Muller Semi Jan 2023CANDIDATE / OFFICEHOLDER
FORM C/OH
CAMPAIGN FINANCE REPORT
COVER SHEET PG I
I Filer ID (Ethics Commission Filers)
2 Total pages filed:
The C/OH Instruction Guide explains how to complete this form.
3 CANDIDATE
_ME? / MRS / MR FIRST MI
OFFICE USE ONLY
OFFICEHOLDER
1,_
NAME
...... ...
Date ReceivRECEIVED
NICKNAME LAST SUFFIX
121ullice-- P1__
JAN 1 7 2023
4 CANDIDATE/
—
ADDRESS / PO BOX; APT / SUITE #; CITY; STATE; ZIP CODE
OFFICEHOLDER
MAILING
7 e�uf rr,-> if V67
ADDRESS
Change of Address
-OFFICE OF CITY SECRETAR
5 CANDIDATE/
AREA CODE PHONE NUMBER EXTENSION
- a an - a ive a or ate Postmarked
OFFICEHOLDER
PHONE
Receipt #
Amount $
6 CAMPAIGN i__4S
/ MRS / MR FIRST MI
TREASURER
Date Processed
NAME
.... .......
NICKNAME LAST SUFFIX
Date Imaged
4
7 CAMPAIGN
STREET ADDRESS (NO PO BOX PLEASE); APT / SUITE #; CITY;
STATE; ZIP CODE
TREASURER
ADDRESS
(Residence or Business)
8 CAMPAIGN
AREA CODE PHONE NUMBER EXTENSION
TREASURER
PHONE
9 REPORT TYPE
�January 15 30th day before election Runoff
15th day after campaign
treasurer appointment
(Officeholder Only)
F-1 July 15 F-1 8th day before election Exceeded Modified
F-1 Final Report (Attach C/OH -FIR)
Reporting Limit
10 PERIOD
Month Day Year Month
Day Year
COVERED
0 THROUGH
_3
11 ELECTION
ELECTION DATE
ELECTION TYPE
Month Day Year
'�Z_r Primary ❑ Runoff ❑
1:1 Other
Description
05-10
General Special
12 OFFICE
OFFICE HELD (if any)
13 OFFICESOUGHT (ifknown)
14 NOTICE FROM
THIS BOX IS FOR NOTICE OF POLITICAL CONTRIBUTIONS ACCEPTED OR POLITICAL EXPENDITURES MADE
BY POLITICAL COMMITTEES TO SUPPORT
POLITICAL
THE CANDIDATE 1OFFICEHOLDER. 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
0 GENERAL
COMMITTEE ADDRESS
Additional Pages
[:]SPECIFIC
COMMITTEE CAMPAIGN TREASURER NAME
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
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
CONTRIBUTIONS MADE ELECTRONICALLY)
2. TOTAL POLITICAL CONTRIBUTIONS
...................
(OTHER THAN PLEDGES, LOANS, OR GUARANTEES OF LOANS)
ALS ITURE
TOTEND
3. TOTAL UNITEMIZED POLITICAL EXPENDITURE.
4. TOTAL POLITICAL EXPENDITURES
$
...................
CONTRIBUTION
BALANCE
5. TOTAL POLITICAL CONTRIBUTIONS MAINTAINED AS OF THE LAST DAY
$ /
..................
OF REPORTING PERIOD
OUTSTANDING
6. TOTAL PRINCIPAL AMOUNT OF ALL OUTSTANDING LOANS AS OF THE
LOAN TOTALS
LAST DAY OF THE REPORTING PERIOD
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.
1
Signature of Candid a or Officeholder
Please complete either option below:
(1)Affidavit ```�������', AMY SHELLEY
P 6 i
``��PPY
:i �= Notary Public, State of Texas
9• Q� Comm. Expires 12-02-2023
��'%FOFs�`��
NOTARY ST Notary ID 12476110-5
orn to and subscribed before me by °cy\��� ��U �`��+� this the day of�V
3 to certify which, witness my hand an seal of office. J
Sign to of ffi er administering oath Printe name of officer ad inistering oath Title of o icer administering o th
• .
(2) Unsworn Declaration
My name is and my date of birth is
My address is
(street) (city) (state) (zip code) (country)
Executed in County, State of on the day of 20
(month) (year)
Signature of Candidate/Officeholder (Declarant)
Forms provided by Texas Ethics Commission www.ethics.state.tx.us Revised 11/15/2022