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Ballot Name: Office Sought: (Include Place/District, if applicable)1st Reviewer: 2nd Reviewer: Item1st 2nd Enter Date Received (located at bottom of application in section to be completed by chair)APPLICATION FOR A PLACE ON THE Republican PARTY GENERAL PRIMARY BALLOT.Office Sought – Distinguishing number (Place, District, etc.) included, if applicable.Indicate Term – Full or Unexpired box is checked.Full Name – First, Middle, LastName To Appear on Ballot Permanent Residence Address – Cannot be a PO Box or Rural Route. Street, city, state, and zip. Legal description, if property has no address.Mailing Address – If different from residential address. Can be a PO Box. (If available) Email Address – If availableOccupation – CANNOT BE BLANKDate of Birth – Born on or before 1/1/01 (18 years old on first day of term to be filled at election). VUID/Voter Registration – VUID is optional, but is required to be a registered voter in the district on/before 12/11/17Phone Numbers – Not RequiredLength of Continuous Residence as of Date Application SwornTexas resident for 12 months before the filing deadline (on or before 12/11/16).Territory from which elected resident for 6 months before the filing deadline (on or before 06/11/17).Oath of Office Name (twice) County of permanent residence Office sought, Distinguishing number, if applicable SignatureNotarized Date, month, year, candidate’s nameNotary’s signature, title, and stampNotary term not expired on date signed. If notary expired prior to date signed, reject application.Petition in Lieu of Filing Fee Received & Verified – Pages must be grouped by circulator and numbered accordingly. Count number of pages and signatures. Minimum number of signatures is the lesser of:500 – OR – 2% of all votes for all gubernatorial candidates cast in their district in the 2014 general election.# of Pages______Signatures______# of Pages______Signatures______Filing Fee Received & Deposited – Check signed, made payable to your county’s party, and not post-dated.$1,250 for a population of 200,000 or more. $750 for a population of under 200,000. After Ballot Review Complete & either Filing Fee Clears – OR – Petitions Verified & APPLICATION ACCEPTED Date and County Chair signs.Enter Candidate Data into SOS websiteConfirm Candidate Info Correct on SOS Website ................
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