Prescribed by Secretary of State
Section 141.031, Chapters 143 and 144, Texas Election Code
ALL INFORMATION IS
REQUIRED TO BE PROVIDED UNLESS INDICATED OPTIONAL
APPLICATION FOR A PLACE ON THE
May 2, 2020 GENERAL ELECTION BALLOT
TO: City Secretary/Secretary of Board
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: Full
FULL NAME (First, Middle, Last): DINESH B MALI
PRINT NAME AS YOU WANT IT TO APPEAR ON THE BALLOT: DINESHMALI
PERMANENT RESIDENCE ADDRESS (Do not include a P.O. Box or Rural Route. If you do not have a residence address, describe the address at which you receive personal mail and location of residence.)
3707 N. Country Club Rd.
PUBLIC MAILING ADDRESS (Campaign mailing address, if available.)
3707 N. Country Club Rd.
PUBLIC EMAIL ADDRESS (If available):
OCCUPATION (Do not leave blank):
DATE OF BIRTH:
VOTER REGISTRATION VUID NUMBER (Optional):
TELEPHONE CONTACT INFORMATION (Optional):
LENGTH OF CONTINUOUS RESIDENCE AS OF DATE APPLICATION SWORN IN STATE:
IN TERRITORY FROM WHICH THE OFFICE SOUGHT IS ELECTED:
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 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.
Before me, the undersigned authority, on this day personally appeared (name)
DINESH B MALI, who being by me here and now duly sworn, upon oath says:
DINESH B MALI, of
Dallas County, Texas, being a candidate for the office of
DCCCD #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 finally convicted of a felony for which I have not been pardoned or had my full rights of citizenship restored by other official action. I have not been determined by a final judgement 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 further swear that the foregoing statements included in my application are in all things true and correct."
Dinesh B. Mali
SIGNATURE OF CANDIDATE
Sworn to and subscribed before me at
3:37pm, this the
21 day of
Signature of Officer Administering Oath
Title of Officer Administering Oath
TO BE COMPLETED BY CITY SECRETARY OR SECREATARY OF BOARD:
(See Section 1.007)
Signature of Secretary
Voter Registration Status Verified