Robbins Semi Jan 2024CANDIDATE / OFFICEHOLDER
FORM C/OH
CAMPAIGN FINANCE REPORT
COVER SHEET PG I
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 / MR FIRST MI
Dr Randy
OFFICE USE ONLY
OFFICEHOLDER
NAME
...........
Dat
NICKNAME LAST SUFFIX
m(iKEDWERID
Robbins
ADDRESS / PO BOX; APT / SUITE CITY; STATE; ZIP CODE
JAI 16 2024
4 CANDIDATE/
OFFICEHOLDER
MAILING
Southiake, T'X 76092
OFFICE OF CITY SECRETARY
ADDRESS
[:] Change of Address
AREA CODE PHONE NUMBER EXTENSION
Date Hand -delivered or Date Postmarked
5 CANDIDATE/
OFFICEHOLDER
PHONE
( 2140,�
MS / MRS / MR FIRST MI
geipt I IF61 A jV
)?�
6 CAMPAIGN
TREASURER
Mrs. Fara
NAME
........
Date Process
NICKNAME LAST SUFFIX
Date Imaged
'Tate
7 CAMPAIGN
STREET ADDRESS (NO PO BOX PLEASE); APT / SUITE #; CITY;
STATE; ZIP CODE
TREASURER
ADDRESS
1219 Whispering Ln, Southlake, TX' 76092
(Residence or Business)
8 CAMPAIGN
AREA CODE PHONE NUMBER EXTENSION
TREASURER
PHONE
817 9380668
9 REPORT TYPE
1January 15 30th day before election Runoff
15th day after campaign
10
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
07 16 23 THROUGH 01
4
1/
11 ELECTION
ELECTION DATE ELECTION TYPE
F-1 Primary Runoff Other
Month Day Year Description
()5,/04 // 24 O General Special
12 OFFICE
OFFICE HELD (if any)
113 OFFICE SOUGHT (if known)
Souffake City Coundi Race 2
1 Southlake City Council Race 2
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 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
COMMITTEE CAMPAIGN TREASURER NAME
0SPECIFIC
COMMITTEE CAMPAIGN TREASURER ADDRESS
GO TO PAGE 2
Forms provided by Texas Ethics Commission www.ethics.state.tx,us Revised 11/15/2022
CANDIDATE/ OFFICEHOLDER FORM C/OH ff
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
$
0
CONTRIBUTIONS MADE ELECTRONICALLY)
2.
TOTAL POLITICAL CONTRIBUTIONS
$
(OTHER THAN PLEDGES, LOANS, OR GUARANTEES OF LOANS)
0
EXPENDITURE
TOTALS
3.
TOTAL UNITEMIZED POLITICAL EXPENDITURE.
$
0
4.
TOTAL POLITICAL EXPENDITURES
$
$1272
CONTRIBUTION 5. TOTAL POLITICAL CONTRIBUTIONS MAINTAINED AS OF THE LAST DAY $ $3012.00
BALANCE OF REPORTING PERIOD
OUTSTANDING 6, TOTAL PRINCIPAL AMOUNT OF ALL OUTSTANDING LOANS AS OF THE $ $6000.00
LOAN TOTALS LAST DAY OF THE REPORTING PERIOD
I I —
18SIGNATURE 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
(1) At AMY - SHELLEY
Notary Public, State of Texas
Comm, Expires 12-02-2027
N Mary ID 124761105
Sworn to and subscribed before me by
to certify which, witness my hand and
ng oath
(2) Unsworn Declaration
My name is
My address is
Executed in
Prinit-ename of officer adlininistering oath
(street)
County, State of
this the day of
Title of 6fficer administe
and my date of birth is
(city) (state) (zip code) (country)
on the - day of 20_,
(month) (year)
Signature of Can didate/Officeholde r (Declarant)
Forms provided by Texas Ethics Commission www.ethics.state,tx.us Revised 11/15/2022
SUBTOTALS
- C/OH FORM C/OH
COVER SHEET PG 3
19
FILER NAME
20 Filer ID (Ethics Commission Filers)
21
SCHEDULE SUBTOTALS
NAME OF SCHEDULE
SUBTOTAL
AMOUNT
1
SCHEDULEAI:
MONETARY POLITICAL CONTRIBUTIONS
$
0
2•
SCHEDULEA2:
NON -MONETARY (IN -KIND) POLITICAL CONTRIBUTIONS
$
Q
3,
... . ........ ___
SCHEDULE B:
PLEDGED CONTRIBUTIONS
$
0
4.
El
SCHEDULE E:
LOANS
$
0
5.
SCHEDULE FI:
POLITICAL EXPENDITURES MADE FROM POLITICAL CONTRIBUTIONS
$
127.20
6.
SCHEDULE F2:
UNPAID INCURRED OBLIGATIONS
$
0
7.
SCHEDULE F3:
PURCHASE OF INVESTMENTS MADE FROM POLITICAL CONTRIBUTIONS
$
0
8.
SCHEDULE F4:
EXPENDITURES MADE BY CREDIT CARD
$
0
9.
SCHEDULE G:
POLITICAL EXPENDITURES MADE FROM PERSONAL FUNDS
$
0
10.
SCHEDULE H:
PAYMENT MADE FROM POLITICAL CONTRIBUTIONS TO A BUSINESS OF C/OH
$
0
11.
SCHEDULE 1: NON -POLITICAL EXPENDITURES MADE FROM POLITICAL CONTRIBUTIONS
$
0
12.
EJ
SCHEDULE K�
INTEREST, CREDITS, GAINS, REFUNDS, AND CONTRIBUTIONS RETURNED
TO FILER
$
I
0
Forms provided by Texas Ethics Commission www.ethics.state.tx.us Revised 11/15/2022
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/PoliticaI Committee Legal Services SalariesA/Vages/Contract Labor Other (enter a category not listed above)
Credit Card Payment The Instruction Guide explains how to complete this form.
I Total pages Schedule Ft:2
FILER NAME
3 Filer ID (Ethics Commission Filers)
Randy Robbins
4 Date
5 Payee name
See Attached Spreadsheet
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
I (C) Check if travel outside of Texas. Complete Schedule T. Check if Austin, TX, officeholder living expense
9 Complete ONLY if direct Candidate / Officeholder name Office sought Office held
expenditure to benefit CIOH
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 I 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
ElCheck iftravel outside 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/01-1
ATTACH ADDITIONAL COPIES OF THIS SCHEDULE AS NEEDED
Forms provided by Texas Ethics Commission wvjw.ethics.state.tx,us Revised 11/15/2022
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