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HomeMy WebLinkAboutNadeau_Application for Place on the Ballot_05.09.2015AW2-15,712011 Prescribed by Secretary of State Sections 141.031, 143,004, 143,006, Texas Election Code All information is required to be provided unless indicated as optional. APPLICATION FOR A PLACE ON THE CITY OF Georgetown GENERAL ELECTION BALLOT TO: City Secretary I request that my name be placed on the above-named official ballot as a candidate for the office indicated below. OFFICE SOUGHT Include any place number or other distinguishing number, if any. INDICATE TERM Georgetown City Council District 5 Eyl FULL UNEXPIRED FULL NAME (First, Middle, Last) PRINT NAME AS YOU WANT IT TO APPEAR ON THE BALLOT Paul Nadeau Paul Nadeau PERMANENT RESIDENCE ADDRESS (Street address and apartment MAILING ADDRESS (If different from residence address) number. If none, describe location of residence. Do not include P.O. Box or Rural Rt.) CITY STATE ZIP CITY STATE ZIP Georgetown I Texas 78628 1 1 EMAIL ADDRESS (Optional) OCCUPATION (Do not leave blank) DATE OFBIRTH VOTER REGISTRATION VUID NUMBER (if applicable) Senior Systems Engineer TELEPHONE NUMBER (Include area code) (Optional) Length of Continuous Residence as of Date Application Sworn OFFICE: IN STATE IN CITY IN DISTRICT OR PRECINCT' 13 yr(s) 0 yr(s) 0 yr(s) HOME: 512-348-4975 3 MOS 11 mos 11 MOS 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 2rior to this election. Before me, the undersigned authority, on this day personally appeared (name) Pat LN Nadeau who being by me here and now duty sworn, upon oath says: 1, 1(narne)_F SOD JULhL_h[adeaU_, of Williamson County, Texas, being a candidate for the office of V C ! j cil Distrir-t R , swear that I will support and defend the Constitution and laws of the United States and o the State of 17exas. 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 finally convicted of a felony for which I have not been pardoned or had my full rights of citizenship restored by other official 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 application are in all things true and correct." SIGNATURE'OF CANDIDATE Swo and subscribed before me at 0 10 this the 10 day of _3D SEAL Signal of administering oath' Title of OUer administering oatL.J ffi TO BE CO (see Section JESSICA ERIN BRETTLE 0all a /is NOTARY PUBLIC Date Received Signature oirCity Secretary State of Texas