TERRY ANDRE HAYES INDEPENDENT CANDIDATES PETITION

INDEPENDENT CANDIDATE'S PETITION FOR A PLACE ON THE BALLOT

NAME OF CANDIDATE: TERRY ANDRE HAYES
ADDRESS: 5145 SILVER CREEK DR. STE.116C, HOUSTON, TEXAS 77017
OFFICE SOUGHT: STATE REPRESENTATIVE

This statement MUST be read to each person before signing the petition.

"I know the purpose of this petition. I have not voted in the general primary election or runoff primary election of any political party that has nominated, at either election, a candidate for the office of State Representative for which Mr. Terry Andre Hayes is a candidate.

AFFIDAVIT OF CIRCULATOR

STATE OF TEXAS, COUNTY OF HARRIS BEFORE ME, the undersigned, on this July 2, 2005 personally appeared TERRY ANDRE HAYES, who being duly sworn, deposes and says: "I called each signer's attention to the above statements and read them to the signer before the signer affixed their signature to the petition. I witnessed the affixing of each signature. The correct date of signing is shown on the petition. I verified each signer's registration status, and believe that each signature is the genuine signature of the person whose name is signed and that the corresponding information for each signer is correct." SWORN TO AND SUBCRIBED BEFORE ME THIS DATE.


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Signature of Circulator


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Signature of Officer Administering Oath


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Title of Officer Administering Oath