07-22-24 Allison Heyward2-26
Prescribed by Secretary of State
Section 141.031, Chapters 143 and 144, Texas Election Code
09/2021
ALL INFORMATION IS
APPLICATION FOR A PLACE ON THE BALLOT FOR A GENERAL ELECTION
FOR A CITY, SCHOOL DISTRICT OR OTHER POLITICAL SUBDIVISION
RED TO BE PROVIDED UNLESS INDICATED AS OPTIONAL' Failure to provide required information may result in
APPLICATION FOR A PLACE ON THE
of
GENERAL ELECTION BALLOT
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.)
t r ("`� C- 1 I P
INDICATE TERM
6� ❑
t Q
FULL UNEXPIRED
FULL NAME first, Middle, Last)
A - I ksar, Aevwct
PRINT NAME AS YOU WANT IT TO APPEAR ON THE BALLOT*
A-t L(e
vonne- rCD
/ spn v wQ rc,
PERMANENT RESIDENCE ADDRESS (Do not include a P . Box or Rural Route. If
PUBLIC MAILING ADDRESS (Optional) (Address for which you receive
you do not havvee a res1iid��nce address, describe ocation of r sidence.)
2(Q 2�
campaign related �cgrrespondenc , if ava' able.)
��2Zg�nse�
tt�h QS
en
CITY
S
STATE
ZIP
Ts, r
CITY
S ATE
ZIP
PUBLIC EMAIL ADDRESS (Optional) (Address for
OCCUPATION (Do not leave blank)
DATE OF BIRTH
VOTER REGISTRATION VOID
whi h you receive campaiggn related emails, if available.)
Cc��ISon-tSc�e� mQ Co
m eber
03,
NUMBER' (Optional)
I�
*`tl
TELEPHONE CONTACT INFORMATION (Optional)
Home: Office: Cell: J�W 5-0
FELONY CONVICTION STATUS (You MUST check one) LENGTH OF CONTINUOUS RESIDENCE AS OF DATE THIS APPLICATION WAS SWORN
I 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
pardoned or otherwise released from the resulting year(s) ) 3 year(s)
disabilities of that felony conviction and I have provided
proof of this fact with the submission of this application.3 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 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) cro-d / who
being by me here and now duly sworn, upon oath says: {n�
"I, (name of candidate) t - w1-S of (`-2LJrAr, No i County, Texas,
being a candidate for the office of a 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 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 am aware that I must disclose
any prior felony conviction, and if so convicted, must provide proof that I have been pardoned or otherwise relea from the resulting disabilities of
any such final felony conviction. I am aware that knowingly providing false information on the application re r in my possible felony conviction
status constitutes a Class B misdemeanor. I further swear that the foregoing state a included in my a p i ti are in all things true and correct."
x
SIGNATURE OAX41NDIDATE
Sworn to and subscribed before me this the VOclay of hkhh by
(day) (mo th) year(( (nam fcandidate)
11 AMA,
Igni f cerAuthor' ed to Ister Oath^ Printed Name of Officer Authorized to Administer Oath
Title of Offic r Authorized to Adln' ister Oath SHEILA M. EDMONOSON
O BE COMPLETED BY FILING OFFICER: THIS APPLICATION IS ACCOMPANIED BY
ASH ❑ CHECK ❑ MONEY ORDER ❑ CASHIERS CHECK OR ❑ PETITION IN L Il
his document and $' filing fee or a nominating petition of pagag
�_1XLLLl/ (See Section 1.007)
Date Received 11 Date Accepted 111
,WfApplicabl PAID BY:
E*% o9117r2Q25
pr Reg ration Status Verified
or Designe
11 —
CODE OF FAIR CAMPAIGN
PRACTICES
FORM CFCP
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 appointment
form. Candidates or political committees that already have a y
current campaign treasurer appointment on file as of September 1, U
1997, may subscribe to the code at any time. Date Hand-deiveredorP
Date Processed
Subscription to the Code of'Fair Campaign Practices is voluntary.
Date Imaged
'I ACCOUNT NUMBER 2 TYPE OF FILER
(Ethics Commission Filers)
CANDIDATE 21 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 I TITLE (Dr.,Mr.,Ms.,etc.) A
FIRSST MI
/t/'
(PLEASE TYPE OR PRINT) �.I 1 70y 1
----------------------------- ----------------/------------------------
NICKNAME LAST n SUFFIX (SR., JR., III, etc.)
�--� '-e w Ct r�J
4 TELEPHONE NUMBER AREA CODE PHONE NUMBER EXTENSION
OF CANDIDATE !�� Q�r� � 4 £�
(PLEASE TYPE OR PRINT) \ a J
5 ADDRESS OF CANDIDATE STREET/POBOX; APT/SUITE#;#;; ` CITY; STATE; ZIP CODE
(PLEASE TYPE OR PRINT)
6 OFFICE SOUGHT
BY CANDIDATE
(PLEASE TYPE OR PRINT)
�ScVCVL (-- c0011C-t-ti �p
7 NAME OF COMMITTEE
(PLEASE TYPE OR PRINT)
8 NAME OF CAMPAIGN TITLE (Dr., Mr., Ms., etc.) FIRST MI
TREASURER ��'
(PLEASE TYPE OR PRINT)---------------------Vv ------'�---------------------------------------------
NICKNAME LAST SUFFIX (SR., JR., III, 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 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) Twill 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) Twill 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 myself to conduct the campaign in accordance
with the above principles and practices.
Signature
-a��as /,zip C9 w
/ Date
Forms provided by Texas Ethics Commission www.ethics.state.tx.us Revised 1/1 /2021
APPOINTMENT OF A CAMPAIGN TREASURER FORM CTA
BY A CANDIDATE PG 1
See
CTA Instruction Guide for detailed instructions.
1 Total pages filed:
2 CANDIDATE
NAME
MS/MRS/MR FIRST MI
OFFICE USE ONLY
Filer to #
A5 4/11-son
--
NICKNAME
LAST SUFFIX
[4 (R-- I Lo oL V-co
Date Received
3 CANDIDATE
ADDRESS / PO BOX; APT / SUITE #; i CITY; STATE; ZIP CODE
MAILING
ADDRESS
2�Zb
` 1 °j'
V1S� ` TS (ZA ac) 1 t
Date Hand -delivered or Postmarked
4 CANDIDATE
AREA CODE
PHONE NUMBER EXTENSION
Receipt#
Amount$
PHONE
G(
Date Processed
5 OFFICE
Date Imaged
HELD
(if any)
C
`
CAI
t
6 OFFICE
SOUGHT
(if known)
l (�
C I (ryl CWI 6-o%
C�,e r
1' `uiie_1
7 CAMPAIGN
MS/MRSlMR
FIRST MI NICKNAME
LAST SUFFIX
TREASURER
NAME
411, 1 (.(jo e-d
8 CAMPAIGN
STREET ADDRESS;
APT / SUITE #; CITY;
STATE; ZIP CODE
TREASURER
STREET
Zlo ZDG
II �1 `
Q h S >2 1 1 1 T S Se1�gr✓�L T7C -p
7 p
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.
@-7 2-��_
&nature of Candidate Date Signed
GO TO PAGE 2
Forms provided by Texas Ethics Commission www.ethics.state.tx.us Revised 1/1/2024