HomeMy WebLinkAboutApplication for A place on the Ballot- Garland, Ronald 01.15.20252-26
Prescribed by Secretary of State
Section 141.031, Chapters 143 and 144, Texas Election Code
09/2021
APPLICATION FOR A PLACE ON THE BALLOT FOR A GENERAL ELECTION
FOR A CiTY, SCHOOL DISTRICT OR OTHER POLITICAL; SUBDIVISION
ALL INFORMATION IS REQUIRED TO BE PROVIDED UNLESS INDICATED AS OPTIONAL' Failure to provide required information may result in rejection of application.
APPLICATION FOR A PLACE ON THE ;# : , e t-C GENERAL ELECTION BALLOT
TO: City Secretary/Secretary of Board {name P electi )"
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.)
i IDIC TERM
G> ll (Ji - S '
1 ElFULL ❑UNEXPIRED
FULL NAME ( irst, Middle, Last)
PRINT NAME AS YOU WANT IT TO APPEAR ON THE BALLOT*
e c A 96 A
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PERMANENT RESIDENCE ADDRESS (Do not include a P.O. Box or Rural Route. If
PUBLIC MAILING ADDRESS (Optional) (Address for which you receive
you d not have a residence address, describe location of residence.)
('9
campaign related correspondence, if available.)
! ! i / JIE� 11 1= !
liC
CITY
STATE
ZZIIP!
CITY
STATE ZiP
/
PUBLIC EMAIL ADDRESS (Optional) (address for
OCCUPATION (Do not leave blank)
DATE OF BIRTH
VOTER REGISTRATION QUID
wtii you receive campaign related emails, if avail tile.
NUMBER' (Optional)
r� Y c+G14E?
TELEPH NE CONTACT INFORMATION (Optional)
1
Home: Office: Cell:
FELONY —CONVICTION STATUS (You MUST check one)
LENGTH OF CONTINUOUS RESIDENCE AS OF DATE THIS APPLICATION WAS SWORN
I have not been finally convicted of a felony.
IN THE STATE OF TEXAS
IN TERRITORY/DISTRICT/ PRECINCT FROM
I have been finally convicted of a felony; but I have been
'Year(s)
WHICH THE OFFICE SOUGHT IS ELECTED
pardoned or otherwise released from the resulting
year(s)
disabilities of that felonry conviction and l have provided
month(s)
month(s)
proof of this fact with the submission of this, application.
*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 or contain a title, 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. Please review sections 52,031, 52.032 and 52.033 of the Texas
Election Code regarding therulesfor how names may be listed on the official ballot.
Before me, the undersigned authority, on this day personally appeared (name of candidate) RQ& Gcwdandwho
being by me here and now d ly sworn, upon oath says:
"l, (name of candidate) I , of e 1 County, Texas,
being a candidate for the office of `t t —,swear that I will support and defend the Constitution and
laws of the United States and of the State odexas. I am a citizen of the United States eligible to hold such office under the constitution and laws of
this state. l 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 am aware that 1 must disclose
any prior felony conviction, and if so convicted, must provide proof that I have been pardoned or otherwise released from the resulting disabilities of
any such final felony conviction. I am aware that knowingly providing false information on the application regarding my possible felony conviction
status constitutes a Class B misdemeanor. I further swear that the foregoing statements included in myapplic ' ion are in all things true and correct."
is j//U
SIGNATURE OF CANDIDATE
l
Sworn to and subscribed before me this the day of Q { u � byad
(day) (month) (year) (name of candidate)
Signature Officer Authorized to Administer Oath WIN
Pri rite TO An nister Oath
ROBYN LOUISE DENSMORE
Notary.Ip #125657056
NY+ {vly Camrriission Expires
Title of Offic r uthorized to Administer Oath ril 15 2026
TO BE COMPLETED BY FILING OFFICE : THIS APPLICA ION IS ACCOMPANIED BY le) PAiD BY:
1-1 CASH F-1 CHECK ❑ MONEY ORDER El CASHIERS CHECK OR ❑ PETITION IN LIEU OF A FILING FE
This document and $ filing fee or a nominating petition of pages received. Voter Registration Status Verified
1 (See Section 1:007)
Date Received Date Accepted Signature of Filing Officer or Designee