Declaration of Candidacy - Koellisch, Robert - 8/28/2017Declaration of Candidacy
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 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
7th day of November,2017, and certify that I possess the le qualifications to
fill said office, and that my residence a esa,�.s:
6 4 3 c w rQ 7 C Chi ,
Candidate's Signature
ti,, go g t/. ,s'/OG%L L / Sc fI
••••-•>, 0, .14 Print Candidate's name above exactly as you wish it to appear on ballot
a s r' P' r �� �, 4017
� � r� � �•� i�vorn to before me this � da of � 0 1 :CD: \ Onel-1,A,(,
t) y q /MilSigned
�'r * 9; r`•• Notary Public i d f r,� State Idaho
residing at ��''� V t k+�
••
saesse ••
My Commission expires "1 � � Q - D t V
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
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 individua 's voter r s ation.k4tb%'
This declaration was accepted b l,(
on y O�� D/ Name, Titlat
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 CLERIC
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.
✓eo',/tmed rejisk•-.Ie ,ez-give^ 4,1-64-tio 8444
RECEIVED & FILED
CITY OF EAGLE
AUG 2 8 201/
File:
ADA COUNTY AFFIDAVIT OF
CERTIFICATION OF SIGNATURES FOR A CANDIDATE PETITION
State of Idaho, )
) ss.
County of ADA)
To the City Clerk of Eagle City, for the State of Idaho:
I, Christopher D. Rich, County Clerk of Ada County hereby
certify that 5 signatures on this
petition are those of qualified electors.
By
Christopher D. Rich
%%% Ji/OI , '•.
/ ,,''Ovv.s ••••••411.-`•••r
•
1....ityCl8 ,.
• n.
% .0"0\••
• 104:11FieSe c
State of Idaho
County of 40A
City of 044L6_
Petition of Candidacy
ss.
PETITION OF CANDIDACY
OF Ro/3e,e r K06 -4L/ SCJ-/
Name of Candidate
FOR OFFICE OF C 1 11 Co r N e l L
This petition must be filed in the office of the City Clerk not earlier than 8:00 a.m. on
the eleventh Monday nor later than 5:00 p.m. on the ninth Friday immediately preceding
election day. The submitted petition must have affixed thereto the names of at least five
(5) qualified electors who reside within the appropriate city.
I, the undersigned, being a qualified elector of the City of Eagle, in the State of Idaho,
do hereby certify and declare that I reside at the place set opposite my name and that I do
hereby join in the petition of -- d3L R- JleeksOLLISe.41a candidate for the office of Eagle
City Council to be voted at the election to be held on the 7th day of November, 2017.
tur� of Petitioner
9
ubChl
STATE OF IDAHO
Printed Name Residence Address Date Signed
f
Z/ + 110.1655 ��. /-(/a 7i7
fill_._ L. m.� _ ..eta .a -
•di 00
I
AiMAD 5u? 1\c,�lv
.C&r' k1 `+o c � S
sn oS NM , frdirty P i c ate � r
County of ODA
I,Mnr_J, Jaa([Scfeing first duly sworn, say: That I am a resident of the State of Idaho
and at least eighteen (18) years of age; that every person who signed this sheet of the
foregoing petition signed his or her name thereto in my presence; I believe that each has
stated his or her residence address correctly, and that each signer is a qualified
elector of the = to of I• .o, and the City of Eagle.
Signed
Signature Collector
Address
fehwase , , Fes, !► 4564,
Address of Signature Collector
to before me this •-'''' qday of ,, 4.Qi1. 2-D t
Signed Notary Public
ti
Residing at ! �� r41 y
Commission expires `f ' — 2C>0