Muller Semi Jan 2018CANDIDATE / 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.
0z
3 CANDIDATE/
- MRS/MR FIRST Ml
OFFICE USE ONLY
OFFICEHOLDER
NAME./-�
Date Received
NICKNAME LAST SUFFIX
4 CANDIDATE/
ADDRESS / PO BOX; APT / SUITE #; CITY; STATE; ZIP CODE
OFFICEHOLDER
MAILING
��y �/F_.s7ccfUurJ Q� Sev71r11+KE 7/ r -1077 -
ADDRESS
❑ Change of Address
5 CANDIDATE/
AREA CODE PHONE NUMBER EXTENSION
Date Hand -delivered or Date Postmarked
OFFICEHOLDER
PHONE
( o/! '? ) 3"8e -aa b /
6 CAMPAIGN
MS / MRS / MR FIRST MI
Receipt #
Amount $
TREASURER
NAME
. . . . . . . . . . . . . . . . . . . . . . . . . . . . .
Date Processed
NICKNAME LAST SUFFIX
Date Imaged
C.t�OZ/Gj
7 CAMPAIGN
STREET ADDRESS (NO PO BOX PLEASE); APT / SUITE #; CITY; STATE;
ZIP CODE
TREASURER
ADDRESS
(Residence or Business)
Sax %3 y3 S .5e&71-114A� 7,1
76()fzj
8 CAMPAIGN
AREA CODE PHONE NUMBER EXTENSION
TREASURER/
8/ ) �/8A v po
` 7 /
PHONE
9 REPORT TYPE
IKA January 15 ❑ 30th day before election ❑ Runoff
❑ 15th day after campaign
treasurer appointment
(Officeholder Only)
❑ July 15 ❑ 8th day before election ❑ Exceeded $500 limit
❑ Final Report (Attach C/OH - FR)
10 PERIOD
Month Day Year Month
Day Year
COVERED
/� Z6/7 THROUGH
11 ELECTION
ELECTION DATE
ELECTION TYPE
❑ Primary ❑ Runoff ❑ Other
-
Month Day Year
Description
General ❑ Special
12 OFFICE
OFFICE HELD (if any)
13 OFFICE SOUGHT (il known)
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GO TO PAGE 2
Forms provided by Texas Ethics Commission www. ethics.state.tx.us Revised 9/8/2015
CANDIDATE / OFFICEHOLDER
FORM C/OH
CAMPAIGN FINANCE REPORT COVER SHEET PG 2
14 C/OH NAME
15 Filer ID (Ethics Commission Filers)
16 NOTICE FROM
THIS BOX IS FOR NOTICE OF POLITICAL CONTRIBUTIONS ACCEPTED OR POLITICAL EXPENDITURES MADE BY POLITICAL COMMITTEES TO
POLITICAL
SUPPORT THE CANDIDATE/ OFFICEHOLDER. THESE EXPENDITURES MAY HAVE BEEN MADE WITHOUT THE CANDIDATES OR OFFICEHOLDER's
COMMITTEE(S)
KNOWLEDGE OR CONSENT. CANDIDATES AND OFFICEHOLDERS ARE REQUIRED TO REPORT THIS INFORMATION ONLY IF THEY RECEIVE NOTICE
OF SUCH EXPENDITURES.
COMMITTEE TYPE
COMMITTEE NAME
❑ GENERAL
e--
COMMITTEE ADDRESS
SPECIFIC
COMMITTEE CAMPAIGN TREASURER NAME
/
❑ Additional Pages
COMMITTEE CAMPAIGN TREASSIRER ADDRESS
17 CONTRIBUTION
1. TOTAL POLITICAL CONTRIBUTIONS OF $50 OR LESS (OTHER THAN
$
TOTALS
PLEDGES, LOANS, OR GUARANTEES OF LOANS), UNLESS ITEMIZED
i
2. TOTAL POLITICAL CONTRIBUTIONS
$
(OTHER THAN PLEDGES, LOANS, OR GUARANTEES OF LOANS)
.
EXPENDITURE
TOTALS
3. TOTAL POLITICAL EXPENDITURES OF $100 OR LESS,
UNLESS ITEMIZED
4. TOTAL POLITICAL EXPENDITURES
$
CONTRIBUTION
5. TOTAL POLITICAL CONTRIBUTIONS MAINTAINED AS OF THE LAST DAYBALANC
$ '
OF REPORTING PERIOD
OUTSTANDING
6. TOTAL PRINCIPAL AMOUNT OF ALL OUTSTANDING LOANS AS OF THE
LOAN TOTALS
LAST DAY OF THE REPORTING PERIOD
$
18 AFFIDAVIT
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
PS' VERONICA LOMAS under Title 15, Election Code.
��PRY GB �i
�:; Notary Public, State of Texas
z Comm. Expires 06-27-2020
Notary ID 12901312-8 \\
ort�`:lzz:cas�6�tis3� � !��� %n
Signature of Candl a(e or O holder
AFFIX NOTARY STAMP/ SEALABOVE
Sworn to and subscribed before me, by the said /�imF�i? /7 /%(//f/° �� this the .-
day of r 20/3_ _, to certify which, witness my hand and seal of office.
UWAr"CC- l^o�'1u /JLO �
Signature of officer administering oath Printed name of officer administering oath Title of officer administering, oath
Forms provided by Texas Ethics Commission www. ethics. state.tx.us Revised 9/8/2015