel Title $1,384.54
POLITICAL EXPENDITURES MADE
FROM POLITICAL CONTRIBUTIONS SCHEDULE F1
If the requested information is not applicable, DO NOT include this page in the report.
EXPENDITURE CATEGORIES FOR BOX 8(a)
Advertising Expense Event Expense Loan Repayment/Reimbursement Solicitation/Fundraising Expense
Accounting/Banking Fees Office Overhead/Rental Expense Transportation Equipment&Related Expense
Consulting Expense Food/Beverage Expense Polling Expense Travel In District
Contributions/Donations Made By Gift/Awards/Memorials Expense Printing Expense Travel Out Of District
Candidate/Officeholder/Political Committee Legal Services Salaries/Wages/Contract Labor Other(enter a category not listed above)
Credit Card Payment 4Th nstruction Guide explains how to complete this form.
1 Total pages Schedule F 1: 2 FILER NA /J /4_L.) 3 Filer ID (Ethics Commission Filers)
kl.
4 Date 5 Payee names /L 6, / s-p...ex
/rt�"/
6 Amount ($) 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) I Check if travel outside of Texas.Complete ScheduleT. I 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
ICheck if travel outside of Texas.Complete ScheduleT. I I 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
Filer Name: Randy Robbins
Date Amount Payee Name Address _Category Description
7/13/2021 $7.03 Wix.Com,Inc. 500 Tery A Francois BlvdFl6 San Francisco,CA 94158 Advertising Website Server
6/21/2021 $84.20 MAILCHIMP 675 Ponce de Leon Ave NE Suite 5000 Atlanta,GA 30308 Advertising Email Service
6/14/2021 $7.03 Wix.Com,Inc. 500 Tery A Francois BlvdF16 San Francisco,CA 94158 Advertising Website Server
5/24/2021 $357.42 REATA FTW 310 Houston St. Ft.Worth,TX 76102 Food/Beverage Food for Volunteers
5/20/2021 $1,290.56 MANNYS UPTOWN TEXMEX R 151 Nolen Dr.Southlake,TX 76092 Food/Beverage Food for Volunteers
5/19/2021 $84.20 MAILCHIMP 675 Ponce de Leon Ave NE Suite 5000 Atlanta,GA 30308 Advertising Email Service
5/13/2021 $7.03 Wix.Com,Inc. 500 Tery A Francois BlvdFl6 San Francisco,CA 94158 Advertising Website Server
5/12/2021 $250.00 CORINTHIAN WELLNESS SPA 1251 E.Southlake Blvd.Southlake,TX 76092 Gift/Awards Volunteer Gifts
5/12/2021 $110.39 CENTRAL MARKET#055 1425 E.Southlake Blvd.Southlake,TX 76092 Gift/Awards Volunteer Gifts
5/5/2021 $3,750.00 Majority Strategies,LLC 12854 Kenan Drive,Suite 110,Jacksonville,Florida 32258 Advertising Targeted Marketing Ads
5/4/2021 $3,750.00 Majority Strategies,LLC 12854 Kenan Drive,Suite 110,Jacksonville,Florida 32258 Advertising Targeted Marketing Ads
5/4/2021 $850.00 LA CREPE DES ROIS 820 W Stacy Rd,Allen,TX 75013 Food/Beverage Food for Volunteers
5/3/2021 $2,500.00 Mikenley Heller P.O. Box 101902 Fort Worth,TX 76185 Consulting Consultant Fees
5/3/2021 $189.13 MANNYS UPTOWN TEXMEX R _151 Nolen Dr.Southlake,TX 76092 Food/Beverage Food for Volunteers
5/3/2021 $159.14 TST*MEAT U ANYWHERE BBQ 919 W Northwest Hwy,Grapevine,TX Food/Beverage Food for Volunteers
5/3/2021 $1,741.42 FAJITA PETES 711 E Southlake Blvd#100,Southlake,TX 76092 Food/Beverage Food for Volunteers
5/3/2021 $33.32 TOM THUMB#2580 100 W Southlake Blvd,Southlake,TX 76092 Food/Beverage Food for Volunteers
4/30/2021 $350.00 ACT SOUTHLAKEP&R 1400 Main Street,Southlake,TX 76092 Advertising Gazebo Rental
4/29/2021 $318.74 STAPLES 200 N Kimball Ave Suite 221,Southlake,TX 76092 Advertising Paper Products
4/27/2021 $1,858.25 METRO MAILER 5719 E.Rosedale St.#809 Ft Worth,TX 76112 Advertising Mail Service
5/2/2021 $12.30 Anedot,Inc 1340 Poydras St.Suite 1770 New Orleans,LA 70112 Accounting/Banking Fees Donation Collection Fees
4/28/2021 $20.30 Anedot,Inc 1340 Poydras St.Suite 1770 New Orleans,LA 70112 Accounting/Banking Fees Donation Collection Fees
4/24/2021 $4.30 Anedot,Inc 1340 Poydras St.Suite 1770 New Orleans,LA 70112 Accounting/Banking Fees Donation Collection Fees