Muller Semi July 2023CANDIDATE / OFFICEHOLDER
FORM C/OH
CAMPAIGN FINANCE REPORT
COVER SHEET PG 1
The C10H Instruction Guide
explains how to complete this form I File, ID (Ethic's Commission Filers)
2 Total pages filed:
3 CANDIDATE f
(_MS11 MRS I MR FIRST MI
OFFICEHOLDER
,-,
NAME
........
Data R RbA;t:IVtU
NICKNAME LAST SUFFIX
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JUL 1 4 2023
4 CANDIDATE i
ADDRESS "PO BOX, APT / SUITE CITY, STATE: ZIP COD!
OFFICEHOLDER
MAILING
Zj y tV
ADDRESS
0 Change of Address
3'eV 7P 4,y A,�- 7 X-
0
FICE OF CITY SECRETARY
Dafe delivered or Date Postmarked
5 CANDIDATE/
OFFICEHOLDER
AREA CODE PHONE NUMBER EXTENSION
PHONE
tile's
Receipt #
Amount S
6 CAMPAIGN
ME I MRS I MR FIRST MI
TREASURER
Date Processed
NAME
NICKNAME LAST SUFFIX
—
Date Imaged
e'02 eve
7 CAMPAIGN
STREET ADDRESS (NO PO BOX PLEASE): APT SUITE #; CITY;
CO
STATE: ZIP DE
'0
TREASURER
ADDRESS
-
Z-3 4 /4,/C
en
(Residence or Business)
8 CAMPAIGN
AREA CODE PHONE NUMBER EXTENSION
TREASURER
PHONE
9 REPORT TYPE
❑ January 15 30th day before election El Runoff
-- 15th day after campaign 10 'treasurer
appointment
(Officeholder Only)
July 15 El Sib day before election El Exceeded Modified
Final Report (Attach CIOH - FR)
Reporting Limit
10 PERIOD
Month Day Year Month
Day Year
COVERED
/ THROUGH
11 ELECTION
ELECTION DATE ELECTION TYPE
Month Day Year Primary Bunch Othei
Description
General Special
12 OFFICE
OFFICE HELD Of say) 13 OFFICE SOUGHT of known)
I e- I ;r/,/ (::
e / /
14 NOTICE FROM
THIS BOX IS FOR NOTICE OF POLITICAL CONTRIBUTIONS ACCEPTED OR POLITICAL EXPENDITURES MADE BY POLITICAL COMMITTEES TO SUPPORT
POLITICAL
THE CANDIDATE [OFFICEHOLDER. THESE EXPENDITURES MAY HAVE BEEN MADE WITHOUT THE CANDIDATE'S OR OFFICEHOLDER'S KNOWLEDGE OR
CONSENT. CANDIDATES AND OFFICEHOLDERS ARE REQUIRED ID REPORT THIS INFORMATION ONLY IF THEY
RECEIVE NOTICE OF SUCH EXPENDITURES,
COMMITTEE(S)
COMMITTEE TYPE COMMITTEE NAME
EIGENERAL 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 8/17/2020
CANDIDATE I OFFICEHOLDER FORM C/OH
CAMPAIGN FINANCE T COVER SHEET PG
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)
TOTANDITURE 3, TOTAL UNITEMIZED POLITICAL EXPENDITURE,
4. TOTAL POLITICAL EXPENDITURES $
CONTRIBUTION 5. TOTAL POLITICAL CONTRIBUTIONS MAINTAINED AS OF THE LAST DAY
BALANCE 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.
Signature of Candidate or Officeholder
Please complete either option below:
AMY SHELLEY
(1)Affidavit 3z° �=Notary Public, State of Texas
Comm, Expires 12-02-2023
Ni„"Notary ID 12476110.5
NOTARY STAMP/SEAL
Sworn to and subscribed before me by t1 �� {"' tJJ this the day ofV�
,
-,'to�which, witness my hand and sal of office.
Signat re of ff' e ministering oath Printed nam officer administerml oath Title of fficer administering oa
s�
(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 8/17/2020