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