Declaration of Candidacy & Treasurer - Pedersen, Eric - 9/7/2011DECLARATION OF CANDIDACY
FOR CITY COUNCIL
I, the undersigned, affirm that I am a qualified elector of the City of Eagle, State of Idaho, and
that I have resided in the City of Eagle for at least thirty (30) days.
I hereby declare myself to be a candidate for the office of City Council, for a term of four (4)
years, to be voted for at the election to be held on the 8th day of November, 2011, and certify
g qua lifications to fill said office, the my residence address is
at I possess e legal � �
p u
Candidate's Signature I
Subscribed and sworn to before me this jy ; of 2011
SEN TEAy
RNFs
3 �OTAh'�,p f of y Public fo the�State of Id
Residing at:
L MY Commission Expires -,,Ac)
Y
Before accepting this Declaration of Candidacy, the City Clerk (or designee) must verify the
following.
This Declaration is accompanied by:
The attached Petition of Candidacy signed by at least five qualified city electors
with the attached verification from the county clerk,
OR
A nonrefundable filing fee of $40.
The City Clerk (or designee) must verify that the person submitting this declaration is a
qualified city elector as defined in Idaho Code 50-402(c) and that the residence address
provided above matches the address on the individual's voter regis tion.
This declaration was accepted bLAaPA
on I?- j l at 1-,b& on
Date Time
After the close of the candidate filing period, a copy of this form must be transmitted
immediately to the Ada County Clerk to assist in ballot preparation.
COUNTY CLERK
Upon receipt of this Declaration of Candidacy, stamp the date and time of receipt on the front of
this document. This document is to be used for ballot preparation.
K: erks\ELECTIOI\General Election 201 Meclaration of Candidac \Declaration of Candidacy City Council.do
D APPOINTMENT AND CERTIFICATION OF POLITICAL TREASURER C-1
Rev 08/07
d FOR CANDIDATES AND COMMITTEES
®
0
(Please Print or Type)
Pursuant to Section 67-6603(c1) Idaho Code. No contribution shall be received or expenditure made by or on behalf of a
candidate or political committee until he or she appoints a political treasurer and certifies the name and address of the treasurer
to the Secretary of State
Certification is for (check appropriate box below);
Name of
S(
CANDIDATE. '-'ndidate
Home Work Cell
Phone: Phone P h o n e:
Office, Seat (if
Sought, 0applicable)
Candidate
Mailing address
Candidate
email address
F� COMMITTEE: committee
"''''
Miscellaneous: i Horne
Phone.
Measure: Ej Committee
Candidate/Measure, Mailing addr
Chairman
email address;
Work
Phone
CERTIFICATION AND APPOINTMENT
CrrY OF EAGLE
SEP 0 7 20111
File:
Route to:
Cell
Phone.
do hereby certify and appoint the following individual who is a registered elector of
Name of Candidate or Committee Chamnan
the State of Idaho as the political treasurer for the above named candidate or committee:
Name of E pzb
Political Treasurer- VIN
RETURN THIS
FORM TO -
Sharon Bergmann
City Clerk
City of Eagle
PO Box 1520
Eagle, ID 83616
(208) 939-6813
Fax: (208) 939-6827
Home Work Cell
Phone. Phone. Phonei
Treasurer
Mailing address!
Treasurer
email address
Signature of Candidate or Committee Chairman
do hereby accept the appointment as political treasurer for
Nafnooii Political easur&
the above named candidate or committee
Signature of Political Treasurer