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HomeMy WebLinkAbout160725 - Candidate Application - John Nichols HAND 2.21 Prescribed by Secretary of State Section 141.031,Chapters 143 and 144,Texas Election Code -JUL 2 5 2016 12/2015 All information is required to be provided unless indicated as optional. APPLICATP)N R AVUMFN{JJ-A• t�OLLEGESTATION,Tx GENERAL ELECTION BALLOT TO:City Secretar ecre ar o7� Boar H��71�� 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 MAYOR *FULL ❑UNEXPIRED FULL NAME(First, Middle, Last) PRINT NAME AS YOU WANT IT TO APPEAR ON THE BALLOT JOHN POWELL NICHOLS JOHN NICHOLS PERMANENT RESIDENCE ADDRESS(Do not include a P.O. Box or Rural PUBLIC MAILING ADDRESS(Campaign mailing address,if available.) Route. If you do not have a residence address, describe the address at which you receive personal mail and location of residence.) CITY STATE ZIP CITY STATE ZIP COLLEGE STATION TX 77840 'clle E ����►`fV /'( ';•1 �`C� PUBLIC EMAIL ADDRESS(If available) OCCUPATION(Do not leave blank) DATE OF BIRTH VOTER REGISTRATION VUID NUMBER(Optional)' TELEPHONE CONTACT INFORMATION (Optional) LENGTH OF CONTINUOUS RESIDENCE AS OF DATE APPLICATION SWORN Home: 7 Q 6 9,3 S 17 IN STATE IN TERRITORY ELECTED FROM Work: 47 year(s) yl year(s) Cell: 10 month(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, 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) John P.Nichols who being by me here and now duly sworn,upon oath says: "I, (name) JohnP.Nihols , of College Station,Brazos County, Texas, being a candidate for the office of Mayor , swear that I will support and defend the Constitution and laws of the United States and of 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 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." X P ,i: $IGN TURE OF I 1168633.0 Sworn to and subscribed before me at 1 f(r ti ,this the a_��y of J w��l ; * Notary Public,State of Texas r f 1 f''" QF. My 1 �2019 sion Aires ` Signature of O Icer Administering Oath Title of Offlicer Administering OatA TO BE COMPLETED BY CITY SECRETARY OR SECRETARY OF BOARD: (See Section 1.007) '7—a 5�6 _ Date Received Signature of Secre Voter Registration Status Verified