HomeMy WebLinkAboutRoberts, Danny Candidacy Application 2025 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.
APPLICATION FOR A PLACE ON THE W R4 1 y CoLil 'I 1f, 1 GENERAL ELECTION BALLOT 1
TO:City Secretary/Secretary of Board (nam 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 placenumber or other distinguis ing number,if any.) IND ATE TERM
W0r 41\ Cir\tOtVI t\,Ili l__ii CPU/nc�l -�ICILe3 FULL UNEXPIRED
FULL NAME(First,Middle,Last) I PRINT NAME AS YOU WANT IT TO APPEAR ON THE BALLOT*
‘ Ctl\f\il pook R176,pi\-- s Olii11.\ fok r hi c
PERMANE 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,�djescribe location of residence.) campai n related c rrespondence,if available.)
2R 0 6Y,n A �, STATE ZIP CITY 0- � 'Bay C2- STATE ZIP
CITY
J 0 A%()\\AVNA \\:A.S ‘K 7 Cp t R, NAk R,cAycl r 115 . TYC, 7 61Na.
PUBLIC EMAIL ADDRESS(Optional)(Address for OCCUPATION(Do not leave blank) DATE OF BIRTH VOTER REGISTRATION VUID
• --- -,--..,.le if available.) NUMBER2(Optional)
rO'ileriSAriNchviN.:,lasmeftoc) , V'`1tf -le9^
• TELEPHOr�—_NNE'�CONTACTT inn-u i.u,,I`('.`1��''rtional)Home: S? I lwnC�t v/�+� Iv�I1I�� �/1V�.�11` �YUc1
FELONY CONVICTION
I�STATUS MUST check one)Office:v� I 'LENGTH OF CONTINUOUS RESIDENCE AS OF(DATE THISLI��N WAS��N
(You
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
pardoned or otherwise released from the resulting ��year(s) year(s)
disabilities of that felony conviction and I have provided
proof of this fact with the submission of this application.3 tj month(s) 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) who
being by me here and now A.,Jly sworn,upo oatth�says:% .,��
"I,(name of candidate) UININ, A�\'@-P--S ,of + I— County,Texas,
being a candidate for the office of ev9T NAVINN\‘V.,%,C_'As) �jiI0 C, au 1 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 pardoned or otherwise released from the resultin 'sabilities of
any such final felony conviction. I am aware that knowingly providing false inf. 1 ation on the pli do egarding my ' e felony conviction
status constitutes a Class B misdemeanor. I further swear that the foregoing s l i
is includes in my a li atio in all things true and correct."
iiil
X cw,l,,
SIGNATURE OF CAIDATE I-
Sworn .. and subscribed before me this the 80 day of 1 axt a_ ,�9.5 ,by Tan n Q be -4S .
(day) (month3 (yeaarr),�n �M me of candidate)
'', ;/' ' / II 4t11 c1 i,k.r F,V1�c 1a
:lgna,ure of� Au horized to Administer Oath4 �1 " GE,.. Printed Name of Officer Authorized to Administer Oath
,s Notarial or Official Seal
Title o Officer Auth ized to Administer Oath . `,,. ?.
TO BE COMPLETED BY FILING OFFICER: THIS APPLICA j'. •IS A 7`pcANI s+ HE REQUIRED FILING FEE(If Applicable)PAID BY:
CASH El CHECK El MONEY ORDER El CASHIERS Si ` P V . IEU OF A FILING FEE.
This document and$MO.00filing fee or a nominatil , -4' .; 4!:. p,,Y P�es received. Voter Registration Status Verified
or 'oa ,
a,r / ao a�' ` / ?- r / �a5 st o,��d�7) P,clit/txxaczitiv.
Date Received Date Accepted ' nature of Filing Officer or Designee