Candidate Dinesh Mali

2-21

Prescribed by Secretary of State

Section 141.031, Chapters 143 and 144, Texas Election Code

1/2017

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.):

DCCCD #5

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.

CITY:IRVING

STATE: TX

ZIP:75038

CITY:IRVING

STATE:TX

ZIP:75038

PUBLIC EMAIL ADDRESS (If available): malielection@aol.com

OCCUPATION (Do not leave blank): Engineering/coorst

DATE OF BIRTH: 1/9/46

VOTER REGISTRATION VUID NUMBER (Optional):1177195138

TELEPHONE CONTACT INFORMATION (Optional):

Home:214-206-8609

Work:

Cell:469-585-2888

LENGTH OF CONTINUOUS RESIDENCE AS OF DATE APPLICATION SWORN IN STATE:17 year(s) 6 month(s)

IN TERRITORY FROM WHICH THE OFFICE SOUGHT IS ELECTED:17 year(s) 6 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 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:

"I, (name) 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 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 further swear that the foregoing statements included in my application are in all things true and correct."

X Dinesh B. Mali

SIGNATURE OF CANDIDATE

Sworn to and subscribed before me at 3:37pm, this the 21 day of January 2020

_________________________________

Signature of Officer Administering Oath

NOTARY PUBLIC

Title of Officer Administering Oath

TO BE COMPLETED BY CITY SECRETARY OR SECREATARY OF BOARD:

(See Section 1.007)

1/22/20

Date Received

Torsha McCarty

Signature of Secretary

Voter Registration Status Verified

APPOINTMENT OF A CAMPAIGN TREASURER BY A CANDIDATE

FORM CTA PG 1

See CTA Instruction Guide for detailed instructions.

1 Total pages filed:

2 CANDIDATE NAME

MS / MRS / MR
Mr.

FIRST
DINESH

MI
B

NICKNAME

LAST
Mali

SUFFIX

3 CANDIDATE MAILING ADDRESS

ADDRESS / PO BOX; APT / SUITE #; CITY; STATE; ZIP CODE
3707 N. COUNTRY CLUB RD IRVING, TX 75038

4 CANDIDATE PHONE

AREA CODE PHONE NUMBER EXTENSION
214-206-8609, 469-585-2888

5 OFFICE HELD (if any)

NONE AT DCCCD

FORMER BOT IRVING ISD

OFFICE USE ONLY

Filer ID #

Date Received

JAN 22 2020

Date Hand-delivered or Postmarked

Receipt #

Amount $

Date Processed

Date Imaged

6 OFFICE SOUGHT (if known)

DCCCD #5 DISTRICT

7 CAMPAIGN TREASURER NAME

MS/MRS/MR

FIRST
NIRMALA

MI
D

NICKNAME

LAST
PATEL

SUFFIX

8 CAMPAIGN TREASURER STREET

ADDRESS (residence or business)

STREET ADDRESS (NO PO BOX PLEASE); APT / SUITE #; CITY; STATE; ZIP CODE
3707 COUNTRY CLUB RD IRVING TX 75038

9 CAMPAIGN TREASURER PHONE

AREA CODE PHONE NUMBER EXTENSION
214-519-3174

10 CANDIDATE SIGNATURE

I am aware of the Nepotism Law, Chapter 573 of the Texas Government Code.

I am aware of my responsibility to file timely reports as required by title 15 of the Election Code.

I am aware of the restrictions in title 15 of the Election Code on contributions from corporations and labor organizations.

Dinesh B. Mali
Signature of Candidate

1-21-20
Date Signed

CANDIDATE / OFFICEHOLDER CAMPAIGN FINANCE REPORT

FORM C/OH
COVER SHEET PG 1

The C/OH Instruction Guide explains how to complete this form.

1 Filer ID (Ethics Commission Filers)

2 Total pages filed:

3 CANDIDATE / OFFICEHOLDER NAME

MS / MRS / MR
MR

FIRST
DINESH

MI
B

NICKNAME

LAST
Mali

SUFFIX

4 CANDIDATE / OFFICEHOLDER MAILING ADDRESS

Change of Address

ADDRESS / PO BOX; APT / SUITE #; CITY; STATE; ZIP CODE
3707 N. COUNTY CLUB RD IRVING, TX 75038

5 CANDIDATE/ OFFICEHOLDER PHONE

AREA CODE PHONE NUMBER EXTENSION
469-585 2888

6 CAMPAIGN TREASURER NAME

MS / MRS / MR
MRS

FIRST
NIRMALA

MI
P.

NICKNAME

LAST
PATEL

SUFFIX

OFFICE USE ONLY

Date Received

JAN 22 2020

Date Hand-delivered or Date Postmarked

Receipt #

Amount $

Date Processed

Date Imaged

7 CAMPAIGN TREASURER ADDRESS (Residence or Business)

STREET ADDRESS (NO PO BOX PLEASE); APT / SUITE #; CITY: STATE; ZIP CODE
3707 COUNTRY CLUB RD IRVING TX 75038

8 CAMPAIGN TREASURER PHONE

AREA CODE PHONE NUMBER EXTENSION
214-519 3174

9 REPORT TYPE

☐ January 15
☑ 30th day before election
☐ Runoff
☐ July 15
☐ 8th day before election
☐ Exceeded Modified Reporting Limit
☐ 15th day after campaign treasurer appointment (Officeholder Only)
☐ Final Report (Attach C/OH - FR)

10 PERIOD COVERED

Month Day Year MonthMonth Day Year

04/02/20 THROUGH / /

11 ELECTION

ELECTION DATE

Month Day Year

05/02/20

ELECTION TYPE

☐ Primary
☑ General
☐ Runoff
☐ Special
☐ Other Description

12 OFFICE

OFFICE HELD (if any)

13 OFFICE SOUGHT (if known)

DCCCD # 5 DISTRICT

GO TO PAGE 2

CANDIDATE / OFFICEHOLDER CAMPAIGN FINANCE REPORT

FORM C/OH
COVER SHEET PG 2

14 C/OH NAME

DINESH B. MALI

15 Filer ID (Ethics Commission Filers)

16 NOTICE FROM POLITICAL COMMITTEE(S)

☐ Additional Pages

THIS BOX IS FOR NOTICE OF POLITICAL CONTRIBUTIONS ACCEPTED OR POLITICAL EXPENDITURES MADE BY POLITICAL COMMITTEES TO SUPPORT THE CANDIDATE / OFFICEHOLDER. THESE EXPENDITURES MAY HAVE BEEN MADE WITHOUT THE CANDIDATE'S OR OFFICEHOLDER'S KNOWLEDGE OR CONSENT. CANDIDATES AND OFFICEHOLDERS ARE REQUIRED TO REPORT THIS INFORMATION ONLY IF THEY RECEIVE NOTICE OF SUCH EXPENDITURES.

COMMITTEE TYPE

☐ GENERAL

☐ SPECIFIC

COMMITTEE NAME

COMMITTEE ADDRESS

COMMITTEE CAMPAIGN TREASURER NAME

COMMITTEE CAMPAIGN TREASURER ADDRESS

17 CONTRIBUTION TOTALS

1. TOTAL UNITEMIZED POLITICAL CONTRIBUTIONS (OTHER THAN PLEDGES, LOANS, OR GUARANTEES OF LOANS, OR CONTRIBUTIONS MADE ELECTRONICALLY)

$ 0

2. TOTAL POLITICAL CONTRIBUTIONS
(OTHER THAN PLEDGES, LOANS, OR GUARANTEES OF LOANS)

$ 0

EXPENDITURE TOTALS

3. TOTAL UNITEMIZED POLITICAL EXPENDITURE.

$ 0

4. TOTAL POLITICAL EXPENDITURES

$ 0

CONTRIBUTION BALANCE

5. TOTAL POLITICAL CONTRIBUTIONS MAINTAINED AS OF THE LAST DAY OF REPORTING PERIOD

$ 0

OUTSTANDING LOAN TOTALS

6. TOTAL PRINCIPAL AMOUNT OF ALL OUTSTANDING LOANS AS OF THE LAST DAY OF THE REPORTING PERIOD

$ 0

18 AFFIDAVIT

I swear, or affirm, under penalty of perjury, that the accompanying report is true and correct and includes all information required to be reported by me under Title 15, Election Code.

Dinesh Mali
Signature of Candidate or Officeholder

AFFIX NOTARY STAMP / SEAL ABOVE

Sworn to and subscribed before me, by the said Dinesh Mali , this the 22 day of January, 2020, to certify which, witness my hand and seal of office.

LaDena Young
Signature of officer administering oath

LaDena Young
Printed name of officer administering oath

Notary
Title of officer administering oath

Candidate Dinesh Mali

Appointment of a Campaign Treasurer by a Candidate: Form CTA

Candidate/Officeholder Campaign Finance Report: Form C/OH