Declaration of Candidacy - Laughlin, Jeff - 9/3/2013 Declaration of Candidacy
I,the undersigned,affirm that I am a qualified elector of the City of L y/c. ,State of Idaho,and
that I have resided in the city for at least thirty(30)days.I hereby declare myself to be a candidate for the office of
C i/ C—o,,y7 7 ,for a term of y years,to be voted for at the election to be held on the 5��
day of November, .. 611'3 ,and certify that I possess the legal qualifications to fill said office,and that my
residence address is /390 AJ S I v C-g 9'u W u y £.51. 2 17 C3( / •
Zdidate's Signature
•
Subscribed and swor 1 ' . ore me this 3 day of S" ' ,c?01,.3.
re 'OSBORj ,
'r Y Sign':�l_J i / li//I:
I Oct./ Notary Public in and for the State of Idaho
? aC k de ∎V =
11°1 �� 7 residing at FJ')G ,1� Y L.o
v0.41)
`q•�••••.♦ ST.......00 4.'x' My Commission expires t 'l)c k01.5
•ii,, A'r t,�,•.
OFFICIAL USE ONLY
CITY CLERK
Before accepting this Declaration of Candidacy,the City Clerk(or designee)must verify:
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. /( cP•00755)
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
registration.
This declaration was accepted by �'=�Akar,.4,.
l CD_AA4, Name,Title
on `Aof2J ✓i2O/3 at -�/i: ,5 & •
/ Date Time'
After the close of the candidate filing period,a copy of this form must be transmitted immediately to the 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.
RECEIVED & FILED
CITY OF EAGLE
tiA APPOINTMENT AND CERTIFICATION OF POLITICAL TREASURER SEP 0 3 I`g
Rev.o:
�!l FOR CANDIDATES AND COMMITTEES
o' .
; gQ File,
(Please Print or Type) Route to:
rPursuant to Section 67-6603(c1), Idaho Code. No contribution shall be received or expenditure ��aJ�brer en behalf of a
EsyO. '
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):
gCANDIDATE: Name Candidaof te: ' -Cr Zrz v a.0
Home acJ Work 'o r Cell 1O
Phone: 93y'3205'___ Phone: g 9^a�JIS Phone: $ 90 - 175s"
Office (if
Sought: 6'1,// e applicable)
Candidate
Mailing address: /3 90 .N S'� I6/A.5 7 e ' L.v c./ )5-45, { g-gC/-C
Candidate
email address: "-c,“... ,5 t,hel 4a e c Inc C v e-✓t
Name of
COMMITTEE: Committee:
Name of Committee
Chairman:
Miscellaneous: Home Work Cell
Phone: Phone: Phone:
Measure: Committee
Mailing address:
Candidate/Measure:
Chairman
email address:
CERTIFICATION AND APPOINTMENT
I, L0.._ (41; H , 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 of
Political Treasurer: — — ' L �(1
Home ? 5 g- Work 2 e- Cell V e
Phone: 93 g..,3 go 5 Phone: g y^p--�17� Phone: pip —2/7
Treasurer
Mailing address: / 3 90 ,, 3,_t V 5 �. ! c F 4 1,_ 'T' rj Z3 c/ b
RETURN THIS Treasurer
'i
FORM TO: S'
Sharon Bergmann
Clerk-Treasurer
City of Eagle re Candidate or Committee Chairman
PO Box 1520
Eagle ID 83616 I, J�-C- 4" 1°1 , do hereby accept the appointment as political treasurer for
(208)939-6813 Name of Political Treasurer
Fax:(208)939-6827 the above named candidate or committee.
sharon@cityofeagle.org
ature of Political Treasurer