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Home My WebLink AboutAll Filing Documents - Ben Graves - 20262-49 Prescribed by Secretary of State Section 141.031, Chapters 143 and 144, Texas Election Code; Section 11,055, Texas Education Code 07/2025 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 resection of aoDlication APPLICATION FOR A PLACE ON THE GENERAL ELECTION BALLOT �name TO: City Secretary/Secretary of Board 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 anyplace number or other distinguishing number, if any.) INNDDICATE TERM L4MJFULL ❑ UNEXPIRED FULL NAME (First, Middle, Last) PRINT NAME AS YOU WANT IT TO APPEAR ON THE BALLOT* S6-SoNi. C",je & ITC- �&-M G--C(X'qe-C,' P ANENT RESIDENCE ADDRESS (Do not include a P.O. Box or Rural Route. If PUBLIC MAILING ADDRESS (Optional) (Address for which you receive of residence.) campaign related correspondence, if available.) STATE ZIP I `y 3 14 CITY STATE ZIP PUBLIC EMAIL ADDRESS (Optional) (address for OCCUPATION (Do not leave blank) DATE OF BIRTH VOTER REGISTRATION VUID 7 NUMBERz (Optional) 1-01110 VG eir na 1) f 819L -W_q-9 9q 2. Home: Office: Cell: FELPNY 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 LIGHT IS ELECTED pardoned or otherwise released from the resulting year(s) year(s) disabilities of that felony conviction and I have provided this fact the 3 proof of with submission of this application month(s) month(s) This Box Must ONLY be Completed by Candidates for School District Board of Trustees Check the Box Below: ❑ I am aware that I am noteligible to serve as a trustee of an independent school district if I am required to register as a sex offender under Chapter 62, Code of Criminal Procedure. *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 swearthat 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) Re —A G?kj-e& who being by me here and now duly sworn, upon h says: (".,,,� , L "I, (name of ca didate) ��+� of County, Texas, Being a candidate for the office of * swear that I will support and defend the Constitution and laws of the United States and of the State of Texas. I am Icitizen of the 0nited 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 application regarding my possible felony conviction status constitutes a Class B misdemeanor. I fu ar th t the foregoing statements included in my application are in all things true and correct. V j /` j IDA Sworn to and subscribed before me this the RX day of =C&Ct6PLV _ by (day) (month) (year) (name of candidate) l Signature of Officer Authorized to Administer Oath4 '•., e of fflMqY9YtoAd inister Oath * My Notary ID # 11092587 0 p'rF'oF O`iarial oPVVk*MWA2026 Title of Officer Aukhorized to Administer Oath TO BE COMPLETED BY FILING OFFICER: THIS APPLICATION 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�EE. ' This document and $ filing fee or a nominating petition of pages received. LJ Voter R tration Status Verified I � q / � (P / tO _ (See Section I.OD7) Date Received Date Accepted Signature of Filing Officer or Designee APPOINTMENT OF A CAMPAIGN TREASURER FORM CTA BY A CANDIDATE PG 1 See CTA Instruction Guide for detailed instructions. 1 Total pages filed: 2 CANDIDATE MS/MRS/MR FIRST MI .OFFICE USE ONLY NAME Filer ID # —MR --- NICKNAME LAST SUFFIX Date Receive r j V jCD ��r JAN 14 2026 3 CANDIDATE STATE; ZIP CODE MAILING ADDRESS tm ty zidw utdiyl'3 utrice !l-e CcAtN Dale Hand -delivered or Postmarked V % `/' I rQ 4 CANDIDATE AREA CODE PHONE NUMBER EXTENSION Receipt# Amount PHONE 2— Date Processed 5 OFFICE HELD t �� ke con, rge, (if any) ub� auvi iI \ 1 6 OFFICE SOUGHT (if known) � y p r cok�, coV ,� I Li V. L LJ� 1�\ _ `� 7 CAMPAIGN MSIMRSIMR FIRST MI NICKNAME LAST SUFFIX TREASURER NAME R n r ors 8 CAMPAIGN STREET ADDRESS; APT! SUITE #; CITY; STATE; ZIP CODE TREASURER STREET ADDRESS (residence or business) ��u. le 71� qG 03 L4 9 CAMPAIGN AREA CODE PHONE NUMBER EXTENSION TREASURER PHONE 10 CANDIDATE SIGNATURE I am aware of the Nepotism Law, Chapter 573 of the Texas Government Code. am aware of my responsibility to file timely reports as required by title 15 of the Election Code. am aware of the restrictions in title 15 of the Election Code on contributions from corporations and labor organizations. — _ 11 1-2—Co Signature of Candidate Date Signed GO TO PAGE 2 Forms provided by Texas Ethics Commission www.ethics.stateJx.us Revised 111/2025 CANDIDATE MODIFIED REPORTING DECLARATION 11 CANDIDATE NAME FORM CTA PG 2 12 MODIFIED REPORTING COMPLETE THIS SECTION ONLY IF YOU ARE DECLARATION I CHOOSING MODIFIED REPORTING •• This declaration must be filed no later than the 30th day before the first election to which the declaration applies. -- The modified reporting option is valid for one election cycle only. •• (An election cycle includes a primary election, a general election, and any related runoffs.) • Candidates for the office of state chair of a political party may NOT choose modified reporting. •- I do not intend to accept more than $1,110 in political contributions or make more than $1,110 in political expenditures (excluding filing fees) in connection with any future election within the election cycle. I understand that if either one of those limits is exceeded, I will be required to file pre -election reports and, if necessary, a runoff report. Year of election(s) or election cycle to which declaration applies Signature of Candidate This appointment is effective on the date it is filed with the appropriate filing authority. TEC Filers may send this form to the TEC electronically at treasappoint(c�ethics.state.tx.us or mail to Texas Ethics Commission P.O. Box 12070 Austin, TX 78711-2070 Non-TEC Filers must file this form with the local filing authority DO NOT SEND TO TEC For more information about where to file go to: https://www.ethics.state.tx.us/filinginfo/QuickFileAReport.php Forms provided by Texas Ethics Commission www.ethics.state.tx.us Revised 1/1/2025