Briggs Application - 01/15/2020 2-21
Prescribed by Secretary of State
Section 141.031,Chapters 143 and 144,Texas Election Code
10.91\
ALL INFORMATION IS REQUIRED TO BE PROVIDED UNLESS INDICATED OPTIONAL
APPLICATION FOR A PLACE ON THE CITY OF DENTON,TEXAS GENERAL ELE IfiRWISQ
TO:CitySecretary/Secretary of Board
JAN 1 5 2Q2g
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 TE kitty Managers I City
` Ma Secretary's Office
t\ ✓ery- b,/�\ yo 2" ❑UNEXPIRED
FULL NAME(First,Middl ,Last PRINT NAME AS YOU WANT IT TO APPEAR ON THE BALLOT'
'4(a a eS e_ GI )44) 616 k
PERMANE RESIDENCE ADDRESS(Do not include a P.O.Box ord PUBLIC MAILING ADDRESS Campaign mai ddress,if available.)
Route. If you do not have a residence address, describe the address
at which you receive personal mail and location of residence.) - O- . g(D 142M F_Ny0
I o Z EC O KLrl gow Si- 1
CITY STATE ZIP CITY STATE ZIP
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y\ y t,,,20 . ,,,,„6.\ 7x i[0iO9
PUBLIC EMAIL ADDRESS(If available) OCCUPATION(Do not leave blank) DATE OF BIRTH VOTER REGISTRATION VUID
1)- CAT`/ ( ' Da/14741
O NUMBER(Optional)2
br% g)seedeA cu Con, ! !� /a5 / _.�
TELEPHONE CONTACT INFORMATION(Optional) LENGTH OF CONTINUOUS RESIDENCE AS OF DATE APPLICATION SWORN
Home: `i%0 _ 3310_ "- ? ? C�L IN STATE IN TERRITORY FROM WHICH THE
4`(.1
7 OFFICE SOUGHT IS ELECTED3
Work: L�
year(s) o?S-- year(s)
Cell:
/ 0 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) A ',' �/w 7( ,who being by me
here and now duly sworn,upon oath says:
"I, (name) /e�1�,,,, > , of 2.00,04x.) County, Texas, being a
candidate for the office of 7,--1-7/0//g/L, /giOPl 7 ,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 applicationare in al hings true and corr
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S = ATU•E OF CA �•_____
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Sworn to and subscribed before me at 47-1/4/1//:PS',this the/1'41 day of _ >.: _ .il v ROSA A RIO
I ry Public
' g+�,N ?�� 9 n f, ‘4,7'1:,:i., ,,,...,';C5 OF TEXAS
/ ID#878078-0
�tII 40 A-V. 'r\....... ?< 7/ �Lrfi/L' M. M Comm.Exo,Ma 23,2020
Signature of Officer Administering• °`f. ``'s�„�.• Title of Offic Administering Oath
TO BE COMPLETED BY CITY SECRE } MSEC' .' •F y•c:!:
(See Section 1.007) <` <� ,e'_ �n d ��?�.
of ^, P.-• a _1 ,;;; Signature of Secretary
Voter Registration Status Verified
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