OFFICIAL RECORD RECENED All clR~i~ gN IS ~EQUIRED TO BE...
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RECENED A ll cl R~i~ gN IS ~ EQUIRED TO BE PROVI 2-23 OFFICIAL RECORD Presc ribed by Secretary of St at e ~ Ci!tilR & f¥ 5 , Texas Elect ion C ode; Secti on 11.056, Texas Educat ion Co de; Section 49.101, Texas Wa t er Cod e 1/2017 OFFICE SOUGHT {Include any place number or other distinguishing number, if any.) ~IC ~ TERM i::::::tru LL DuNEXPIRED PRINT NAME AS YOU WANT IT TO APPEAR ON THE LIST OF /h c ch_ 0-€..- ( DECM/t:: N C μ, IDATES ~ ) PERMANENT RESIDENCE ADDRESS {Do not in clude a P.O. Box or Rural ress for which you receive campaign Route . If you do not have a residence address, describe location of related correspondence.) residence.) CITY STATE PUBLIC EMAIL ADDRESS {If available) ('>11 (. Q_ {+~ r1.t, >.., (n If @cy1,u,,,1 (, C6 ZIP rJh/6 OCCUPATION {Do not lea ve blank) v c.-te..~s \ '5vt STATE ZIP DATE OF BIRTH VOTER REGISTRATION VUID NUMBER 2 {Optional) CONTACT INFORMATION (Optional) Home: LENGTH OF CONTINUOUS RESIDENCE AS OF DATE APPLICATION SWORN Ce ll : IN STATE JO year{s) __ month{s) IN TERRITORY FROM WHICH THE OFFICE SOUGHT IS ELECTED 3 3.{l year{s) __ mont h{ s) If using a nickname as part of your name to appear on the ballot, you are also signing and swearing to the following statements: I further swear that my nickname does not constitute a slogan nor does it indicate a political, economic, social, or religious view or affiliation. I have been commonly known by this nickname for at least three years prior to this election. Before me, the undersigned authority, on this day personally appeared {name) /h ( chuJ</ f 4-f h...ftS , who being by me here and now duly swo~n, upon {_ th says : " I, {name) /J!lc lhAJV J · S of ft;,,-y~J- County, Texas, being a ca ndidate for the office of oi.--- swear that I will support and defend the Const it ution and laws of the United States and of the State f Texas. I am a citizen of the United States eligible to hold such office under the constitution and laws of thi s state. I have not been fi na lly convicted of a felony for which I have not been pardoned or had my full rights of citize nshi p restored by ot her officia l action . I have not been determined by a final judgment of a court exercising probate jurisdiction to be totally mentally incapacitated or partially mentally incapacitated without the right to vote. I am aware of the nepotism law, Chapter 573, Government Code. I further swear that the foregoing statements included in my app li cation are in all thi 0 BE COMPLETED BY FILING OFFICER: {See Section 1.007) .--/ Voter Registration Status Verified Date Received X
Transcript of OFFICIAL RECORD RECENED All clR~i~ gN IS ~EQUIRED TO BE...
RECENED All clR~i~ gN IS ~EQUIRED TO BE PROVI
2-23 OFFICIAL RECORD Prescribed by Secretary of State
~ Ci!tilR&f¥5 , Texas Election Code; Section 11.056, Texas Education Code; Sectio n 49.101, Texas Water Code 1/2017
OFFICE SOUGHT {Include any place number or other distinguishing number, if any.) ~IC~ TERM
i::::::tru LL
DuNEXPIRED
PRINT NAME AS YOU WANT IT TO APPEAR ON THE LIST OF
/h c ch_ 0-€..- ( DECM/t::N Cµ, IDATES~ )
PERMANENT RESIDENCE ADDRESS {Do not include a P.O. Box or Rural ress for which you receive campaign Route . If you do not have a residence address, describe location of related correspondence.) residence.)
CITY STATE
~ PUBLIC EMAIL ADDRESS {If available)
('>11 (. Q_ {+~ r1.t, >.., (n If @cy1,u,,,1 (, C6
ZIP
rJh/6 OCCUPATION {Do not leave blank)
v c.-te..~s \ '5vt ~
STATE ZIP
~ DATE OF BIRTH VOTER REGISTRATION VUID
NUMBER2 {Optional)
CONTACT INFORMATION (Optional) Home:
LENGTH OF CONTINUOUS RESIDENCE AS OF DATE APPLICATION SWORN
Ce ll :
IN STATE
JO year{s)
__ month{s)
IN TERRITORY FROM WHICH THE
OFFICE SOUGHT IS ELECTED3
3.{l year{s)
__ month{s)
If using a nickname as part of your name to appear on the ballot, you are also signing and swearing to the following statements: I further swear that my nickname does not constitute a slogan nor does it indicate a political, economic, socia l, or re ligious view or affiliation . I have been commonly known by this nickname for at least three years prior to this election.
Before me, the undersigned authority, on this day personally appeared {name) /h ( chuJ</ f 4-f h...ftS , who being by me
here and now duly swo~n, upon {_th says:
" I, {name) /J!lc lhAJV J · S of ft;,,-y~J- County, Texas, being a
ca ndidate for the office of oi.--- swear that I will support and defend the Constitution and laws of the United States and of the State f Texas. I am a citizen of the United States eligible to hold such office under the constitution and laws of this state. I have not been fi na lly convicted of a felony for which I have not been pardoned or had my full rights of citizenship restored by other officia l action . I have not been determined by a final judgment of a court exercising probate jurisdiction to be totally mentally incapacitated or partially mentally incapacitated without the right to vote. I am aware of the nepotism law, Chapter 573, Government Code.
I further swear that the foregoi ng statements included in my app lication are in all thi
0 BE COMPLETED BY FILING OFFICER: {See Section 1.007) .--/
Voter Registration Status Verified ~ Date Received
X
