David Scagliola Place 5ALL INFORMATION IS
TO BE PROVIDED UNLESS INDICATED
APPLICATION FOR A PLACE ON THE c�
TO: City Secretary/Secretary of Board
2 -21
Prescribed by Secretary of State
Section 141.031, Chapters 143 and 144, Texas Election Code
IA017
x- GENERAL ELECTION BALLOT
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
�% ILL
/. ❑UNEXPIRED
FULL NAME (First, Middle, Last) - P-RIINNT NAME AS YOU WANT IT TO APPEAR ON THE
_ �¢r/IT� `• ,���1106�¢-" Jl�U1P� � _ sc�G�CIoB�
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.)
3 y/ 9 ,C,F,t��,�/� Li+/
PUBLIC MAILING ADDRESS (Campaign mailing address, if available.)
3 Woo` Jak_xeemw 61,v
CITY STATE ZIP CITY STATE ZIP
Sc #E/erz- T9 71P/V � - _' '-5CWeWry rX 7?ld?'
PUBLIC EMAIL ADDRESS (If available) OCCUPATION (Do not leave blank) DATE OF BIRTH VOTER REGISTRATION VOID
CGJ% ryt it or NUMBER (Optional)'
roi�- @SojCtlrr-
TELEPHONE CONTACT INFORMATION (Optional) LENGTH OF CONTINUOUS RESIDENCE AS OF DATE APPLICATION SWORN
Home: (� �rQ6 P. !f3 d IN STATE IN TERRITORY FROM WHICH THE
J-3 OFFICE SOUGHT IS ELECiED3
Work: VI&
year (s) L�year (s)
Cell. ;10 57d! 9 976 ! 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) A01-3 Z SC s ,C-- l /OC,g-who being by me
here and now duly sworn, upon oath says:
(name) �/A�I A L_ ✓ C�� [ /D�.+� ofa/�Ar!%I°e� County, Texas, being a
candidate for the office of V&Wlele ,n w!SAA P.t' C 4, 4 Sr1i rrht++ear that I will support and defend the Constitution and laws
of the United States and of the State of Texas. I am a citizen he 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 a4i t4ings truond ;orred/
SI ATU
DI ATE
Sworn to and subscribed before meat
this th
day of
Signature of Officer Administering Oath'
Title of Officer mini ring Oath
ilyDr
TO BE COMPLETED BY CITY SECRETARY OR SECRETARY OF BOARD:
(See Section 1.007)
Date Received
ture of Secr y
voter Registration Status Verified I'
APPOINTMENT OF A CAMPAIGN TREASURER FORM CTA
BY A CANDIDATE PG 1
See CTA Instruction Guide for detailed instructions. 1 Total pa es filed:
Z CANDIDATE MS /MRS /MR DZ- FIRST MI OFFICE USE ONLY
NAME - --
�/J,. � Flier ID#
NICKNAME LAST SUFFIX
3 CANDIDATE ADDRESS IPOBOX; APTISUITE #; CITY; STATE; ZIPCODE
MAILING
ADDRESS
4 CANDIDATE
PHONE
5 OFFICE
HELD
(if any)
6 OFFICE
SOUGHT
NF 1--%
7 CAMPAIGN
TREASURER
NAME
8 CAMPAIGN
TREASURER
STREET
ADDRESS
(residence or business)
9 CAMPAIGN
TREASURER
PHONE
.O CANDIDATE
SIGNATURE
AREA CODE PHONE NUMBER
10'3o)
EXTENSION
S /MRS/MR:A.P FIRST / MI NICKNAME
Date Received
Date Hand- dellvered or Postmarked
Receipt # AmoreaS
Date Processed
Date Imaged
LAST SUFFIX
STREET ADDRESS (NO PO BOX PLEASE); APT / SUITE #; CITY; STATE; ZIP CODE
3 4?"ry �dX�m.4-1 Z,s�
!!3 c a-54T7- arc
AREA CODE PHONE NUMBER EXTENSION
(P'3a} 606�-113�
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 av��, a of the restrictions in title 15 of the Election Code on contributions
from liorporations and la'3or organizations.
A./ f�
ate Si ned
Forms provided by Texas Ethics Commission
GO TO PAGE 2
www.ethics.stat6.tx.us
Revised 1/1/2020
CANDIDATE MODIFIED
REPORTING DECLARATION
11 CANDIDATE
NAME
12 MODIFIED
REPORTING
DECLARATION
FORM CTA
PG 2'
COMPLETE THIS SECTION ONLY IF YOU ARE
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. ••
1 do not intend to accept more than $900 in political contributions or
make more than $900 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.
O"`�J�O
Year of electlon(s) orelection cycle to
which declaration applies
Signature of I'date
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 treasa::; oint_ ethics.state.tx.us
or mail to
Texas Ethics Commission
P.O. Box 12070
Austin, TX 78711 -2070
For more information about where to file go to:
hftps://www.ethics.state.tx.us/filinginfo/0uickFileAReport.php
Forms provided by Texas Ethics Commission www.ethics.state.tx.us
Revised 1/112020
Texas Ethics Commission P.O. Box 12070 Austin, Texas 78711-2070 (512) 463 -SB00 (TDD 1 -500-M -2989)
CODE OF FAIR CAMPAIGN FORM CFCP ,
PRACTICES COVER SHEET
i
OFFICE USE ONLY
Pursuant to chapter 258 of the Election Code, every candidate and D.R..Ned
political committee is encouraged to subscribe to the Code of Fair -1
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. Date Hand- dellvered or PoslmeAwd
Date Processed
Subscription to the Code of Fair Campaign Practices is voluntary.
Date Imaged
1 ACCOUNT NUMBER 2 TYPE OF FILER
(Ethics Comrtussion Filers)
CANDIDATE POLITICAL COMMITTEE
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 nT `` �Mr.,Ms.,etc.) FIRST MI
TY
(PLEASE PE ORPItINT)
NICKNAME LAST (( r SUFFIX (SR. JR., Ill, etc.)
4 TELEPHONE NUMBER AREA CODE PHONE NUMBER EXTENSION
OF CANDIDATE /�U 1 / ^ 113 O
(PLEASE TYPE OR PRINT) 1 1 v
5 ADDRESS OF CANDIDATE STREETIPOeOX: APT I SUITE 9; CITY; STATE; +��ZIIPCODE
(PLEASE TYPE OR PRINT) /� if /,0-' 2 /�wo�� Z,4) SG�+d�'T'z- Mae
ae
g OFFICE SOUGHT ✓
BY CANDIDATE
(PLEASE TYPE ORPPJNT)
7 NAME OF COMMITTEE
(PLEASE TYPE OR PRINT)
8 NAME OF CAMPAIGN TITLE M,.,Ms.,etc.) FIRST MI
TREASURER 1-->,+(/! Z) Z- SG,9er—G/d-d
(PLEASE TYPE OR PRINT) . . . . . . ..
NICKNAME LAST SUFFIX (SR., JR., Ill, etc.)
GO TO PAGE 2
www_ethics.state.tX.Us
Revised 1112312010
Texas Ethics Commission P.O. Box 12070 Austin, Texas 78711-2070 (512) 463 -5800 (TDD 1- 800 -735 -2989)
CODE OF FAIR CAMPAIGN PRACTICES
There are basic principles of decency, honesty, and fairplay that every candidate and political committee in this state
has a moral 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 may be
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 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 rare, sex, religion, or national origin.
1
(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 or patriotism 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, hereby voluntarily endorse, subscribe to, and solemnly pledge myselfto conduct the campaign in accordance
with the above principles and practices.
. rgnatUre
www.ethics.state.tx.us
I
Revised 11/23/2010
712112020 Check Your Voter Registration Status - Vote.org
re egistered to ote .
will
V You are registered to vote.
David Scagliola
is registered to vote at
3418 Foxbriar Ln, Schertz, TX 78108 -2233.
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