|
<br />PLEASE TYPE OR PRINT lEGIBLY
<br />
<br />PROVIDE AIL REQUESTED INFORMATION
<br />
<br />STATEMENT OF ELECTED/APPOINTED
<br />OFFICER
<br />
<br />(Pursuant to Tex. Const. art. XVI, f1(b), amended 2001)
<br />
<br />I, VphnJ1nn TnnVlMIVI , do solemnly swear
<br />(or affirm), that I have not directly or indirectly paid, offered, promised to pay,
<br />contributed, or promised to contribute any money or thing of value, or promised any
<br />public office or employment for the giving or withholding of a vote at the election at
<br />which I was elected or as a reward to secure my appointment or confirmation,
<br />whichever the case may be, so help me God.
<br />
<br />UNDER PENALTIES OF PERJURY, I DECLARE THAT I HAVE READ THE FOREGOING STATEMENT AND
<br />THAT THE FACTS STATED THEREIN ARE TRUE
<br />
<br />1/?!?/04
<br />Date
<br />
<br />
<br />1(1 Pnhi"p, H(1ftft)./\ ('nIlVli"y
<br />City and/or County
<br />
<br />Position to Which Elected/Appointed
<br />
<br />Form No. 2201
<br />
<br />liIi"'~'!r-~~"',\r, .:
<br />
<br />/.-' \\\ If i~'
<br />/' ~ \ .,Ol""HI/".,' ,f~'/ I
<br />" . "ttt "II "\lli:
<br />j ,.j .;, ttoe '1;, ,1(1'
<br />i/ H {} ,./ ';'
<br />// .. .. (,(;tol,1
<br />/. '\'4 !: ' .. ' it
<br />I'lli,..,> J .."
<br />!. ,ot " . . , .. '
<br />z ., "'-.'li17// ""~;
<br />,'1,," l'q'!>>.,h to '!.
<br />'fd ':. ,:,' .. 1
<br />I~I ., 4~;:7""'- ,':(,;;
<br />,..~,-:;;,.\f~. /' ~~ a" C ,:
<br />1'1l~. '/f// t>tt\ l-t
<br />11,\, ;~i I,! "u !'I"y
<br />'1\ If' "u" H ..""a" /~J
<br />I\\\\~ d.:11Ifllllll ({'\\ ~
<br />
<br />~""~"~"i"" '
<br />
|