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Gwen Jones Place 52 -21 Prescribed by Secretary of State Section 141,031, Chapters 143 and 144, Texas Election Gode 1/2017 ALL INFORMATION 15 REQUIRE TO BE PROVIDED UNLESS INDICATED OPTIONAL APPLICATION FOR A PLACE ON THE __ T _ ? _r__ _ GENERAL ELECTION BALLOT TO: City Secretary/Secretary of Board 1 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.) INDJ,CATE TERM /7 FU LL �l P /ace 5 I ❑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 Route. If you do not have a residence address, describe the address at which you receive personal mail and location of residence.) lag?, ,51 l vcr /-ree 61v'6� CITY STATE .-qc h erf-7 �7Tx PUBLIC EMAIL ADDRESS (If available) 93 anes 2cl-11 CQsatx, rr.co, PUBLIC MAILING ADDRESS (Campaign mailing address, if available.) 14'x8' ,Sr Iverfree 131vd. ZIP CITY STATE ZIP -7515/ I Scher% TX -78154 OCCUPATION (Do not leave blank) DATE OF BIRTH VOTER REGISTRATION VOID t NUMBER (Optional) Z �ef(re�L TELEPHONE CONTACT INFORMATION (Optional) LENGTH OF CONTINUOUS RESIDENCE AS OF DATE APPLICATION SWORN Home: &/0-56(o-,37P/ IN STATE IN TERRITORY FROM WHICH THE OFFICE SOUGHT IS ELECTED3 Work: , / A N year (s) I Q year {s} Cell: I months) -7 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 j 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) CW�n�� '�-'Dn�°� _, who being by me here and now duly sworn, upon oath says: "I, (name) L-9 wr' db n +� 7an es of _ _7 GIQ'da- I u,Qe County, Texas, being a candidate for the office of COUAr- j me- bcl -dam 5_.Sc hfft7_ 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." SIGNATURE OF CANDIDATE �\1t11 �i Irltr!/ Sworn to and subscribed before me at w i z this the -J-7_ day of, A O n ,�� v i 'k Le LLJ Sig ure of Officer Administering Oath Title 6f offic rnis ring 0 ath{{{{{{����VV1111� TO BE COMPLETED BY CITY SECRETARY OR SECRETARY OF BOARD: �F °v � d .......... (See Section 1.007) '? - / � - 2oa r� Date Received Signa a of Secretary Voter Registration Status Verified IM/ _ APPOINTMENT OF A CAMPAIGN TREASURER FORM CTA BY A CANDIDATE PG 1 5 OFFICE Date Imaged 1 Total pages filed: See CTA Instruction MSIMRSIMR Guide for detailed instructions. FIRST MI 2 CANDIDATE OFFICE USE ONLY NAME 6 OFFICE MIll5. L�o ct-do l n ,(- FlarID� / / j cour)L` l 1 bloc' t�l NICMAME LAST SUFFIX DoleRecelved mcKNAME LAST SUFFIX Y; ' ADDRES .. PO BOX; APT i SUITE N: CITY STATE; ZIP CODE N 3 CANDIDATE MAILING ADDRESS (l °L° �! 1fd 5C�itp 8 CAMPAIGN STREET ADDRESS (NO PO BOX PLEASE); APT I SUITE N; CITY; STATE; ZIP CODE TREASURER STREET �/ �l �Il� �•C°�° 81V6L AREA CODE PHONE NUMBER EXTENSION Date Hand- daBvered or Poatrnarked Receipt# Amount's 4 CANDIDATE PHONE (residence or business) 9 CAMPAIGN (021 SJ _ f_ ,. 3 —)L7 1 EXTENSION Date Processed 5 OFFICE Date Imaged HELD (if any) 6 OFFICE SOIow)T / / j cour)L` l 1 bloc' t�l 7 CAMPAIGN MSJMRSAIP FIRST MI mcKNAME LAST SUFFIX TREASURER NAME DavroL Z / (r 8 CAMPAIGN STREET ADDRESS (NO PO BOX PLEASE); APT I SUITE N; CITY; STATE; ZIP CODE TREASURER STREET �/ �l �Il� �•C°�° 81V6L �CACA'Z- T,X 7SISLI ADDRESS � $ (residence or business) 9 CAMPAIGN AREA CODE PHONE NUMBER EXTENSION TREASURER PHONE / ,�O j C[�� r 3 r7 g I 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. Signature of Candidate Date Signed GO TO PAGE 2 Forms provided by Texas Ethics Commission wwmethics.state.N.us Revised 1/1/2020 Texas Ethics Commission P.O. 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 I?ateRaceived political committee is encouraged to subscribe to the Code of Fair Campaign Practices. The Code may be filed with the proper filing K-1 7 — -70 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. Subscription to the Code o f Fair Campaign Practices is voluntary. Date Processed Date Imaged 7 ACCOUNT NUMBER 2 TYPE OF FILER (Ethics Commission Filers) CANDIDATE ff POLITICAL COMMITTEE if filing as a candidate, complete boxes 3 - 8, 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.,MiL,eta) FIRST MI (PLEASE TYPE OR PRINT) Mrs wle.ndo �n � W CKNAME LAST SUFFIX (SR., JR., III, etc.) Z7ona s 4 TELEPHONE NUMBER AREA CODE PHONE NUMBER EXTENSION OF CANDIDATE °� `A _ / (PLEASE TYPE OR PRINT) 5 ADDRESS OF CANDIDATE STREET I PO BOX; APT I SUITE # CITY; STATE; 21P CODE (PLEASETYPEORPRINT) i ar'g Sf l ve-r-free ,61vaL ,a5chertz TX 7 gl s y S, OFFICE SOUGHT BY CANDIDATE (PLEASE TYPE ASE T OR PRINT) e nuncr l /I'lcmber Place 1` 5 7 NAME OF COMMITTEE (PLEASE TYPE OR PRINT) 8 NAME OF CAMPAIGN TITLE (Dr.,Mr., Us, sta.) FIRST MI TREASURER Mr, /,avicL (PLEASE TYPE OR PRINT) . . . . . NICKNAME LAST SUFFIX (SR., JR., III, etc.) GO TO PAGE 2 www.ethics,state.N.us Revised 11/23/2010 Texas Ethics Commission P.O. Box 12070 Austin. Texas 78711 -2070 (512) 463 -5800 (TDD 1 - — - - CODE OF FAIR CAMPAIGN PRACTICES There are basic principles of decency, honesty, and fairplay 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 constitutiotWrights to a free and untxammeled choice and the will of the people maybe fully and clearly expressed on the issues. TjffiREFORE: (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) 1 will notuse orpermit the use ofcharacter defamation, whispering campaigns, libel, slander, orscurrilous attacks on any candidate or the candidate's personal or family life. (3) 1 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 orpatriotismofmy 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 from voting. (6) I will defend and uphold the right of every qualified voter to full 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 andpubliely repudiate methods and tactics that may come from others that I have pledged not to use or condone. I shat I take finn action against any subordinate who violates any provision of this code or the laws governing elections. 1, 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 myself to conduct the campaign in accordance with the above principles andpractices. . Z �//- 6, �g &�,, �) , , 0 � le Signature Date www.ethics.state.tx.us Revised 11/2312010