Donna LusignanState of Idaho
County of Ada
City of Meridian
RECETVET*t�
AUG 2 6 2019 tion
CITY ur..
CITY CLERKS --F;11---E
of Candidacy
AD'A DO 1 t- 0110RS
2019 AV 26 PM 12. 58
PETITION OF CAN DIDACYOF :DO,4/i -4 1—US10WXAJ
e of Candidate
FOR OFFICE OF �LlyUn C
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 5:00p.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 mom/ �/ , in the State of Idaho, do hereby
peLffy and de Tare that I reside at the place set opposite my name andthatIIlo hereby jjom in the petition of
Xl c%9 LUS ((,,f14 (1 , a candidate for the office of .1 / /a M U/► C- (, L to be voted at the
election to be held on the 5' day of November, 2019.
OT,
Signature of
Petitioner
Printed Name
Residence Address
Date
Signed
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STATE OF IDAHO
COUNTY OF ADA
I, 0 `M ,r LUStakk\ being 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 ence; I believe that each has stated his orher name and residence address correctly, and that each
te.r isa qua i to f the State of Idaho, and the City of Meridian.1yy�d Address /0.33 �� `" Y"rLj, � �` / VW1 b,'9�1[/—�—�
Signa .hector Address of Signature Collector '0-3 Z
Subscribed and sworn to before me this �o day of G U 5-T , ZO 19
,A • e, Deny Signed Notary Public
�.•�� 4, .>� N°' 20/8'.oa Residing at i3 . -: 0
• —.� -
• Commission expires k\ It a0 d
'13 LIC 40
.,. Apr �y0• �.
(Notary Seal)
ADA COUNTY AFFIDAVIT OF
CERTIFICATION OF SIGNATURES FOR A CANDIDATE PETITION
State of Idaho, )
ss.
County of ADA)
To the Clerk of Meridian City, for the State of Idaho:
I, Phil McGrane, County Clerk of Ada County hereby
certify that signatures on this petition
are those of qualified electors.
Phil McGrane
�eeee � � o � u ee®••®®
By
Deputy Clgr�c�, :'OV
1DAH0 ® n
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•sej�nu'��e�
Declaration of Candidacy
I, the undersigned, affirm that I am a qualified elector of the City of Meridian, State of Idaho, and
that I have resided in the cat,n
for at least thirty (30) days. I hereby declare myself to be a candidate
-foMe office of C � e 1 L &)9—r for a term of _ years, to be voted for at
-the�olection to be held on the 5`h day of N ovember 2019, and certify that I possess the legal
qua�ications to filllli ii and tllaf rty residence address is /033 CCJesi' (��p,E l� r,
t� AUG 2 6 2019 ��
t
-_ - CI1 r
CITY CL! ? s Signature
LSubmribed and sworn to before me this day of a U l
Signed 4..0 L ,,,••••u��u•,,•,
Notary Public in and for the S e of Idaho ��� Gee, .Den q
Residing at
•'F�' Ao
�.�
.0 NOTAR y`
ll�l'
My Commission expires 91-20 : PUBLIC
UB LIC
'•. •*SCO I 1 Mr. 04
OFFICIAL USE ONLY °'•,;�te Of
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
individual's voter registration.
This declaration was accepted by r S tJO C I C CrI on
Name, Title Date
at I
T' e
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.