HomeMy WebLinkAbout140721 - Candidate Application - Karl P. MooneyAW2-20, 7/2011
Prescribed by Secretary of State
Sections 141.031, Chapter 144, Texas Election Code
AH information is required to be provided unless indicated as optional.
APPLICATION FORA PLACE ON THE y ;'rc .t' yrs " GENERAL ELECTION BALLOT
TO: Secretary of Board
I request that my name be placed on the above-named official ballot as a candidate for the office indicated below,
OFFICE SOUGHT INDICATE TERM
Include any place number or other t„airrtrisliin umher, i
II t FULL UNEXPIREDiio
Middle, Last) ANT IT TO APPEAR ON THE BALLOT
PERMA NT RESIDENCE ADDRESS (Street address and apartment
number. If none, describe location of residence. Do not include P.O.
Box or Rtral Rt.)
All.,IN(i AI)l7ldlitiS (lt difl rcrtt IrottN reside]
CI 1 1' STATE ZIP
1!'MAll `AI3l)RItiSS (Optional) OCCUPATION (I;Io not leave blank
TELEPHONE NI,T' 111
OFFICE:
^
DATE OF BIRTH COUNTY OF RESIDENCE
Include area code) (Optional) Length of Continuous Residence as of Date Application Sworn
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If using a nickname as part of your name to appear on the ballot, you are also signing and swearing to the fo lowing 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 conatnonly known by this nickname for at least three years prior to this election
Before me, the undersigned authority, on this day personally app
here and now duly swom, upon oath says: "I, (` p rra ` /
who being by me
County, Texas, being a candidate for the office of „,'rreS, ,
swear that I will support and
defend the Constitution and laws of the United States an n oft e State^ of 1 ew is am a eitirctt 1'tlte 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."
NAV ° l ! OF (::' ANI 11II:)ATE
to ntd subscribed before -one at
E)'
Signature of (1 ' icr°r admi nc terinl, oath'
this the t ....._.._ day of
t'.......
Title of Officer administering oath
SHERRY MA ` H8URN'
Notary Public, Sta of Texas
My Cornmissio Expires
JULY 26, 015
TO BE COMPLETED BY SECRETARY OF BOARD:
See Section 1 007)
Date Received