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Cedric Edwards - Place 4AW2 -15, 7/2011 Prescribed by Secretary of State Sections 141.031, 143.004, 143.006, Texas Election Code All information is required to be provided unless indicated as optional. APPLICATION FOR A PLACE ON THE CITY OF y GENERAL ELECTION BALLOT TO: City Secretary 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 0 �Jl FULL 0 UNEXPIRED i �-, 0 Liu � C 1 I� FULL NAME (First, Middle, Last) PRINT NAME AS YOU WANT IT TO APPEAR ON THE BALL OT Cad �� �. �,���� � � � � �� � ►® �'��� �` � ���t� ��,-�' s PERMANENT RESIDENCE ADDRESS (Street address and apartment MAILING ADDRESS (If different from residence address) number. If none, describe location of re deuce. Do not include P.O. Box or Rural Rt.) t)) Lp ke (A()ti)Cv U CITY STATE ZIP CITY STATE ZIP 1, e -Z, ) I'i 15 EMAIL ADDRESS (Optional) OCCUPATION (Do not leave blank) DATE OF BIRTH VOTER REGISTRATION VUID NUMBER (if applicable) CCL�u�rrcl� S(!�C�✓�jZ .0 ,, 1�1QAC1 0,I A6\V 5L�� �`�1� 67 c TELEPHONE NUMBER (Include area code) (Optional) Length of Continuous Residence as of Date Application Sworn OFFICE: -- ( IN STATE IN CITY IN DISTRICT OR PRECINCT' yr(s) r-d yr(s) — yr(s) HOME: 1 U — mos _ mos _ mos 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 social, or religious view or affiliation. I have swear that my nickname does not constitute a slogan nor does it indicate a political, economic, 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) C' C: z t who being by me "I, here and now duly sworn, upon oath says: (name) swear that I will support and County, Texas, being a candidate for the office of %, defend the Constitution and laws of the United States and of e State of Texas. I 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 been determined by a final judgment of a court exercising probate jurisdiction to be totally citizenship restored by other official action. I have not incapacitated or partially mentally incapacitated without the right to vote. I am aware of the nepotism law, Chapter 573, Government Code. mentally I further swear that the foregoing statements included in my application are in all things true and correct." SIGNATURE OF CANDIDATE Sworn and subscribed before me ai this the day of BRENORIME DENNIS NOTARY PUBLIC L ft A- STATE OF TEXAS l Title of O cer a istering oath MY Cotnmisslon Explres 1103.18 ignature of Officer administering oath' SECRETARY: TO BE COMPLETED BY CITY (See Section 1.007) Date Received Signature of City Secretary TGvnc P:thinc r:nmmicQinn P n Rny 1 ?n7n Austin. Texas 78711 -2070 (512) 463 -5800 (TDD 1- 800 -735 -2989) APPOINTMENT OF A CAMPAIGN TREASURER FORM CTA Y A CANDIDATE PG See CTA Instruction Guide for detailed instructions. 1 Total pages filed: 2 CANDIDATE NAME MS /MRS /MR FIRST MI N' \ R OFFICE USE ONLY Acct. # . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . NICKNAME LAST SUFFIX Date Received jj ` 3 CANDIDATE ADDRESS / PO BOX; APT/ SUITE #; CITY; STATE; ZIP CODE MAILING ADDRESS 4 CANDIDATE AREA CODE PHONE NUMBER EXTENSION Date Hand - delivered or Postmarked PHONE ^ b> j p 4 Date Processed 5 OFFICE HELD l , � a� Date Imaged (if any) L`y'1 e-f l 6 OFFICE SOUGHT��� (if known) 7 CAMPAIGN TREASURER MS/MRS /MR FIRST MI NICKNAME LAST SUFFIX NAME 8 CAMPAIGN TREASURER STREET ADDRESS (NO 1POlBOX jPPLLEAgSE�);, APT / SUITE t !CITY; STATE; / ZIP- CODE f �• �'--� �LilL2V` ` (0 `�4 STREET l l I\ i � / 1 �� ADDRESS (residence or business) 9 CAMPAIGN AREA CODE PHONE NUMBER EXTENSION TREASURER PHONE J /I l `� '� ,' 3 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. am aware of the restrictions in title 15 of the Election Code on contributions from 9prporations and labor organizations. Signature of Candidate Date Signed GO TO PAGE 2 www.ethics.state.tx.us Revised 07/14/2010 TPY59C Fthicc (:nmrniccinn P _ Rnx 1 ?n7n Austin. Texas 78711 -2070 (512) 463 -5800 (TDD 1- 800 -735 -2989) CANDIDATE MODIFIED FORM CTA DEPORTING DECLARATION PG 2 11 CANDIDATE NAME 12 MODIFIED REPORTING COMPLETE THIS SECTION ONLY IF YOU ARE DECLARATION CHOOSING MODIFIED REPORTING •• This declaration must be filed no later than the 30th day before the first election to which the declaration applies. •- •• The modified reporting option is valid for one election cycle only. •• (An election cycle includes a primary election, a general election, and any related runoffs.) •• Candidates for the office of state chair of a political party may NOT choose modified reporting. •- I do not intend to accept more than $500 in political contributions or make more than $500 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. C r_1 r, Year of election(s) or election cycle to Signature of Candidate which declaration applies This appointment is effective on the date it is filed with the appropriate filing authority. www.ethics.state.tx.us Revised 07/14/2010 A.. C -r ,, 7a711_9mn 15121463 -5800 (TDD 1- 800 - 735 -2989) texas c>:nlcs uonuntssivn - -- - - CODE OF FAIR CAMPAIGN FORM CFCP COVER SHEET PRAC TICES OFFICE USE ONLY Pursuant to chapter 258 of the Election Code, every candidate and DateRecelved political committee is encouraged to subscribe to the Code of Fair Campaign Practices. The Code may be filed with the proper filing P � 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) POLITICAL COMMITTEE El 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., tr Ms., etc.) FIRST /2MI (PLEASE TYPE OR PRINT) `-°° J ._ ............ .... NICKNAME LAST SUFFIX (SR.,JR., III, eta) 4 TELEPHONE NUMBER AREA CODE PHONE NUMBER EXTENSION OF CANDIDATE / (1�1 `C L 1 6—e (PLEASE TYPE OR PRINT) 5 ADDRESS OF CANDIDATE STREET /PO BOX; APT /SUITE#; CITY; STATE; ZIP CODE � � (PLEASETYPE OR PRINT) I l�/ � � ���°L-' l • 1 � �C -ate.° Shy `C.' " l � -�i [[ 6 OFFICE SOUGHT BY CANDIDATE (PLEASE TYPE OR PRINT) 7 NAME OF COMMITTEE (PLEASE TYPE OR PRINT) 8 NAME OF CAMPAIGN TREASURER TITLE (Dr., Mr., Ms., etc) FIRST MI �.r` ar'�� (PLEASE TYPE OR PRINT) ­.­.... . NICKNAME LAST SUFFIX (SR., JR., III, eta) GO TO PAGE 2 www.eth1cs.state.tx.us Revised 11 1'zjizWlU F. v. OUA IGU /V /AWSLIH, IeXas tOt I- I -ZU /U (bl Z)4bd -bBUU (IUL) 1 -800- There are basic principles of decency, honesty, and fairplay that every candidate andpolitical committee in this state has amoral obligation to observe anduphold, in order that, after vigorously contestedbut fairly conducted campaigns, our citizens may exercise their constitutional rights to a free and untrammeled choice andthe will ofthe people maybe My and clearly expressed onthe 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 orpatriotism ofmy 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 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, herebyvoluntarily endorse, subscribe to, and solemnlypledge myselfto conduct the campaign in accordance with the above principles and practices. ature Date www.ethics.state,tx.us Revised 11123/2010