HomeMy WebLinkAbout200813 -- Candidate Application -- Craig ReganRECEIVED
DRUG 3 1020
BY: 2+cfp
ALL INFORMATION IS REQUIRED TO BE PROVIDED UNLESS IN MCA 614,146
2-21
Prescribed by Secretary of State
Section 141.031, Chapters 143 and 144, Texas Election Code
1/2017
APPLICATION FOR A PLACE ON
TO: City Secretary/Secretary of Board
I request that my name be placed on the above
THE ; o2c,, GENERAL
ELECTION BALLOT
below.
-named official ballot as a candidate for the office indicated
OFFICE SOUGHT (Include any place number or other distinguishingsnumber, if any.)
6// 54 Ita-- 0/1/tom. ,,,,l P/ace. Sg
INDICATE
TERM
F
FULLL'"NAME (First, Middle, Last)
/CAt, /" licliri C,( . Z�- "`—
PRINT NAME AS YOU WANT IT TO APPEAR ON THE BALLOT1
Cfc; lC�[" �i:.-
PERMANE RESIDENCE ADDRE (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(�e)ljmailandlocation of residence.)
2 717 , ) (c wide ji, /1 L)
ty/l-, S 4,,"7T-< .--1- -1Eys--
PUBLIC MAILII ADDRE S (Campaign mailing address, if available.)
CITY
Cc,// .� lc -
STATE
ZIP
-7--15'5
CITY
C.% �'��%,—
STATE
ZIP
7 g-';,r
PUBLIC EMAIL ADDRESS (If available)
f C. n'1C�G C=OU/1C i, l@ M°� /'''''
OCCUPATION (Do ne9t leave blank)
,sc�f c•-� /or-�t ,C
V6//lest' . eI® "
iDATE OF BIRTH COS
c�' Ct
C,G / G 3 /
VOTER REGISTRATION VUID
NUMBER (Optional) z
TELEPHONE CONTACT INFORMATION (Optional)
Home:
Work:
Cell: 1'1 al - 1,66 f
LENGTH OF CONTINUOUS RESIDENCE AS OF DATE APPLICATION SWORN
IN STATE
1 0 year
(s)
IN TERRITORY
OFFICE
FROM
SOUGHT IS
year (s)
WHICH THE
ELECTED3
,Sj 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)
here and now duly sworn, upon oath says:
"I, (name) CA-cn;C5 3.G "n , of
r
l.,CCA.i. Gt3Q,01Ah , who
being by me
Texas, being a
and laws
and laws of
by other
incapacitated or
�,J `J
?CcCZ.OS County,
candidate for the office of kce.c.42, .S' , swear
that I will support
to hold such
or had my
probate jurisdiction
law, Chapter 573,
tr an
and defend
office under
full rights
to be totally
Government
¢t."
the Constitution
the constitution
of citizenship restored
mentally
Code.
of the United States and of the State of Texas. I am a citizen of the United
this state. I have not been finally convicted of a felony for which I have
official action. I have not been determined by a final judgment of a court
partially mentally incapacitated without the right to vote. I am aware of
I further swear that the foregoing statements included in my application
X
States eligible
not been pardoned
exercising
the nepotism
are in all thi
GN RE OF CANDID lAN Whn rci
Sworn to and subscr efe
f►. , this the 1'3 ay o G * *
Nptary Puolic, State
Commission E
June 20. 202
SEALMY
Signature of Officer Administering Oath4 —title of Offidgr Adminifteri Oath
TO BE COMPLETED BY CITY SECRETARY OR SECRETARY
(See Section 1.007)
Voter Registration Status Verified
OF BOARD:
"' J3 -020
Date Received Sign re ec
of Texas
xpires