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Brian Beck - Application for a Place on the Ballot - 02-10-2021 2-21 Prescribed by Secretary of State Section 141.031,Chapters 143 and 144,Texas Electron Code 1/2017 ALL INFORMATION IS REQUIRED TO BE PROVIDED UNLESS INDICATED OPTIONAL APPLICATION FOR A PLACE ON THE City of Denton, Texas GENERAL ELECTI TO:City Secretary/Secretary of Board RECEIVED 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 FEB Denton City Council -District 2 ®FULL City Managers 1 City ❑UNEXPIRED I Secretary's Offi FULL NAME(First,Middle,Last) PRINT NAME AS YOU WANT IT TO APPEAR ON THE Brian Wayne Beck Brian Beck 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 124 Mill Pond Road at which you receive personal mail and location of residence.) 124 Mill Pond Road CITY STATE ZIP CITY STATE ZIP Denton TX 76209 Denton TX 76209 PUBLIC EMAIL ADDRESS(If available) OCCUPATION(Do not leave blank) DATE OF BIRTH VOTER REGISTRATION VUID NUMBER(Optional)2 beckfordentcn@gmail.com Computational Biologist 1144928584 TELEPHONE CONTACT INFORMATION (Optional) LENGTH OF CONTINUOUS RESIDENCE AS OF DATE APPLICATION SWORN Home: IN STATE IN TERRITORY FROM WHICH THE OFFICE SOUGHT IS ELECTED Work: 13 year(s) 13 year(s) Cell: 940-557-5580 7 month(s) 7 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)Brian W. Beck who being by me here and now duly sworn,upon oath says: "I, (name) Brian W. Beck of Denton County, Texas, being a candidate for the office of Denton City Council -District 2 _ 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 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 thinP82we-4nd correct." SIGNATURtO ROSA A. RIOS Sworn to and subscribed before me at this the 7V'_day of % Iotery Public,State of Tex is Z-6 ram; Comm.S*Ires 05-23-202 Notary ID 8760780 Signature of Officer Administering Oath° Title'of Officer Administering Oath TO BE CITY SECRETARY OR SECRETARY OF BOARD: (See a ty` p Da e R ceived Signature of Secretary Vo gis � Verified I� Q7*' t��lS