Torres-Lepp Semi Jan 2022CANDIDATE / OFFICEHOLDER
FORM C/OH
CAMPAIGN FINANCE REPORT
COVER SHEET PG 1
1 Filer ID (Ethics Commission Filers)
2 Total pages filed:
The C/01-1 Instruction Guide
explains how to complete this form.
6
3 CANDIDATE/
MS MRS / MR FIRST MI
OFFICEHOLDER
Amy J,
NAME
.......... I ........
Date Rece"'-0'—'V'-*'-0
NICKNAME LAST SUFFIX
Torres
J A N 1 8 2022
4 CANDIDATE/
ADDRESS / PO BOX; APT / SUITE #; CITY; STATE; ZIP CODE
OFFICEHOLDER
MAILING
ADDRESS
FFICE OF CITY SECRETARN
Change of Address
5 CANDIDATE/
OFFICEHOLDER
AREA CODE PHONE NUMBER EXTENSION <
(
I nd-d I' � 3Dt,e,P�t;ai-kod
kce
PHONE
0,-)
I pIt'—#
Receipt
AMOUnt $ 1
6 CAMPAIGN
MS / MRS / MR FIRST MI
TREASURER
Amy i
I
NAME......
.
I .............. ...... ......... ................. —
Date Processed
NICKNAME LAST SUFFIX
Date Imaged
Torres
7 CAMPAIGN
STREET ADDRESS (NO PO BOX PLEASE); APT ISUITE #; CITY;
STATE; ZIP CODE
TREASURER
1378
(Residence or Business)
8 CAMPAIGN
AREA CODE PHONE NUMBER EXTENSION
TREASURER
PHONE
(214
REPORT TYPE
January 15 30th day before election Runoff
15th day after campaign
F
treasurer appointment
(Officeholder Only)
July 15 8th day before election Exceeded Modified
F F
Final Report (Attach CIOH - FBI
; Reporting Limit
10 PERIOD
Month Day Year Montt)
Day Year
COVERED
7 1 21 THROUGH 12 / 31 /21
11 ELECTION
ELECTION DATE
ELECTION TYPE
Month Day Year
Primary Runoff Other
Description
General Special
12 OFFICE
OFFICE HELD (if any)
13 OFFICESOUGHT (if known)
Southlake City Council- Place 5
1
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
COMMITTEE(S)
CONSENT, CANDIDATES AND OFFICEHOLDERS ARE REQUIRED TO REPORT THIS INFORMATION ONLY IF THEY RECEIVE NOTICE OF SUCH EXPENDITURES.
COMMITTEE TYPE COMMITTEE NAME
GENERAL
COMMITTEE ADDRESS
Additional Pages
SPECIFIC
COMMITTEE CAMPAIGN TREASURER NAME
I
COMMITTEE CAMPAIGN TREASURER ADDRESS
I
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)
Amy J. Torres
17 CONTRIBUTION
1. TOTAL UNITEMIZED POLITICAL CONTRIBUTIONS (OTHER THAN
$
TOTALS
PLEDGES, LOANS, OR GUARANTEES OF LOANS, OR
0.00
CONTRIBUTIONS MADE ELECTRONICALLY)
2. TOTAL POLITICAL CONTRIBUTIONS
(OTHER THAN PLEDGES, LOANS, OR GUARANTEES OF LOANS)
$ 17408.90
TEXPENDITUREOTALS
3. TOTAL UNITEMIZED POLITICAL EXPENDITURE.
4. TOTAL POLITICAL EXPENDITURES
s 2485.13
CONTRIBUTION 5. TOTAL POLITICAL CONTRIBUTIONS MAINTAINED AS OF THE LAST DAY
BALANCE OF REPORTING PERIOD
OUTSTANDING 6. TOTAL PRINCIPAL AMOUNT OF ALL OUTSTANDING LOANS AS OF THE
LOAN TOTALS LAST DAY OF THE REPORTING PERIOD $ 93441.25
18 SIGNATURE 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, Election Code.
Signature of Candidate or Officeholder
AMY SHELLEY
(1) Affidavit
Notary Public, State of Texas
F Comm. Expires 12-02-2023
Notary ID 12476110-5
NOTARY STA
Sworn to and subscribed before me by
to certify which, witness my hand �Aeal of office,
L
Signature of offi—er afnijistering oath P
My name is
My address is
(street)
Executed in County, State of
Forms provided by Texas Ethics Commission
this the g—�-- day of
of officer ad4inistering oath Title of officer administering oath
and my date of birth is
(city) (state) (zip code) (country)
on the _ day of 20
(month) (year)
Signature of Candidate/Officeholder (Declarant)
www.ethics.state.tx.us Revised 8/17/2020
SUBTOTALS
- C/OH FORM C/OH
COVER SHEET PG 3
19 FILER NAME
Amy J. Torres
20 Filer ID (Ethics Commission Filers)
21
SCHEDULE SUBTOTALS
NAME OF SCHEDULE
SUBTOTAL
AMOUNT
1.
■ SCHEDULEA1:
MONETARY POLITICAL CONTRIBUTIONS
$ 1,408.90
2.
SCHEDULE A2:
NON -MONETARY (IN -KIND) POLITICAL CONTRIBUTIONS
$
3.
SCHEDULE 8:
PLEDGED CONTRIBUTIONS
$
4.
SCHEDULE E:
LOANS
$
5.
■ SCHEDULE F1:
POLITICAL EXPENDITURES MADE FROM POLITICAL CONTRIBUTIONS
$ 2,485.13
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 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 Guide explains how to complete this form.
1 Total pages Schedule Al:
2 FILER NAME
3 Filer ID (Ethics Commission Filers)
Amy J. Torres
4 Date
5 Full name of contributor out-of-state PAC (ID#: )
7 Amount of contribution ($)
Martin Law
08/19/2021
.............................................................................
6 Contributor address; City; State; Zip Code
1,408.90
560 N. Kimball Ave., #100 Southlake, TX 76092
8 Principal occupation / Job title (See Instructions)
g Employer (See Instructions)
Law Firm
Self
Date
Full name of contributor out-of-state PAC (ID#: >
Amount of contribution ($)
..................................................................................
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 ($)
..................................................................................
Contributor address; City; State; Zip Code
Principal occupation / Job title (See Instructions)
Employer (See Instructions)
Date
Full name of contributor out-of-state PAC (ID#: )
Amount of contribution ($)
.............. ............ ............................................... I........
Contributor address; City; State; Zip Code
Principal occupation / Job title (See Instructions)
Employer (See Instructions)
ATTACH ADDITIONAL COPIES OF THIS SCHEDULEAS 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
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 SalariesNVages/Contract Labor Other (entera category not listed above)
Credit Card Payment
The Instruction Guide explains how to complete this form.
1 Total pages Schedule F1:
2 FILER NAME
3 Filer ID (Ethics Commission Filers)
Amy J. Torres
4 Date
5 Payee name
07/14/2021
Brandstorm Creative
6 Amount ($)
7 Payee address; City; State; Zip Code
675.00
733 Ashleigh Lane Southlake, TX 76092
8
(a) Category (See Categories listed at the top of this schedule)
(b) Description
PURPOSE
Advertisting Expense
Mailer
OF
EXPENDITURE
(c) Check if travel outside of Texas. Complete ScheduleT. Check if Austin, TX, officeholder living expense
9 Complete ONLY if direct Candidate / Officeholder name Office sought Office held
expenditure to benefit C/OH
Date
Payee name
07/23/2021
Frost Bank
Amount ($)
Payee address; City; State; Zip Code
8.00
641 E. Southlake Blvd. Southlake, TX 76092
Category (See Categories listed at the top of this schedule)
Description
PURPOSE
Accounting/ Banking
Banking Service Fee
OF
EXPENDITURE
Check if travel outside of Texas. Complete Schedule 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
08/20/2021
Priority Signs & Graphics
Amount ($)
Payee address; City; State; Zip Code
P.O. Box 32 Grapevine, TX 76051
11786.13
Category (See Categories listed at the top of this schedule)
Description
PURPOSE
Advertising Expense
Signs
OF
EXPENDITURE
Check if travel outside of Texas. Complete ScheduleT. Check if Austin, TX, officeholder living expense
Complete ONLY if direct Candidate / Officeholder name Office sought Office held
expenditure to benefit C/OH
ATTACH ADDITIONAL COPIES OF THIS SCHEDULE AS NEEDED
Forms provided by Texas Ethics Commission www.ethics.state.tx.us Revised 8/17/2020
POLITICAL EXPENDITURES MADE
FROM POLITICAL CONTRIBUTIONS SCHEDULE F1
If the requested information is not applicable, DO NOT include this page in the report.
EXPENDITURE CATEGORIES FOR BOX 8(a)
Advertising Expense Event Expense Loan Repayment/Reimbursement Solicitation/Fundraising Expense
Accounting/Banking Fees Office Overhead/Rental Expense Transportation Equipment & Related Expense
Consulting Expense Food/Beverage Expense Polling Expense Travel In District
Contributions/Donations Made By Gift/Awards/Memorials Expense printing Expense Travel Out Of District
Candidate/Officeholder/Political Committee Legal Services Salaries/Wages/Contract Labor Other (entera category not listed above)
Credit Card Payment
The Instruction Guide explains how to complete this form.
1 Total pages Schedule F1:
2 FILER NAME
3 Filer ID (Ethics Commission Filers)
91
Amy J. Torres
4 Date
5 Payee name
08/23/2021
Frost Bank
6 Amount ($)
7 Payee address; City; State; Zip Code
8.00
641 E. Southlake Blvd. Southlake, TX 76092
8
(a) Category (See Categories listed at the top of this schedule)
(b) Description
PURPOSE
Accounting/ Banking
Banking Service Fee
OF
EXPENDITURE
(c) Check if travel outside of Texas. Complete ScheduleT. Check if Austin, TX, officeholder living expense
g Complete ONLY if direct Candidate / Officeholder name Office sought Office held
expenditure to benefit C/OH
Date
Payee name
09/23/2021
Frost Bank
Amount ($)
Payee address; City; State; Zip Code
8.00
641 E. Southlake Blvd. Southlake, TX 76092
Category (See Categories listed at the top of this schedule)
Description
PURPOSE
Accounting/ Banking
Banking Service Fee
OF
EXPENDITURE
Check iftravel outside ofTexas. Complete Schedule T Check if Austin, TX, officeholder living expense
Complete ONLY if direct Candidate / Officeholder name Office sought Office held
expenditure to benefit C/OH
Date
Payee name
Amount ($)
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.CompleteScheduleT. 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