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Application for Place on Ballot - Roden, GaryAW2-15,7/2011 Prescribed by Secretary of State Sections 141.03 1, 143.004, 143.006, Texas Election Code All information is required to be provided unless indicated as optional. I APPLICATION W)R A PLACE ON THE CITY OF Cogpel1 GENERAL ELECTION BALLOT 1 TO: City Secretary I I request that my name be placed on the above-named omcial ballot as a candidate for the office indicated below. I I I OFFICE SOUGHT lnclude any place number or other distinguishing number, if any. INDICATE TERM I City Council Place lf- 1 FULL 0 ,EXPIRED I Gary Don Roden I Gary Roden I I FULL NAME (First, Middle, Last) PRINT NAME AS YOU WANT IT TO APPEAR ON THE BALLOT I Coppell I Texas 1 75019 EMAIL ADDRESS (Optional) I OCCUPATION (Do not leave blank) I DATE OF BIRTH 1 VOTER REGISTRATION WID NUMBER PERMANENT RESIDENCE ADDRESS (Street address and apartment number. If none, describe location of residence. Do not include P.O. Box or Rural Rt.) 130 Clover Meadow CITY I STATE I ZIP MAILING ADDRESS (If different from residence address) I IN STATE I CITY gdroden5O@gmail.com IN CITY STATE I ZIP I IN DISTRICT OR PRECINCT1 I design and construction business owner 51 - yr(s) L6 Y r(s) 1 Amos 7 mos I - TELEPHONE NUMBER (Include area code) (Optional) 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. lo/^^^^^^ Length of Continuous Residence as of Date Application Sworn Before me, the undersigned authority, on this day personally appeared (name) Gary Don Roden , who being by me here and now duly sworn, upon oath says: "I, (name) Gary Roden of Dallas- County, Texas, being a candidate for the office of City C0uncil Place rt , swear that I will support and defend the Constitution and laws of the United States and of the State of Texas. I an :itizen 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. 1 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. (if applicable) IO~ ( 98972.3 I further swear that the foregoing statements included in my Sworn to and subscribed before me at n .,. ,.-- CItl dV TO BE COMPLETED BY ClTY SECRETARY: 7 FEB 0 6 2612 (See Section 1.007) Coppell, TX 7501 9 Texas Ethics Commission P.O. Box 12070 Austin. Texas 7871 1-2070 (51 2) 4635800 (TDD 1-800-735-2989) APPOINTMENT OF A CAMPAIGN TREASURER FORM CTA BY A CANDIDATE PG 1 1 Total pages filed: OFFICE USE ONLY ACCt # Date Rece~ved .- -- -- - .---, - -- FEB 0 6 iDi2 SECX3iGY See 2 CANDIDATE NAME 3 CANDIDATE MAILING ADDRESS CTA Instruction Guide for detailed instructions. 2 MSlMRSlMR FIRST MI Mr. . . . Gary . D ... . . * NIC~U&~ ' ' ' LAST' ' SUFFIX ' ' ' Roden ADDRESS I PO BOX, APT I SUITE #, CITY. STATE, ZIP CODE 130 Clover Meadow Coppell, TX 75019 4 CANDIDATE PHONE 5 OFFICE HELD (lf any) 6 OFFICE SOUGHT (I known) 7 CAMPAIGN TREASURER NAME 8 CAMPAIGN TREASURER STREET ADDRESS (residence or busmess) 9 CAblPAlGN TREASURER PHONE 10 CANDIDATE SIGNATURE AREA CODE PHONE NUMBER EXTENSION (214) 803-8291 Date Imaged NIA City Council Place : + MSIMRSIM R FIRST MI NICKNAME LAST SUFFIX Mr. Reymund R~Y Zuniga STREET ADDRESS (NO PO BOX PLEASE); APT 1 SUITE #. CITY. STATE. ZIP CODE 321 Beechwood AREA CODE PHONE NUMBER EXTENSION ( 214) 536-9929 I am aware of the Nepotism Law, Chapter 573 of the Texas Government Code. I am aware of my responsibility to file timely reports as required by title 15 of the Election Code. I am aware of the restrictions in title 15 of the Election Code on contributions 2 / 4 / zoir Date Signed GOT0 PAGE 2 www.ethics.state.tx.us Revised 0711 41201 0 Texas Ethics Commission P.O. Box 12070 Austin, Texas 7871 1-2070 (51 2) 463-5800 (TDD 1-800-735-2989 PRACTICES FORM CFCP Covew SHEET OFFICE USE ONLY Pursuant to chapter 258 of the Election Code, every candidate and DateRecetved political committee is encouraged to subscribe to the Code of Fair Campaign Practices. The Code may be filed with the proper filing authority upon submission of a campaign treasurer appointment form. Candidates or political committees that already have a current campaign treasurer appointment on file as of September 1, 1997, may subscribe to the code at any time. Subscription to the Code of Fair Campaign Practices is voluntary. 1 Date HandQeliverN w Postmarked 1 ACCOUNT NUMBER (Ethii Commission Filers) 2 TYPE OF FILER CANDIDATE POLITICAL COMMITTEE [I] I If filing as a candidate, complete boxes 3 - 6, If filing for a political committee, complete then read and sign page 2. boxes 7 and 8, then read and sign page 2. I 3 NAME OF CANDIDATE TlTLE (Dr.. ~r., ~s.. etc.) FIRST MI (PLEASE TYPE OR PRINT) Mr. Gary D ............................................... NICKNAME LAST SUFFLX (SR.. JR.. Ill, etc.) Roden 4 TELEPHONE NUMBER OF CANDIDATE (PLEASE TYPE OR PRINT) AREA CODE PHONE NUMBER ( 21 4 ) 803-8291 --- 5 ADDRESS OF CANDIDATE I STREET~ PO BOX; APT 1 SUITE #: CITY; STATE; -- -- ZIP CODE (PLEASE NPE OR PRINT) 1 130 Clover Meadow Coppell TX 7501 9 6 OFFICE SOUGHT BY CANDIDATE (PLEASETYPE OR PRINT) City Council Place. Lj- 7 NAME OF COMMITTEE (PLEASE TYPE OR PRINT) 8 NAME OF CAMPAIGN TREASURER (PLEASE TYPE OR PRINT) I TITLE (a. M.. u.. etc.) FIRST MI Reymund ........................................... NICKNAME I LAST SUFFIX (SR.. JR.. Ill, etc.) I R~Y Zuniga GO TO PAGE 2 www.ethics.state.tx.us Revised 11 1231201 Texas Ethics Commission P.O. Box 12070 Austin, Texas 7871 1-2070 (51 2) 463-5800 (TDD 1-800-735-2989) CODE OF FAIR CAMPAIGN PRACTICES There are basic principles of decency, honesty, and fair play that every candidate and political committee in this state has amoral obligation to observe and uphold, in order that, after vigorously contested but fairly conducted campaigns, our citizens may exercise their constitutional rights to a fiee and untrammeled choice and the will of the people may be llly and clearly expressed on the issues. THEREFORE: (1) I will conduct the campaign openly and publicly and limit attacks on my opponent to legitimate challenges to my opponent's record and stated positions on issues. (2) I will not use or permit the use of character defamation, whispering campaigns, libel, slander, or scurrilous attacks on any candidate or the candidate's personal or family life. (3) I will not use or permit any appeal to negative prejudice based on race, sex, religion, or national origin. (4) I will not use campaign material of any sort that misrepresents, distorts, or otherwise falsifies the facts, nor will I use malicious or unfounded accusations that aim at creating or exploiting doubts, without justification, as to the personal integrity or patriotism of my opponent. (5) I will not undertake or condone any dishonest or unethical practice that tends to corrupt or undermine our system of free elections or that hampers or prevents the 111 and fiee expression of the will of the voters, including any activity aimed at intimidating voters or discouraging them fiom voting. (6) I will defend and uphold the right of every qualified voter to 111 and equal participation in the electoral process, and will not engage in any activity aimed at intimidating voters or discouraging them fiom voting. (7) I will immediately and publicly repudiate methods and tactics that may come hm others that I have pledged not to use or condone. I shall take firm action against any subordinate who violates any provision of this code or the laws governing elections. I, the undersigned, candidate for election to public office in the State of Texas or campaign treasurer of a political committee, hereby voluntarily endorse, subscriie to, and solemnly pledgemyselfto conduct the campaign in accordance with the above principles and practices. Date www.ethics.state.tx.us Revised 11 I23120 1 0