Declare Candidacy & appoint treasurer - Butler, Mark - 8/29/2011 DECLARATION 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
that I possess the legal qualifications to fill said office,and the my residence address is
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Candidate s Signature .,�
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Subscribed and sworn to before me this o / day of Ale, „ , ,2011 ''.
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otary Pu•1 c •r t e S e:of •l4ah�'' -
Residing at #I/ i ivt AC=
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OFFICIAL USE ONLY '•. •�•m Si:►P� a'��
CITY CLERK
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/
V 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 re:istration.
This declaration was accepted byll g
Title
on / at g,'G5CIh-,
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.
C:\Documents and Settings\tosborn\Local Settings\Temporary Internet Files\Content.Outlook\YRCHO4EJ\Declaration of Candidacy-City
Council.doc
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i•• = APPOINTMENT AND CERTIFICATION OF POLITICAL TREASURER C-1
Rev.08107
'i A.:f;_ ` FOR CANDIDATES AND COMMITTEES
,,,,,,,!=i,›,,1r (Please Punt or Tyne)
s ;� tt�: 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 r �i
VCANDIDATE: Candidate L I
va L
Home ,0 { -)A, Work ^ Cell
Phone: pd,uU I J ` `71 I Phone: SI?fl% Phone: Sn 1l
Office Seat(if
Sought: 6-1G1.6.- C 17'I Co MW C) L applicable)
Candidate ��// A CQ / 'j �� (� 1 I
Mailing address: Fa O/' 3 t 1 J l� I l t, L E --1-.J O 3 4 1 D
Candidate //��p
email address: nil U lk j_E VAT L ® GivipoL .. CID M
Name of RECEIVED & FILED
. : N CITY OF EAGLE
COMMITTEE: Committee:
Name of Committee AUG 0 8 2611
Chairman:
Miscellaneous: [ Work Cell FI.:
Phone: Phone: Pt oIt§oUte to;.
Measure: I Committee
Mailing address:
Candidate/Measure: l
Chairman
email address:
TY)A CERTIFICATION AND APPOINTMENT
I, 9..Y,Y, L 7-f"-> U , do hereby certify and appoint the following individual who is a registered elector of
Name of Candidate or Committee Chairman
the State of Idaho as the political treasurer for the above named candidate or committee:
Name l Pr ,✓I,G-I e A-t r-ti,5�/�-
Political Treasurer
�/ 1 /� ..51.../ �1 1.�G1 f�/
Home 2�0 { J b JUDY Work 2OS 0 1 Phone: 2� Z 6 qi"{i
Phone: 2 1- ► Phone: }}---
Mailing address: 2 3 l W et COfl t e✓ ] V e 4?-3621
Treasurer -S-ru,V GIC A YL,tSCJ a6d91eO I/I Pi`t`
RETURN THIS email address.
FORM TO: 010'-vu,t4.____
Sharon Bergmann
City Clerk Signature of Candidate or Committee Chairman
City of Eagle Fraact.e- I(�SGI�
PO Box 1520 l do hereby accept the appointment as political treasurer for
Eagle, ID 83616 Name of Political Treasurer
(208)939-6813 the above named candidate or committee.
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Fax: (208)939-6827 Signature of Political Treasurer
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