HomeMy WebLinkAbout180803 - Candidate Application - Elianor-Azarak Vessali 2-21
Prescribed by Secretary of State
Section 141.0pitEr EIVage1 Code
I ,1 °0 /2017
ALL INFORMATION IS REQUIRED TO BE PROVIDED UNLESS INDICATED OPTIONAL
APPLICATION FOR A PLACE ON THE College Station,TX GEN RAI L C I N EtALLOT
TO:City Secretary/Secretary of Board BYC3—, 8.m ! r
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.) INDI TE TERM
FULL
College Station City Council-Place 4
UNEXPIRED
FULL NAME(First,Middle,Last) PRINT NAME AS YOU WANT IT TO APPEAR ON.THE BALLOT1
Elianor-Azarak Vessali Elianor Vessali
PERMANENT RESIDENCE ADDRESS,(Do vaot include a P.O.i Box or,Rural PUBLIC MAILING ADDRESS(Campaign mailing address,if available.)
Route. If you do not have a residence address, describe the address
at which you receive personal mail and location of residence.)
110 Pershing Avenue
CITY STATE ZIP CITY STATE ZIP
College Station TX 77840
PUBLIC.EMAIL ADDRESS(If available) OCCUPATION(Do not leave blank) DATE OF BIRTH VOTER REGISTRATION VUID
NUMBER(Optional)2
elianorOvessalitx.com Realtor 111 270 3934
TELEPHONE CONTACT INFORMATION(Optional) LENGTH OF CONTINUOUS RESIDENCE AS OF DATE APPLICATION SWORN
Home: IN STATE IN TERRITORY FROM WHICH THE
OFFICE SOUGHT IS ELECTED3
Work:
13 year(s) 4 year(s.)
Cell: 713-304-6340 1 month(s) 7 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) Elianor-Azarak Vessali ,who being by me
here and now duly sworn,upon oath says:
"I, (name) Elianor-Azarak Vessali , of Brazos County, Texas, being a
candidate for the office of Colleee Station City Council-Place 4 .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. l have not been frrally convicted of a felony for which lr have not been pardoned,or had my fullr 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,awareof the nepotism law,'Chapter 573,NGovernmentCode.
I further swear that the foregoing statements included in my application ar all things true a d correct."
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SIGNAT JI�R KI :crE 'er
Sworn to and subscribed before meat a%Cci a►n. ,this the 3 day of ,ctiA , :-.�c i► • 12948552-2 I
Notary Putg Agnate of Texas
(����l 1 �,� My Commission Expires I
�Pts`til eid ser.re. I , ti — June '?JU21r .. ..�
Signature of Officer Administering Oath4 Title of Officer Admikistering Oath r
TO BE COMPLETED BY CITY SECRETARY OR SECRETARY OF BOARD:
(See Section 1.007) 2 3 - (Q c-M__ l Gt, L
ram( Date Received Signe e of'Se r tary
Voter Registration',Status'Verified u #q