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Tony Diaz2-49 Prescribed by Secretary of State Section 141.031, Chapters 143 and 144, Texas Election Code; Section 11.055, Texas Education Code 07/2025 APPLICATION FOR A PLACE ON THE BALLOT FOR A GENERAL ELECTION FOR A CITY, SCHOOL DISTRICT OR OTHER POLITICAL SUBDIVISION ALL INFORMATION IS REQUIRED TO BE PROVIDED UNLESS INDICATED AS OPTIONALI Failure to provide required information may result in rejection of application. r APPLICATION FOR A PLACE ON THE 60 ncr e? y4j t7.";',P 1°hr r7 GENERAL ELECTION BALLOT I TO: City Secretary/Secretary of Board (name of election) 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 ( L --- i 24 'eL_' / ❑ UNEXPIRED FULL NAME (First, Middle, Lastp PRINT NAME AS YOU WANT IT TO APPEAR ON THE BALLOT* D1 z -7;n D' "Q a il z. PERMANENT RESIDENCE ADDRESS (Do not include a P.O. Box or Rural Route. If PUBLIC MAILI ADDRESS (Optional) (Address for which you receive you do not have a residence address, describe location of residence.) campaign related correspondence, if available.) CITY s�t�rfz STATE ZIP CITY STATE ZIP 7}c 70/54 PUBLIC EMAIL ADDRESS (Optional) (Address for OCCUPATION (Do not leave blank) DATE OF BIRTH VOTER REGISTRATION VUID which you receive campaign related emails, If available.) NUMBERZ (Optional) /8 �f-ireA, 6 r TELEP14ONE CONTACT IN FORMATION (Optional) Home: fi Office: WIA Cell: o2/0— FELONY CONVICTION STATUS (You MUST check one) LENGTH OF CONTINUOUS RESIDENCE AS OF DATE THIS APPLICATION WAS SWORN 5� 1 have not been finally convicted of a felony. IN THE STATE OF TEXAS IN TERRITORY/DISTRICT/PRECINCT FROM ❑ I have been finally convicted of a felony, but I have been WHICH THE OFFICE SOUGHT IS ELECTED 2'P pardoned or otherwise released from the resulting -year(s) year(s) disabilities of that felony conviction and I have provided f f this fact with the submission of this application.3 � month(s) Jf months) Must ONLY be Completed by Candidates for School District Board of Trustees Box Below: are that I am not eligible to serve as a trustee of an independent school district if I am required to register as a sex offender under Chapter 62, Code r nal Procedure. ickname 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 es not constitute a slogan or contain a title, 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. Please review sections 52.031, 52.032 and 52.033 of the Texas Election Code regarding the rules for how names may be listed on the official ballot. Before me, the undersigned authority, on this day personally appeared (name of candidate) nr� _ who being by me here and now duly sworn, upon oath sayt� "I. (name of candidate) jz of County, Texas, Being a candidate for the office of e-641 F.0 5 ./A.1*d , ti WLi j O&IInAd iPLiAZAvear that I will support and defend t e Constitution and laws of the United States and of the hate of Texas. I aM a izen of the United Stat s eligible to hold such office under the constitution and laws of this state. I have not been determined by a final udgment of a court exercising probate jurisdiction to be totally mentally incapacitated or partially mentally incapacitated without the right to vote. I am aware of l :he nepotism law, Chapter 573, Government Code. I am aware that I must disclose any prior felony conviction, and if so convicted, must provide proof that I havel reen pardoned or otherwise released from the resulting disabilities of any such final felony conviction. I am aware that knowin I providing false information on he application regarding my possible felony conviction status constitutes a Class B misdemeanor. I further swear th foregol statements included in my application are in all things true and correct. X S ATURE OF ATE Sworn to and subscribed before me this the I day of _ Na�f,cc -,, E_ r� by ^ (day) (month) (year) �ame of candidate) C.� ignature of Officer Authorized to Administer Oa x� Print NNa�mm of Officer Aut ized to AdministuX g�EREE� COURNEY Notary ID #i2479 .t4� ��k of � My C&iifis�li8h 2 `f l Sea Title of Officer uthorize Administer Oath_ July 13. 2029 TkBE COMPLETED BY FILING OFFICER: THIS APPLICATION IS ACC (If Applicable) PAID BY: CASH ❑ CHECK ❑ MONEY ORDER ❑ CASHIERS CHECK OR ❑ PETITION IN LIEU OF A FILING FEE. This document and $ @S filing fee or a nominating petition of pages received. ❑ Voter Registration Status Verified IJ �CJ / / —5 (See Section 1.007) � Date Received Date Accepted Pig!atur�eofFlrin�gOfficr or Designee CODE OF FAIR CAMPAIGN PRACTICES Pursuant to chapter 258 of the Election Code, every candidate and 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 appointment form. Candidates or political committees that already have a current campaign treasurer appointment on file as of September 1, 1997, may subscribe to the code at any time. Subscription to the Code of Fair Campaign Practices is voluntary. FORM CFCP COVER SHEET OFFICE USE ONLY Hate Processed Date Imaged 1 ACCOUNT NUMBER Z TYPE OF FILER (Ethics Cormlission Piers) �..,( CANDIDATE iX1 POLITICAL COMMITTEE 1 { If Nft as a came, complete boxes 3 - 6, if filing for a politics! cvmmftfw, complete i then read and sign page Z boxes 7 and 8, then read and sign page 2. 3 NAME OF CANDIDATE (PLEASETYPE OR PRINT) 4 TELEPHONE NUMBER OF CANDIDATE (PLEAWTYPEORPF&M 5 ADDRESS OF CANDIDATE (PLEASE TYPE(R PRINT) 6 OFFICE SOUGHT BY CANDIDATE (PLEASE TYPE OR PRINT) 7 NAME OF COMMITTEE (PLEASETYPEORPRINT) 8 NAME OF CAMPAIGN TREASURER (PLEASE TYPEOR PRINT) TITLE Mrg Lis., sic_) FIRST ---------------------------- NICtMAME LAST a* Z_ AREA CODE PHONE NUMBER ro) Flo 3o2,, STREET IPOBM APT/SUITE& CITY.. q `7 6 Mrk- h kX, . Che(r ItZI MI ------------------------ SUFFIX(SR., JR.,gl.affi) EXTENSION STATE: ZIPCOOE 7?( 7 1?15-4 TITLE (Dr.. Mr., Vy. air.) FIRST MI �J/4-C� -------------------- ------------------------------------------- NICKNAME LAST SUFFIX (SR., JR.. ill.etc.) GO TO PAGE 2 Forms provided by Texas Ethics Commission www.ethics.state.tX.us Revised 1/1/2021 CODE OF FAIR CAMPAIGN PRACTICES There are basicpzmciples ofdecency, honesty, and fair play that everycandidate andpolitical committee in this state has amoral obligation to observe and uphold, in orderthat, aftervigorouslycontested but fairly conducted cam our citizens may exercise theirconstitutional rights to a five and untrammeled choice and the will ofthe people maybe fully and clearly expressed on the issues. (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, whispering campaigns, libel, slander, or scurrilous attacks on any candidate or the candidate's personal or family life. (3) I will not use orpermit any appeal to negative prejudice based on race, sex, religion, or national origin. (4) I will not use campaign material of airy sort that misrepresents, distorts, or otherwise falsifies the facts, norwill I use malicious or unfounded accusations that aim at creating or exploiting doubts, without justification, the personal integrity orpatriotism ofmy 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 orprevents the full and free expression ofthe will of the voters, including any activity aimed at intimidating voters or discouraging them from voting. (6) I will defend and uphold the right ofevery 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. () Iwill immediately and publicly repudiate methods andtactics that my come from others that I have pledged not to use orcondone. I shall take fnm action against any subordinate who violates anyprovision 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. Sigimttne r I r7 zo 2.5 Date Forms provided by Texas Ethics Commission www ethics.state.tx.trs Revised 111l2021 APPOINTMENT OF A CAMPAIGN TREASURER FORM CTA I ! BY A CANDIDATE PG 1 See CTA Instruction Guide for detailed instructions. I Th-te! =ems Red: 2 CANDIDATE IUSI'artRsi'`'R J FIRST M1 OFFICE USE ONLY NAME ---- SUFFIX Filer ID # ------------------------------------- NKXNAME LAST — Date Received V jLL Z 3 CANDIDATE ADDRESS IPOBOX; APTISUITEi CITY; STATE; DP CODE MAILING ADDRESS � �� `� 9u ©AP- t°�ax. 4 CANDIDATE AREA CODE PHONE NUMBER EXTENSION Anpun PHONE (Rio , �j V 4/ —) 3 o z d EDate S OFFICE HELD (if any) 6 OFFICE SOUGHT known) ff z 17 (f / Xa�L J 7 CAMPAIGN MS1WR FIRST MI NICKNAME LAST SUFFIX TREASURER NAME arJ � az 8 CAMPAIGN sTREETPLDRIBM. APTISUITEt CITY; STATE; aPC ODE TREASURER STREET f� , L - - 1 L / ADDRESS ! - / o Off. { Qli-� lsiviuN z— 7-y l�� CST• (residence or business) I 9 CAMPAIGN AREA CODE PHONE NUMBER EXTENSION TREASURER PHONE (aI D '10 CANDIDATE SIGNATURE I am aware of the Nepotism Law, Chapter 573 of the Texas Govemment Code. I am aware of my responsibility to file tidy 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. S of 68ndidate Date Signed Forms provided by Texas Ethics Commission GO TO PAGE 2 www.ethics.state.tx.us Revised 1/1/2025 CANDIDATE MODIFIED REPORTING DECLARATION 11 CANDIDATE NAME 12 MODIFIED REPORTING DECLARATION COMPLETE THIS SECTION ONLY IF YOU ARE CHOOSING MODIFIED REPORTING FORM CTA PG 2 -- This declaration must be filed no later than the 30M day before the first election to which the declaration applies. •• The modified reporting option is valid for one election cycle only. •- on won cYc"a P Yelection, a general election, and arty rewed nmotfs.) • Candidates for the office of state chair of a political party may NOT choose modified reporting. I do not intend to accept more than $1.110 in political contributions or make more than $1,110 in political expenditures (excluding filing fees) in connection with any future election within the election cycle. I understand that if either one of those limits is exceeded, I will be required to file pre -election reports and, if necessary, a runoff report_ Year of eiecbon(s) orelecxion cycle to Which declaration applies Sign of Candidate This aPpointment is effective on the date it Is filed with the appropriate filing authority. TEC Filers may send this form to the TEC electronically at trea_sa,a2oint@ethics.state.tx.us or mail to Texas Ethics Commission P.O. Box 12070 Austin, TX 787112070 Non-TEC Filers must file this form with the local filing authority DO NOT SEND TO TEC For more information about where to file go to: ht435:llwww.ethics.state.tx.us/filinginfo/QuickFileAReport.php Forms provided by Texas Ethics Commission wwmethics.state.tx.us Revised 1/1/2025 AFFIDAVIT FOR CANDIDATE OR OFFICEHOLDER: ELECTRONIC FILING EXEMPTION An exemption affidavit must be submitted with each paper report. Beginning on January 1, 2025, a candidate or officeholder who has accepted more than $33,910 in political contributions or made more than $33,910 in political expenditures in any calendar year must file all subsequent reports electronically OFFICE USE ONLY I Date Received T� f Date Hand -delivered or Date Postmarked i Receipt# Amount$ � If Date Processed Filer name Filer ID # Date Imaged 1. 1 swear or affirm that I have not accepted more than $33,910 in political contributions or made more than $33,910 in political expenditures in a calendar year. 2. 1 further swear or affirm that I do not use computer equipment to keep current records of political contributions, political expenditures, or persons making political contributions to me. 3. 1 further swear or affirm that no person acting as my agent or consultant, and no person with whom I contract, uses computer equipment to keep current records of political contributions, political expenditures, or persons making political contributions to me. 4. 1 further swear or affirm that I understand that I am required to file my campaign finance reports electronically if I, my agent or consultant, or a person with whom I contract exceeds $33,910 in political contributions or political expenditures in a calendar year, or uses computer equipment to keep current records of political contributions, political expenditures, or persons making political contributions to me. 5. 1 am filing this affidavit with the _ rIA1 Z- toort due on r 19o% I understand that this affidavit is required tote filed with each campaign finan�c report for which I am claiming an exemption from electronic filing. Please complete either option below: (1) Affidavit NOTARY STAMP/SEAL Sworn to and subscribed before me by 20 , to certify which, witness my hand and seal of office. Signature of officer administering oath Printed name of officer administering oath Signature of Filer this the day of Title of officer administering oath r: (2) Unsworn Declaration I My name Is and my date of birth is — l iF i 4 5 3 _ My address is yzo �6` rz_ 72?/ (street) city st to zip code), country Executed in County, State of _ r.0 LO on the day of At , , 20_2—�. (month Si ature of Filer (Declarant) FILERS WHO ARE EXEMPT FROM THE ELECTRONIC F16NG REQUIREMENT ARE STILL REQUIRED TO FILE CAMPAIGN FINANCE REPORTS ON PAPER Forms provided by Texas Ethics Commission www.ethics.state.tx.us Revised 1/1/2025