Johnson Application for Place on the Ballot - 02/05/2020 2-22
Prescribed by Secretary of State
Section 141.031,Chapters 143 and 144,Texas Election Code
2017
ALL INFORMATION IS REQUIRED TO BE PROVIDED UNLESS INDICATED OPTIONAL
APPLICATION FOR A PLACE ON THE City of Denton, Texas SPECIAL EL:C + ' 4,
TO:City Secretary/Secretary of Board F85 200
I request that my name be placed on the above-named official ballot as a candidate for the office indicated below. ,. �p�
OFFICE SOUGHT(Include any place number or other distinguishing number,if any.) ' . ;=� YJ
FULL NAME(First, Middle,Last) PRINT NAME AS YOU WANT IT TO APPEAR ON THE BALLOT
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PERMANENT RESIDENCE ADDRESS(Do not include a P.O.Box or Rural PUBLIC MAILING ADDRESS(Campaign mailing address,if available.)
Route. If you do not have a residence address, describe the address
at which
1you
lreceive
Ypperson`al mail and location of residence.)� 1N Ig. 0 I kArn, ��' K r
I i"T 1 '((T 11 \A.\-",YY\ ( ) 0 KI K / ( T
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CITY STATE ZIP CITY STATE ZIP
-1.> YO\- CI' �'�s -TY\ 7 6 °CI L" IN\ ' -' 0 rte ' IJ40
PUBLIC EMAIL ADDRESS(If available) OCCUPATION(Do not leave blank) DATE OF BIRTH VOTER REGISTRATION VUID
l ) NUMBER(Optional)2
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TELEPHONE CONTACT INFORMATION(Optional) LENGTH OF CONTINUOUS RESIDENCE AS OF DATE APPLICATION SWORN
Home: IN STATE IN TERRITORY FROM WHICH THE
OFFICE SOUGHT IS ELECTED3
Work: iu year(s) J. year(s)
i
Cell: G L1 i� _ '3.J� -� I I 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 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.
Before me,the undersigned authority,on this day personally appeared(name) y('d J
i A I) k NS0 ,who being by me
here and now dui sworn,upon oath says:
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"1, (name) 1 r d ► ‘' JD Yln�, [�i'V , of P kki+0 County, Texas, being a
candidate for the office of — r ' - , . . 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 Un"ed States eligible to hold such office under the constitution and laws of
this state. I have not been finally convicted of a felony for which I have not been pardoned or had my full rights of citizenship restored by other
official action. 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 further swear that the foregoing statements included in my application ar in all things true a(nd correc "
SIGNATOR. •F C D ... , ZOLAINA R PARKER
Sworn to and subscribed before me at 01._ this the rJ�' day of T[�,ru�.� 0t-�`'_1 NOtBry/PUbIIC
Q "—�— A. i� STT, OF TEXAS
Q / /� �:�oF,+' D125830537
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Signat - of Officer i s - ' : r :th° Z Title Off DT-Kb
ring Oath J
TO BE • PLETED #1 SE 1 ;CR RY OF B•ARD:
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(See Se ion 1.007) r /A� it - �L (�C{�[�i
�/ r e Received i re of Secretary
Voter Registration Sta �
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