HomeMy WebLinkAbout200818 -- Application for Place on Ballot -- Jacob Randolph2-26
Prescrib ed by Secretary of State
RECEIVED
AUG 18 2022 Section 141.031, Chapters 143 and 144, Te xas El ection Code
09/2021
APPLICATION FOR A PLACE ON THE BALLOT FOR A GENERAL ELECTION
FOR A CITY, SCHOOL DISTRICT OR OTHER POLITICAL SUBDIVISION
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AS
ALL INFORMATION IS REQUIRED TO BE PROVIDED UNLESS INDICATED AS OPTIONAL1 Failure to provide required information may result in rejection of application.
APPLICATION FOR A PLACE ON THE City of College Station 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 .) INDICATE TERM
Mayor [{]FULL D UNEXPIRED
FULL NAME {First, Middle, Last) PRINT NAME AS YOU WANT IT TO APPEAR ON THE BALLOT*
Jacob Lee Randolph Jacob Randolph
PERMANENT RESIDENCE ADDRESS (Do not include a P .0. Box or Rural Route. If PUBLIC MAILING ADDRESS {Optional) (Address for which you receive
you do not hav e a residence address, describe lo ca tion of residence.) campaign related correspondence, if ava ilabl e.)
CITY STATE ZIP CITY STATE ZIP
College Station TX 77840
PUBLIC EMAIL ADDRESS {Optional) (Address for OCCUPATION {Do not leave blank) DATE OF BIRTH VOTER REGISTRATION VUID
NUMBER 2 (Optional) wh ich you rece ive campaign related ema il s, if available.)
TELEPHONE CONTACT INFORMATION (Optional)
Home : Office :
FELONY CONVICTION STATUS (You MUST check one)
0 I have not been finally convicted of a felony .
D I have been finally convicted of a felony, but I have been
pardoned or otherwise released from the resulting
disabilities of that felony conviction and I have provided
proof of this fact with the submission of this application.3
Cell: (
LENGTH OF CONTINUOUS RESIDENCE AS OF DATE THIS APPLICATION WAS SWORN
IN THE STATE OF TEXAS IN TERRITORY /DISTRICT/PRECINCT FROM
WHICH THE OFFICE SOUGHT IS ELECTED
~year{s) _1_year{s)
_3_ 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 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 se ctions 52.031, 52 .032 and 52 .033 of the Te xas
Election Code reg;irding 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)_J_a_c_o_b_R_a_n_d_o_l~p_h ________ , who
being by me here and now duly sworn, upon oath says:
"I, {n ame of candidate) Jacob Randolph 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 j urisdiction 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 disclo se
any prior felony conviction, and if so convicted , must provide proof that I have been pardoned or otherwise rel ease d from the resulting disabilitie s of
any such final felony conviction . I am aware that knowingly providing false information on the application regard ing my possible felony conviction
status constitutes a Class B misdemeanor. I further swear that the foregoing statements included in my application are in all things true and correct ."
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Sworn to and subscribed before me this the L2_ ay of
(day)
SIGNA1fUREOFCANDloATE
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{m'bflth) (year) •. _ ~:::_::~~.c;;:~~~~~~---=-
(V o._,"f\._-+. f-:-f'IN.a-H-~-~_,_.,.,.,......__~·~¥1--
Signature of Offic uthorized to Administer Oath4 Printed Na
-f1 (£ B (] 0 k k lC-w l'f2'9--< Not<Wtre· ~~~~~~
Title of Offi cer Authorized to Admini ster Oati':
TO BE COMPLETED BY FILING OFFICER: THIS APPLICATION IS ACCOMPANIED BY THE REQUIRED FILING FEE (If Applicable) PAID BY:
D CASH D CHECK D MONEY ORDER D CASHIERS CHECK OR D PETITION IN LIEU OF A FILING F_g,.
This document and$ 0 filing fee or a nominating petition of ___ pages received. ~ Voter Registration Status Verified
Date Rece iv ed Date Accepted
CODE OF FAIR CAMPAIGN FORM CFCP
PRACTICES COVER SHEET
OFFICE USE ONLY
Pursuant to chapter 258 of the Election Code, every candidate and Date Received
political committee is encouraged to subscribe to the Code of Fair
Campaign Practices. The Code may be filed with the proper filing RECEIVED
authority upon submission of a campaign treasurer appointment AUG 18 2022 form. Candidates or political committees that already have a (2 :22~ current campaign treasurer appointment on file as of September 1,
1997, may subscribe to the code at any time. Date Hand-delivered or Postmarked
Date Processed
Subscription to the Code of Fair Campaign Practices is voluntary.
Da te Ima ged
1 ACCOUNT NUMBER 2 TYPE OF FILER /
(Ethics Commission Filers)
D CANDIDATE G2I POLITICAL COMMITTEE
If filing as a candidate , complete boxes 3 -6, If filing for a political committee, complete
then read and sign page 2. boxes 7 and 8, then read and sign page 2.
3 NAME OF CANDIDATE TITLE (Dr., Mr., Ms., etc .) FIR ST Ml
(PLEAS E TYPE OR PRINT) ~-------------------~~<:~-~------------------~---------------------
NICKNAME ~olotp h S UFFIX (SR., JR ., Ill , etc.) .
4 TELEPHONE NUMBER AREA CODE PHONE NUMBER EXTENSION
OF CANDIDATE (
(PLEASE TYPE OR PRINT)
5 ADDRESS OF CANDIDATE STREET I PO BOX; APT I S UITE#; CITY;
6 OFFICE SOUGHT M cv~V BY CANDIDATE
(PLE ASE TYPE OR PRINT)
-
7 NAME OF COMMITTEE
(PLEASE TYPE OR PRINT)
8 NAME OF CAMPAIGN TITLE (Dr., Mr., Ms., etc.) FIR ST Ml
TREASURER
(PLE ASE TYPE O R PRINT) ~---------------------------------------------------------------------------
NI C KN A ME LAST SUFFI X (SR., JR ., 111, etc.)
GO TO PAGE 2
Forms provided by Texas Ethics Commission www .ethics.state.tx.us Revised 1 /112021
CODE OF FAIR CAMPAIGN PRACTICES
RECEIVED
AUG 18 2022
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There are basic principles of decency, honesty, and fair play that every candidate and political committee in this state
has a moral obligation to observe and uphold, in order that, after vigorously contested but fairly conducted campaigns,
our citizens may exercise their constitutional rights to a free and untrammeled choice and the will of the people may be
fully and clearly expressed on the issues.
THEREFORE:
(1) I will conduct the campaign openly and publicly and limit attacks on my opponent to legitimate challenges to my
opponent's record and stated positions on issues.
(2) I will not use or permit the use of character defamation, whispering campaigns, libel , slander, or scurrilous attacks
on any candidate or the candidate's personal or family life.
(3) I will not use or permit any appeal to negative prejudice based on race, sex, religion , or national origin.
( 4) I will not use campaign material of any so1t that misrepresents , distorts, or otherwise falsifies the facts, nor will I
use malicious or unfounded accusations that aim at creating or exploiting doubts, without justification, as to the
personal integrity or patriotism of my opponent.
(5) I will not undertake or condone any dishonest or unethical practice that tends to corrupt or undermine our system
of free elections or that hampers or prevents the full and free expression of the will of the voters, including any
activity aimed at intimidating voters or discouraging them from voting.
(6) I will defend and uphold the right of every qualified voter to full and equal participation in the electoral process,
and will not engage in any activity aimed at intimidating voters or discouraging them from voting.
(7) l will immediately and publicly repudiate methods and tactics that may come from others that I have pledged not
to use or condone. l shall take firm action against any subordinate who violates any provision of this code or the
laws governing elections.
I, the undersigned , candidate for e lection to public office in the St<tte ofTex::is or c::impaign treasurer of a political
committee, hereby voluntarily endorse, subscribe to, and solemnly pledge myself to conduct the campaign in accordance
with the above principles and practices.
Forms provided by Texas Ethics Commission www.ethics.state.tx.us Revised 1 /1 /2021