Hohman Application for a Place on the Ballot - 02/21/2020 2-22
Prescribed by Secretary of State
Section 141.031,Chapters 143 and 144,Texas Election Code
1/2017
ALL INFORMATION IS RE UIRED TO BE PROVIDED UNLESS INDICATED OPTIONAL
APPLICATION FOR A PLACE ON THE City of Denton,Texas SPECIAL
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 other distinguishing number,if any.)
City Manager's I City
FULL NAME(First, Middle,Last) PRINT NAME AS YOU WANT IT TO APPEA O
Jo�u ka 0;IUJ rn ' V� 4 o�.�a
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.)
CITY STATE ZIP CITY STATE ZIP
Dt",4 V�, I-I *-- 1762o-7 ,
PUBLIC EMAIL ADDRESS(If available) OCCUPATION(Do not leave blank) DATE OF BIRTH VOTER REGISTRATION VUID
I- NUMBER(Optional)2
opt �l��,vtgh 3Ala i l , r`6411, b� f�eke Y - 3 / 10 /73 S-V&tV(95-
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: " LV year(s) r year(s)
Cell: 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. ^� �i/
Before me,the undersigned authority,on this day personally appeared(name) Y�`/ . ,v_/i!Y/e /-4 who being by me
here and now duly sworn,upon oath says: 7
"I, (name) n I`!7 / F. of ��6�Y7 lk� County, Texas, being a
candidate f the office of swear that I will support and defend the Constitution and laws
of the United States and of the ate of Texas.I am a citizen of the United States eligible to hold such office under the constitution and laws of
this state. 1 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.
,N
I further swear that the foregoing statements included in my application are in alI'thing true and correct."
L1 —-
SIGNATURE OF C
Sworn to and subscribed before me at this the a� ay of P ROSA A BIOS
#_� N; Nt Public
'* STATE OF TEXAS
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' M Cumin,Exp.May 23,2020
Signature of Offic i*nl istert 16 K9 Title of Office Administering Oath DIRIWAN
TO BE COMPLE �.C1TY RE �SECRETARY OF BOARD:
(See Section 1.Ob7) t Z
D e Recef ed Signature of Secretary
Voter Registraion iatu e
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