HomeMy WebLinkAbout200811 -- Application for Place on Ballot -- Bob YancyAL
2-27
Prescribed by Secretary of State
Section 141.031, Chapters 143 and 144, Texas Election Code
09/2021
APPLICATION FOR A PLACE ON THE BALLOT FOR A SPECIAL ELECTION
FOR A CITY, SCHOOL DISTRICT OR OTHER POLITICAL SUBDIVISION
RECEIVED
AUG 11 2022 n
V:aGlr g
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.)
City Council, Place 5
INDICATE
TERM
n
"
1 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. Box or Rural Route.
If you do not have a residence address, describe location of residence.)
CITY
College Station
STATE
Texas
ZIP
77845
CITY
College Station
STATE
Texas
ZIP
77842
PUBLIC EMAIL ADDRESS (Address for which you
receive campaign related emalls, if available.)
VOTER REGISTRATION VUID
NUMBER2 (Optional)
TELEPHONE CONTACT INFORMATION (Optiona )
Home: Office: Cell: (
FELONY CONVICTION STATUS (You MUST check one)
LENGTH OF CONTINUOUS RESIDENCE AS OF DATE THIS APPLICATION WAS SWORN
✓ I have not been finally convicted of a felony.
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
IN THE STATE OF TEXAS
33 year(s)
IN TERRITORY/DISTRICT/PRECINCT FROM
WHICH THE OFFICE3S LIGHT IS ELECTED
year(s)
0 month(s)
0
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 taise information on the application regarding 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 cor t."
X�
SIGNATURE •,�■�
1i�� NDID;+
Sworn to and subscribed before me this the a 1411 day of (d.Si-- , 0e -/ by Rums }'1QS (ob f+ % i .
l
q (day) month) (year (name of candidta{e) /
AP/ ddk c &'W _ _
b . a 1-v L
Administer Oath
Si: f ture of Officer Authorized to Administer Oath^
h rit i/slS�'l�i
yvEntr. itoRREr Offic s uthorized to
Notary Public - State Of Texas
ID 9374'1°ru" ''1
Title of Officer -Authorized to Administer Oath '
: My Commission 6 ► s 08-21-2024
TO BE COMPLETED BY FILING OFFICER: THIS APPLIC T 0 CYO►' • v ' ' ' : - G FEE (If Applicable) PAID BY:
CASH CHECK ❑ IMONEY ORDER � CASHIERS CHECK OR NI PETITION IN LIEU OF A FILING FEE.
This document and $ filinglifee or a nominating petition of pages received. Voter Registration Status Verified
OS , l l 12022 op / i i 10022 (See Section 1.007 /77
Date Received Date Accepted Signatu
le of I g Officer or Designee