Download potential judicial candidate unofficial declaration of

POTENTIAL JUDICIAL CANDIDATE UNOFFICIAL DECLARATION OF POSSIBLE INTEREST IN OFFICE
This process is entirely preliminary.
CANDIDATE NAME
LAST NAME
FIRST NAME
MIDDLE NAME
COUNTY OF RESIDENCE: Candidate must reside in Harris County, regardless of where he/she work or vote.
MAILING ADDRESS
CITY
ZIP CODE
RESIDENCE ADDRESS
CITY
ZIP CODE
CONTACT INFO: (Please complete each section, if possible.)
OFFICE PHONE (PRIVATE):
OFFICE PHONE PUBLIC:
CELL PHONE (PRIVATE)
CELL PHONE (PUBLIC)
HOME PHONE (PRIVATE)
HOME PHONE (PUBLIC)
ALTERNATE PHONE NUMBER:
Do you have voicemail?
 YES
 NO
EMAIL ADDRESS (PUBLIC)
EMAIL ADDRESS (PRIVATE)
OFFICE SEEKING – Please indicate the type of court (i.e. Civil, Criminal etc.).
DO NOT INDICATE A PARTICULAR COURT OR POSTION NUMBER.
 CIVIL DISTRICT COURT  CRIMINAL DISTRICT COURT  COUNTY CIVIL COURT  COUNTY CRIMINAL COURT
 PROBATE COURT
 FAMILY COURT
 JUVENILE COURT
 JUSTICE OF THE PEACE
HCDP STAFF, PLEASE VERIFY THE INFORMATION LISTED BELOW THIS LINE.
DATE RECEIVED:
VOTER UNIQUE IDENTIFICATION (VUID) NUMBER:
HCDP SUSTAINING MEMBER  YES
CERTIFICATION (CERT) NUMBER:
 NO
DISCLAIMER: This is a private, confidential, unofficial PRELIMINARY statement of potential interest in seeking judicial
office. It does not constitute a declaration of candidacy, nor will it be shared with anyone (including judges) other than
Harris County Democratic Party officials (including members of its Judicial Candidates Committee). You will be
contacted shortly by someone from the HCDP to discuss what needs to be done next to explore your potential
candidacy. IT IS IMPERATIVE THAT ALL POTENTIAL CANDIDATES CONTACT THE HCDP TO INFORM US OF YOUR
POSSIBLE INTEREST IN SEEKING JUDICIAL OFFICE AND THIS FORM SHOULD BE USED TO ACCOMPLISH THAT.
ELECTION INFO
HARRIS COUNTY DEMOCRATIC PARTY
ADMIN UPDATE 05/11/2017