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STATEMENT OF
FEC
FORM 1 ORGANIZATION
Office Use Only

1. NAME OF (Check if name Example: If typing, type

COMMITTEE (in full) over the lines.
12FE4M5
is changed)

Patrick W Schubert Sr Committee to Elect

1157 Beadle Court

ADDRESS (number and street)
(Check if address
▼

is changed)
Box Elder SD 57719

CITY STATE ZIP CODE

▼ ▼ ▼

COMMITTEE'S E-MAIL ADDRESS

(Check if address patwschubert@gmail.com

▼

is changed)

Optional Second E-Mail Address

patwschubert@gmail.com

COMMITTEE'S WEB PAGE ADDRESS (URL)

(Check if address www.RetireTheRINO.com
▼

is changed)

M M / D D / Y Y Y Y

2. DATE 11 10 2021

3. FEC IDENTIFICATION NUMBER C C00794073

▼

4. IS THIS STATEMENT ✘ NEW (N) OR AMENDED (A)

I certify that I have examined this Statement and to the best of my knowledge and belief it is true, correct and complete.

Type or Print Name of Treasurer Schubert Sr, Patrick, William, Mr, Schubert S

M M / D D / Y Y Y Y
Schubert Sr, Patrick, William, Mr, Schubert S
Signature of Treasurer [Electronically Filed] Date 11 10 2021

NOTE: Submission of false, erroneous, or incomplete information may subject the person signing this Statement to the penalties of 2 U.S.C. §437g.
ANY CHANGE IN INFORMATION SHOULD BE REPORTED WITHIN 10 DAYS.

Office For further information contact:

Federal Election Commission FEC FORM 1
Use (Revised 06/2012)
Toll Free 800-424-9530
Only Local 202-694-1100
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FEC Form 1 (Revised 02/2009) Page 2

5. TYPE OF COMMITTEE
Candidate Committee:
(a) ✘ This committee is a principal campaign committee. (Complete the candidate information below.)

(b) This committee is an authorized committee, and is NOT a principal campaign committee. (Complete the candidate
information below.)
Name of Schubert, Patrick, William, Mr., Sr
Candidate

SD
Candidate Office State
Party Affiliation REP Sought: House ✘ Senate President
00
District

(c) This committee supports/opposes only one candidate, and is NOT an authorized committee.

Name of
Candidate

Party Committee:
(National, State (Democratic,
(d) This committee is a or subordinate) committee of the Republican, etc.) Par ty.

Political Action Committee (PAC):

(e) This committee is a separate segregated fund. (Identify connected organization on line 6.) Its connected organization is a:

Cor poration Cor poration w/o Capital Stock Labor Organization

Membership Organization Trade Association Cooperative

In addition, this committee is a Lobbyist/Registrant PAC.

(f) This committee supports/opposes more than one Federal candidate, and is NOT a separate segregated fund or party
committee. (i.e., nonconnected committee)

In addition, this committee is a Lobbyist/Registrant PAC.

In addition, this committee is a Leadership PAC. (Identify sponsor on line 6.)

Joint Fundraising Representative:

(g) This committee collects contributions, pays fundraising expenses and disburses net proceeds for two or more political
committees/organizations, at least one of which is an authorized committee of a federal candidate.

(h) This committee collects contributions, pays fundraising expenses and disburses net proceeds for two or more political
committees/organizations, none of which is an authorized committee of a federal candidate.

Committees Participating in Joint Fundraiser

1. FEC ID number C
2. FEC ID number C
3. FEC ID number C
4. FEC ID number C
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FEC Form 1 (Revised 02/2009) Page 3

Write or Type Committee Name

Patrick W Schubert Sr Committee to Elect

6. Name of Any Connected Organization, Affiliated Committee, Joint Fundraising Representative, or Leadership PAC Sponsor

NONE

Mailing Address

CITY STATE ZIP CODE

Relationship: Connected Organization Affiliated Committee Joint Fundraising Representative Leadership PAC Sponsor

7. Custodian of Records: Identify by name, address (phone number -- optional) and position of the person in possession of committee
books and records.

Schubert Sr, Patrick, William, Mr, Schubert S

Full Name
1157 Beadle Court
Mailing Address

Box Elder SD 57719

Title or Position CITY STATE ZIP CODE

Owner 605 391 6046

Telephone number

8. Treasurer: List the name and address (phone number -- optional) of the treasurer of the committee; and the name and address of
any designated agent (e.g., assistant treasurer).

Full Name Schubert Sr, Patrick, William, Mr, Schubert S

of Treasurer
1157 Beadle Court
Mailing Address

Box Elder SD 57719

CITY STATE ZIP CODE

Title or Position
605 391 6046
Telephone number
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FEC Form 1 (Revised 02/2009) Page 4

Full Name of
Designated Schubert, Debra, Ann, Mrs,
Agent
1157 Beadle Court
Mailing Address

Box Elder SD 57719

CITY STATE ZIP CODE

Title or Position
605 391 6046
Telephone number

9. Banks or Other Depositories: List all banks or other depositories in which the committee deposits funds, holds accounts, rents
safety deposit boxes or maintains funds.
Name of Bank, Depository, etc.

Highmark FCU
725 5th Street
Mailing Address

Rapid City SD 57701

CITY STATE ZIP CODE

Name of Bank, Depository, etc.

Mailing Address

CITY STATE ZIP CODE

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FEC FORM 2
STATEMENT OF CANDIDACY

1. (a) Name of Candidate (in full)

Schubert, Patrick, William, Mr., Sr
(b) Address (number and street) Check if address changed 2. Candidate’s FEC Identification Number
1157 Beadle Court
S2SD00134
(c) City, State, and ZIP Code 3. Is This New Amended
Box Elder SD 57719 Statement ✘ (N) OR (A)
4. Par ty Affiliation 5. Office Sought 6. State & District of Candidate
REPUBLICAN PARTY Senate SD 00

DESIGNATION OF PRINCIPAL CAMPAIGN COMMITTEE

7. I hereby designate the following named political committee as my Principal Campaign Committee for the 2022 election(s).
(year of election)
NOTE: This designation should be filed with the appropriate office listed in the instructions.
(a) Name of Committee (in full)
Patrick W Schubert Sr Committee to Elect
(b) Address (number and street)
1157 Beadle Court

(c) City, State, and ZIP Code

Box Elder SD 57719

DESIGNATION OF OTHER AUTHORIZED COMMITTEES

(Including Joint Fundraising Representatives)

8. I hereby authorize the following named committee, which is NOT my principal campaign committee, to receive and expend funds on behalf of my
candidacy.

NOTE: This designation should be filed with the principal campaign committee.

(a) Name of Committee (in full)

(b) Address (number and street)

(c) City, State, and ZIP Code

I certify that I have examined this Statement and to the best of my knowledge and belief it is true, correct and complete.

Signature of Candidate Date .

Schubert, Patrick, William, Mr, Sr 11/10/2021
[Electronically Filed]

NOTE: Submission of false, erroneous, or incomplete information may subject the person signing this Statement to penalties of 2 U.S.C. §437g.

FEC FORM 2 (REV. 02/2009)