Davidhizar, Paul, ballot application, 7-25-182-21
Prescribed by Secretary of State
Section 141.031, Chapters 143 and 144, Texas Election Code
1/2017
ALL INFORMATION IS REQUIRED TO BE PROVIDED UNLESS INDICATED OPTIONAL
APPLICATION FOR A PLACE ON THE CA:r1 OF R.-Lot-A-50t(tf 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.)
hZi(FULL
COIA-(
1Yht01 f 4)1. - 1} - 1 e 65-�`; ot1 L
1
INDICATE
TERM
UNEXPIRED
FU
NAME
4k I
(First, Middle, Last)
M� ' Cs�
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PRIN ME AS YOU WANT IT TO APPEAR ON THE BALLOT'
k i f_ ZPoVia�t C�. t �� Vel �t r
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.)
C4413 ki[ICtre5+ br
PUBLIC MAILING ADDRESS (Campaign mailing address, if available.)
L32 EMK5 Lke
CITY
-0t4v;t3viI\e.
STATE
T
ZIP
`1134o
CITY
uK-t-sv`tliC
STATE
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ZIP
'i7314O
PUBLIC EMAIL ADDRESS (If available)
1
Pvt k Zar C 3 u QI 1 •
OCCUPATION (Do not leave blank)
ttAt�'S"�Q(-
DATE OF BIRTH
b ( / 28 / 1q5 l�y
VOTER REGISTRATION VUID
NUMBER (Optional) 2
I CO( . Xj 3 65
TELEPHONE CONTACT INFORMATION (Optional)
Home:
Work: Raj(, .- 438 _%33
Cell: f6 _ r42 - 35-7,7
LENGTH OF CONTINUOUS RESIDENCE AS OF DATE APPLICATION SWORN
IN STATE
gs year(s)
IN TERRITORY FROM WHICH THE
OFFICE SOUGHT IS ELECTED3
Z -D year(s)
4' month(s)
1 ( 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) 34.c. I J(t �i 0'— , who being by me
here and now duly swoirn, upon oath says: 1' l
"I, (name) ')iK 1 ZQ- W
QA114, of Q �er- County, Texas, being a
candidate for the office of C:,�„ea,te4,ti.ea-a+-1eJ-e -{-:t• 41 1 , swear that I will support and defend the Constitution and laws
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of the United States and of the State of Texas. I am d citizen of the United
this state. I have not been finally convicted of a felony for which I have not
official action. I have not been determined by a final judgment of a court exercising
partially mentally incapacitated without the right to vote. I am aware of the
I further swear that the foregoing statements included in my application a
X
States
been
nepotism
_ in
eligible to hold
pardoned or had
probate jurisdiction
law, - . pter
all thi ue an,
such office
my full rights
to
573 Government
corr-
c
under the constitution and laws of
of citizenship restored by other
be totally mentally incapacitated or
Code.
tit r
LEE WOODWARD
Si NATURE OF
,'1 , . 1 .:1 - -
wo n to and .ub cribed before me at ' : S( -N_ p� , this the'.0 .ay of 1!1 ,
4N71i,AD • STATE OF TEXAS
^1 ' `
%'141V MY COMM -EXP. 2/19/21
NOTARY ID 12681012-9
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IlL
t
I.,Sign
re of Officer Administering Oath4 Tiife of ffi r Administ ring Oat
Ts :E COMPLETED BY CITY SECRETARY OR SECRET
(See Section 1.007)
Y OF B ARD:
Date
Voter Registration Status Verified
yr -
Receive Si a ure of Sec ary