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<br />required information (if no relevant information, list "None") <br />J, occupation present employment - paid or unpaid <br /> <br />occupational background previous employment - paid or unpaid <br /> <br />J, educational background schools attended, use attachment if needed <br /> <br /> <br />other <br /> <br />J, prior governmental experience elected or appointed <br /> <br />By signing this document, I hereby state: <br />~ that I will accept the nomination for the office indicated <br />~ that I will qualify for said office if elected <br />~ that all information provided by me on this form, including my occupation, educational and occupational background, and <br />prior governmental experience, is true to the best of my knowledge <br /> <br />Check the appropriate box (not applicable to candidates for federal office - US Senate and US Representative): <br /> <br />o By marking this box, I certify I do not have an existing candidate's committee and I do not expect to spend more than $300 <br />or receive more than $300 during each calendar year. I understand I must still keep records of all campaign transactions <br />and if total contributions or total expenditures exceed $300 during a calendar year, I must follow the requirements detailed <br />in the 2008 Campaign Finance Manual. <br /> <br />o By marking this box, I certify that I have already filed or will soon file a Statement of Organization for Candidate <br />Committee (SEL 220). For detailed instructions, see the 2008 Campaign Finance Manual. <br /> <br />-~ <br /> <br />candi~~ture - <br /> <br /> <br />..1lcJ:k(}1J - <br /> <br />date sig ed <br /> <br />This information is a matter of public record and may be published or reproduced. <br /> <br /> <br />for office use only <br /> <br />initials <br /> <br />candidate ID number <br /> <br />receipt number <br /> <br />candidate committee ID number <br /> <br />office number <br />