HomeMy WebLinkAboutNomination Papers - SmithOFFICIAL FILING FORM C1it v ;.Rk-A -WS of
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AFFIDAVIT OF NOMINEE & OATH OR AFFIRMATION OF NOMINEE
AFFIDAVIT OF NOMINEE
State of California
County of Riverside ) ss.
1, Anyse Smith
MUNICIPAL
City: of P Im desert
Issued by: e
SIGN UR
City Cler c
TITLE
Date: 0-1 l (0 1 ZOZy
, under penalty of perjury, state that I am a nominee for the office
of Palm Desert City Council
Ward or Councilmanic District 3 ® Full Term ❑ Short Term
I will accept the office in the event of my election to this office at the election to be held on November 5, 2024
1 desire my name to appear on the ballot as follows: AVX4jg, srkX�
PRI T OR TYPE YOUR NAME
and I desire the following designation to appear on the ballot under my name:
a
(Print or type your principal profession(s), vocation(s), or o cupation(s), In 3 words or less; or the name of the elective public office you
hold or "Incumbent". If you leave this space blank, no designation will appear on the ballot.)
My residence address is as follows:
etazd
RESIDENCE ADDRESS: NUMBER, STREET, CITY & ZIP
MAILING ADDRESS, IF DIFFERENT
SIGNATURE OF NOMINEE
DAY TELEPHONE NUMBER EVENING TELEPHONE NUMBER
EMAIL ADDRESS:
OATH OR AFFIRMATION OF NOMINEE
FAX
I do solemnly swear (or affirm) that I will support and defend the Constitution of the United States and the
Constitution of the State of California against all enemies, foreign and domestic; that I will bear true faith and
allegiance to the Constitution of the United States and the Constitution of the State of California; that I take this
obligation freely, without any mental reservation or purpose of evasion; and that I will well and faithfully discharge the
duties upon which I am about to enter.
State of California
County of Riverside I ss.
Subscribed and sworn to before me this 16th
SIGNATU
r OF OFF
C
TITLE OF OFFICE
NOMINEE
2024