HomeMy WebLinkAbout170814 - Candidate Application - Elianor-Azarak Vessali 2-21
Prescribed by Secretary of State
Section 141.031,Chapters 143 and 144,Texas Election Code
1/2017
ALL INFORMATION IS REQUIRED TO BE PROVIDED UNLESS INDICATED OPTIONAL
APPLICATION FOR A PLACE ON THE College Station, TX GENERAL ELECTION BALLOT
TO:City Secretary/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(Include any place number or other distinguishing number,if any.) INDICATE TERM
College Station City Council - Place 1 kf FULL
UNEXPIRED
FULL NAME(First,Middle,Last) PRINT NAME AS YOU WANT IT TO APPEAR ON THE BALLOT'
Elianor-Azarak Vessali Elianor Vessali
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.)
110 Pershing Avenue
CITY STATE ZIP CITY STATE ZIP
College Station TX 77840
PUBLIC EMAIL ADDRESS(If available) OCCUPATION(Do not leave blank) DATE OF BIRTH VOTER REGISTRATION VUID
NUMBER(Optional)2
elianor@vessalitx.com Realtor 111 270 3934
TELEPHONE CONTACT INFORMATION(Optional) LENGTH OF CONTINUOUS RESIDENCE AS OF DATE APPLICATION SWORN
Home: IN STATE IN TERRITORY FROM WHICH THE
OFFICE SOUGHT IS ELECTED'
Work: 12 year(s) 3 year(s)
Cell: 713-304-6340 2 month(s) 8 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(narne)Elianor-AZarak Vessali ,who being by me
here and now duly sworn,upon oath says:
"I, (name) Elianor-Azarak Vessali , of Brazos County, Texas, being a
candidate for the office of College Station City Council-Place 1 .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 1)ALtJY\(fl- (IA
SIGN URE O A MN)
Sworn to and subscribed before me at :'}.)Qry‘. this the VA day of S a , " • 131O 220-8 )
* * Notan,SPAblic,State of Texas
�fMy Commission Expire: )
dWO,H April 17,2021 )
Signature of Officer Administering Oath4 Title of Office Administering Oath
TO BE COMPLETED BY CITY SECRETARY OR SECRETARY OF BOARD: �3/1(See Section 1.007) ' /t4 —/7 ���G�
Date Received Signa re of S tar
Voter Registration Status Verified Pe f*9
Texas Ethics Commission P.O.Box 12070 Austin,Texas 78711-2070 (512)463-5800 (TDD 1-800-735-2989)
APPOINTMENT OF A CAMPAIGN TREASURER FORM CTA
BY A CANDIDATE PG I
See CTA Instruction Guide for detailed instructions. 1 Total pages filed:
2 CANDIDATE -Ms MRS/MR FIRST MI OFFICE USE ONLY
NAME Elianor-Azarak
Acct.U
NICKNAME LAST SUFFIX _
Elianor Vessali Date Received g
3 CANDIDATE ADDRESS/PO BOX; APT/SUITE it; CITY; STATE; ZIP CODERE CF
9„
VED\
MAILING
ADDRESS 110 Pershing Avenue College Station TX 77840 AUG 1 4 '11.I 1 011��
r
vaR7. ..
4 CANDIDATE AREA CODE PHONE NUMBER EXTENSION Date Ha drdhlikEltgilcBostmerketr----
PHONE
713 )304-6340 Date Processed
5 OFFICE Date Imaged
HELD
(if any)
6 OFFICE
SOUGHT College Station City Council-Place 1
(if known)
7 CAMPAIGN MS/MR MR FIRST MI NICKNAME LAST SUFFIX
TREASURER
NAME Walter TapBentz II
8 CAMPAIGN STREET ADDRESS(NO PO BOX PLEASE); APT I SUITE tt; CITY; STATE; ZIP CODE
TREASURER
STREET 705 Plum Hollow Drive College Station TX 77845
ADDRESS
(residence or business)
9 CAMPAIGN AREA CODE PHONE NUMBER EXTENSION
TREASURER
PHONE
979 ) 324-4610
10 CANDIDATE
SIGNATURE I am aware of the Nepotism Law,Chapter 573 of the Texas Government Code.
I am aware of my responsibility to file timely reports as required by title 15 of
the Election Code.
I am aware of the restrictions in title 15 of the Election Code on contributions
from corporations and labor organizations.
ajbAn' i i '10,09(tdit: gl1IA / 201'3-
Sign";re of Candidate Date Signed
GO TO PAGE 2
www.ethics.state.tx.us Revised 07/14/2010