Declaration of Candidacy Moberly Seat 6/� Declaration of Candidacy
l✓lVL
I, a QWthe undersigned, affirm that I am a qualified elector of the City of
Meridian, State of Idaho, an that I have resided in the city for at least thirty (30) days. I hereby declare myself to
�1 /� /
be a candidate for the office of brit( COVh(,i tI `. SQA b , for a term of years, to be voted for at the
i
election to be held on the 5th day of November, 2013, 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 (�* day ofD, e n, nZ 013 - '
. •''��1,„y Signed / QAC Z. S��Gr�
�: �OTAit 1 ••L2 :
Notary Public in and for the State of Idaho
residing at pl/I I
pUB4�G
'•,•rj9r�•••••rPQgp`,
My Commission expires 'J
lotOF OF Vo .••
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
1// A nonrefundable filing fee of $40.
The City Cleric (or designee) must verify that (lie 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. II 11 II II
This declaration was accepted byJA A U (' e e L • 4o � ✓t2. un � l —ris
Name, Title
Oil at2,k P A4.,
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 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.