200811 -- Application for Place on Ballot -- Bob Yancy2-27
Prescribed by Secretary of State
Section 141.031, Chapters 143 and 144, Texas Election Code
09/2021
RECEIVED
APPLICATION FOR A PLACE ON THE BALLOT FOR A SPECIAL ELECTION
FOR A CITY, SCHOOL DISTRICT OR OTHER POLITICAL SUBDIVISION
AUG 11 ZOZZ n
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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 College Station City Council, Place 5 SPECIAL 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
City Council, Place 5 D FULL [VJ UNEXPIRED
FULL NAME (First, Middle, Last)
James Robert (Bob) Yancy
PRINT NAME AS YOU WANT IT TO APPEAR ON THE BALLOT*
Bob Yancy
PERMANENT RESIDENCE ADDRESS (Do not include a P.O. BoK or Rural Route.
If you do not have a residence address, describe location of residence .)
PUBLIC MAILING ADDRESS (Address for which you receive campaign related
correspondence, if available.)
CITY
College Station
DATE OF BIRTH
STATE
Texas
ZIP
77842
VOTER REGISTRATION VUID
NUMBER2 (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
0 I have not been finally convicted of a felony.
0 I have been finally convicted of a felony, but I have been
pardoned or otherwise released from the resulting
IN THE STATE OFTEXAS
~year(s)
disabilities of that felony conviction and I have provided O
proof of this fact with the submission of this application.3 __ month(s)
IN TERRITORY/DISTRICT/PRECINCT FROM
WHICH THE OFFICE SOUGHT IS ELECTED
~year(s)
_o_ 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) Bob Yancy who being by me
here and now duly sworn, upon oath says:
"I, (name of candidate) Bob Yancy of Brazos county, Texas,
being a candidate for the office of College Station City Council, Place 5 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 information on the application regarding my possible felony conviction status constitutes ci Class B misdemeanor. I further
swear that the foregoing statements included in my application are in all th~s true and c ~
~ ..... ~.;;;..l;~~~;;;...~_,fZ.~~~~~~~~~~~~-
Sworn to and subscribed before me this the ~ day of~-_,,_~---~-----~
(day)
Si
TO BE COMPLETED BY FILING OFFICER: THIS APPLIC f 0 G FEE (If Applicable) PAID BY:
D CASH D CHECK D ~ONEY ORDER D CASHIERS CHECK OR PETITION IN LIEU OF A FILING FEE ./
This document and$ () filing fee or a nominating petition of ___ pages received. rn"' Voter Registrjltion Status Verified
Date Received Date Accepted