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HomeMy WebLinkAbout220725 -- Candidate Application -- John Nichols2-26 RECEIVED Prescribed by Secretary of State Section 141.031, Chapters 143 and 144, Texas Election Code JULN 25 [ULL 2g 09/2021 APPLICATION FOR A PLACE ON THE BALLOT FOR A GENERAL ELECTION FOR A CITY, SCHOOL DISTRICT OR OTHER POLITICAL SUBDIVISION ALL INFORMATION IS REQUIRED TO BE PROVIDED UNLESS INDICATED AS OPTIONAL' Failure to provide required information may result in rejection of application. APPLICATION FOR A PLACE ON THE College Station, Texas GENERAL ELECTION BALLOT TO: City Secretary/Secretary of Board (name of election) 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.) I INDICATE TERM MAYOR a FULL ❑ UNEXPIRED FULL NAME (First, Middle, Last) PRINT NAME AS YOU WANT IT TO APPEAR ON THE BALLOT* John P Nichols John Nichols PERMANENT RESIDENCE ADDRESS (Do not include a P.O. Box or Rural Route. If PUBLIC MAILING ADDRESS (Optional) (Address for which you receive you do not have a residence address, describe location of residence.) campaign related correspondence, if available.) CITY STATE ZIP CITY STATE ZIP College Station I TX 77840 PUBLIC EMAIL ADDRESS (Optional) (Address for OCCUPATION (Do not leave blank) DATE OF BIRTH VOTER REGISTRATION VUID which you receive campaign related emails, if available.) NUMBERZ (Optional) TELEPHONE CONTACT INFORMATION (Optional) Home: Office: Cell: FELONY CONVICTION STATUS (You MUST check one) LENGTH OF CONTINUOUS RESIDENCE AS OF DATE THIS APPLICATION WAS SWORN Q✓ I have not been finally convicted of a felony. IN THE STATE OF TEXAS IN TERRITORY/DISTRICT/PRECINCT FROM ❑ I have been finally convicted of a felony, but I have been WHICH THE OFFICE SOUGHT IS ELECTED pardoned or otherwise released from the resulting 53 year(s) 46 year(s) disabilities of that felony conviction and I have provided proof of this fact with the submission of this application.3 10 month(s) 4 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 or contain a title, 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. Please review sections 52.031, 52.032 and 52.033 of the Texas Election Code regarding the rules for how names may be listed on the official ballot. Before me, the undersigned authority, on this day personally appeared (name of candidate) John P. Nichols who being by me here and now duly sworn, upon oath says: "I, (name of candidate) John P. Nichols of 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 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 am aware that I must disclose any prior felony conviction, and if so convicted, must provide proof that I have been pardoned or otherwise released from the resulting disabilities of any such final felony conviction. I am aware that knowingly providing false inform n the application regarding my possible felony conviction status constitutes a Class B misdemeanor. I further swear that the foregoing ements i luded in my application are ip all Xhings true and correct." � `` SIG URRE OF CANDIDATE Sworn to and subscribed before me this theqday of �l).�&� , by VNV\ 't'. N-��► \b \� (day) (mon (year) (name of candidate) Signature of Officer Authorized to Administer Oath4 of Notary Public - State of Texas DO'13297020.3 Title of Officer t Rprized to Administer Oath �FaF IAv Comm. Emim 3-11.2025 TO BE COMPLETED BY FILING OFFICER: THIS APPLICATION IS ACCOMPANIED 01 BY: ❑ CASH ❑ CHECK ❑ MONEY ORDER ❑ CASHIERS CHECK OR ❑ PETITION IN LIEU OF A FILING FEE. This document ands$ 19 filing fee or a nominating petition of pages received. ❑ Vot r Registration Status Verified L 7 Z5 __ _/-J Date Rpcp..ived Date Accepted Signor Designee