Bert Crawford - Place 72 -21
Prescribed by secretary of State
Section 141,031, Chapters 143 and 144, Texas Election Code
12/2015
All Informatinn is renuired to he nrovided unless indicated as ontinnal
APPLICATION FOR A PLACE ON THE 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
FULL
UNEXPIRED
FULL NAME (First, Middle, Last)
PRINT NAME AS YOU WANT IT TO APPEAR ON THE BALLOT
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
PUBLIC EMAIL ADDRESS (If available)
OCCUPATION (Do not leave blank)
DATE OF BIRTH
VOTER REGISTRATION VUID
NUMBER (Optional)'
TELEPHONE CONTACT INFORMATION (Optional)
LENGTH OF CONTINUOUS RESIDENCE
AS OF DATE APPLICATION SWORN
Home:
IN STATE
IN TERRITORY ELECTED FROM
Work:
year (s)
year
Cell: f
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:
"I, (name) of County, Texas, being a
candidate for the office of 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 application are in all things true and correct."
X'
SIGNATURE OF CANDIDATE
Sworn to and subscribed before me at this the r day of t
SENNNA R. SCHM
NOTARY PUB
STATE OF TE
Signature of Officer Administering Oath Title o Officer(Admini tering Oath
MY Commission Expires
BE BY CITY SECRETARY OR SECRET F BOARD:
(oe S colon 1007) --2-0/ tl
Rec6lved ` ; Signature of Secreta
Voter Registration Status Verified
EKEL
C
S
x-01 -2019
Texas Ethics Commission P.O. Box 12070 Austin. Texas 78711 -2070 (512) 463 -5800 (TDD 1- 800 - 735 -2989)
APPOINTMENT OF A CAMPAIGN TREASURER FORM CTA
BY A CANDIDATE PG 1
1 Total pages filed:
See CTA Instruction Guide for detailed instructions.
2 CANDIDATE
MS /MRS /MR FIRST MI
OFFICE USE ONLY
NAME
Acct. #
. .
NICK . NAME . . . . . . . . . . . L . AST . . . . . . . . . . . . . . . . SUFFIX . . . . . .
Dale Received
r
i
3 CANDIDATE
ADDRESS / PO BOX; APT / SUITE #; CITY; STATE; ZIP CODE!`
MAILING
,
ADDRESS
9. r /
4 CANDIDATE
AREA CODE PHONE NUMBER EXTENSION
Date Hand - delivered or Postmarked
PHONE
Date Processed
5 OFFICE
Date Imaged
HELD,
(if any)
6 OFFICE
SOUGHT
(if known)
7 CAMPAIGN
MS /MRS /MR FIRST MI NICKNAME LAST SUFFIX
TREASURER
NAME
8 CAMPAIGN
STREET ADDRESS (NO PO BOX PLEASE); APT / SUITE #; CITY; STATE; ZIP CODE
TREASURER
STREET
ADDRESS
(residence or business)
9 CAMPAIGN
AREA CODE PHONE NUMBER EXTENSION
TREASURER
PHONE
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.
f�
SignA re of Candidate Date Signed
GO TO PAGE 2
www.ethics.state.tx.us Revised 07/1412010
Texas Ethics Commission P.O. Box 12070 Austin, Texas 78711 -2070 (512) 463 -5800 (I'DD 1- 800 - 735 -2989)
CODE OF FAIR CAMPAIGN
FORM CFCP
PRACTICES CTICES
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
Campaign Practices. The Code may be filed with the proper filing
authority upon submission of a campaign treasurer appointme'nt
form. Candidates or political committees that already have a�,
current campaign treasurer appointment on file as of September 1,
Date Hand-deliveredorPostmarked '
1997, may subscribe to the code at any time.
Dale Processed
Subscription to the Code gfFair Campaign Practices is voltmtaly.
Date Imaged
1 ACCOUNT NUMBER
2 TYPE OF FILER
(Ethics Commission Filers)
CANDIDATE Fj POLITICAL
COMMITTEE
ff 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)
. . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
NICKNAME LAST
. . . . . . . . . . . . . . . . . .
SUFFIX (SR., JR., III, etc,)
4 TELEPHONE NUMBER
AREA CODE PHONE NUMBER
EXTENSION
OF CANDIDATE
r \
(PLEASE TYPE OR PRINT)
5 ADDRESS OF CANDIDATE
STREET PO BOX; APT /SUITE CITY;
STATE; ZIPCODE
(PLEASE TYPE OR PRINT)
6 OFFICE SOUGHT
BY CANDIDATE
(PLEASE TYPE OR PRINT)
NAME OF COMMITTEE
(PLEASE TYPE OR PRINT)
8 NAME OF CAMPAIGN TITLE (Dr., Mr., Ms., etc.) FIRST
MI
TREASURER
(PLEASE TYPE OR PRINT) . . . . . . . . . . . . . . . . . . . . . . . . . .
. . . . . . . . . . . . . . .
NICKNAME LAST
SUFFIX (SR., JR., III, etc.)
GO TO PAGE 2
www.ethics.state.tx.us Revised 11/23/2010
Icnaa�unw%..vllninssiulI r- .U. 6uX ILU /u Husun, IeXas /u/ I I -ZU /u (bl2)4w -bbuu (IUU'I -buu-
There are basic principles of decency, honesty, and fair play that every candidate and political committee in this state
has amoral obligation to observe and uphold, in order that, 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 orpermit the use of character defamation, wh ispering 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 sortthat 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 corrupt or undermine our system
of free elections or that hampers or prevents the full and free expression of the will of the voters, including any
activity aimed at intimidating voters or discouraging them fi-om voting.
(6) I will defend and uphold the right of every qualified voter to f it I and equal participation in the electoral process,
and will not engage in any activity aimed at intimidating voters or discouraging them from voting.
(7) Twill inunediately 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 apolitical
committee, hereby voluntarily endorse, subscribe to, and solemnly pledge myself to conduct the campaign in accordance
with the above principles and practices.
Signature
Date
www.ethics.state.tx.us Revised 11/23/2010