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160725 - Candidate Application - Jerome Horace RektorikHAND o .. ") fl' JUL Z 5 2016 Jl b ,, VJ;J3 !;Lsslndlcatedaso Hooal 2-21PresalledbySeet'etJryofStateSec:tlon141.031, Chi 145end144. Tens f.IKtionCode12/2015 APPLICATION FOR A PLACE ON THE _c_o _u e _g e_s_ta_tio_n._r _e x _as ________ GENERAL ELECTION BALLOT TO: CitySecretary/Secretaryof Board OFFICE SOUGHT (Includeanyplace number or otMr dlstlngulshlngnumber, If any.} INDICATE TERM FULL College ti nCiy-?uncil -P lace_2 ______ ··---------------·-· --·---OuNEXPtREOfUUNAME (First, Middle, Last) PRINT NAME AS YOU WANT fTTO APPEAR ON THEBAUOTHoraceJeromeRektorikJeromeRektorik PERMANENT RESIDENCE ADDRESS (DonotInclude a P.O. 8o11; or Rural PUBLIC MAILING ADDRESS (Campal1n meHln& address, tfavailable.) Route. If youdonot havea residence address, describe the address at whichyoureceivepersonal maltand locationofresidence.) 437 Chimney Hill Drive437ChimneyHillDrive c:l lege Stati __ :_·-·-_--_--_---_-_ ----_ .... ST_r...,:_:s _..._-_:_:_:_4_0 ---1 c:llege s_--t_atio n---------4-s-; __ : TE_ x as z77_8_4_o_---1PUBLICEMAILADDRESS (If available ) OCCUPATION (Do not leaveblank) DATE OF 81RTH VOTERREGISTRATION VUfONUMBER {Optional) l ·rektorik65 mail.com Retired TELEPHONE CONTACT INFORMATION (Optional) l,' Home: 979 -846 -2727 Work: Cell: May/ 31 / 1942 104 131 2989LENGTHOFCONTINUOUSREStDENCEASOFDATEAPPL.lCATIONSWORNfNSTATEtNTERRITORYELErnDFROM year (s) J!lyear (s) ff{fl; 1_ month(s) _J_ month(sl /11 If ustn1a nicknameas partofyourname to appearon the ballot, you are also s'8nlngand swearlncto the following statements: I further swear that mynkkna me does notconstitute a slogan nor does It indicate a polltical, economic, social, or rellglous vtew or afffllatlon. t have been commonlyknown b this nlclcname for at teas! P.rlor _!!!ISel tlo-----------·-----------------Beforeme, theundersigned authority, on this day personally appeared (name) HoraceJerome Rektorik here and now duly sworn, uponoath says: whobeingbyme 1, (name) Horace Jerome Rektorik of Brazos County, Texas, being a candidatefor the office of College Station City Counc i l, Place2 swear that & wlU supportand defend the Constitution and laws of the United States and of t he State ofTe)(as. t am a citizen of the UnitedStates ellglbleto hold suchofficeunder theconstitution and laws ofthisstate. 1 have not been finally convicted ofa felony forwhich I have not beenpardonedorhad myfull rightsof citizenshiprestoredbyother officialaction. I havenotbeen dete rmined bya final judsment of a courtexercising probatejurisdictionto be totallymentallylncapacltltedorpartiallymentallyineapacltat.edwithout the right to vote. I am aware ofthe nepotismlaw, Chapter573, Government Code. I furtherswear that thefore goin g statements Included tn my applicationare In