Allen, Ronald, ballot application, 8-8-172-21
Prescribed by Secretary of State
Section 141.031, Chapters 143 and 144, Texas Election Code
1/2017
ALL INFORMATION I5 REQUIRED TO BE PROVIDED UNLESS IICATEp 0 IONAL
APPLICATION FOR A PLACE ON THE GENERAL ELECTION BALLOT
TO: City Secretary/Secretary of Board
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.)
1A)f,l3 1
INDICATE
TERM
FULL
UNEXPIRED
FULL NAME (First, Middle, Last)
"atI) N 4L t E,J
PRINT NAME AS YOU WANT IT TO APPEAR ON THE BALLOT'
(�N -j D 0 Ltr,.)
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.)
Civd^ 60-seit, da4N9----/
PU LIC MAILING ADDRESS (Campaign mailing address, if available.)
fJ//0E
CITY
go j,:atoj
STATE
4...
ZIP
77)24-Dabl&u:Dt7
CITY
STATE ZIP
7 3 4t-0
PUBLIC EMAIL ADDRESS (If available)
OCCUPATION (Do not leave blank)
•
DATE OF BIRTH
//0 / LI e
V ER REGISTRATION VUID
NUMBER (Optional) 2
f0o / 7 S- SI Y
elb.:24ci
TELEPHONE CONTACT INFORMATION (Optional)
Home: �39)-fr.. e
Work:(4 b) ),41-:-..740
Cell: (q 34` s/— 3 ^.5 `7
LENG OF CONTINUOUS RESIDENCE AS OF DATE APPLICATION SWORN
IN STATE
/!
6 7 year (s)
IN TERRITORY FROM WHICH THE
OFFICE SOUGHT IS ELECTED3
(�
G T year (s)
1 month(s)
'7 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)atzwho being by me
here and now duly orn, upon oath says:
"I, (name) -�`' C%`^ , of W .�/�- County, Texas, being a
candidate for the office of tuk4 3 (44.,, ,(yp , trte.4 JJ.L..- , 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 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 a ings true and correct."
X if / /
SIGNAT RE • CA • DATE LEE WOODWARD
Swo
to ands bscrib d before me .t o , this the 13A day of _ a �' \ . NOTARY PUBLIC
_
/I
`3 V STATS OE TEXAS
1 . MY COMM. EXR 2/19/21
I INS ft.'iv r NOTARY 1268 -9
Sigra u - of Offi ' dmini - : i . Title c(0 icer Admi il.teri . 0.
TO BE • MPLETED BY CITY SECRETARY OR SECRETA OF OARD:VIP
fS e Section 1.007)
f
II t iIII_
Date ecei d gn:ture.i Secretary
Voter Registration Status Verified