Muller Semi July 2022CANDIDATE / OFFICEHOLDER FOR C/O
FINANCECAMPAIGN COVER SHEET PG 1
The ClOH Instruction Guide explains how to complete this form.
1 Filer ID (Ethics Commission Filers) 2 Total pages filed:
3 CANDIDATE /
MS 1 MRS 1 MR FIRST MI
-----QE.ELC USE ONLY
OFFICEHOLDER
f
NAME
Date Receiv
NICKNAME LAST SUFFIX
1- } r . 12
ADDRESS 1 PO BOX„ APT I SUITE.#; CITY; STATE; ZIP CODE I N g r')tt23
tJF�tY i t
4 CANDIDATE /
OFFICEHOLDER
CtJj
MAILING
ADDRESS
/
Change of Address
rat; 6 OFFICE OF CITY SECRETA
AREA CODE PHONE NUMBER EXTENSION
deberedlor Date Postmarked
5 CANDIDATE/
OFFICEHOLDER
PHONE
\ 1 //9F3
•-"MS MRS t MR FIRST MI Receipt If Amount $
6CAMPAIGN
TREASURER
„ r�
NAME
_� Date Processed
NICKNAME LAST SUFFIX
Date Imaged
yy
4 11i i C Cj}t L6 }� ' ("3
7 CAMPAIGN
STREET ADDRESS (NO PO BOX PLEASE); APT I SUITE #; CITY; STATE; ZIP CODE
TREASURER
ADDRESS
GU 4 /C.' C{,:.5 ` Ili '` l
(Residence or Business)
8 CAMPAIGN
AREA CODE PHONE NUMBER EXTENSION
TREASURER
PHONE
//{ }}
1 t''r 7 I � -6 U l
9 REPORT TYPE
❑ January 15 30th day before election Runoff 15th day after campaign
treasurer appointment
(Officeholder Only)
t� y July 15 El 8th day before election El Exceeded Modified Final Report (Attach C/OH - FR)
Reporting Limit
10 PERIOD
Month Day Year Month Day Year
COVERED
f /� /` ,--
THROUGH
✓ / � � / ��
c
11 ELECTION
ELECTION DATE
ELECTION TYPE
Month Day Year
Primary Runoff ❑ Other
Description
y �-•-
v�
General El Special
12 OFFICE
OFFICE HELD (if any)
13 OFFICE SOUGHT (if known)
14 NOTICE FROM
THIS BOX IS FOR NOTICE OF POLITICAL CONTRIBUTIONS ACCEPTED OR POLITICAL EXPENDITURES MADE BY POLITICAL COMMITTEES TO SUPPORT
POLITICAL
CANDIDATE I OFFICEHOLDER. THESE EXPENDITURES MAY HAVE BEEN MADE WITHOUT THE CANDIDATE'S OR OFFICEHOLDER'S KNOWLEDGE OR
CONSENT.
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
❑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)
l
EXPENDITURE
TOTALS
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
LOAN TOTALS
6. TOTAL PRINCIPAL AMOUNT OF ALL OUTSTANDING LOANS AS OF THE
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.
Signature of Candidate or Officeholder
Please complete either option below:
(1)Affidavit PYP/// AMY SHELLEY
i i5 Notary Public, State of Texas
=�"i9fF
5�+`` Comm. Expires 12-02-2023
NOTARY S /' of `� Notary ID 12476110-5
Sw rn to and subscribed before me by ��'� ��� \ this the day of
l of office.
to certify which, witness my hand Icsya(W `
Sign tur of offi er dministering oath Prin name of officer ajministering oath Title of officer administerin ath
• .
(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 120
(month) (year)
Signature of Candidate/Officeholder (Declarant)
Forms provided by Texas Ethics Commission www.ethics.state.tx.us Revised 11115/2022