Declaration of Candidacy for City Council - Gindlesperger, Melissa - 8/23/20211110011111110
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Phil IliVIcGriarte, JD, MPA
Clerk of the District. Court
Trent Tr ipple
Chief Deputy
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29,21. CA ATE F114/Sc: PACKET
Congratulations on your decision to run for office. Attached you will find various forms required
to run for office. Please read the enclosed instructions and complete the packet in its entirety.
Candidate Name:
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Home/Cell Number: .......„„„;-2Q%-- 5-5-7 glurS
Email: tfl
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Candidate Name Pronunciation:
Ada County provides Hart InterCivic Touch Writer assisfive voting devices in
polling locations to support independent voting. This device has an audio
feature that will read the ballot In order to ensure your name is recorded
into the audio system correctly please indicate pronunciation of a difficult
name or enter guidelines ("rhymes with...": "sounds like...") in the field below.
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Pronunciation Notes:
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For infernal use only
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CITY OFFICE
DECLARATION OF CANDIDACY
CANDIDATE FILING PERIOD.(ic 50410)
Opens: August 23, 2021 (8:00 am)
Closes: September 3, 2021 (5:00 pm)
CANDIDATE WITHDRAWAL DEADLINES f1 C 34-1405A)
September 17, 2021 (5:00 pm)
I CANDIDATE INFORMATION
I Candidate Name (As it: appear on your voter registration record.)
MI
-I��
OFFICE INFORMATION
Filing for the Office of:
First
City Name:
Last
C�r nct
Residence Address (As it appears on your voter registration record.)
Street Address
i 9 W TI ovder G-
Mailing Address.
Street Address
1 S-09 030 Pottle' C�
BALLOT NAME
Write your name exactly as you would[ like it to appear on the ballot
City
City
State
State
dC�
CITY OF EAGLE
AUG 2 3 2021
File:
Route to:
Cowia,
Eaglsz,__.
Zip Code
S3{e
Zip Code
Suffix
County
County
CAMPAIGN FINANCE INFORMATION
!l do hereby certify that I am a registered elector of the State of Idaho and appoint myself as treasurer for my campaign. If any campaign
finance contributions or expenditures reach or exceed $500, I will create a Campaign Finance account with the Secretary of State, and may
at that time, appoint another person as Treasurer or remain as my own Treasurer.
1 CERTIFICATION
I, the undersigned, being a resident of the Statej Idaho and of the ci liste above, do hereby declare myself a candidate for the office entered
above to be voted on at the Election to be held on the dayof in , 2021 and I certify that the information on this Declaration is
true and accurate.
I further certify that I possess the legal qualifications to hold said office. 1 submit herewith the fling fee of ($40.00), or in lieu glItie filing fee the
nominating petition containing the five (5) signatures of qualified electors as statutorily required.
Dated:
v£sl,431a01-�
Subscribed and sworn to before me this da . o
Signature:
Notary Public in and for the
My Commission Expires:
State of Idaho, residing at
Candidate Signatur
aozA
KELLIE HEKOW`
COMMISSION #17014
NOTARY PUBLIC
STATE OF IDAHO
MY COMMISSION EXPIRES "`�
•
EC-3A - Declaration of Candidacy for City Offices —Approved by the Idaho Secretary of State
Revised 0e/11/2021