Whitson, David - Place 5 - the City of North Richland Hills, Texas

Whitson, David - Place 5 - the City of North Richland Hills, Texas

AW215 12
3009
Prescribed by Secretary of State
Sections t4 L03 L 143
004 143
006 Texas Election Code
All information is required to be provided unless indicated as optional Se requiere luda In inf
mocidn a menoc que hoya alguna indicaci
n
qne no es obligatoria
APPLICATION FOR
A
NORTH RICHLAND HILLS
PLACE ON THE CITY OF
APLICACIONPARAUNLUGAR ENLABOLETADELACIUDADDE
GENERALSPECIAL ELECTION BALLOT
NORTH RICHLAND HILLS
GENERALESPECIAL
ELECCION
TO City Secretary
A Secrelurin
u
de It Ciudad
I request that my name be placed on the above named official ballot as a candidate for the office indicated below
ifo que ml nombre esle puesvo en 1u urribu nombrada baleen conio cundidato para pue
Soli
stoofficial indicado abujo
SOUGHT
OFFICE
Include
bx
any
hp
u
PUESTOOFICIAL SOLICITADO
or other distinguishing number
o numera de
lugor a
Council Place 5
City
FULL NAME
nurnero
oo
City
que
hace
INDICATE FULL OR UNEXPIRED TERM
if any
aJicial diifi
place number
e1p
to
is a awns
si
of North Richland Hills
ti i
First Middle Last
NOMBRE COMPLETO
PRINT NAME AS YOU WANT IT TO APPEAR ON THE BALLOT
de Pila
Nombre
INDIOUE SI L 7LRtIINO DLL PUESTO 0I7CIAL ES
RMINO COMPLETO O NO COMPLETADO
T
hits aIgun
Segundo
Nombre
Apellido
ESCRIBA SUNOMBRE COMO DESEA QUE APAREZCA EN LA BOLETA
David Whitson
William David Whitson
PERMANENT RESIDENCE ADDRESS Street address and apartment
number If none describe location of residence Do not include P
O
MAILING ADDRESS If different from residence address
C1ON POSTAL Si es me
DIRE
dijrr o su direeeirin de reside
Box or Rural Rt DIR
CCION DE RESIDENCIA PBRMANENTE Culler Nurnero de
Deportornenm si no lime de
iba to Incalidod d se tesldencio No inchnn su caja pascal
nits
a1
8425 Donna Drive
STATE
CITY CIUDAD
N Richland Hills
OCCUPATION Do
EMPLEO No
Financial
to
not
deje
leave
en
AIERO DE YLLEFONO
Include
Indus el
817
DE
I
FECH
area
codigo de
code
la
HOME
DE SU
ESIADO
ZIP ZONA POSTAL
NUM DE FUID DE POTANTE si upplicable
NACIMIENTO
00287809
d
Length of Continuous Residence as of Date Application Sworn
Optional
acuhaliro
Ownil
4215
280
en que hoR
dido en un Sala Logo en la Fecho en que Presl
j Jnrarner to Sobre 1 S
Im oud
IN
I7SU 01 ICINAJ
STATE
EN EL
817
STATE
CIUDAD
VOTER REGISTRATION VUID NUMBER if applicable
DATE OF BIRTH
blank
blonco
Analyst
OFFICE
CITY
76182
1949
06
08
TELEPHONE NUMBER
W
ZIP ZO
NA POSTAL
sYADO
Texas
1033
485
32 y
s 2
r
DOMICILIO
IN
EST4DO
EN
IN DISTRICT OR PRECINCT
CITY
ENEL DISI
RITO 0 PRECINTO
CIUDAD
17 y
s5
r
117
mos
mos
es
0m
mitoLs
EL
oLs
a
es
nres
5 mos
s
airn
s
mes
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 Para poder hreluh un apndn corno paste de sit nobs complem el la
ro
deb
Ud
Jirrnm la eiguiente
indicocion de on cteencios o afl ions
papelem
Before
the
me
here and
now
undersigned authority
rcia Adema
cjuro gate se ne hoconocido pot este opodo pnr tons de ryes aims Adenms juro que el apndn noes un lerno politico ni
as ec
olili
on
this
o
icos social
s n reli glasas
day personally
swam upon oath says
being a candidate for the office
duly
appe
ed
name
0
hl
h
of
1 nam
of
counry
4
who bein
b
me
AR
r
6
Me
swear that 1 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 at aware of the nepoti sin law Chapter 573 Government Code
County Texas
I further swear that the foregoing statements included in my application are in all things true and correct
persona
To habiendo crqui y ahora presloda jarrornenlo debido bnjo jm mnenlo dice Yo
del
condado
de
wndo
Terns
andidato
I o o el puesto
oJicial
solemnemenlejm o que apapm y defenders 1a Co
a0uci6n 7as leyes de ha E
stados Unidos y del Estndo de Terns So ci
dano de 7os
d
stados Unidos legible pora ocupar col puesto gficial bnjo la Constim
E
hini fits lees de este Eslado No me han delei tomado par onjuicio Bnaf de i i corle de fa legafLacidn
de ten leslamenlo ser Inmlmente incapacitado menlalmenle o parciahw incup ilado sin el derecho de roar ni he
vido prubado culpablefrnalmenle de una elanio pot la cool
no Ire sido perdonado o pot la canal no sr me hum rest
luido I
rnenle mis derecho
sde cindodonia pot media de otra accidn oliciaL Yo iengo conocimiento de la ley Ie el
I 1ismo regain e1 capilulo 573 de Cdigo Gohierno
mi
la
crutoridad
snscrila
pmccro
en
I
Ante
de
Adem6s juro gue lac precedents declmnciones gue inclupo en mi solicilud son verdaderar
esldn coccus en tad s sentidos
X
SIGNATURE OF CANDIDATE FIRMA DEL CANDIDATO
Swom
to
and subscribed
Juradoysuccrilo anle mi
before
me
at
me
this the
diu
I
en
tS
IC UR1
1
AH
day of
2
c
n
S
11
de
ftr
of Officer administering oath
gnature
Finn del oficial udminisirando el
juramenio
r
S
Title of Officer adAiinistering oath
iindo del ifml udminist do el
juruntento
OEE 0 v1WE AI
YE
LLJJ
Sec
Section
007
1
Date Received
FEB
6111
aopm
CITY SECRETARY
Signature of City Secretary
iLi3