HomeMy WebLinkAboutNotice of Candidacy and Affidavit: : Rick MohrigCITY OF MILTON
*+* CUSTOMER RECEIPT ***
Oper: MLTGSRI Type: OC Drawer: 1
Date: 8/7/07 23 Receipt no: 9803
Description Quantity Amount
MISCL MISCELLANEOUS
1.00 $390.00
Trans number: 10494
G/L account number:
10011303419100
iffl@0001111000
RELIABLE RENOVATION & REPAIR
RUCK MOHRIG
Tender detail
CK CHECK 354 $390.00
Total tendered $390.00
Total payment $390.00
Trans date: 8/27/07 Time: 15:6:44
*** THANK YOU FOR YOUR PAYMENT ***
TO
!Aperintendent of Elections
of
State of Georgia
County/Municipality
NOTICE OF CANDIDACY AND AFFIDAVIT
(COUNTY/MUNICIPALITY)
RECEIVED
AG9li�' a`s�
CITy CLERIC
CITY OF W&T014
I, the undersigned, being first duly sworn on oath, do depose and say: that my name is �i (CGCG v o�ptHQS' J"[LYi�"iel
that my residence address is 130 5-- Pelle f-,eYye Dr.
(Street Number) (Street)
u
G11�
3046
(State) (zip
that my post office address is S'fIMC ACMQy C /
that my telephone number is 7 6 7gn '�3 ^ A �� 6b 3--
(Business) (Home)
that my profession, business, or occupation (if any ) is 4� � �04 `74/J ;
that the name of my precinct is h f S t/'►' C f �i 6 p7 �� � s that I am an elector of the county/municipality of my
residence eligible to vote in tthe e ect� ion in which I am a candi ate; that the name of
the office I am seeking is
CL44 In eiJ�mbt '! -4 r i' C' ; that my date of birth is Q / % ; that I have been a legal resident
(Furn'i'sh Circuit, District, o ost if Applicable)
,.,,,.he State of Georgia for ears; that I have been a legal resident of 40 h county for ears;
that I have been a legal resident of my district (if applicable) for
years; that I have been a legal resident of my
circuit (if applicable) for years; that I am a citizen of the United States; that I am eligible to hold such office; that I am a
candidate for such office in the C,+� G /`%� „. D/SP'Ilct ld on the day of /y6o r , 200;
(Election)
that I 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 of 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
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. Ch. 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.
IN
Sworn to and subscribed before me this A -1 -H-�
(Notary Public)
JEANETTE R MARCHIAFAVA
Notary Public, Fulton CO" OA
My Commission Expires My Commission Expires August 29, 2009
(Required by Ga. Election Code, Sec. 21-2-132.)
ignature of Candidate)
day of , 20 01
Form-NC-C&M-05 (over)
1. I desire that my name appear iion the ballot as follows:
�i 1cC K 1/10 n V' r�G1
(Please Print)
2. (a) I am running in a special election for a partisan office and my party affiliation is
(Ram running as a nonpartisan candidate [/e-�
(c) I am running as an independent candidate [ ]
(d) 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 an statute and party rule governing and allowing such method of nomination):
3. (a) [ ] I am required to file the above Notice followed by a nomination petition containing at least.
r valid signatures due
(b) [ 4T-17am not required to submit a nomination petition, because I am:
[ ] Specify [Code § 21-2-132]:
4. (a) [ I hereby tender cash/check in the amount of $ 3%0, OO
NAME OF BANK:h/a*h A u f4 a l n
CHECK NUMBER: 3,51
(b) [ ] I hereby file a Pauper's Affidavit, accompanied by a qualifying petition as prescribed in O.C.G.A. Sec. 21-2-132 (g), in
lieu of paying the qualifying fee.
NOTE: CANDIDATES FOR THE FOLLOWING OFFICES MUST FILE AN ADDITIONAL AFFIDAVIT IN
ACCORDANCE WITH THE LISTED CODE SECTION AND MAY HAVE OTHER REQUIREMENTS IN ORDER
TO BE QUALIFIED TO SEEK OFFICE. CANDIDATES SHOULD REVIEW THE QUALIFICATIONS FOR THE
OFFICE FOR WHICH THEY OFFER FOR ELECTION CAREFULLY.
CLERK OF SUPERIOR COURT O.C.G.A. § 15-6-50(b)(2)
JUDGE OF THE PROBATE COURT O.C.G.A. § 15-9-2(a)(2)
SHERIFF O.C.G.A. § 15-16-1(c)(2)
CORONER O.C.G.A. § 45-16-1(b)(2)
TAX RECEIVER O.C.G.A. § 48-5-210(b)(2)
TAX COLLECTOR O.C.G.A. § 48-5-210(b)(2)
TAX COMMISSIONER O.C.G.A. § 48-5-210(b)(2)