Vicki Byrd - Application for a Place on the Ballot - 02-08-2021 2-21
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EIVED Prescribed by Secretary of State
Section 141.031,Chapters 143 and 144,Texas Election Code
1/2017
I R UIRED TO BE PROVIDED UNLESS INDICATED OPTIONAL
L CATION OR A PLACE ON THE CITY OF DENTON, TEXAS GENERAL ELECTION BALLOT
sI�/C.e tary of Board
Ge
at 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
EFULL
❑UNEXPIRED
FULL NAME(First,Middle,Last) PRINT NAME AS YOU WANT IT TO APPEAR ON THE BALLOT'
iLl�r
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 you receive personal mail and location of residence.) ' j i �- / / Au Lj{ y I r42- L�
CITY STATE ZIP CITY STATE ZIP
PUBLIC EMAIL ADDRESS(If available) OCCUPATION(Do not leave blank) DATE OF BIRTH VOTER REGISTRATION VUID
NUMBER(Optional)2
✓Lr/� � o l� -fir r�
TELEPHONE CONTACT INFORMATION(Optional) LENGTH OF CONTIN US 1111INCE AS OF DATE APPLICATION SWORN
Home: IN STATE IN TERRITORY FROM WHICH THE
OFFICE SOUGHT IS ELECTED3
Work:
year(s) �_t�-year(s)
Cell: �f f1 f/S f f 05 _ 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) V1 C_ -1 (�_T/Y� who being by me
here and now duly sworn,upon oath says:
"I, (name) `y Yl c i✓ of County, Texas, being a
candidate for the office of I - _.0- I swear that I will support and defend the Constitution and laws
of the United States and of the kt4e 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 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 are in all things true and correct."
X r It" - 6---N -) I k�)
SIGNATURE OF CANDICaTr
Sworn to and subscribed before me at this the day of
ZOLAINA R A 1KRrR
x Notary Pi
C�'�"cAf STATE Or
Signat re f Offi er Administering Oath° Title of Icer A istering Oa tl :' �;
TO B MPLETED BY CITY SECRETARY OR SECRETARY OF BOARD: - '
(See Section 1.007) 02
Date Re dived Signature of Secretary
Voter Registration Status Verified