HomeMy WebLinkAboutApplication for Nomination Papers - PollyELECTION DATE: K) ov , 3, Zb2k,
TO BE COMPLETED BY CANDIDATE
tvn PoII1
NAME ASR ISTERED
DATE
(ilk, De scxf CA C/z2Ii
RESIDENCE ADDRESS INCLUDING CITY AND ZIP
?a lw,
MAILING ADDRESS IF DIFFERENT FROM RESIDENCE
E -Mail Address:
TELEPHONE NUMBER(S): Day ( ) ≤/ — (�
l?a Iw, De se--+ GIB L� Ai1(, I
OFFICE SOUGHT
OFFICE USE
Fax: ( ) k/ A
Eve. (
Full Term ❑ Short Term
DISTRICT/WARD (if applicable)
Registration checked by: I a — Sos JeIpcjc a (951) 486-7200 or 800-773-8683
( ERK ATV OFFICE)
Precinct Number: ti/A Date of Registration: t'.31R
Material issued by:
(CI LERK/
Declaration of Candidacy
Nomination Paper
Ballot Designation Worksheet
Candidate's Statement Form
EEI Code of Fair Campaign Practices
Statement of Economic Interests/Manual
Resolution concerning Candidate Statement
Campaign Disclosure Forms
TO BE READ AND SIGNED BY CANDIDATE
To the best of my knowledge, I meet the eligibility requirements for the office I seek. At my request the nomination
documents listed above have been issued to me and I am aware that they must be filed with the City Clerk, during
normal business hours no later than _JJ�
STATE LAW REQUIRES CANDIDATE INFORMATION BE A MATTER OF PUBLIC RECORD.
Please indicate if you give permission for your home address and telephone number to be listed on the internet.
❑ Yes
{ No (If NO,
requeridas est6n disponibles al solicitarlas