Loading...
HomeMy WebLinkAboutNotice of Candidacy and Affidavit: Neal O'BrienCITY OF MILTON ** CUSTOMER RECEIPT *** Date: M8/28/D07 19 Receiptt no: 9M Description Quantity Amount MISCL MISCELLANEOUS Trans number: 1.00 $390.00 G/L account number: 10542 10011303419100 10000001111000 NEIL J OBRIEN ELECTION QUALIFING FEE Tender detail CK CHECK 6725 $390.00 Total tendered $390.00 Total payment $390.00 Trans date: 8/28/07 Time: 16:07:37 *** THANK YOU FOR YOUR PAYMENT *** TO: Superintendent of Elections of County/Municipality State of Georgia NOTICE OF CANDIDACY AND AFFIDAVIT (COUNTY/MUNICIPALITY) RECEIVED AN 28 1W 1a;05� C1TY CLERK QTY OF MILTON I, the undersigned, being first duly sworn on oath, do depose and say: that my name is /y f ! (-- 'J` OR - 1 1' that my residence address is (035- ID �- l (Street Number) (Street) IA(L-iCAs �cri-1©hJ Knit) 3o©DLl—g3LZ (City) (County) (State) (Zip Code) that my post office address is WA that my telephone number is -?7O - Sc -to - 03 12 99 `C60 776 -7L16 p7g7 ' (Business) (Home) p f that my profession, business, or occupation (if any ) is 1 �t-�n1� I �p 5 (�t,� L 1114 -I that the name of my precinct is W L- (rD `I ; that I am an elector of the county/municipality of my residence eligible to vote in the election in which I a/m' a candidate; that the name of the office I am seeking is V14 1(, j �!J C L 1'/ � Ll,&0� h l S (4C % �7 ; that my date of birth is Jof54�Fl 9S ; that I have been a legal resident Furnish Circuit, District, or Post if Appliable) ,C� * (d , the State of Georgia for -/ ears; that I have been a legal resident of (` UG 1 �J county for —d—years; years; 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 ears; 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(PA-t— &�t be held on the 2 L'57 -q --day of f }U414c S / , 20 o-7 (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. (Signature of Cand' Sworn to and subscribed before me this day of 0� , 20�• 1AA4 2!� t 4&o, (Notary Public) JEANETTE R MARCHIAFAVA Notary Public, Fulton Co., GA My Commission Expires My Commission Expires August 29, 2009 (Required by Ga. Election Code, Sec. 21-2-132.) 0001, Form-NC-C&M-05 (over) 1. I desire that my name appear on the ballot as follows: N" o `�R� (Please Print) 2. (a) I am running in a special election for a partisan office and my party affiliation is (b) I am running as a nonpartisan candidate [t� (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. valid signatures due (b) [ ] I am not required to submit a nomination petition, because I am: [ ] Specify [Code § 21-2-132]: 4. (a) [VfI*hereby tender cash/check in the amount of $©_ NAME OF BANK: OCL -t-4 CHECK NUMBER: &-7Z (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 JUDGE OF THE PROBATE COURT SHERIFF CORONER TAX RECEIVER TAX COLLECTOR TAX COMMISSIONER O.C.G.A. § 15-6-50(b)(2) O.C.G.A. § 15-9-2(a)(2) O.C.G.A. § 15-16-1(c)(2) O.C.G.A. § 45-16-1(b)(2) O.C.G.A.§ 48-5-210(b)(2) O.C.G.A.§ 48-5-210(b)(2) O.C.G.A.§ 48-5-210(b)(2)