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Home My WebLink AboutBallot Designation Worksheet - AkkermanRiverside County, Registrar of Voters BALLOT DESIGNATION WORKSHEET �.,,.,,•• November 5, 2024 General Election (Elections Code §§ 13107, 13107.3, 13107.5 California Code of Regulations § 20711) This entire form must be completed, or it will not be accepted and you will not be entitled to a ballot designation. DO NOT LEAVE ANY RESPONSE SPACES BLANK. If information requested is not applicable, please write "NIA" in the space provided, otherwise the information MUST be provided. UPON FILING, THIS WORKSHEET WILL BE A PUBLIC DOCUMENT, Candidate Name: e- S M G (1 Gender (optional, for translation use onl : 0ffice:P0Ln1 32(,e A CCOV4) C A V6Ar1%4' 7 Email: r Home Address: 1 Home/Mobile: 7� Name (or other person authorized to act on your behalf): Attorney 2 ,..._. Information Address: Phone Number(s) Business: Mobile: Fax: You may select as your ballot designation one of the following designations: (a) Your current principal profession(s), vocation(s), or occupation(s) [maximum total of three words, separated by a slash (b) The full t tie of the public office you currently occupy and to which you were elected. (c) "Appointed [full title of public office]" if you currently serve by appointment in an elective public office and are seeking election to the same office or to some other office. (d) "Incumbent" if you were elected (or, if you are a Superior Court Judge, you are a candidate for the same office that you hold) to your current public office and seek election to the same office. NOTE: A candidate for the office of Representative in Congress, Member of the State Board of Equalization, State Senator, or Member of the Assembly shall not choose the word "incumbent" as a designation to appear on the ballot. (e) "Appointed Incumbent' if you were appointed to your current elective public office and seek election to the same office. Proposed Proposed Ballot Deli nafon s : oC 8L/61'r)4f5- DLC>nP Ballot 3 Alternate Ballot Designaticn(s)1: U51 h(75 5 OCA) SOP r Designation(s) Alternate BdIlot Designation(s) 2: In the spaces provided on the next page(s): (a) Describe why you believe you are entitled to use the proposed ballot designation. ram- 3 (b) If your proposed ballot designation contains one or more slashes ('r) separating words in your ballot designation for separate Ncipafession(s), vocation(s), or occupation(s) (collectively known as "PVOs"), complete a justification section for each separate PVO. (' rn (c) Attach any documents or exhibits that you believe support your proposed ballot designation, -0 (d) If using the title of an elective office, attach a copy of your certificate of election or appointment. w (e) Any supporting documents will not be returned to you. Do not submit originals. It is your responsibility to justify your proposed ballot designation and to provide all requested details. If your proposed ballot designat on includes the word volunteer," indicate the title of your volunteer position and the name of the entity for which you volunteer along with a brief description of the type of volunteer work you do and the approximate amount of time involved. You may only use the ballot designation "community volunteer" if you vd unteer for a 501(c)(3) charitable, educational, or religious organization, a governmental agency or an educational institution. You may not use "community volunteer" together with another designation. Rev 0512024 Riverside County, Registrar of Voters BALLOT DESIGNATION WORKSHEET �•.., ,+•' November 5 2024 General Election (Elections Code §§ 13107. 131117 3. 13107 5: California Code of Regulations § 20711) Page 2 If your proposed ballot designation contains one or more slashes (T) separating multiple principal profession(s), vocation(s), or occupation(s) (collectively known as WWI, complete a justification section for each separate PVO. Justification for use of Proposed Ballot Designation(s) If you are proposing 4 a'ternate ballot designations, please provide justification for use of those on Justification for use of 1k PVO- C/1 v rT 7Q157 O ! f Current or most recent'ob title: tS5 ,5 Start/End Dates: - 2 + Employer Name or Business: is r e-k ke rM'a n Person who can verify this information: Name:k,h , A I1 kerry,os- Phone Number(s): Justification for use of 2111 PVO: Current or most recent 'ob title Start/End Dates: Employer Name or Business Person who can verify this information: Name Phone Number(s) Email Justification for use of 3"' PVO: Current or most recent job title: Start/End Dates: Employer Name or Business: Person who can verify this information: Name: Phone Number(s): Email: Before signing below, answerlinitial the following questions, Does your proposed ballot designation: 1) Use only a portion of the title of your current elected office? Dyes 91 No Initial 2) Non -judicial candidates: Use only the word "Incumbent' for an elective office to which you were appointed? Dyes El No Initial 3) Use more than three total words for your principal professions, vocations, or occupations? Dyes 12f No Initia 4) Suggest an evaluation of you, such as outstanding, leading, expert, virtuous, or eminent? Dyes 16 No Initia 5) Refer to a status (Veteran, Activist, Founder, Scholar), rather than a profession, vocation, or occupations? ❑Yes6o Initial 6) Abbreviate the word 'retired? Dyes"'No Initial 7) Place the word "retired' after the words it modifies? Example: Accountant, retired Dyes of No IzX Refer to a racial, religious, or ethnic group? ❑Yes RfNo Initial 12) Refer to any activity prohibited by law? ❑Yes YNO Initia If the answer to any of these questions is "yes," your proposed ballot designation is likely to be rejected. X 07 l 20 f 20 2y Candidate' Sinned: Month Dav Year For your reference, attached are Elections Code sections 13107, 13107 3, and 1 s 107 5, and California Code of Regulations (CCR), title 2, section 20711. You also may wish to consult CCR. title 2, sections 20712-20719 (found at www.sos.ca.00vt. V- 0512024 . a Riverside County, Registrar of Voters BALLOT DESIGNATION WORKSHEET •+....••' November 5, 2024 General Election (Elections Code §§ 13107. 13107 3, 13107.5; California Code of Regulations § 20711) Page 3 COMPLETE THIS PACE ONLY IF one or more Alternate Ballot Designation(s) are provided. If this page is not applicable, please initial: Justification for Alternate Ballot A Designation(s)1 Justification for Alternate Ballot Designation(s) 2 Justification for use of 1rt LPVO: ACAV47 4 Av511)e55 li[en5c LA)rj e e,�y � aj,�. Q5P�. Current or most recent job title: I)er StarUEnd Dates: i oo Em er Name or Business r� /jt�L A m ct✓+ Person who can verify this information: Name ka jL j fijil(kernaj Phone Numbers)?/ ? ) Justification for use of 2nd PVO: Current or most recent job title: StarUEnd Dates: Employer Name or Business: Person who can verify this information: Name: Phone Number(s): Email Justification for use of 3r4 PVO: Current or most recent'ob title- Start/End Dater. Employer Name or Business. Person who can verify this information: Name: Phone Number(s) Email - Justification for use of 10 PVO: Current or most recent job title: Start/End Dates Employer Name or Business: Person who can verify this information: Name: Phone Number(s): Email Justification for use of 2nd PVO: Current or most recent lob title: StarUEnd Dates. Employer Name or Business. Person who can verify this information: Name: Phone Number(s) Email: Justification for use of 3rd PVO: Current or most recent job title: Start/End Dates: Employer Name or Business: Person who can verify this Information: Name: Phone Number(s): Email: Rev 0512024 CITY OF PALM DESERT 2024 - 2025 BUSINESS LICENSE CERTIFICATE TO ail IOltYlG N AgiylpGsplai NAM .5or Stnrrns r MV'L Bin roe Crtyapatm Oesar C.%%> w GNP *AD AM Hotel MUALE00ASONVOtd Busetess flame GREGG AMERMAN Business Location Description MUSIC" PALM DESERT CA 92260•8365 Business Ormerfsl GREGG AKKERIIAN Business Type HOME OFFICE GREGG AKttLRKAN License N • ElfeeLre flue February 01 2024 PALM UE5ER1, CA 9226u-83G5 Expiration Data January 31 2025 THIS BUSINESS LICENSE DOBS NOT PERWT A BUSINESS THAT IS OTHERWISE PROHIBITED_ GREGG AKKERIMN Far all rngaros rggarait9 This I.CanW ccrta;L H1 13usr ml Tar. 9b;CKC. [emir at AA2 325. W-t Thank ycu for your payment on your City of Porn Deserl Business License ALL LICENSES MUST BE AVAILABLE FOR INSPECTION UPON REOU#ST. it you have queshws conceming your business license contact he Busiess Licensing Center vta snail at PaYndeserl@HilLgov cam err by telephone at 442-325-3954 Keep this pumon for your license srParmle In case you need a repacemen! for any lost. stolen, or destroyed license. A fee may be charged for a replacement of duplicate hccnse. Tfuz orrhfit:ate does not entitle the folder to coredud huwncss before corrrplrtng •Aith al reguremeMs d. the pa<rF Aeserl Munlnpal Goble and other applicable lain. not tD conduct business in a tore where conducting such business vtotsles Isx If YOU have a feed prate of business mMin Ine City of Palm Desert pleame dodgy the Business License above in a conspicuous Piece at this premises. Otherwise every BL ceH fcale holder not having a fixed place of business in the City shall keep the Business Lj=nso Cedificate upon his Or her person of affixed in plan visor araj can vehicle. van or other movable structure or device at all times .f required by the Cd.mkw Sterling January 1 202t Assetroly Sil 1607 tequrrs the prevention of gendet-based discrrrtirabon of buvness cstabirshmens. A fur notice is available in English of other languages by gong to. hips!,1ASA%v dca cis gov.rublicatanv ' BUSINESS LICENSING, 8839 N CEDAR AVE 0212 ■ • FRESNO CA93720-i832 EW . GREGG AKKERMAN PALM DESERT, CA 9226f,-836S City of Palm Desert BUSINESS LICENSE CERTIFICATE license Number Batt at Issue: 02N1r2024