HomeMy WebLinkAbout240819 -- Application for Place on Ballot -- Melissa McIlhaney2-49
Prescribed by Secretary of State
Section 141.031, Chapters 143 and 144, Texas Election Code
09/2023
APPLICATION FOR A PLACE ON THE BALLOT FOR A GENERAL ELECTION
FOR A CITY, SCHOOL DISTRICT OR OTHER POLITICAL SUBDIVISION
RECEIVED
AUG 19 2024 !S
L4�3tM
r
ALL INFORMATION IS REQUIRED TO BE PROVIDED UNLESS INDICATED AS OPTIONAL' Failure to provide required information may result in rejection of application.
APPLICATION FOR A PLACE ON
TO: City Secretary/Secretary of Board
I request that my name be placed on the
THE N,Dve eiher s' j 202y- fitltrSIAVVENERAL
ELECTION BALLOT
(name of election)
above -named official ballot as a candidate for the office indicated below.
OFFICE SOUGHT (Include anyplace
nplacenumber or other distinguishing number, if any.)
l (�E L(< (?4N Ci 1 '1' lice, 4
INDICATE
TERM
vDI
FULL
UNEXPIRED
FULL NAM (First, Middle, Last)
Me lissQ Mav"1o, OcTI ha►I1
PRINT NAME AS YOU WANT
Melissa
IT TO APPEAR ON THE BALLOT*
t"1 LIa&v1eL
PERMANENT RESIDENCE ADDRESS (Do not include a P.O. Box or Rur Route. If
you do not have a residence address, describe location of residence-)
11
MAILING ADDRESS (Optional) (Address for whi
campaign related correspondence, if available.)
11
receive
CITY
eo\\ec Sty ,o--,
STATE
TX
ZIP
-Tv ?Li-0
CITY
btiete s h
STATE
7X
ZIP
�-1g40
PUBLIC EMAIVADDRESS (Optional) (Address for OCCUPATION (Do not leave blank)
which you receive campaign related emails, if available.) ;1
rneri 4A-(� frn4vtkt{echwre.t CJf(S)n1255 O(The y
ATE OF BIRTH
10 /
REGISTRATION VUID
NUMBER2 (Optional)
TELEPHONE NTACT INFORMATION (Optional)
Home: Office: Cell:
FELONY CONVICTION STATUS (You MUST check one)
LENGTH OF CONTINUOUS RESIDENCE AS OF DATE THIS APPLICATION WAS SWORN
X I have not been finally convicted of a felony.
❑ I have been finally convicted of a felony, but 1 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
year(s)
month(s)
IN TERRITORY/DISTRICT/PRECINCT
WHICH THE
OFFICE SOUGHT
year(s)
FROM
IS ELECTED
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)
being by me here and now duly sworn, upon oath says:
"I, (name of candidate) m 11 SSA- MCl/. of 12
,A
Me 1155A Ill `1% /1(l.h7, who
r(,. 205 County,
/
Texas,
Constitution and
and laws of
or partially
that I must disclose
disabilities of
felony conviction
true and correct."
being a candidate for the office of, �b�1P P 5`1'd1DIn Oi-I'� (1Vt-Mt % p/it1C j1, swear
that I will support and defend the
to hold such office under the constitution
to be totally mentally incapacitated
573, Government Code. I am aware
or otherwise released from the resulting
the application regarding my possible
ed in iy application are in all things
laws of the United States and of the Statetf Texas. I am a citizen
this state. I have not been determined by a final judgment of a court
mentally incapacitated without the right to vote. 1 am aware of the
any prior felony conviction, and if so convicted, must provide proof
any such final felony conviction. I am aware that knowingly providing
status constitutes a Class B misdemeanor. I further swear that the
of the United States eligible
exercising probate jurisdiction
nepotism law, Chapter
that I have been pardoned
false information on
foregoing statements incl
X
SIGNATURE OF CANDI TM
Sworn to and subscribed before me this the
i (j l Iut t
y q� day of t"� LACt UA3t , acaoi, , by / " `Q, li SSo. !& j uu.n.k1(day)
`('month)
(year) (name of candidate)
1
N
S re of Officer A ize inister Oath°
<
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Pri
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(
Officer*Oft6RANCo Admi
• �; •• STATE OF TEXAS
2-2
� tr%,c: 4'. ; r ; ahyn . JuICV n 06. 2025
ter
Oath
Title of Officer Authorized to Administer Oath (
_ _ _
TO BE COMPLETED BY FILING OFFICER: THIS
❑ CASH ❑ CHECK ❑ MONEY ORDER
This document and $ 0 filing fee
APPLICATION
❑ CASHIERS CHECK
or a nominating
/ �0.[4
IS
OR
petition
(See
ACCOMPANIED BY THE
❑ PETITION IN LIEU
of pages
REQUIRED FILING FEE (If Applicable) PAID BY:
OF A FILING FEE.
received. Voter Registration Status Verified
ThJ2 —
d 8 / / q / 02424 op' / /9
Section
1.007)
Date Received Date Accepted
Sign ture of I ng Officer or Designee
2-49
Prescribed by Secretary of State
Section 141.031, Chapters 143 and 144, Texas Election Code
09/2023
INSTRUCTIONS
An application for a place on the general election for a city, school district or other political subdivision, may not be filed earlier
than 30 days before the deadline prescribed by this code for filing the application. An application filed before that day is void.
All fields of the application must be completed unless specifically marked optional.
For an election to be held on a uniform election date, the day of the filing deadline is the 78th day before Election Day.
If you have questions about the application, please contact the Secretary of State's Elections Division at 800-252-8683.
NEPOTISM LAW
The candidate must sign this statement indicating his awareness of the nepotism law. When a candidate signs the application,
it is an acknowledgment that the candidate is aware of the nepotism law. The nepotism prohibitions of chapter 573,
Government Code, are summarized below:
No officer may appoint, or vote for or confirm the appointment or employment of any person related within the second degree
by affinity (marriage) or the third degree by consanguinity (blood) to the officer, or to any other member of the governing body
or court on which the officer serves when the compensation of that person is to be paid out of public funds or fees of office.
However, nothing in the law prevents the appointment, voting for, or confirmation of anyone who has been continuously
employed in the office or employment for the following period prior to the election or appointment of the officer or member
related to the employee in the prohibited degree: six months, if the officer or member is elected at an election other than the
general election for state and county officers.
No candidate may take action to influence an employee of the office to which the candidate is seeking election or an employee
or officer of the governmental body to which the candidate is seeking election regarding the appointment or employment of
a person related to the candidate in a prohibited degree as noted above. This prohibition does not apply to a candidate's
actions with respect to a bona fide class or category of employees or prospective employees.
FOOTNOTES
'An application for a place on the ballot, including any accompanying petition, is public information immediately on its filing.
(Section 141.035, Texas Election Code)
'Inclusion of a candidate's VUID is optional. However, many candidates are required to be registered voters in the territory
from which the office is elected at the time of the filing deadline. Please visit the Elections Division of the Secretary of State's
website for additional information. http://www.sos.state.tx.us/elections/laws/hb484-faq.shtml
3Proof of release from the resulting disabilities of a felony conviction would include proof of judicial clemency under Texas
Code of Criminal Procedure 42A.701, proof of executive pardon under Texas Code of Criminal Procedure 48.01, or proof of a
restoration of rights under Texas Code of Criminal Procedure 48.05. (Texas Attorney General Opinion KP-0251)
One of the following documents must be submitted with this application.
Judicial Clemency under Texas Code of Criminal Procedure 42A.701
Executive Pardon under Texas Code of Criminal Procedure 48.01
Restoration of Rights under Texas Code of Criminal Procedure 48.05
4A11 oaths, affidavits, or affirmations made within this State may be administered and a certificate of the fact given by a judge,
clerk, or commissioner of any court of record, a notary public, a justice of the peace, city secretary (for a city office), and the
Secretary of State of Texas. See Chapter 602 of the Texas Government Code for the complete list of persons authorized to
administer oaths.