HomeMy WebLinkAboutNotice of Candidacy - Carol Cookerly - 8/20/2019 - Notice of Candidacy and AffidavitPr -
RECEIVED
HOME OF'
AUGMILTON � o 2019
[STAB I1�IiID 2M, CITY CLERK
�CITY OF MILTON
To: The City of Milton Office of the City Clerk / .' 15— am
2006 Liberty Walk
Milton, GA 30004
NOTICE OF CANDIDACY AND AFFIDAVIT
CITY OF MILTON
I, the undersi ned, being first duly sworn on oath, do depose and say: my name is
(,
my residence address is
M Ilv?q
(City)
my post office address is
my telephone number is _
l 36 ov
(Street Number)
(2ovkerll
�la vja�crlCc ��
J�(Street)
300o y
(Zip Code)
yoy z�� a�iq
(Home)
"4
my profession, business, or occupation (if any) is 7
" �- e ;
my email address is OCLV-O / �Ob �'; �' ✓lam/ • �U
A4 /-
the name of my precinct is fY L ZerV Li ; I am an elector of the municipality of my residence eligible to
vote in the election in which I am a candidate; that the name of the office I am
seeking is 'cJ i S f'iGi c z- s t Z ; my date of birth is AV9y f
(District/Post)
(County)
(State)
a`/ ;/6 2-u37
(Business)
I have been a legal resident of the State of Georgia for 450 -�-- consecutive years; I have been a legal
resident of r /�fr� county for -3o consecutive years; I have been a legal resident of
my district for 20 consecutive years; I am a citizen of the United States; I am eligible
to hold such office; that I am a candidate for such office in the ��h cr'a
(Election)
to be held on the day of �U cJe,!?bC✓ , 20 l 9; 1 have never been convicted and sentenced in any
court of competent jurisdiction for fraudulent violation of primary or election laws, malfeasance in office, or felony
involving moral turpitude or conviction of domestic violence under the laws of this State, any other State, or the United
States, or, if so convicted that my civil rights have been restored; and at least ten years have elapsed from the date of
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completion of the sentence without subsequent conviction of another felony involving moral turpitude; and that I am
not a defaulter for any federal, state, county, municipal, or school system taxes required of such officeholder or
candidate if such person has been finally adjudicated by a court of competent jurisdiction to owe those taxes, but such
ineligibility may be removed at any time by full payment thereof, or by making payments to the tax authority pursuant
to a payment plan, or under such other conditions as the General Assembly may provide
by general law (pursuant to Ga. Const. Art. II, Sec. II, paragraph III), and that I will not knowingly violate any
provisions of the Georgia Election Code (O.C.G.A. §. 21-2) or of the rules or regulations adopted thereunder.
I understand that any false statement knowingly made by me in this Notice of Candidacy and Affidavit will subject
me to criminal penalties as provided by law and I hereby request you to cause my name to be placed on the ballots to
be used in such election as a candidate for the office I am seeking.
(Signature of Candidate)
Sworn to and subscribed before me this 2 U
I 0-
(Notary ublic)
day of J U1 Q a,_ , 20 -) CI .
J
My Commission Expires
(Required by Ga. Election Code O.C.G.A.§ 21.2.132.)
I desire that my name appear on the ballot as
Follows (the surname of the candidate shall
Be as it appears on the candidate's voter
Re istration card):
A�I�ld
O�
(Please Print)
�.��`` V%4 E D wV
4�
m f 11� kf'•t;tn
EXPIRES
e GI:UIZ(ilA �
s November 11. 2019 i
ty y�'AUBL`'C,
40
Should I be elected, I desire that my name
appear on official documents as follows:
lease Print)
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iLM
CHECK ONLY ONE
1. ❑ I am running in a special election for a partisan office and my party affiliation is
I am running as a nonpartisan candidate.
❑ I am running as an independent candidate.
❑ I am the nominee of the
Party (Body) nominated by:
❑ Convention (Certified copy of the minutes of the convention attested by the Chairman
and Secretary of the convention is being filed herewith);
❑ Other (Specify method of nomination and statute and party rule governing and allowing
such method of nomination):
2. ❑ I am required to file the above Notice followed by a nomination petition containing at least
valid signatures due , 20
EJ-1 am not required to submit a nomination petition pursuant to O.C.G.A. § 21-2-132, because I am:
❑ Running as a nonpartisan
O'Running as an incumbent.
❑ Running in a special election.
❑ Running for a state-wide office nominated by a duly constituted political body
convention.
OD
3. ❑ I hereby tender cash/check in the amount of $ � 90
Name of Bank: )uri -f-reu S e-
Check Number: 70 Z. 7
In the event that a candidate pays his or her qualifying fee with a check that is subsequently returned for insufficient
funds, the Superintendent shall automatically find that such candidate has not met the qualifications for holding the
office being sought, unless the bank, credit union, or other financial institution returning the check certifies in
writing by an officer's or director's oath that the bank, credit union, or financial institution erred in returning the
check as prescribed in O.C.G.A. § 21-2-6 (d).
❑ I hereby file a Pauper's Affidavit, accomplished by a qualifying petition as prescribed in O.C.G.A. § 21-2-
132 (g), in lieu of paying the qualifying fee.
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