Declaration of Candidacy MilamDeclaration of Candidacy
I, the undersigned, affirm that I am a qualified elector of the City of Mer i d 1 cu—j—, 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
II #f SC -Y�-
h r o lnc I Sea?for a term of _� years, to be voted for at the election to be held on the
—T'
day of November, 0?013, and certify that I possess the legal qualifications to fill said office, and that my
residence address is
Candidate's Signature
fore me this i O day of \3
Signed
Notary Public in and for the State of Idaho
residing at l-.t?akd _U_�La 3_I
My Commission expires 0�4 ogwa aoyS
OFFICIAL USE ONLY
CITY CLERK
Before accepting this Declaration of Candidacy, the City Clerk (or designee) must verify:
This declaration is accompanied by:
OR
The attached Petition of Candidacy signed by at least five qualified city electors with the attached verification
from the county clerk,
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. J
This declaration was accepted by A Ue-e-
Cly �/VtPt✓1 F l 1�
Name, Title
on 7sa // 3 at 3 DA .
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.