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110218 - Candidate Application - Karl P. MooneyREOUEST TO PLACE NAME ON CITY OFFICER BALLOT /Charter Provision No. 79) L TO: City Secretary for the City of College Station, Texas , do hereby certify that I am a candidate for the office of est that my name be printed upon the official ballot for this ion, May 14, 20 1 1. I am a qualified voter of the State of Texas, and am and have been a bonafide resident of the City of College Station, Texas for at least one (I) year. I am not disqualified or ineligible to serve on the City Council if elected. I reside a Precinct No. , College Station, Texas. SUBSCRIBED AND SWORN TO BEF bW SOLICITUD PARA ANADIR A LA BOLETA DE ELECCIONES PUESTOS DE FUNCIONARIOS DE LA CIUDAD JProvisi6n del Estatuto No. 79) PARA: Secretario de la Ciudad de College Station, TX yo, , por este medio certifico que soy un candidato para el cargo de , y pido que se imprima mi nombre en la boleta oficial para este cargo particular en las elecciones de la ciudad del 14 de mayo de 201 1. Reuno 10s requisitos necesarios para votar en el Estado de Texas, y soy y he sido un residente confiable y de buena fe de la Ciudad de College Station, Texas por lo menos un (I) afio. No estoy descalificado ni soy inelegible para servir en el Consejo de la Ciudad si fuera electo. Resido en la direccion siguiente: , Distrito Electoral No. , College Station, Texas. FIRMADO Y JURADO ANTE MI ESTE DIA DE ,2011. Notario Publico, Condado de Brazos, Texas AW2-IS, 1212009 Prescribed by Secretary of Stale Seclions 141 03 1, 143.004, 143 006, Texas Election Code All inlormalion is required to be provided unless indicated as optional (Se reyeicrr rod0 la in/on~racion, o Inenor que haya alg~ma indicaodn qus no cs obliga~orio) APPLICATION FOR A PLACE ON THE CITY OF fqp rmm (GENERALISPECIAL) ELECTION BALLOT (APLICACION PARA IJN LUGAR EN LA dO12ETA DE /A CIUDA- pp . ELECCION (GTJERAL ESPECIAL)) TO: City Secre~ary (A: Secrclar,u(o) dr. 10 Crvhd) I request that my name be placed on the above-noned official ballot as a candidate for the office indicated below (Solrc~lo qjre mi ~tumhre e.\l/ puerlu en la orrrbo nombrrrdo holcru cujnu cond~dorr, puro pucsrv ciJ,/iool r,,drcado uhajo.) TO BE COMPLETED BY CITY SECRETARY: (See Sauon 1 007) OFFICE SOUG HT (PUESTO OFl;ICIAL SOLICITADO) Include any place number or other distittguishing number, if any. Date Received I INDICATE FULL OR UNEXPIRED TERM (1NI)IQUESI EL TEXMIhl) DEL PUFSIO OI.7CIAI. a d!kren~e 0 ~II<II. ,I hay alpno ) TERMIN) COMI%ETO 0 NO ,OOMlLL;WDO) FULL NAME (First, Middle, Last) PERMANENT RESIDENCE ADDRESS (Street address and apmlnent number. If none, describe location of residence. Do not include P.O. Box or Rural Rt.) (DlREClONDEkEYIDENClA PERMANEWE: Culh y Nhrro de Dvwramenro st no nee. drscribo la locabdad de ru rerldencro. No mrlup rv cap portal 0 "'10 mrai) @ad 9; ulLder~ /d$ d% PRINT NAME AS YOU WANT IT TO APPEAR ON THE BALLOT MAILING ADDRESS (If different bom residence address) (DlRECCIONPOSTAL(9 er dferenle o m direcclbnde nridenno)) CITY (CIUDAD) STATE (EXADO) ZIP ffONA FUTAO OCCUPATION (Do not leave blank) DATE OF BIRTH VOTER REGISTRATION VUID NUMBER (if applicable) TELEPHONE NUOBER (Include area code) (Optional) (NUMERO DE TELElONO-lxluy el c4go de lo ared) (Focul~om) oF,lc,: 779 - 8'Yfi3-9/4 Length of Continuous Residence as of Date Application Sworn (T~emp en que ha Renddo en w &lo Lagor en b Fecho en que Presld Juromento Sobre b &/land) IN STATE IN cm (DE SV OFICINA% (ENEL FSADO) I (EN EL CIUDAD) (DE SV MMUUO:) (aIb(s) (me(er)) (am(d (mshs)) IN DISTRICT OR PRECINCT1 (EN EL DISTRITO 0 PRECNTO) /lyr(s)gmos (ab(sJ (me$&) 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. Pampoder lnclurr wr a+ wmoparte de su nombre mmpLlo d b plpirra, UddebrmJlrmar la slguienre conrlancla: Ademal, jum qur re me ho mnocldo pr ute opodo por mns dr ms aflor. Ahmar, ]urn que el a+ no er un IermpoI~Hco nl wra mndacooon de mb creencias o oplocionespobllcar. economrcas, rociaks, o reli,qima~. Before me, the undersigned authority, on this day , who being by me here and now duly sworn, upon oath says: "I, , of P~-=ZO~ County. Texas, being a candidate for the office of , swear that 1 will support and defend the Constitution and laws of the United Sta e to hold such office under the Conslitution and laws of this state. I have not been finally convicted of a felony for which 1 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 all things hue and correct." (Anls mi, la auro"da4 surcrila aporecid en persona , quicn habiendo qur y ohora prerrado jummenlo debido, bajo jummenro dice. "Yo, - del conkdo & Terns, siendo c~drdolo pva el pueslo ajcial de solemn~~enle]um que awri y dejnderd la Consfirucibn y lar/~ios Esrador Unrdos y del Eslada de Texas. Soy cidno do 10s Eslados Unidos elegible pom ocupor la1 puerro ojcial bajo la Conrriruc,dn y lor le~s de esu Errado. No me han derennlnado por un juiciojnal de urn cone de la legaliwcidn de un res(menro, rer roralmenre incopcialo menrolmenre o porcialmenre rncopocirado sin el derecho de mar, ni he rido pmbado culpablejmlmenle de um/elonb por la cwl no he sjdo ~erdonado o por lo cual no sr me han resriru~da enleramma mir derechos de ciudad~la por medio de arm accion ojciol Ya lengo conoc~mrenlo de la ley sobre el neporirmo seajn el capirulo 573 de Cage Gobiemo Ademdsjuro que lospreceden/s declaracrones 9ue incluyo en mi sol~ci~udso~~ verrbderasy esldn correclar en lpdos senlidos '") A