HomeMy WebLinkAbout260720 -- Candidate Application -- Mark Smith2-49 RECEIVED
Prescribed by Secretary of State �'f7 /� c Section 141.031, Chapters 143 and 144, Texas Election Code; Section 11.055, Texas Education Code JUL �021i
07/2025 Ai
APPLICATION FOR A PLACE ON THE BALLOT FOR A GENERAL ELECTION I.- L2 p'''�
FOR A CITY, SCHOOL DISTRICT OR OTHER POLITICAL SUBDIVISION
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 THE C r -w "I� (Z' lfx4 a5",2 , GENERAL ELECTION BALLOT
TO: City Secretary/Secretary of Board 1 (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
CiT�7 112Le ?C, ! �IGG� OFULL F1 UNEXPIRED
FULL NAME -(First, Middle, Last) PRINT NAME AS YOU WANT IT TO APPEAR ON THE BALLOT'`
PERMANENT RESIDENCE ADDRESS (Do not include a P.O. Box or Rural Route. If PUBLIC MAILING ADDRESS (Optional) (Address for which you receive
you
�4jt4Lr�
CITY STATE ZIP CITY
ill (e�.e 5�-rt h �� 7-794 5
PUBLIC EM IL ADDRESS (Optional) (Address for I OCCUPATION (Do not leave blank)
which you receive campaign related emails, if available.) red
TELEPHONE
�CONTACT INFORMATION (Optional)
c(?� `22 't—r
Home: 0,!;. Office:
FELONY CONVICTION STATUS (You MUST check one)
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
DATE OF BIRTH
STATE I ZIP
VOTER REGISTRATION VUID
NUMBER2 (Optional)
Cell:
LENGTH OF CONTINUOUS RESIDENCE AS OF DATE THIS APPLICATION WAS SWORN
IN THE STATE OF TEXAS IN TERRITORY/DISTRICT/PRECINCT FROM
WHICH THE OFFICE SOUGHT IS ELECTED
year(s) year(s)
Qmonth(s) month(s)
This Box Must ONLY be Completed by Candidates for School District Board of Trustees
Check the Box Below:
1 am aware that I am not eligible to serve as a trustee of an independent school district if I am required to register as a sex offender under Chapter 62, Code
of Criminal Procedure.
*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) OL V (i.1 `_7VVVi i7h who being by me here
and now duly sworn, upon oath says:
1, (name of candidate) y 16k✓� 4 t INNof R va -4-0 IsCounty, Texas, Being a candidate for
the office of ce r t. f,� . ( j7l u CG. I , swear that I will support and defend the Constitution and laws of the United States and of the
State of Texas. 1 am a citizen 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 tha nowingly providing false information on
the application regarding my possible felony conviction status constitutes a Class B misdemea or I f her swear th he foregoing statements included in my
application are in all things true and correct. v
A IGNA R DIDATE r
Sworn to and subscribed before me this the W� day of � tit) � � , by
(day) (month) (year) (name of candidate)
Sign'dt`6recof Officer Authorized to/Administer Oath t _ Printed Name of Officer Authorized to Administer Oath
5�-a 1 t�SSI✓IT'V� �U►l�fG `�.�`�Y'F� .,,� ANN MARIE WILLIAMS
Title of Officer Authorized to Administer Oath '0 Notary Public, State of Texas
TO BE COMPLETED BY FILING OFFICER: THIS APPLICATION IS ACCOMPANIED BY THE RE -loll N"r('S�Fi�'a�e�rD E Y:
CASH ❑ CHECK1:1 MONEY ORDER El CASHIERS CHECK OR ❑ PETITION IN LIEU O*\ �1til ei`�'FF Notary 1 344 3
This document and $ filing fee or a nominating petition of pages received. IV Voter Registration Status Verged
l�7 / ZQ / 2_v2j__ P% / 20 / 2004 (See Section 1.007) _�
Date Received Date Accepted Signatu e o %cling Officer or Designee