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HomeMy WebLinkAboutMitchell, Russell 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 INDICATED AS OPTIONAL1 Failure to provide required information may result in rejection of application. tAPPLICATION FOR A PLACE ON THE City Of North Richland Hills GENERAL ELECTION BALLOT II 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 City Council- Place 6 VFULL UNEXPIRED FULL NAME(First,Middle,Last) PRINT NAME AS YOU WANT IT TO APPEAR ON THE BALLOT* Russell D Mitchell Russ Mitchell PERMANENT RESIDENCE ADDRESS(Do not include a P.O.Box or Rural Route.If 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.) 3917 Diamond Loch West 3917 Diamond Loch West CITY STATE ZIP CITY STATE ZIP North Richland Hills Tx 76180 North Richland Hills Tx 76180 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.) NUMBER2(Optional) russmitchellagency@gma Insurance Agency Own 1044208933 TELEPHONE CONTACT INFORMATION(Optional) Home:(817) 313-3579 Office: (817) 865-2004 Cell: (817) 313-3579 FELONY CONVICTION STATUS(You MUST check one) LENGTH OF CONTINUOUS RESIDENCE AS OF DATE THIS APPLICATION WAS SWORN E 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 been WHICH THE OFFICE SOUGHT IS ELECTED it -, pardoned or otherwise released from the resulting 70 year(s) 4 year(s) 17 disabilities of that felony conviction and I have provided proof of this fact with the submission of this application.3 6 month(s) 6 �j 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) Russell D Mitchell ,who being by me here and now duly sworn,upon oath says: "I,(name of candidate) Russell D Mitchell ,of Tarrant County,Texas, being a candidate for the office of NRH City Council Place 6 , 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 pard.•-. or otherwise released from the resulting disabilities of any such final felony conviction.I am aware that knowingly providing false inform.•on o the application regarding my possible felony conviction status constitutes a Class B misdemeanor. I further swear that the foregoing sta • •- •�!.ed in ry application- -- in all things true and correct." X11 , ''# - t ATURE OF CANDIDATE Sworn to and subscribed before me this the l/7'4 day of ,, yur� , 2ce.y ,by -u5Se I 144.i./+ei1r.,/( • (day) (month)-' (year) (name of candidate) Les.+..+ _ L ;;vyt-{. ~ ,),;_ Signature of Officer Authorized to Administer Oath4 PrintF d..y f OfficeTRACIMMER8( iniste-Oath ,t , J /_ _ !° =* � :*= My Notary ID#125381736 i`� T�tJ ,aF ,-of-li4 st4 tatpl 12,2025 Title of Officer Aurized to Administer Oath "' TO BE COMPLETED BY FILING OFFICER: THIS APPLICATION IS ACCOMPANIED BY THE REQUIRED FILING FEE(If Applicable)PAID BY: E CASH CHECK El MONEY ORDER El CASHIERS CHECK ORiPETITION IN LIEU OF A FILING FEE This document and$ 15O— filing fee or a nominating petition of pages received. Voter Registration Status Verified 7 J //LI ZOTi ( l / 0 / ab (See Section 1.007) _ ...6— �-e-�1 Date Received Date Accepted Signature of Filing Officer or Designee