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2023 Johnson SOPA COPPELL STATEMENT OF OFFICER Y ° Article XVI, Section 1 of the Texas Constitution Statement (Sandra Johnson, do solemnly swear (or affirm) that I have not directly or indirectly paid, offered, promised to pay, contributed, or promised to contribute any money or thing of value, or promised any public office or employment for the giving or withholding of a vote at the election at which I was elected or as a reward to secure my appointment or confirmation, whichever the case may be, so help me God. Title of position to which elected or appointed: alternate board member Execution Under penalties of perjury, I declare that I have read the foregoing statement and that the facts stated therein are true. iYkaita o023 GQ-Yt6/4. c ")14d-r--71 Date ignature of Offi It is required that all elected or appointed state and local officers to take the official oath of office found in section 1(a) and to subscribe to the anti-bribery statement found in section 1(b) before entering upon the duties of their offices. . 14N • CIT • Or COPPELL OATH OF OFFICE Article XVI, Section 1 of the Texas Constitution In the name and by the authority of The State of Texas I, Sandra Johnson , do solemnly swear (or affirm), that I will faithfully execute the duties of the office of the Library Board of the State of Texas, and will to the best of my ability preserve, protect, and defend the Constitution and laws of the United States and of this State, so help me God. .---fr/ch.Gt/ .: ) 9-14--71- ignature of Offic r 0 Certification of Person Authorized to Administer Oath State of Texas County of Dallas Sworn to and subscribed before me on this 1 day of M.Gt./C.P— , 20 2-3. (Affix Notary Seal, only if oath administered by a notary.) 8-6,A., 6 — - Signature of Nota Public or .‘1aFP', SARA EGAN Signature of Other Person Authorized to i 'i:Notary Public,State of Texas TA •r Comm.Expires 03-13-2026 Administer An Oath -', 0;,;� Notary ID 131487461 SO-{k. F:46l.1(\ Printed or Typed"Name Pursuant to Article XVI, Section 1 of the Texas Constitution, the Oath of Office may not be taken until a Statement of Officer has been subscribed to and as required,filed. TN • CITY Or COPPELL PUBLIC ACCESS OPTION FORM Texas Government Code Section 552.024 The Public Information Act allows employees, public officials and former employees and officials to elect whether to keep certain information about them confidential. Unless you choose to keep it confidential, the following information about you may be subject to public release if requested under the Texas Public Information Act. Therefore, please indicate whether you wish to allow public release of the following information. Sandra Johnson Printed Name Do you Give Permission for Public Access to: NO YES Please indicate by placing an "X" in appropriate box. Home Address ✓' / Home Phone Number Cell Phone Number Email Address v/ Social Security Number V Information that reveals whether you have family members. ✓ Emergency Contact Information V Q-4o 6 / 0 0 o 3 Signature Date This form should be completed and signed by the employee no later than the 14th day after the date the employee begins employment, the public official is elected or appointed, or a former employee or official ends employment or service.