Application - Walker, Jim 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 1 FULL UNEXPIRED
FULL NAME(First,Middle,Last) PRINT NAME AS YOU WANT IT TO APPEAR ON THE BALLOT*
James William Walker Jim Walker
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.)
400 Hawk Court
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.) NUMBER2(Optional)
jwwesq@aol.com Attorney
TELEPHONE CONTACT INFORMATION(Optional)
Home: Office: Cell:
FELONY CONVICTION STATUS(You MUST check one) LENGTH OF CONTINUOUS RESIDENCE AS OF DATE THIS APPLICATION WAS SWORN
❑✓ 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
62 year(s) 25 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) 7 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)James William Walker ,who
being by me here and now duly sworn,upon oath says:
"I,(name of candidate) James William Walker of Dallas County,Texas,
being a candidate for the office of Coppell City Council, Place 1 , 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 th- . - is• -•arding my possible felony conviction
status constitutes a Class B misdemeanor. I further swear that the foregoi a e t inc ded" my 'p at on are in all things true and correct."
6.441111
SIcNATI RE OF CANDIDATE
Sworn to and subscribed before me this the la d gW4 ay of t/� aDe�-3 ,by J�°►vw e.b up. W.A.\\[�.� .
(day) (month' (year) (name of candidate)
/�7 Adrienne Hickey
Signature of Officer Authorized to Ad ster Oath4 Printed Name of Officer Authorized to Administer Oath
t%O, ^ �uuai 1 �.�`arP o, ADRIENNE HICKEY
Title of Officer Authorized to Administer Oath :%' i+s Notary Public,State of Texas
TO BE COMPLETED BY FILING OFFICER: THIS APPLICATION IS ACCOMPANIED B` f�btF IN PErE�IQ1�31t 1 ', AID BY:
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❑CASH El CHECK ❑MONEY ORDER ❑CASHIERS CHECK OR ❑PETITION Ifs I�L� 94 �FILIN�13 D
1
This document and
$ filing fee/ or a nominating petition of pages rec ive . V V. 'egistration Status Verified
/ 1 7� /2m3 O\ / lb / (See Section 1.007) tre
Date Received Date Accepted Signature of Filing Of'cer or Designee