19 - Resignation of Council Member Stone & Filling of the Vacancy in District 1

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2-26 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 .L INFORMATIONREQUIRED TO BE PROVIDED UNLESS INDICATED AS OPTIONAL' Failure to provide required inforrmation mayresult in rejection of application. APPLICATION FOR A PLACE ON THE C. r�� `NERAL ELECTION BALLOT TO: City Secretary/Secretary of Board (name of election) I request that my name be placed on the above-named official ballot as a candidate for the office indicated below. ... o c. lstin uishin number, if an I ... ..... _. ERM _ _ OFFICE SOUGHT (Include any place number or other distinguishing g y.)� NDI E TERM FULL NA E ._. p-' _...... ......il1:1 UNEXPIRED L first, Ml�ddle Last) �X PRINT NAME AS YOU WANT IT TO APPEAR ON THE BALLOT* PERMANENT REST ENCE ADDRESS (Do no include a P.O. Box or Rural Route. If I PMAILING � NG ADDRE�S O'ptin..... �.._.._ ( p oval) (Address for which you receive yCoITM oe a residence address,describe location residence.) campaign related correspondence, if not available.) 7'Pl� i� c�SSTATE ZIP CITY STATE ZIP PUBLIC EMAIL ADDRESS (Optional) Address for OCCUPATION Do not leave blank DATE ( p ) ( ( ) OF BIRTH VOTER REGISTRATION VUID which you receive campaign related emails, if available.) NUMBERZ (Optional) TELEPHONE CONTACT INFORMATION �. , " ', ...��..n.; i C ....1-631-1-1, . �.�. ...... ...�.. _.. _ -- ..................- ON (Optional) 4z i Home: U (You MUST check one) Office: —LENGTH OF CONTINUOUS RESIDENCE AS OF (DATE THIS PPLIC TION WAS SWORN FELONY CONVICTION STATUS Yo.._..w '� _ RN ave not been finally convicted of a felony. IN THE STATE OF TEXAS IN TERRITORY/DISTRICT PRECINCT FROM OM ❑ I have been finally convicted of a felony, but I have been WHICH THE OFFICE SOUGHT IS ELECTED pardoned or otherwise released from the resulting year(s) year(s) disabilities of that felony conviction and I have provided proof of this fact with the submission of this application.3 month(s) month(s) g a nickname as part of your name to appear o „ * pp n 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 the rules for how names may be listed on the official. ballot... _ authors on this da personally appeared (name of candidate) 5 h ..r - Before me, the undersigned'ty, y p r-' e ,who being by me here and now duly sworn upon oath says: "I, (name of candidate) tp1/[ of iWl rti� County, Texas, beingcandidate office _lm. ..m" swear that I will support and defend the Constitution and laws of the Un n United States and the State of 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 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 I 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 my application are in all things true and correct." �. SIGNATURE OF CANDIDATE o a ,4��bd b tan scribeefore me this the da�� — - �" y of FEE12LAAV- 2022 A�5�►altgra nnoorc (day) (month) (yea ;LAR"file (name of candidate) gnat r o effcr Authorsz to Administer Oath" .n n "SAe __ - _.... � ...... a........ zed r atrse d to Administer Oath - .._F._ �y I ��••_� Title of Officer Authorized to Administer Oath —fit f..... .. ......... ............. ....... ..... TO BE COMPLETED BY FILING OFFICER: THIS APPLICATION IS ACCOMPANIED BY THIGr11, Applicable) PAID BY: This document and $ EV ORDER aAnommating petition of pages re �i A 2 ❑ CASH ❑ CHECK ❑ MON R ❑ PETITION IN LIEU 11 ceived.ff I f I I `Voter Registration Status Verified �/fJJ (See Section 1.007 _ Date Received Date Accepted nature of Filing Officer or m,. ... m_.......... _ P, ,,,. _...... ��. -- _... �._ � .... Designee