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Application - Jun, John 2-26 Prescribed by Secretary of State Section 141.031,Chapters 143 and 144,Texas Election Code 09/2021 APPLICATION FOR A PLACE ON THE BALLOT FOR A GENERAL ELECTION FOR A CITY, SCHOOL DISTRICT OR OTHER POLITICAL SUBDIVISION ALL INFORMATION IS REQUIRED TO BE PROVIDED UNLESS INDICATED AS OPTIONAL'Failure to provide required information may result in rejection of application. APPLICATION FOR A PLACE ON THE City of Coppell GENERAL ELECTION BALLOT TO:City Secretary/Secretary of Board (name of election) I request that my name be placed on the above-named official ballot as a candidate for the office indicated below. OFFICE SOUGHT(Include any place number or other distinguishing number,if any.) INDICATE TERM Coppell City Council, Place 5 ✓ FULL UNEXPIRED FULL NAME(First,Middle,Last) PRINT NAME AS YOU WANT IT TO APPEAR ON THE BALLOT* John Young-Chu Jun John Jun PERMANENT RESIDENCE ADDRESS(Do not include a P.O.Box or Rural Route.If PUBLIC MAILING ADDRESS(Optional)(Address for which you receive you do not have a residence address,describe location of residence.) campaign related correspondence,if available.) 619 Allen Road CITY STATE ZIP CITY STATE ZIP Coppell TX 75019 PUBLIC EMAIL ADDRESS(Optional)(Address for OCCUPATION(Do not leave blank) DATE OF BIRTH VOTER REGISTRATION VUID which you receive campaign related emails,if available.) NUMBER'(Optional) johnjun612@gmail.com Attorney TELEPHONE CONTACT INFORMATION(Optional) Home: Office: Cell: (469)235-1633 FELONY CONVICTION STATUS(You MUST check one) LENGTH OF CONTINUOUS RESIDENCE AS OF DATE THIS APPLICATION WAS SWORN • Q I have not been finally convicted of a felony. IN THE STATE OF TEXAS IN TERRITORY/DISTRICT/PRECINCT FROM ❑ I have been finally convicted of a felony,but I have been WHICH THE OFFICE SOUGHT IS ELECTED 35 year(s) 23 year(s) pardoned or otherwise released from the resulting disabilities of that felony conviction and I have provided proof of this fact with the submission of this application.3 month(s) month(s) *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 or contain a title,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. Please review sections 52.031,52.032 and 52.033 of the Texas Election Code regarding the rules for how names may be listed on the official ballot. Before me,the undersigned authority,on this day personally appeared(name of candidate) John Y.John ,who being by me here and now duly sworn,upon oath says: "I,(name of candidate) John Y.Jun of Dallas County,Texas, being a candidate for the office of Coppell City Council, Place 5 , swear that I 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 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 am aware that I must disclose any prior felony conviction,and if so convicted,must provide proof that I have been pardoned or otherwise released from the resulting disabilities of any such final felony conviction. I am aware that knowingly providing false information on the .pplication regarding my possible felony conviction status constitutes a Class B misdemeanor. I further swear that the foregoing statements included i , yap. 'catio e in all things true and correct." X /ktir�� SIGNATUR •F CANDI I ATE tt, Sworn o a . subscribed b: • - me this the L'ay of s1 J .A (\ 4 V n . (day) (month) (year) (name of candidate) A-/r- _�,,sPRrn�e,� ASHLEY� Signatu of Officer Aut - ed to Administer Oath4 __° i+i Notary IPt tied EMut�Of Masi 4'1thorized to Administer Oath v +P Comm. Expires 02 24-2023 � WI 1arA '';',,,°;, ��� Notary ID V301'28128 I Title of Officer Aut . ized to Administer Oath _ TO BE COMPLETE' :Y FILING OFFICER: THIS PLICATION IS ACCOMPANIED BY THE REQUIRED FILING FEE(If Applicable)PAID BY: ❑CASH ❑CHECK ❑MONEY ORDER ❑CASHIERS CHECK OR ❑PETITION IN LIEU OF A FILING F . This document and$ filing fee or a nominating petition of pages re eiv . to Registration Status Verified (CAn � / 1(4 / ( t#3 O\ / `CI:. / 102:5 (See Section 1.007) Date Received Date Accepted Signature of Filing Offi or Designee