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2-22 <br /> Prescribed by Secretary of State <br /> Section 141.031,Chapters 143 and 144,Texas Election Code <br /> 1/2017 <br /> ALL INFORMATION IS REQUIRED TO BE PROVIDED UNLESS INDICATED OPTIONAL <br /> APPLICATION FOR A PLACE ON THE City of Denton,Texas SPECIAL ELECTION BALLOT <br /> TO:City Secretary/Secretary of Board <br /> I request that my name be placed on the above-named official ballot as a candidate for the office indicated below. <br /> OFFICE SOUGHT(Include any place number or other distinguishing number,if any.) <br /> City Council District 2 <br /> FULL NAME(First,Middle,Last) I PRINT NAME AS YOU WANT IT TO APPEAR ON THE BALLOT' <br /> James Clayton Freeman Clayton "Starfire" Freeman <br /> PERMANENT RESIDENCE ADDRESS(Do not include a P.O.Box or Rural PUBLIC MAILING ADDRESS(Campaign mailing address,if available.) <br /> Route. If you do not have a residence address, describe the address <br /> at which you receive personal mail and location of residence.) <br /> 723 Bolivar St 723 Bolivar St <br /> CITY STATE ZIP CITY STATE ZIP <br /> Denton Texas 76201 Denton Texas 76201 <br /> PUBLIC EMAIL ADDRESS(If available) OCCUPATION(Do not leave blank) DATE OF BIRTH VOTER REGISTRATION VUID <br /> NUMBER(Optional)2 <br /> Artist 02 / 03 /1983 <br /> TELEPHONE CONTACT INFORMATION(Optional) LENGTH OF CONTINUOUS RESIDENCE AS OF DATE APPLICATION SWORN <br /> Home: IN STATE IN TERRITORY FROM WHICH THE <br /> OFFICE SOUGHT IS ELECTED3 <br /> Work: <br /> 37 year(s) 12 year(s) <br /> Cell: <br /> 0 month(s) 10 month(s) <br /> 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 <br /> that my nickname does not constitute a slogan nor does it indicate a political, economic, social, or religious view or affiliation. I have been <br /> commonly known by this nickname for at least three years prior to this election. <br /> Before me,the undersigned authority,on this day personally appeared(name) James Clayton Freeman ,who being by me <br /> here and now duly sworn,upon oath says: <br /> "I, (name) James Clayton Freeman of Denton County, Texas, being a <br /> candidate for the office of City Council District 2 ,swear that I will support and defend the Constitution and laws <br /> 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 <br /> 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 <br /> official action. I have not been determined by a final judgment of a court exercising probate jurisdiction to be totally mentally incapacitated or <br /> partially mentally incapacitated without the right to vote.I am aware of the nepotism law,Chapter 573,Government Code. <br /> I further swear that the foregoing statements included in my application are i . things true .•. .rrect." <br /> x <br /> • <br /> `QH / SIGNATURE OF CANDIDATE <br /> J� <br /> Sworn to and subscribed •. .� .'�k this the D da of gib <br /> O ( ZOLAINkEVARKER <br /> 77 <br /> o�• I .�� Nota bllc <br /> o I ( ' %� '* STATE OF TEXAS <br /> __ I . r ID#125830537 <br /> Signat re of I. icer Ad g iv ha Title . Offi e Adminis - ing Oath l _ ` My Comm.Exp.Sept.7,2022 <br /> TOB. COMP 'TED BY CI ':Y O• .• x' •YOFBO,RD: <br /> (See S- 1.007) * .1�� ,ISA • 30 `If [''` DetA - <br /> . Date Received Si: rryy •f Secretary <br /> Voter Registration Status Verified M <br />