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Edmondson Semi July 2021CANDIDATE / OFFICEHOLDER FORM C10H CAMPAIGN FINANCE REPORT COVER SHEET PG I The C10H Instruction Guide explains how to complete this form. I Filer ID 'Ethics COMMSS40r, Filers) 2 Total pages flle& 3 CANDIDATE I NIS / MRS ! MR FIRST MI OFFICEHOLDER Ms. Debra OFFICE USE ONLY NAME —1- ....... Date Received NICKNAME LAST SUFFIX Edmondson Rg 4 CANDIDATE/ ADDRESS I PC SOX, APT 1 SUITE CITY STATE, ZIP CODE OFFICEHOLDER JUL 15 2021 MAILING ADDRESS P.O. Box 92801, Southlake, TX 76092 OFFICE OF CITY SECRETARY 2 Change of Address 5 CANDIDATE/ AREA CODE PHONE NUMBER EXTENSION Cat Ha d-delivered or Dare Postmarked OFFICEHOLDER (817 ) O-V- PHONE 846-6469 Receipt Amount S 6 CAMPAIGN ME I nRs t MR FIRST MI P� TREASURER I r. Mark NAME Date Processed NICKNAME LAST SUFFIX Perkins Date Imaged 7 CAMPAIGN j STREET ADDRESS (NO PC BOX PLEASE' APT I SUF E 4:CITE. STATE- 7 P CODE -1 TREASURER ADDRESS 3100 McKinnon St.; Suite 450 Dallas TX75201 (Residence or Business) 8 CAMPAIGN AREA CODE PHONE NUMBER EXT ENSION I TREASURER PHONE h 214) 797-4727 9 REPORT TYPE i7 January 15 301h, day before election Runoff 5th day after campaign reasurer appointment July 15 8th day before election f—I Exceeded Modified V , Reporting Limit Fire! Report lAtrach C,0 H L--j 10 PERIOD Month Day Year Month Day Year COVERED 4 ''24 THROUGH 06 2021 30 2021 11 ELECTION— ELECTION DATE ELECTION TYPE Pnmary --i Month -nay ear 71 Runoff !__j Omer Description 05 ,01 2021 General 7Special 12 OFFICE OFFICE HELD of any} 13 OFFICE SOUGHT M known, N/A Mayor of Southlake 14 NOTICE FROM THIS SOX IS FOR NOTICE OF POUTICAL CONTRIBUTION'S ACCEPTED OR POLITICAL EXPENDITURES MADE BY POLITICAL COMMITTEES TO SUPPORT POLITICAL THE CANDIDATE I OFFICEHOLDER- THESE EXPEMDJTURES MAY HAVE BEEMMADE MTHOQTTHE CANDIDATES OR OFFICEHOLDER'S KNOWLEDGE OR CONSENT. CANDIDATES AND OFFICEHOLDERS ARE REQUIRED TO REPORT THIS INFORMATION ONLY IF THEY RECEIVE. NOTICE OF SUCH EXPENDITURES. COMMITTEES) COMMI-ILT-IFE TYPE COMMITTEE NAME —N-RAL COMMITT EEADDRESS Additional Paces ( €SPECIFIC COMMITTEE CAMPAIGN TREASURER NAME ON! M I TT E E -- A N1 PA. I G N T R E A S U R E'R ADD R E S5 GO TO PAGE 2 Forms provided by Texas Ethics Commission www.ethics.state.tx.us Revised 8/17/2020 FORM C/OH COVER SHEET PG 2 16 Filer ICI (Ethics Commission Filers) ,5 .0 4. TOTAL POLITICALEXPENDITURES $11,496,10 5, TOTAL POLITICAL CONTRIBUTIONS MAINTAINED AS OF THE LAST DAY OF REPORTING PERIOD 165.08 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, 7R GUARANTEES OF LOANS) EXPENDITURE 3. TOTAL. UNITEMIZED POLITICAL EXPENDITURE. TOTALS CONTRIBUTION BALANCE OUTSTANDING 6, TOTAL. PRINCIPAL AMOUNT OF ALL OUTSTANDING LOANS AS OF THE LOAN TOTALS � LAST DAY OF TIME REPORTING PERIOD I s, I swear, or affirm, under penalty of perjury, that the accompanying report is true and correct and includes all information required to be reported by me under Title 15, Flea"on Cade. IU Signature of Candidate or Officeholder M INS III! I 4� 'AasnPU, ARTHA SEYBOLD °•'Notary Public„ State of Texas 1 Affidavit [t Comm, Expires 05.01.20 3 ror Notary tD 126097000 NOTARY STAMP/ SEAL Swam to and subscribed before me by d this the day of Ct to Kywhic , witn my an and seal ice ems,.IV 2 Signature of officer administering Printed name of officer administering oath tte of officer administering oath My name is and my date of birth is .icy address is , (street) (city) (state) (Zip code) (country) Executed in County, State of can the _ day of 2Q (month) (Year) Signature of Candidate/Officeholder (Declarant) Forms provided by Texas Ethics Commission .ethics.stateAx.us Revised 8/17/2020 SUBTOTALS - C/OH FORM C/OH COVER SHEET PG 3 19 FILER NAME Debra Edmondson 20 Filer ID (Ethics Commission Filers) 21 SCHEDULE SUBTOTALS NAME OF SCHEDULE SUBTOTAL AMOUNT 1 • ® SCHEDULEAl: MONETARY POLITICAL CONTRIBUTIONS $ 2700.00 2• El SCHEDULEA2: NON -MONETARY (IN -KIND) POLITICAL CONTRIBUTIONS $ 3. SCHEDULE B: PLEDGED CONTRIBUTIONS $ 4. SCHEDULE E: LOANS $ 5. ® SCHEDULE F1: POLITICAL EXPENDITURES MADE FROM POLITICAL CONTRIBUTIONS $1 1 ,496.10 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• SCHEDULE G: POLITICAL EXPENDITURES MADE FROM PERSONAL FUNDS $ 10. SCHEDULE H: PAYMENT MADE FROM POLITICAL CONTRIBUTIONS TO A BUSINESS OF C/OH $ 11. SCHEDULE 1: 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 Kevlsea of it izuzv MONETARY POLITICAL CONTRIBUTIONS SCHEDULE Al 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 At: 2 FILER NAME 3 Filer ID (Ethics Commission Filers) Debra Edmondson 4 Date 5 Full name of contributor ❑ out-of-state PAC (ID#: 7 Amount of contribution ($} 4/24/2021 Terrence Welch ................................ ..................... ...... $100.00 6 Contributor address; City; State; Zip Code 4 Ryddington PI., Dallas, TX 75230 8 Principal occupation / Job title (See Instructions) 9 Employer (See Instructions) Attorney Brown & Hofineister LLP Date Full name of contributor ❑ out-of-state PAC (ID#: ) Amount of contribution ($) 4/24/2021 Penny Pannell .................................................................................. $75.00 Contributor address, City; State; Zip Code 1429 Kensington Ct., Southlake, TX 76092 Principal occupation / Job title (See Instructions) Employer (See Instructions) Retired Date Full name of contributor ❑ out-of-state PAC (ID#: ) Amount of contribution ($) 4/25/2021 Hazel Murphy $25.00 Contributor address; City; State; Zip Code 906 Emerald Blvd., Southlake,TX 76092 Principal occupation / Job title (See Instructions) Employer (See Instructions) Retired Date Full name of contributor ❑ out-of-state PAC (ID#: ) Amount of contribution ($) 4/27/2021 Annie Costello .........I....................................... ....... ................. . Contributor address; City; State; Zip Code 50 00 1862 N. Peytonville Ave., Southlake,TX 76092 Principal occupation / Job title (See Instructions) Employer (See Instructions) Retired 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.ethlcs.state.tx.us meviseu of! 114u4V MONETARY POLITICAL CONTRIBUTIONS SCHEDULE Al 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 Ai: 2 FILER NAME 3 Filer ID (Ethics Commission Filers) Debra Edmondson 4 Date 5 Full name of contributor ❑ out-of-state PAC (ID#: 7 Amount of contribution ($) 4/28/2021 James Livingston .................................................................................. $50.00 6 Contributor address; City; State; Zip Code 4712 Cabernet Circle Colleyville TX 76034 $ Principal occupation / Job title (See Instructions) 9 Employer (See Instructions) CPA [IMcEwen Date Full name of contributor ❑ out-of-state PAC (ID#: > Amount of contribution ($) 5/1 /2021 .....Diane...Harris...................................................... ............ $100.00 Contributor address; City; State; Zip Code 1026 Mission Dr., Southlake, TX 76092 Principal occupation / Job title (See Instructions) Employer (See Instructions) Not Employed Date Full name of contributor ❑ out-of-state PAC (ID#: ) Amount of contribution ($) Mark Perkins 5/23/2021 . ........................................................................ $2300.00 Contributor address; City;State; Zip Code 8911 Guernsey Lane, Dallas, TX 75220 Principal occupation / Job title (See Instructions) Employer (See Instructions) Date Full name of contributor ❑ out-of-state PAC (ID#: ) Amount of contribution ($) .................................................................................. 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.etnics.state.tx.us MtMbeu 01 1; i4u4u 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/FundraisingExpense 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 SalanesMFages/ContractLabor Other (enter a category not listed above) Credit Card Payment The Instruction Guide explains how to complete this form. 1 Total pages Schedule Ft: 2 FILER NAME 3 Filer ID (Ethics Commission Filers) Debra Edmondson 4 Date 5 Payee name 4/26/2021 Reilly Echols Printing 6 Amount ($) 7 Payee address; City; State; Zip Code $3742.51 1710 S. Harwood; Dallas, TX 75215 8 (a) Category (See Categories listed at the top of this schedule) (b) Description PURPOSE OF Printing Expense Print and mail flyers EXPENDITURE (c) Check iftraveloutsideofTexas.Complete ScheduleT. El Check if Austin, TX, officeholder living expense 9 Complete ONLY if direct Candidate / Officeholder name Office sought Office held expenditure to benefit C/OH Date Payee name 5/06/2021 Hustle, Inc Amount ($) Payee address; City; State; Zip Code $1500.00 595 Market St., Suite 920 San Francisco, CA 94105 Category (See Categories listed at the top of this schedule) Description PURPOSE OF Advertising Expense Textin Service g EXPENDITURE Check iftraveloutside ofTexas.Complete ScheduleT. Check if Austin, TX, officeholder living expense Complete ONLY if direct Candidate / Officeholder name Office sought Office held expenditure to benefit C/OH Date Payee name 5/07/2021 Hustle, Inc Amount ($) Payee address; City; State; Zip Code 595 Market St., Suite 920 San Francisco, CA 94105 $3005.59 Category (See Categories listed at the top of this schedule) Description PURPOSE Texting Service OF Advertising Expense EXPENDITURE Check if travel outside ofTexas. Complete Schedule T. Check if Austin, TX, officeholder living expense Complete ONLY if direct Candidate / Officeholder name Office sought Office held expenditure to benefit C/OH ATTACH ADDITIONAL COPIES OF THIS SCHEDULE AS NEEDED Forms provided by Texas Ethics Commission www.ethlcs.state.tx.us Mt:vrseu or i rrzu" POLITICAL EXPENDITURES MADE FROM POLITICAL CONTRIBUTIONS SCHEDULE F1 If the requested information is not applicable, DO NOT include this page in the report. EXPENDITURE CATEGORIES FOR BOX 8(a) Advertising Expense Event Expense Loan Repayment/Reimbursement Solicitation/FundraisingExpense Accounting/Banking Fees Office Overhead/Rental Expense Transportation Equipment & Related Expense Consulting Expense Food/Beverage Expense Polling Expense Travel In District Contributions/Donations Made By Giff/Awards/Memonals Expense Printing Expense Travel Out Of District Candidate/Officeholder/Political Committee Legal Services SalaneWJages/Contract Labor Other (entera category not listed above) Credit Card Payment The Instruction Guide explains how to complete this form. 1 Total pages Schedule Ff: 2 FILER NAME 3 Filer ID (Ethics Commission Filers) Debra Edmondson 4 Date 5 Payee name 5/21 /2021 Kitchen Table Consulting 6 Amount ($) 7 Payee address; City; State; Zip Code 125 Marseilles Dr. Hurst, TX 76054 $1190.0 8 (a) Category (See Categories listed at the top of this schedule) (b) Description PURPOSE Consulting Expense Consulting OF EXPENDITURE (C) Check if travel outside of Texas. Complete Schedule Check if Austin, TX, officeholder living expense 9 Complete ONLY if direct Candidate / Officeholder name Office sought Office held expenditure to benefit C/OH Date Payee name 5/21/2021 Abigail Diggs Amount ($) Payee address; City; State; Zip Code 1988.00 1824 Wndsong Dr., Keller, TX 76248 Category (See Categories listed at the top of this schedule) Description PURPOSE OF Consultingg Campaign Mana er EXPENDITURE Check fftravel outside ofTexas. 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 6/25/2021 Libby Belcher Amount ($) Payee address; City; State; Zip Code $70.00 PO Box 247 Seminole, TX 79360 Category (See Categories listed at the top of this schedule) Description PUROF SE Phone Banking Phone Banking EXPENDITURE Check if travel outside of Texas. Complete Schedule El 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.etmcs.state.tx.us Rcvwcu — DESIGNATION OF FINAL REPORT FORM C/01-1 - FR The Instruction Guide explains hairo complete this forin. Complete only if "Report Type" on page I is marked "Final Report!' 2 Filer ID (Ethics Commission Filers) 13&9+ z I do not expect any further political contributions or political expenditures in connection with my candidacy, I understand that designating a report as a final report terminates my campaign treasurer appointment. I also understand that i may not accept any campaign contributions or make any campaign expenditures without a carrlpaior nrer ap ointmen on file. Signature of Candidate t-fceholder FILER WHO IS NOTAN OFFICEHOLDER -- Complete A & B below only if you are not an officeholder. -- 000000�� Check only one: [X] I do not have unexpended contributions or unexpended interest or income earned from political contributions. I have unexpended contributions or unexpended interest or income earned from political contributions. I understand that I may not convert unexpended political contributions or unexpended interest or income earned on political contributions to personal use. I also understand that I must file an annual report of unexpended contributions and that I may not retain unexpended contributions or unexpended interest or income earned on political contributions longer than six years after filing this final report, Further, I understand that I must dispose of unexpended political contributions and unexpended interest or income earned on political contributions in accordance with the requirements of Election Code, § 254,204, Check only one: I do not retain assets purchased with political contributions or interest or other income from political contributions. I do retain assets purchased with political contributions or interest or other income from political contributions. I understand that I may not convert assets purchased with political contributions or interest or other income from political contributions to personal use. I also understand that I must dispose of assets purchased with "pofificall contributions i accordance with the accordance requirements of Election Code, § 254104, S Si C i arture o Candidate 5 OFFICEH0V-`*ErMZ -- Complete this section only if you are an officeholder I am aware that I remain subject to filing requirements applicable to an officeholder who does not have a campaign treasurer on file. I am also aware that I will be required to file reports of unexpended contributions if, after filing the last required report as an officeholder, I retain political contributions, interest or other income from political contributions, or assets purchased with political contributions or interest or other income from political contributions, Signature of Officeholder Forms provided by Texas Ethics Commission \vvitmethics.state.mus MtMbt�u of I 114 U4V