Finley Application for a Place on the Ballot - 02/10/2020 z-zz
Prescribed by Secretary of State
Section 141.031,Chapters 143 and 144,Texas Election Code
ALL INFORMATION IS RECIUIRED TO BE PROVIDED UNLESS INDICATED OPTIONAL 1/2017
APPLICATION FOR A PLACE ON THE City of Denton,Texas SPECIAL ELE IOR0MIND
TO:City Secretary/Secretary of Board
I request that my name be placed on the above-named official ballot as a candidate for the office indicated below. F E B 1 0 2020
OFFICE SOUGHT(Include any place number or other distinguishing number,if any.) City Manager's/City
C (x _ OkV-V� Secretary's Office
FULL NAME(First, fiddle,Last) b� PRINT NAME AS YOU WANT IT TO APPEAR ON THE BALLOT'
\Y HIV �V t
PERMANE ESIDENCE ADDRESS(Do of include a P.O.Box or Rural PUBLIC MAILIN DDRESS(Campaign maili ddress,if available.)
Route. If you do not have a residence address, describe the address MAGI
I 1/„
at which you recei a personal it and`ocation of residence.) AGI
TX lu 201
CITY STATE ZIP CITY STATE ZIP
vA N -T� -[-X IQ 201
PUBLIC EMAIL ADDRESS(If available) OCCUPATION(Do not leave blank) DATE OF BIRTH VOTER REGISTRATION VOID
NUMBER(Optionalf
VA Ck�
TELEPhbNE CONTACT INFORM TION(Optional) AENGTH OF CONTINUOUS RESIDENCE AS OF DATE APPLICATION SWORN
Home: IN STATE IN TERRITORY FROM WHICH THE
OFFICE SOUGHT IS ELECTED
Work:
hyear(s) 1�, year(s)
Cell: q II\ U-16 � 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. 1 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)� i i t'�i>� �iiJ who being by me
here and now duly sworn,upon oath says:
"I (name) 'I of !i'/JK County, Texas, being a
candidate for the offi a of d4akw I e ear that I will support and defend the Constitution and laws
of the United States and of the State of Texas.ram 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 thi nd arrec "
X �
GNATURE OF CAN6KYATE
Sworn to and subscribed before me at this the/ day of A RICE
nr��
y Public
STATE OF TEXAS
ID#676078-0
Signature of Officer Administering O %A Title of Officer Administering M COMM.Ex�.Ma 23.20•.
TO BE COMPLETED BY CITY SECR 0 Y.9F BOARD:
(See Section 1.007)
to a eitred Signature of Secretary
Voter Registration Status Ve 'dd
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