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Robin Thompson Application Place 52 -21 Prescribed by Secretary of State Section 141.031, Chapters 143 and 144, Texas Election Code 1/2017 ALL INN -UKMAI IUN IS KtLlUIKtU IU lit NKUVIUtU UNLUO INUILAI tU UNIIUNAL APPLICATION FOR A PLACE ON THE C. \-C� O ScK�QT2 GENERAL ELECTION BALLOT 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. OFFICE SOUGHT (Include any place number or other distinguishing number, if any.) INDICATE TERM COU(\ C.\) f I0. ©FULL ❑ UNEXPIRED FULL NAME (First, Middle, Last) PRINT NAME AS YOU WANT IT TO APPEAR ON THE BALLOTl C�0-1.\q (,�.�rn PIS 'ZIr. 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.) 0\ In c R.c�•�e s�q, � r7 CITY STATE I ZIP I CITY STATE I ZIP C\_'vp,_A'Z —Cj( -7 l s PUBLIC EMAIL ADDRESS (If available) OCCUPATION (Do not leave =1n ) DATE OF BIRTH VOTER REGISTRATION VOID C�c�nn.b+c Viz' of ' NUMBER (Optional) Z c4 %(&jq,�,p,��. cones J V C��� Coupe. \+r•car� ca, Oq 09S 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-9 Work: a tc,— � -2 year (s) .� year (s) Cell: alp— SD\ — 'a3'-!� (5 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) who being by me here and now duly sworn, upon oath says: n "I, (name) l"�ob% C__ ?SCw, of ITVa�a`�(� County, Texas, being a candidate for the office of S �oJr\c ,1, ?ka►cc 5 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 t Sworn to and su ny application are in all things true and correct." X c- f �5 SIGNATURE OF CANDIDATE -I— . this the ? y-' day of I SEAL gnature of Officer Administering Oath' Title of/Off icer Administe ng Oath TO BE COMPLETED BY CITY SECRETARY OR SECRETARY OF BOARD: (See Section 1.007) 7 — 2— l 4 Date Received Signature of Secretary Voter Registration Status Verified E'My ONNA R. SC HMOEKEL NOTARY PUBLIC STATE OF TEXAS mmisslon Expires 12- 01.2019 ny application are in all things true and correct." X c- f �5 SIGNATURE OF CANDIDATE -I— . this the ? y-' day of I SEAL gnature of Officer Administering Oath' Title of/Off icer Administe ng Oath TO BE COMPLETED BY CITY SECRETARY OR SECRETARY OF BOARD: (See Section 1.007) 7 — 2— l 4 Date Received Signature of Secretary Voter Registration Status Verified 2 -21 Prescribed by Secretary of State Section 141.031, Chapters 143 and 144, Texas Election Code 10/2016 INSTRUCTIONS An application to have the name of a candidate placed on the ballot for any general election may not be filed earlier than 30 days before the deadline prescribed by this code for filing the application. An application filed before that day is void. All fields must be completed unless specifically marked optional. The general election filing deadline is 5:00 p.m. 78 days prior to election day for any uniform election date. If you have questions about the application, please contact the Secretary of State's Elections Division at 800 - 252 -8683. NEPOTISM LAW The candidate must sign this statement indicating areness o nepotism law. The nepotism prohibitions of chapter 573, Government Code, are summarized below: No officer may appoint, or vote for or confirm t e appointment or employment of any person related within the second degree by affinity (marriage) or the third degree by consanguinity (blood) to himself, or to any other member of the governing body or court on which he serves when the compensation of that person is to be paid out of public funds or fees of office. However, nothing in the law prevents the appointment, voting for, or confirmation of anyone who has been continuously employed in the office or employment for the following period prior to the election or appointment of the officer or member related to the employee in the prohibited degree: six months, if the officer or member is elected at the general election for state and county officers. No candidate may take action to influence an employee of the office to which the candidate is seeking election or an employee or officer of the governmental body to which the candidate is seeking election regarding the appointment or employment of a person related to the candidate in a prohibited degree as noted above. This prohibition does not apply to a candidate's actions with respect to a bona fide class or category of employees or prospective employees. Examples of relatives within the third degree of consanguinity are as follows: (1) First degree: parent, child; (2) Second degree: brother, sister, grandparent, grandchild; (3) Third degree: great - grandparent, great - grandchild, uncle, aunt, nephew, niece. These include relatives by blood, half - blood, and legal adoption. Examples of relatives within the second degree of affinity are as follows: (1) First degree: spouse, spouse's parent, son -in -law, daughter -in -law; (2) Second degree: brother's spouse, sister's spouse, spouse's brother, spouse's sister, spouse's grandparent. Persons related by affinity (marriage) include spouses of relatives by consanguinity, and, if married, the spouse and the spouse's relatives by consanguinity. These examples are not all inclusive. FOOTNOTES For rules concerning the form of a candidate's name or nickname on the ballot, see Subchapter B, Chapter 52 of the Texas Election Code. 2Inclusion of a candidate's VUID is optional. However, many candidates are required to be registered voters in the territory from which the office is elected at the time of the filing deadline. Please visit the Elections Division of the Secretary of State's website for additional information. http: / /www.sos. state. tx. us /elections /laws /hb484- faci.shtml 3This refers to the length of residence inside the district or territory from which the office is elected. For example, length of residence in a school district, for a school trustee office elected at large. This field MUST BE COMPLETED. 4All oaths, affidavits, or affirmations made within this State may be administered and a certificate of the fact given by a judge, clerk, or commissioner of any court of record, a notary public, a justice of the peace, city secretary (for a city office), and the Secretary of State of Texas. Taxac Fthir_c r.nmmi�Ginn PCB. Box 12070 Austin. Texas 78711 -2070 (512) 463 -5800 (TDD 1- 800- 735 -2989) CODE OF FAIR CAMPAIGN FORM CFCP PRACTICES COVER SHEET OFFICE USE ONLY Pursuant to chapter 258 of the Election Code, every candidate and Date Received political committee is encouraged to subscribe to the Code of Fair �:-1 7 Campaign Practices. The Code may be filed with the proper filing 0 1 authority upon submission of a campaign treasurer appointment form. Candidates or political committees that already have a current campaign treasurer appointment on file as of September 1, Date Hand - delivered or Postmarked 1997, may subscribe to the code at any time. Date Processed Subscription to the Code of Fair Campaign Practices is voluntary. Date Imaged 1 ACCOUNT NUMBER 2 TYPE OF FILER (Ethics Commission Filers) CANDIDATE NA POLITICAL COMMITTEE If filing as a candidate, complete boxes 3 - 6, If filing for a political committee, complete then read and sign page 2. boxes 7 and 8, then read and sign page 2. 3 NAME OF CANDIDATE TITLE (Dr., Mr., Ms., etc.) FIRST MI (PLEASE TYPE OR PRINT) C ................. ............................... NICKNAME LAST SUFFIX (SR., JR., III, etc.) 4 TELEPHONE NUMBER AREA CODE PHONE NUMBER EXTENSION OF CANDIDATE a (PLEASE TYPE OR PRINT) 5 ADDRESS OF CANDIDATE STREET /PO BOX, APT /SUITE #, cCITY-, �� S STATE; ZIP CODE 2 �X v I�� (PLEASE TYPE OR PRINT) C\-, f!� CI �� U t1� i 6 OFFICE SOUGHT SC\ Z C \.�, �unC �� P� �CE BY CANDIDATE j� e�.t t (PLEASE TYPE OR PRINT) 7 NAME OF COMMITTEE (PLEASE TYPE OR PRINT) 8 NAME OF CAMPAIGN TITLE (Dr., Mr., Ms., etc.) FIRST MI TREASURER \�V_ t Yl •. (PLEASETYPE OR PRINT) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . NICKNAME LAST SUFFIX (SR., JR., III, etc.) GO TO PAGE 2 www.ethics.state.tx.us Revised 11/23/2010 texas CInICS uommISSIOn r.U. L50X l2U /U iAusun. IexaS lbri l -2U /U (5 'l Z) 4b3 -bbUU ( I UL) l- buu- /3b- 2yJMI) CODE OF FAIR CAMPAIGN PRACTICES There are basic principles of decency, honesty, and fair play that every candidate andpolitical committee in this state has amoral obligation to observe and uphold, in orderthat, after vigorously contested but fairly conducted campaigns, our citizens may exercise their constitutional rights to a free and untrammeled choice and the will ofthe people maybe fully and clearly expressed on the issues. THEREFORE: (1) I will conduct the campaign openly and publicly and limit attacks on my opponent to legitimate challenges to my opponent's record and stated positions on issues. (2) I will not use or permit the use of character defamation, whispering campaigns, libel, slander, or scurrilous attacks on any candidate or the candidate's personal or family life. (3) I will not use or permit any appeal to negative prejudice based on race, sex, religion, or national origin. (4) I will not use campaign material of any sort that misrepresents, distorts, or otherwise falsifies the facts, nor will I use malicious or unfounded accusations that aim at creating or exploiting doubts, without justification, as to the personal integrity or patriotism of my opponent. (5) I will not undertake or condone any dishonest or unethical practice that tends to corruptor undermine our system of free elections or that hampers or prevents the firll and free expression of the will of the voters, including any activity aimed at intimidating voters or discouraging them from voting. (6) I will defend and uphold the right of every qualified voter to firll and equal participation in the electoral process, and will not engage in any activity aimed at intimidating voters or discouraging them from voting. (7) I will immediately and publicly repudiate methods and tactics that may come from others that I have pledged not to use or condone. I shall take firm action against any subordinate who violates any provision of this code or the laws governing elections. I, the undersigned, candidate for election to public office in the State of Texas or campaign treasurer of a political committee, hereby voluntarily endorse, subscribe to, and solemnly pledge myselfto conduct the campaign in accordance with the above principles and practices. , a\,CL�, cm Signature o-7 /,1 yZ, o(5 Date www.ethics.state.tx.us Revised 11/23/2010