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Ralph Gutierrez - Place 2z -u Prescribed by Secretary of State seNon 141.031, Chapters 143 and 144, Texas Election Cnde 12/2015 ~' APPLICATION FOR A PLACE ON THE _ ® yelqlwx 20 IK GENERAL ELECTION BALLOT TO: City Secretary/Secretary of Board I requestthat 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,) INND�DIC��ATE TERM L1lSFUL•L n Cr� ®Gt/�%G .� %��Cf C / l,! O UNEXPIRED FULL NAMES (First, Middle, Last) PRINT NAME AS YOU WANT IT TO APPEAR ON THE BALLOT eel Z 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,) / 0/6 CITY STATE ZIP� CITY STATE ZIP� se- ZZ / /�/ PUBLIC EMAIL ADDRESS (if available) OCCUPATION (Do not leave blank) u• �, /�'f DATE OF BIRTH VOTER REGISTRATION VOID 1 NUMBER (Optional) p 119s R� TELEPHONE CONTACT INFORMATION (Optional) LENGTH OF CDNTINUDUS RESIDENCE AS OF DATE APPLICATION SWORN Home: IN STATE 'IN TERRITORY ELECTED FROM Z s year (s) year (s) Work: Cell: Z /0 a 9 7 9— 01 a month (s) month(s) If using a nickname as part of your name to appear an 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 politicai, economic, social, or religious view or affiliation. I have been commonly known by this nickname for at leastthree years prlorto this election. Before me, the undersigned authority, on this day personally appeared (name) j& 1&_,e ! 'a L/'Pee , who being by me here and now duly sworn, upon oath hssays: � % "I, (name) e& [!'66% /'erg' - r- of �Q //.t012 County, Texas, being a candidate for the office ofSeXelelZ �i¢v La >li/ A &je- ZswearthatlwlP support and defend the Constitut Ion -and laws of the United States and of the State of Texas, I a 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 ri I restored b other official action. l have not been determined by a final Judgment of a court exercising probate Jurisdiction to et Y. men partially mentallyincapacitated without the right to vote, I am aware of the nepotism law, Chapter S73, Go t` E. NOTARY PUBLIC STATE OF TEXAS �� I further swear thatthe foregoing statements Included in -my application are In all thi ue a ect" nr. My Commission Expires 1 X ATURE OF CANDIDATE Sworn to and subscribed before me at this the ay of SEAL n �&ignature o�Offfll'cer Ad ministering oath2 Title �fflce Adminis Oath TO BE COMPLETED BY CITY SECRETARY OR SECR RY ll BOARD: -(See Section 1.007) Date Received Signature of Secretary .Voter Registration Status Verified NIS •a3 -18 on ❑,,., 200-7n AI stlR s Texa 78711 -207n (512) 463 -5800 (TDD 1 --800- 735 -2989) ILi7.dJ CL111W l uII II I11 —IVI I -- - APPOINTMENT OF A CAMPAIGN TREASURER FORM CTA BY A CANDIDATE PG � 1 Total pages flied; See CTA Instruction Guide for detailed instructions. L 2 CANDIDATE MSI MRS /MR FIRST MI OFFICE USE ONLY NAME p j . la e . . . . . . . . . 'LAST Acct # NICKNAME SUFFIX Date Recelved 3 CANDIDATE 'ADD f PO BOX; APT / SUITE# CITY; STATE ZJP CODE MAILING ADDRESS 1 4 ��I ✓��i�� 1 4 CANDIDATE AREA CODE PHONE NUMBER EXTENSION Date Hand-delivered or Postmarked PHONE Date Processed , I 5 OFFICE Date imaged HELD (if any) 6 OFFICE SOUGHT (If known) �/ ! /!/ 6- •f I /� L C �r 7 CAMPAIGN MS/MRS/MR FIRST MI NICKNAME LAST SUFFIX TREASURER NAME ',% ` / r %'lS ��9GCe/ L e ®J 111 elv PZ . 8 CAMPAIGN STREET ADDRESS (ND PO BOX PLFASE); APT / SUITE# CITY; STATE; ZJP CODE TREASURER STREET ADDRESS (residence or business) 9 CAMPAIGN AREA CODE PHONE NUMBER EXTENSION TREASURER PHONE (27& 9 70— — 177/ 10 CANDIDATE SIGNATURE I am aware of the Nepotism Law, Chapter 573 of the Texas Government Code, I am aware of my responsibility to file timely reports as required by title 15 of the Election Code. I am aware of the restrictions in title 15 of the Election Code on contributions from corporations and labor organizations. nature Of Candidate Date Signed GO TO PAGE 2 www. ethics. state. tx,us Revised 07/14/2010 Texas Ethics Commission P.O. Box 12070 Austin, Texas 78711 -2070 (512) 463 -5800 (1 uu 1 -wu- There are basic principles of decency, honesty, and fair playthat every candidate and political committee is this state has amoral obligationto observe anduphold, in orderthat, after vigorously contestedbutfairly conducted campaigns, our citizens may exercisetheir constitutionalrights to afree anduntrammeled choice andthewill ofthe people maybe fully and clearly expressed onthe issues. 1�• 721 •' (1) Iwill conductthe campaign openly and publicly and Emit attacks on my opponentto legitimate challenges to my opponent's record and stated positions on issues. (2) Iwillnotuse orpermittheuse 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 notuse campaign material of any sortthat misrepresents, distorts, or otherwise falsifies the facts, nor wiIlI 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 corrupt or undermine our system of free elections or that hampers or prevents the full and free expression ofthe will of the voters, including any activity aimed atintimidatingvoters or discouragingthem from voting. (6) I will defend and uphold the right of every qualified voter to full and equal participation in the electoral process, and willnot engage in any activity aimed at intimidating voters or discouraging them from voting. (7) NU 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 ofthis code or the laws governing elections. I, the undersigned, candidate for election to public office inthe State of Texas or campaigntreasurer of apolitical committee, herebyvoluntarily endorse, subscribe to, and solemnlypledge myselfto conductthe campaign in accordance with the above principles and practices. Signafnre Xy 2© ,/ Date www.ethics,state.tx.us Revised 11/23/2010