Ralph Gutierrez2-49
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 OPTIONAL' Failure to provide required information may result in rejection of app
APPLICATION FOR A PLACE ON THE A&VeAlAgyr ?0Z9-Jc-Ace1
ZGENERAL 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.) IND CATE TERM
0.0 FULL ❑ UNEXPIRED
FULL NAM (First, Middle, Last) PRINT NAME AS YOU WANT IT TO APPEAR ON THE BALLOT*
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PERMANENT RESIDENCE ADDRESS (Do not include a P.O. Box or Rural Route. If PUBLIC WAILING ADDRESS (Optional) (Address for which you receive
you do not have a residence address, describe loc9tion of residence.) campaign related correspondence, if available.)
CITY STATE ZIP CITY' j ?NUMBER2
E ZIP
7 �g s Sc� e,* e
PUBLIC EMAIL ADDRESS (Optional) (Address for OCCUPATION (Do not leave blank) DATE OF BIRTH R REGISTRATION VOID
which you receive campaign related emails, if available.) (Optional)
TELEPHONE CONTACT INFORMATION (Optional)
Home: Office: Cell:
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 SO GHT IS ELECTED
pardoned or otherwise released from the resulting year(s) 3 year(s)
disabilities of that felony conviction and 1 have provided
proof of this fact with the submission of this application.' _L month(s) month(s)
This Box Must ONLY be Completed by Candidates for School District Board of Trustees
Check the Box Below:
I am aware that 1 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
of Criminal Procedure.
*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) `4.' who being by me here
and now duly swom, upon oat say
"I, (name of candidate) G L of I(rt A4 At a C County, Texas, Being a candidate fo
the office of Z swear that I will support and defend t e Constitution and laws of the United States and of the
State of Texas. I arnfa citizen of thk United States eligible to hold such office under the constitution and laws of this state. 1 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 o
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 released from the resulting disabilities of any such final felony conviction. I am aware that knowingly providing false information on
the application regarding my possible felony conviction status constitutes a Class B misdemeanor. I fu r t the foregoing statements included in my
application are in all things true and correct. V
/� SIG RE nt bLNnln&TF
Sworn to and subscribed before me this the -Z day of
(day)
to Administer Oath4
Title of Offi*ejf Authorized to Admkhter Oath
Printed
by
candidate)
f!Mkk0gr Oath
SHEILA M EDMONDSON
y1*kkV ID ff 124952131
TO BE COMPLETED BY FILING OFFICER: THIS APPLICATION IS ACCOMPANIED BY THE Q D FILINt� of AMhable) ID BY:
'
—1 CASHCHECK MONEY ORDER CASHIERS CHECK OR ❑ PETITION IN LIEU F
This docu ent and $ f �� ` filing fee or a nominating petition of pages received. Voter e �is�t(ratio/n Status Verged
% / (See Section 1.007)
)ate Received Date Accepted Si of Fili ff Officer or Designee
APPOINTMENT OF A CAMPAIGN TREASURL.,.
BY A CANDIDATE
See CTA Instruction Guide for detailed instructions.
2 CANDIDATE MS/MRSJMR FIRST J MI
NAME
3 I.HIV U I LJH I t
MAILING
ADDRESS
41 CANDIDATE
PHONE
-----------
J-�& /? -�----------------------
NICKNAME
LAST SUFFIX
6:a-11'ell,ez
ADDRESS / PO
BOX; APT / SUITE #; CITY; STATE; ZIP CODE
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Se-X e,el-z JX 7 9/S�l
AREA CODE
PHONE NUMBER EXTENSION
Q210)
3 ,441 9�21
5 OFFICE
HELD
(N any)
6 OFFICE
SOUGHT
(if known)
�l
7 CAMPAIGN
MS/MRS/MR FIRST
MI NICKNAME
TREASURER
NAME
8 CAMPAIGN
STREET ADDRESS; APT I SUITE
#; CITY;
TREASURER
' STREET
y I/ 1,1er1rCe
/O/
ADDRESS
pL cC,
15e4eplz-
(residence or business)
9 CAMPAIGN
AREA CODE PHONE NUMBER
EXTENSION
TREASURER
PHONE
Q/0)
j 10 CANDIDATE
J SIGNATURE
FORM CTA
PG 1
1 Total pages filed:
OFFICE USE ONLY
Filer ID #
Date Receive
q(;7
tic,
Date Hand -delivered or Postmarked
Receipt# Amoturta
Date Processed
Date Imaged
LAST SUFFIX
ie�'Z
STATE; ZIPCODE
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 corpo do s r labor organizations.
07
IVI.���s
4t-ureof Candidate Date Signed
GO TO PAGE 2
Forms provided by Texas Ethics Commission www.ethics.state.tx.us
Revised 1/1/2025
CODE OF FAIR �':- : TPAIGN
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.
1 ACCOUNT NUMBER
(Ethics Commission Fiters)
2 TYPE OF FILER
CANDIDATE to
If riling as a candidate, complete boxes 3 - 6,
then read and sign page 2.
FORM CFCP
COVER SHEET
OFFICE USE ONLY
Date Received
Date
Date Processed
Date Imaged
POLITICAL COMMITTEE
If riling for a political committee, complete
boxes 7 and 8, then read and sign page 2.
3 NAME OF CANDIDATE TITLE (Dr., Mr., Ms., etc.) FIRST // MI
(PLEASE TYPE OR PRINT)gcL _�Gr_ I— -----------------------------------------
NICKNAME LAST SUFFIX (SR., JR., III, etc.)
l z-1 � &e,(,//e- "eZ
Q TELEPHONE NUMBER AREA CODE PHONE NUMBER EXTENSION
OF CANDIDATE
(PLEASE TYPE OR PRINT) ` 1,7/0 2 7/
5 ADDRESS OF CANDIDATE STREET/POBOX; APT/SUITE#, CITY; STATE; ZIP CODE
(PLEASE TYPE OR PRINT)
/vP����e 5��e,�fz
g OFFICE SOUGHT
BY CANDIDATE ,� A
(PLEASE TYPE ORPRINT) k
7 NAME OF COMMITTEE
(PLEASE TYPE OR PRINT)
$ NAME OF CAMPAIGN TITLE (Dr., Mr., Ms., etc.) FIRST MI
TREASURER /�
(PLEASE TYPE OR PRIM) _4 -------------- A!5�C-------------------------------------------
lNICKNAME I /LAST / SUFFIX (SR., JR., 111, etc.)
/C aZ2
GO TO PAGE 2
Forms provided by Texas Ethics Commission www.ethics.state.tx.us Revised 1/1/2021
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 orderthat, aftervigorously contested but fairly conducted campaigns,
ourcitizens may exercise their constitutional rights to a free and untrammeled choice and the will ofthepeople maybe
fully and clearly expressed on the issues.
�:10 to •
(1) I will conduct the campaign openly and publicly and limit attacks on my opponent to legitimate challenges to m;
opponent's record and stated positions on issues.
(2) I will not use orpemrit the use ofcharacter defamation, whispering campaigns, libel, slander, or scurrilous attack
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 ofany 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 corruptor 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 ofthis 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
✓omrnittee, hereby voluntarily endorse, subscribe to, and solemnly pledge myself to conduct the campaign in accordance
with the aboveprinciples and practices.
%ZD ZS
Date
Forms provided by Texas Ethics Commission www.ethics.state.N.us Revised 1/1/2021