HomeMy WebLinkAbout260727 -- Application for Place on Ballot -- Bob Yancy�' County, Texas, Being a candidate for
the office of MAY o1� C9 Li C i 79Jsi swear that 1 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 ri_ht to vote. I am aware of
the nepotism law, Chapter 573, Government Code. I am aware that I must disclose any prior felony conviction . nd if so convicted,,'t provide proof that I have
been pardoned or otherwise released from the resulting disabilities of any such final felony conviction. I • re tha owing• oviding false information on
the application regarding my possible felony conviction status constitutes a Class B misdemeanor. I • " he weary i or.: sing statements included in my
application are in all things true and correct.
2-49
Prescribed by Secretary of State
Section 141.031, Chapters 143 and 144, Texas Election Code; Section 11.055, Texas Education Code
07/2025
RECEIVED
JUL 2 7 2026
APPLICATION FOR A PLACE ON THE BALLOT FOR A GENERAL ELECTION IV. 38
FOR A CITY, SCHOOL DISTRICT OR OTHER POLITICAL SUBDIVISION
ALL INFORMATION'S 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 r maG ,Tkrrc tI GENERAL 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.) IN ATE TERM
FULL UNEXPIRED
FULL NAME (First, Middle, Last) PRINT NAME AS YOU WANT IT TO APPEAR ON THE BALLOT*
�� y4;Cy
PERMANENT RESIDENCE ADDRESS (Do not include a P.O. Box or Rural Route. If
of residence.)
CITY STATE ZIP
CbA- C- C-51V-)c�l')
\X
(Av
PUBLIC MAILING ADDRESS (Optional) (Address for which you receive
campaign related correspondence, if available.)
CITY STATE
9A 7�S C�LtC6 Ti �rio4 Tans
PUBLIC EMAIL ADDRESS (Optional) (Address for OCCUPATION (Do not leave blank)
which you receive campaign related emails, .ifavail(a�blle.)) (Z p
TELEPHONE CONTACT INFORMATION (Optional)
Home: Office:
ZIP
DATE OF BIRTH VOTER REGISTRATION VUID
NUMBER2 (Optional)
FEAONY CONVICTION STATUS (You MUST check one) LENGTH OF CONTINUOUS RESIDENCE AS OF DATE THIS APPLICATION WAS SWORN
M I have not been finally convicted of a felony. IN THE STATE OF TEXAS IN TERRITORY/DISTRICT/PRECINCT FROM
• I have been finally convicted of a felony, but I have been36 WHICH THE OFFICE SOUGHT IS ELECTED
pardoned or otherwise released from the resulting years) '/�('.n' year(s)
disabilities of that felony conviction and I have provided (�
proof of this fact with the submission of this application.3 V month(s) - month(s)
This Box Must ONLY be Completed by Candidates for School District Board of Trustees
Check the Box Below:
❑ I 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) (313i YA (4 , who being by me here
and now duly sworn, upon oath says: rzo
"I, (name of candidate) . of
Sworn to and subscribed before me this th
(day)
X
s UREOFCA
day of Ul l I by
(month) G (year)
(na a of car idate)
n 11AlC1lgrl4ENTON
er AuthliiereYcPASIklester Oa h
STATE OF TEXAS
iciNMY.GOMM. EXP. 08/20/29
Title of Officer Au orized to
dminister Oath NOTARY ID 129465522
TO BE COMPLETED BY FILING OFFICER: THIS APPLICATION IS ACCOMPANIED BY THE REQUIRED FILING FEE (If Applicable) PAID BY:
❑ CASH ❑ CHECK MONEY ORDER ❑ CASHIERS CHECK OR 0 PETITION IN LIEU OF A FILING FEE.
This document and $ filing fee or a nominating petition of pages received. Voter Registration Status Verified
Signature bf Officer Authorized to
` � G ' 5eucl (AN,
minister Oath'
(/ / / 2.7 /2D2L 07 / 27 / 20 6o (See Section 1.007)
Date Received Date Accepted
Signat e o ing Officer br Designee