AW2-16 Prescribed by Secretary of Slate Sections 141.063, 142.007, Texas Election Code 2/09

OFFICIAL RECORD CITY SECRETARY

FT. WORTH, TX

PETITION FOR A PLACE ON THE CITY GENERAL ELECTION BALLOT (PETICI6N PARA QUE SU NOMBRE ESTE PUESTO EN LA BOLETA DE LA ELECCJ6N GENERAL DE LA CIUDAD)

Signing the petition of more than one candidate for the same office in the same election is prohibited. 'Se rohibe 1rmar la eticilm de mcis de un candidato ara el mismo uesto o 1cial en la misma e/ecci6n.

COMPLETE ALL BLANKS. (LLENE TODOS LOS ESPACIOS EN BLANCO.)

You are hereby requested to place the name indicated below on the ballot for the next general election for the City of Fort Worth for the office indicated. or la resente se la solicita ue el nombre de/ individuo indicado aba ·o este uesto en la bo/eta ara la r6xima e/ecci6n eneral de la Ciudad de ara el uesto o zcial indicado.

Name (Nombre) '

Michael D. Crain

Address (Direcci6n) Office sought (Puesto oficia/ so/icitado)'

4450 Oak Park Lane #100427, Fort Worth, TX 76109 Fort Worth City Council - District 3

Street Address (Including City, Texas, Zip) {DirecciOn de Residencia (lncluye Ciudad, Estado, Codigo Postal))

Voter VUID Number" (N'Um. de VUID de Volante)

Date ofBirth3

AFFIDAVIT OF CIRCULATOR (DECLARACION A DE LA PERSONA QUE HACE CIRCULAR LA PETIC/ON) TE OF TEXAS (f!STADO DE TEl1S) COUNTY OF (CONDADO DE) Tarrant BEFORE ME, the undersigned, on this _j_t2Jl~date) personally appeared (ANTE Ml, ell/a suscrito(a). en este

(fecha) compareci6) Michael D. Crain , (name of person who circulated petition) - (nombre de la persona que hizo circular la p etici6n) who being duly sworn, deposes and says: " I called each signer' s attention to the above statements and read them to the signer before the signer affixed their signature to the petition. I witnessed the affixing of each signature. The correct date of signing is shown on the petition . I verified each signer's registration status and believe that each signature is the genuine signature of the person whose name is signed and that the corresponding information for each signer is correct." (quien, habiendo prestado e/Juramento correspondiente, declar6 y dijo: "Llame /a atenciOn de cadafirmante sobre la declaraci6n citada y se la lei antes de que la suscribiera. Atestigiie cadafirma, y lafecha correcta de lasfirmas cons/a en la p etici6n. Verifique la situaci6n de cadafirmante en lo concerniente a su inscripci6n y creo que cadafirma es ' e la persona cuyo nombre aparece firmado y que son exactos los datos correspondientes a c ante. ") SWORN TO AND SUBSCRIBED BEFORE ME THIS DA TE (JURADO Y SUSCRITO ANTE Ml, CON ESTA FEC

(SEAL)

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AW2-16 Prescribed by Secretary of State Sections 14 1.063, 142.007, Texas Election Code 2/09

OFFICIAL RECORD CITY SECRETARY

PT. WORTH, TX

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111111' Notary ID 3896065

AW2-16 Prescribed by Secretary of Stale Sections 141.063, 142.007, Texas Election Code 2/09

OFFICIAL RECORD CITY SECRETARY

FT, WORTH, TX

PETITION FOR A PLACE ON THE CITY GENERAL ELECTION BALLOT (PET/Cf ON PARA QUE SU NOMBRE ESTE PVESTO EN LA BOLETA DE LA ELECCION GENERAL DE LA CJUDAD)

Signing the petition of more than one candidate for the same office in the same election is prohibited. (Se rohihe 1rmar la tici611 de mtis de un candidato ra el mismo uesto o ,cial en la misma elecciOn.

COMPLETE ALL BLANKS. (LLENE TODOS LOS ESPACIOS EN BLANCO.)

You are hereby requested to place the name indicated below on the ballot for the next general election for the City of Fort Worth for the office indicated. or la resente se la solicita ue el 11ombre de/ i11dividuo i11dicado aba ·o este uesto e11 la bole/a ara la r6xima elecci611 e11eral de la Ciudad de ara el uesto o ,cial indicado.

Name (Nombre)' Address (Direcci611} Office sought (Puesto oficiol solicitado)'

Michael D. Crain 4450 Oak Park Lane #100427, Fort Worth, TX 76109 Fort Worth City Counci 't,.- District 3

Printed Name Street Address {Including City, Texas, Zip) (DirecciOn de Re.sidcncia (Jnclttyc Ciudad E.rtado, Ccidigo Postal))

oter VUID Number' (N,im. de VUID de Vorame)

Date of Birth3 Fecha de Nacimie11to

AFFIDAVIT OF CIRCULATOR (DECLARACION JURADA DE LA PERSONA QUE HACE CIRCULAR LA PEJ/f:!OJI) STA TE OF TEXAS (ffSTADO DE TEJ~S) COUNTY OF (CONDADO DE) Tarrant BEFORE ME, the undersigned, on this l_/ L:t:J 1!:f (date) personally appeared (ANTE Ml, ell/a suscrito(a), en este ([echo) comparecio) Michael D. Crain , (name of person who circulated petition) - (nombre de la persona que hizo circular la pe1ici6n) who being duly sworn, deposes and says: "I called each signer's attention to the above statements and read them to the signer before the signer affixed their signature to the petition. I witnessed the affixing of each signature. The correct date of signing is shown on the petition. I verified each signer's registration status and believe that each signature is the genuine signature of the person whose name is signed and that the corresponding infonnation for each signer is correct." (quien, habiendo prestado el juramento correspondiente, declaro y dijo: "llanu! la atenci6n de ante sobre la declaraci6n citada y se la lei antes de que la suscribiera. Atesligiii! cadafinna, y la fee orrecla de las firmas cons/a en la petici611. Verifique la s ituaciim de cadafirmanle en lo concerniente a su inscripcidn y creo que cadafi. a es la au/ tico de la persona cuyo nombre aparecefirmado y que son exactos /os datos correspondienles a cadafir ante.") SWORN TO AND SUBSCRIBED BEFORE ME THIS DATE (JURADO Y SUSCRITO ANTE Ml, CON ESTA FE 'A)

(SEAL)

Oath mt11/o O icia/ cJe{/Je /a uncio'1{lr/o(a) llC /e tom6 Urtllllt!nlo)

,,,11111,, $'~~-~!'.~f\ MARY J . KAYSER ~f{:.A.:'i~! Notary Public, State of Texas -~ •. -~ ...... C "'..:;.~.k ... &q 0 mm. Expires 01 -1 1-2026

~jC'Of "''\~ N ,,1, "'' otary ID 3896066

AW2- 16 Prescribed by Secretary or State Sections 141.063, 142.007, Texas Election Code 2/09

OFFICIAi. RECORD CITY SECRETARY

FT. WORTH, TX

PETITION FOR A PLACE ON THE CITY GENERAL ELECTION BALLOT (PETICI6N PARA QUE SU NOMBRE ESTE PUESTO EN LA BOLETA DE LA ELECCI6N GENERAL DE LA CIUDAD)

Signing the petition of more than one candidate for the same office in the same election is prohibited. (Se hibe {irmar la eticitm de mcis de un candidato ra el mismo uesto o 1cia/ en la misma eleccilm.

COMPLETE ALL BLANKS. (LLENE TODOS LOS ESPACIOS EN BLANCO.)

You are hereby requested to place the name indicated below on the ballot for the next general election for the City of Fort Worth for the office indicated. 'Por la resente se la solicit a 11e el nombre def individuo indicado aba ·o este uesto en la bole/a ara la roxima e/eccion enera/ de la Ciudad de ra el uesto o 1cia/ indicado.

Name (Nombre)' Address (Direccion) Office sought (Puesto oficial solicitado)'

Michael D. Crain 4450 Oak Park Lane #100427, Fort Worth, TX 76109 Fort Worth City Council - District 3

Printed Name Street Address (Including City, Texas, Zip) (Direcci011 de Residencia (lnc/uye Ciudad, Estado. COlligo Postal))

County (Co11dado)

Voter VUID Number' {Ntlm. de VU!D de Yotame)

Date of Birth3

l l 7 /.;..7 / n,-

A FlDAVIT OF CIRCULATOR (DECLARACION JURADA DE LA PERSONA QUE HACE CIRCULAR LA PETICION) F TEXAS (f!STADO DE TE.l,!,S) COUNTY OF (CONDADO DE) Tarrant BEFORE ME, the undersigned, on this ./-!ti:LJ'J.J. (date) personally appeared (ANTE Ml, ell/a suscrito(a), en estc

(fecha) compareci6) Michael D. Crain , (name of person who circulated petition)- (11ombre de la persona que hizo circular la peticion) who being duly sworn, deposes and says: "I called each signer's attention to the above statements and read them to the signer before the signer affixed their signature to the petition. I witnessed the affixing of each signature. The correct date of signing is shown on the petition. I verified each signer's registration status and believe that each signature is the genuine signature of the person whose name is signed and that the corre ding infonnation for each signer is correct." (quien, habiendo prestado e/juramenlo correspo11die111e, declaro y dijo: "llame la atencidn de cada jirmante sobre la declaracitin citada y se la lei antes de que lo suscribiera. Atestigiie cadafin11a, y 7ech ·orrecla de las flnna.r cons/a en la petici6n. Verifique la sil11aci611 de coda firmante en lo concerniente a su inscripciOtt y creo que cadafirma es la 1/entica de la persona cuyo nombre aparecefirmado y que son exactos los daJos correspo d s a · afirmante. 'J SWORN TO AND SUBSCRIBED BEFORE ME THIS DATE (JURADO Y SUSCRITO ANTE Ml, CON ESTA FECHA /

(SEAL)

Si Si Ur! le 1t1m6 ummenll1)

,,,,,~~'t:J,,, MARY J . KAYSER , ~~ ••••• 49:~ • ~'?{:..A.:·~\ Notary Public, State of Texas

~~·.Ji:~,iE Comm. Exi,lru 01-11-2025 ~~Zi°Rf:~,,.;; Notary ID 3896065

AW2-16 Prescribed by Secretary of State Sections 141.063, 142.007, Texas Election Code 2/09

OFFICIAL RECORD CITY SECRETARY

FT. WORTH, TX

PETITION FOR A PLACE ON THE CITY GENERAL ELECTION BALLOT (PETJCION PARA QUE SU NOMBRE ESTE PUESTO EN LA BOLETA DE LA ELECCION GENERAL DE LA CIUDAD)

Signing the petition of more than one candidate for the same office in the same election is prohibited. ohibe mnar la eticidn de mtis de un candidato ara el mismo ueslo o 1cial en la misma e/eccilm.

COMPLETE ALL BLANKS. (LLENE TODOS LOS ESPAC/OS EN BLANCO.)

You are hereby requested to place the name indicated below on the ballot for the next general election for the City of Fort Worth for the office indicated. 'Por la resente se la solicit a 11e el 110111bre de/ individuo indicado aha ·o este uesto e11 la ho/eta ara la roxima e/eccion eneral de la Ciudad de ara el uesto o 1cial i11dicado.

Name (Nombre) ' Address (Direccion) Office sought (Puesto oficial solicitado)'

Michael D. Crain 4450 Oak Park Lane #100427, Fort Worth, TX 76109 Fort Worth City Council - District 3

Date Signed (Fecha de Flrma)

Signature (Firma)

Printed Name (Nombre en letra de mo/de)

Street Address (Including City, Texas, Zip) (DirccciOn de Residencia (Jnc/11ye Ciudad. Estado, Codigo Postal))

County (Co11dado)

Voter VUIO Number' (N,im. de VU!D de Vota,ue)

Date of Birth3

AF ID VITO CJRCULA OR (DEC RAC/0 'JURADA ELA PERSONA QUE HACE CIRCULAR LA 'f,[lf:JON) STA TE OF TEXAS ~STADO DE TE.l,:fS) COUNTY OF (CONDADO DE) Tarrant BEFORE ME, the undersigned, on this J_jjp}~(date) personally appeared (ANTE Ml, ell /a suscrito(a), en este (!echo) comparecio) Michael D. Crain (name of person who circulated petition) - (nombre de la persona que hizo circular la peticion) who being duly sworn, deposes and says: " I called each signer's attention to the above statements and read them to the signer before the signer affixed their signature to the petition. 1 witnessed the affixing of each signature. The correct date of signing is shown on the petition. I verified each signer' s registration status and believe that each signature is the genuine signature of the person whose name is signed and that the corresponding information for each signer is correct." (quien, habiendo prestado elj11ra111e1110 correspondie111e, dec/aro y dijo: "L/ame la alenciOn de cada ante sobre la declaraci6n cilada y se la lei antes de que la suscribiera. Atestig,1e cadafirma, y /afecha correcla de /asfirmas cons/a en la pelici6n. Verifique la situaciOn de cadafirmanle en lo c:oncerniente a su inscripciOn y creo que cadajirm ' a de la persona cuyo nombre aparece jim,ado y que son exactos los datos correspondientes a c mante. ") SWORN TO AND SUBSCRIBED BEFORE ME THIS DATE (JURADO Y SUSCRJTO ANTE Ml. CON ESTA FECH. '

(SEAL)

,,, .. ,,,, .:-1~~.~f.11~'.e MARY J . KAYSER fr(.~YfiNotary Public, State of Texas w'!l\~ ....... C E ~:-tk .... .::.+"'~ omm. xpires 01 -11-2025 .. ,.:C"o,~"''"

~,,1/lllll'' Notary ID 3896065 ..

AW2-16 Prescribed by Secretary of State Sections 141.063, 142.007, Texas Election Code 2/09

OFFICIAL RECORD CITY SECRETARY

PT. WORTH, TX

PETITION FOR A PLACE ON THE CITY GENERAL ELECTION BALLOT (PETICI6N PARA QUE SU NOMBRE ESTE PUESTO EN LA BOLETA DE LA ELECCJ6N GENERAL DE LA CJUDAD)

Signing the petition of more than one candidate for the same office in the same election Is prohibited. rohibe 1rmar la etici6n de mcis de un candidalo ara el mismo uesto o lcia/ en la misma e/ecci6n.

COMPLETE ALL BLANKS. (LLENE TODOS LOS ESPACJOS EN BLAN CO.)

You are hereby requested to place the name indicated below on the ballot for the next general election for the City of Fort Worth for the office indicated. 'Por la resente se la so/icita ue el nombre de/ individuo indicado aba ·o este uesto en la bole/a ara la roxima e/eccion eneral de la Ciudad de ra el uesto o 1cial indicado.

Name (Nombre)' Address (Direccion) Office sought (Puesto oficial so/icitado)'

Michael D. Crain 4450 Oak Park Lane #100427, Fort Worth, TX 76109 Fort Worth City Council - District 3

Date Signed (Fecha de Firma)

Signature {Firma)

Printed Name (Nombre en letra de mo/de)

Street Address (Including City, Texas, Zip) (Direcci6n de Residencia (Inc/uye Ciudad, Estado, C6digo Postal))

County (Condado)

AFFIDA VJT OF CIRCULATOR (DECLARACION JURADA DE LA PERSONA QUE HAGE CIRCULAR LA PETICJON)

Voter VU ID Number' (NUm. de VUID de Volante)

Date of Birth3

STA TE OF TEXAS (f!ST. ODE TEl1,S) COUNTY OF (CONDADO DE) Tarrant BEFORE ME, the undersigned, on this /_.! 2i2f .2./(date) personally appeared (ANTE MI, el/la suscrito(a), en este (fecha) comparecio) Michael D. Crain (name of person who circulated petition) - (nombre de la persona que hizo circular la peticion) who being duly sworn, deposes and says: "I called each signer's attention to the above statements and read them to the signer before the signer affixed their signature to the petition. I witnessed the affixing of each signature. The correct date of signing is shown on the petition. I verified each signer's registration status and believe that each signature is the genuine signature of the person whose name is signed and that the corresponding information for each signer is correct." (quien, habiendo prestado el juramento correspondiente, dec/aro y dijo: "Llame la atenci6n de cadafirmante sabre la declaracion citada y se la lei antes de que la suscribiera. AtestigiJf! codafirma, y la/ echo correcta de las firmas cons/a en la petici6n. Verifique la situaci6n de cadafirmante en lo concerniente a su inscripci6n y creo que cada firma es la aute la persona cuyo nombre aparece firmado y que son exactos los datos correspondientes adq, rm le. ") SWORN TO AND SUBSCRIBED BEFORE ME THIS DATE (JURADO Y SUSCRITO ANTE MI, CON ESTA FECHA)

(SEAL)

Si Si oath (Tirulo o cial dellde la uncionario(a ue le tomO ·uromento)

,,,1111,,, S-~~~-~r,~;,,,_, MARY J . KAYSER ~~ '*•