Declaration of Candidacy - Pence, Zachary - 8/24/2015Declaration of Candidacy
I, the undersigned, affirm that I am a qualified elector of the City of E:9 b,2 ,2 , 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
(Z it y r_ew x(I I , for a term of H years, to be voted for at the election to be held on the 3
day of November, Z015 , and certify that I possess the legal qualifications to fill said office, and that my
residence address is
Candidate's Signature
Subscribed and sworn to before me this H day of
Signed. - -.�
LANCE BOEfTCHER Notary Public in and for the State of Idaho
NOTARY PUBLIC q
STATE OF IDAHO residing at
h
My Commission expires I L42 J'/ d - -) 9
Zac �gn�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 burst rive qualified city electors with the attached verification
from the county clerk,
OR
XA nonrefundable filing fee of S40.
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 ind Iduat's voter
registration. i �r2/ C�
i 1� I� �� N q1 U This declaration was accepted by �� C �Z1 V,
V c� ✓�� L /r Name, Title
on Date Time
After the close of the candidate riling 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.
P- wY,t,leo' 106AdA.LO
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