HomeMy WebLinkAbout140721 - Candidate Application - Julie SchultzAW2-15, 7/2011
Prescribed by Secretary of State
Sections 141.031, 143.004, 143.006, Texas Election Code
All information is required to be provided unless indicated as optional.
APPLICATION FOR A PLACE ON THE CITY OF
TO: City Secretary
I request that my name be placed on the above-named official ballot as a candidate for the office indicated below,
INDICATE TERM
I X FULL LJ UNEXPIRED
GENERAL ELECTION BALLOT
OFFICE SOUGHT Include any place number or other distinguishing number, if any.
FULL NAM ?: (First, Middle, Last)
PERMANENT RESIDENCE ADDRESS (Street address and apartment
number. If none, describe location of residence. Do not include P.O.
Box or Rural Rt.)
PRINT NAME AS YOU WANT IT TO APPEAR ON THE BALLOT
MAILING ADDRESS (If different from residence address)
Cl1'Y STATE ZIP CITY
COO .,.-
n a `TeXOS ' `7 71 5
STATE ZIP
EMAIL ADDRESS (Optional) OCCUPATION (Do not leave blank) DATE OF BIRTH VOTER REGISTRATION VUID NUMBER
if applicable)
Gkske , £- 3 O oe.-ir
TELEPHONE NUMBER (Include area code) (Optional)
OFFICE:q,q-` LO-1—of
HOME: Or -7 01_ (0914— `1 a LicP
1OND(o059 0`7
Length of Continuous Residence as of Date Application Sworn
IN STATE IN CITY IN DISTRICT OR PRECINCT'
yr(s) 32 yr(s) yr(s)
p mos ,5 mos S mos
If nicknamepartyourappeargyou signing and swearing to the following statements: I further
swear that mynickname does not constitute a slogan nor does it indicate apolitical, economic, social, or religious view or affiliation. 1 have
usinga ) as of name to on ballot, are also
fonbeencommonlyknownbthisnicknameforatleastthreec a r dor to this elect
Before me, the undersigned authority, on this day personally appeared
here and now duly sworn, upon oath says: I (name)A,0,\1mm
County, Texas, being a candidate for the office °f Co
defend the Constitution and laws of the United States and e State of I a-xa„5, 1 all rriti rata of the 1 /lined State” eligible to hold such office under
the Constitution and laws of this state. I have not been finally convicted of a felony for which I have not been pardoned or had my full rights of
citizenship restored by other official action. 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.
who being by me
swear that I will support and
I further swear that the foregoing statements included in my application are in all things true and correct."
Sworn to and subscribed before me at this the day of _.. r G,:_ `
u n utu:are of OI`l e atcirnioaisturing oath2
TO BE COMPLETED BY CITY SECRETARY:
See Section 1.007)
u
Title of Officer administering oath
t:i-atc Received City Secretary