Raquel Gutierrez2-50
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 SPECIAL 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 rejectlon of applicat
APPLICATION FOR A PLACE ON THE SPECIAL ELECTION BALLOT
TO: City Secretary/Secretary of Board (dalrne 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
e;i
FULL ® UNEXPIRED
FULL NAME (First, Middle, L ) PRINT NAME AS YOU WANT IT TO APPEAR ON THE BALLOT'
PERMANgNT RESIDENCE ADDRESS (Do not include a P.O. Box or Rural Route. PUBLIC MAILING ADDRESS (Address for which you receive campaign related
If you do not have a residence address, describe location of residence.) correspondence, if availabl )
CITY STATE ZIP CITY.
� ? � 76 /sue & C
PUBLIC EMAIL ADDRESS (Address for which you
receive campaign related emails, if available.)
�c�iu 1 C �•
TELEPHONE CONTACT INFO TION (Optional)
Home.• /U X
FELONY CONVICTION STATUS (You MUST check i
09 1 have not been finally convicted of a felony.
OCCUPATION (Do not leave blank)
DATE OF BIRTH
VA
STATE I ZIP
1 ,61,5-
VOTER REGISTRATION VUID
�D NUMBERz (Optional)
Office: n / ,4-- Cell: 1f0 r '7F",?17—
LENGTH OF CONTINUOUS RESIDENCE AS OF DATE THIS APPLICATION WAS SWORN
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)
This Box Must ONLY be Completed by Candidates for School District Board of Trustees
Check the Box Below:
I am aware 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 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) .7 who being by me here and
now duly sworn, upon oat says: ;rl
"I, (name of c ndidateof (I County, Texas, being a candidate for the
office of swear that I will sukpbrt and defend the Constitution and laws of the United States and of the State of
Texas. I am a citizen of the 61ted 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 incap a)ed 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 ' d 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 aw a t, nowingly providing false information on the application
regarding my possible felony conviction status constitutes a Class B misdemeanor. I further s ea t the foregoing statements included in my application are in all
things true and correct." X
. - NATURE OF CANDIDATE
Sworn to d subscribed before me this the Z-14 day of by
(da) (month n e of candidate)
(It I a
SHEILAM EDMON SSign f is A h rized Administer Oath4Notary ID #1249(;A a of Officer Authorized to A minister Oath
My Commission Expires March 17, 2029
14'Ct@, 0f (1%fli'121 $r•�:i
Title of Office Authorized to Adminis r Oath
TO BE COMPLETED BY FILING O ER: THIS APPLICATION IS ACCOMPANIED BY THE REQUIRED FILING F (If Applicable) PAID BY:
CASH HECK MONEY ORDER ❑ CASHIERS CHECK OR ❑ PETITION IN LIEU OF A FILING FEE
T/hiissjdocu eZ and $��,�filing�feee or a nominating petition of pages re o er R istration Status Vgdfied
SL 1/ U'� �s1L� J12_ (See Section 1.007)
Date Received Date Accepted Signature of Filing Officer or Designee
APPOINTMENT OF A CAMPAIGN TREASURER FORM CTA
BY A CANDIDATE PG 1
See CTA Instruction Guide for detailed instructions. 1 Total pages filed:
2 CANDIDATE MS{�'-RS;MR FIRST MI OFFICE USE ONLY
NAME
Filer ID #
y --------------------------
NICKNAME LAST SUFFIX Date Received
t i
goc— /!
3 CAN D I DATE ADDRESS / PO BOX; APT / SUITE #; CITY; STATE; ZIP CODE
MAILING
ADDRESS-H��i
��J /i� /!J Date Hand -delivered or Postmarked
4 CANDIDATE AREA CODE PHONE NUMBER EXTENSION Receipt# Amount$
PHONE �j � �J
( ) f �Y—�/^--f— Date Processed
5 OFFICE Dale Imaged
HELD /
(if any) A Il
6 OFFICE
SOUGHT
(if known)
7 CAMPAIGN MS? R /MR FIRST MI NICKNAME LAST SUFFIX
TREASURER
NAME Gr de��C�
8 CAMPAIGN STREETADDRESS; APT lSUITE #; CITY; STATE; ZIP CODE
STREET
TREASURER
ADDRESS
(residence or business)
9 CAMPAIGN AREA CODE PHONE NUMBER EXTENSION
TREASURER
PHONE ri�D jig ^ Q 7? y
10 CANDIDATE j
SIGNATURE II 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.
1 am aware of th a trictions in title 15 of the Election Code on contributions
from corporatio % a labor organizations.
Forms provided by Texas Ethics Commission
of Candidate
GO TO PAGE 2
www.ethics.state.tx.us
Date Signed
Revised 1/1/2026
6
CODE OF FAIR CAMPAIGN FORM CFCP
PRACTICES 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
'0 fli
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 -delivered or Postmarked
Subscription to the Code of Fair Campaign Practices is voluntary. Date Processed
Date Imaged
1 ACCOUNT NUMBER
2 TYPE OF FILER
(Ethics Commission Filers)
CANDIDATE ® POLITICAL COMMITTEE
If riling as a candidate, complete boxes 3 - 6, if filing for a political committee, complete
then mad and sign page 2. boxes 7 and 8, then read and sign page 2.
3 NAME OF CANDIDATE
TITLE (Dr., Mr.. Ms., etc.) �` >FIRST ,j MI G I
(PLEASE TYPE OR PRINT)
-------------------------- ----------------------------------'-------------
NICKNAME LAS SUFFIX (SR., JR., III, etc.)
4 TELEPHONE NUMBER
AREA CODE PHONE NUMBER EXTENSION
OF CANDIDATE
(PLEASE TYPE OR PRINT)
� �O) 4 / /
5 ADDRESS OF CANDIDATE
STREET/POBOX; APT/SUITE`y#; CITY;
(PLEASE TYPE OR PRINT)
Y'6�z'SSTATE;ZZJPPCCOD/E
/A-' / /< 79 )�
6 OFFICE SOUGHT
BY CANDIDATE
`—Zee
(PLEASE TYPE ORPRINT)
//!�// r%rT�7i� L'
l` ��?�� ;
7 NAME OF COMMITTEE
(PLEASE TYPE OR PRINT)
�/ rrr���
/ / L�`% Gf�f lj LC/ G
8 NAME OF CAMPAIGN
TREASURER
TITLE (Dr., Mr., Ms., etc.) FIRST Ml
Z.
(PLEASE TYPE OR PRINT)
------------- ---------------------------------------------------
NICKNAME LAST /,, /� SUFFIX(SR.,JR.,III, etc.)
1 f7i�1"r`r` Z
c/
�" of
GO TO PAGE 2
Forms provided by Texas Ethics Commission
wwmethics.state.N.us Revised 1/1/2021
CODE OF FAIR CAMPAIGN PRACTICES
There are basic principles ofdecency, honesty, and fairplay that every candidate andpolitical committee in this stat(
has amoral obligation to observe and uphold, in orderthat, aftervigorously 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.
ir.i01: 0
(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 orpemut 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 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 corruptor undermine our system
of free elections or that hampers or prevents the full and free expression of the will ofthe 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 anyprovision ofthis code orthe
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.
Date
Forms provided by Texas Ethics Commission www.ethics.state.tx.us Revised 1/1/2021