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HomeMy WebLinkAbout191213 -- Application for Place on Ballot -- Marycruz DeLeon MoralesRECEIVED DEC 1 3 71l14? BY: `�'l `�`O`Section 14 r1..'�... rs 2-22 Prescribed by Secretary of State 43 and 144, Texas Election Code 1/2017 ALL INFORMATION IS REQUIRED TO BE PROVIDED UNLESS INDICATED OPTIONAL APPLICATION FOR A PLACE ON TO: City Secretary/Secretary of Board I request that my name be placed on the above THE City c 0,) (( 5'iy ©✓1 SPECIAL ELECTION BALLOT 1 J -named official ballot as a candidate for the office indicated below. OFFICE SOUGHT (Include any place number or other distinguishing Ci k CA C-i number, C;4- ./ Cco if any.) Lf & i t la�i' r FULL NAME (First, Middle, Last c..ryCwurbe-Lun cd -5 PRINT NAME AS YOU WANT IT TO APPEAR ON THE BALLOT' M aq, It)r.De,Le eon, l r�C-5 PERMANENT RESIDENCE ADDRESS (Do not include a P.O. Box or Rural Route. If you do not have a residence address, describe the address at which you receive personal mail and location of residence.) /6%O tUtvJd-rvte_ c A)`_)1>f PUBLIC MAILING ADDRESS (Campaign mailing address, if available.) CITY c2 0tk ? - 0 rl STATE 7( ZIP 7 7sLi 5 CITY STATE ZIP PUBLIC EMAIL ADDRESS (If available) %) j OA �(/t II _ ., A _I-efk I V{,N, `X pnU�jt �C`)('X_r_l �'( OCCUPATION LCGMC (Donot leave blank) li,01 `k"` ist DATE OF BIRTH Q' I Z- /` / O i VOTER REGISTRATION VUID NjUMBEER((Optiiojnal)2 G if 5/ l 0 75 0 TELEPHONE N�CT INFORMATION (Optional) Home: Work: Cell: ei 7�_ (i92 _DSlc( LENGTH OF CONTINUOUS RESIDENCE AS OF DATE APPLICATION SWORN IN STATE 7 year (s) IN TERRITORY OFFICE FROM SOUGHT IS j� ( year (s) WHICH THE ELECTED3 I, month(s) y 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)(``(,<,f here and now duly sworn, upon oath _rl says: "I, (name) Mt7.i1\ C-(U'L�.e_eooral e•S of 1)Z�LI—tavl MO(al I) , who being by me Texas, being a and laws and laws of by other incapacitated or -p GJ ( o Z.05 County, candidate for the oftice ofC .y kC.c..11e4eS CA., Oa` uttLtk,—PIaCe_ tt , swear that I will support to hold such or had my probate jurisdiction law, Chapter 573, true and col-ct." and defend the Constitution office under the constitution full rights of citizenship restored to be totally mentally Government Code. J of the United States and of the State t>f Texas. I am a citizen this state. I have not been finally convicted of a felony for official action. I have not been determined by a final judgment partially mentally incapacitated without the right to vote. I I further swear that the foregoing statements included in of the United States eligible which I have not been pardoned of a court exercising am aware of the nepotism my application are in all things X IGNATURE OF CANDIDATE Sworn to and subscribed before me at L-1 % 0 It,ry , this the \'3 iay o f Ls a„b\� . • sFnL 2o��wv?u , USA Mc�220KEN -8 Notary Public, State of Texas Id Commission FYpirea Signature of Officer AdministeringgllOath4 Title of Officer Ad istering TO BE COMPLETED BY CITY SECRETARY OR SECRETARY (See Section 1.007) Voter Registration Status Verified OF BOAR ,/ — / 3 —/ 9 y April 17, 2021 • — — - Date Received ign ture ecretary