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HomeMy WebLinkAboutOujesky, Rita Wright Candidacy Application 2024 2-49 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 ALL INFORMATION IS REQUIRED TO BE PROVIDED UNLESS IN CATED AS OPTIONAL'Failure to provide required information may result in rejection of application. APPLICATION FOR A PLACE ON THEof (`-IVdA(Und ail(S 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.) INDICATE TERM Cr-r4 CV ivc a- PL01/44-s- 7-"' ND FUL nL I 1 UNEXPIRED FULL NAME(First,Middte,Lasit) PRINT NAME AS YOU WANT IT TO APPEAR ON THE BALLOT* 2frc VA lel E7 f tT CaLIZSIt. , P-cT t VJ G1ftT 0 u.--3's.5 K.1 PERMANENT RESIDENCE ADDRESS(Do not include a P.O.Box or Rural Route.I PUBLIC MAILING ADDRESS(Optional)(Address for which you receive you do not have a residence address,describe location of residence.) campaign related correspondence,if available.) ��(2 C-1r c.^4-0a5 CA- CITY STATE ZIP CITY STATE ZIP N. ea,tefrIci. if; ( s. 7. Mot&V PUBLIC EMAIL ADDRESS(Optional)(Address for OCCUPATION(Do not�leave blank) DATE OF BIRTH VOTER REGISTRATION VUID which you receive campaign related emails,if available.) tRhQ/1ci 4h I'44 i i Ser— NUMBER2(Optional) rl4-3.wrijk4-04:tcsK;" t I 0c<_pn�si � �/ / � � �G�4f� g TELEPHONE CONTACT INFORMATION(OW0914e, Home: 8i i(, s g 399 Office: Cell: $I"7 2..(0'3 7‘cT-- FELONY CONVICTION STATUS(You MUST check one) LENGTH OF CONTINUOUS RESIDENCE AS OF DATE THIS APPLICATION WAS SWORN A.I have not been finally convicted of a felony. IN THE STATE OF TEXAS IN TERRITORY/DISTRICT/PRECINCT FROM EI have been finally convicted of a felony,but I have been WHICH THE OFFICE SOUGHT IS ELECTED pardoned or otherwise released from the resulting 1 year(s) 32-year(s) disabilities of that felony conviction and I have provided proof of this fact with the submission of this a lication 3 O month(s) month(s) pp *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) -Ri-T-Ac QCGEfT DIA.,_]'-X,.S Alio being by me here and now duly sworn,upon oath says: _ "I,(name of candidate) Prrolgr Viet CaFPr 0 EACEsiel 1 ik42-*"4' T- County,Texas, being a candidate for the office of Co 4.11 CotislCi 1 t3 - 4 P(a.�.•a . wear 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 false information on the application regarding my possible felony conviction status constitutes a Class B misdemeanor. I further swear that the foregoing stat 'cluded in my applicat• n ar in all ' s true and correct." SIGNATURE OF CANDIDATE Sworn to and subscribed before me this the •. day of v t" A�1 , a-4 ,by tt( �v i b-Vv . (day) (month) (year) (name of candidate) t k.Xis- i`_,4-J D �� ���`„YP�4G ALICIA RICHARDSO ��'a�®S Signature of Officer Authorized to Administer Oath4 �`io�0� `��s Notary Pdli!' t taf :gg er Authorized to Administer Oath biaLVComm.h: -5 Expires 02-24-2027 'i or 0 icial Seal Title of Officer Autho ' d to Administer Oath ��''',� ��`'� Notary ID $ � TO BE CO LETED BY FILING OFFICER: THIS APPLICATION IS ACCOMPANIED BY THE REQUIRED FILING F (If Applicable)PAID BY: CASH CHECK 0 MONEY ORDER 0 CASHIERS CHECK OR 0 PETITION IN LIEU OF A FILING FEE. This document and$15b•00 filing fee or a nominating petition of tea-pages received. V r Registration Status Verified / 11 / a�a� ' / r 1 / (See Section 1.007) 1 (.u� Date Received Date Accepted Signature of Filing Officer or Designee