HomeMy WebLinkAboutNotice of Candidacy and Affidavit: Roger SantiTO: A RECEIVED
p intendent of Elections
of County/Municipality
State of Georgia AUG 29 W
`�- LERK
NOTICE OF CANDIDACY AND AFFIDAVIT Cr of CIT'Y CzLEIRX x
(COUNTY/MUNICIPALITY) /� .
I, the undersigned, being first duly sworn on oath, do depose and say: that my name is fl dGf� /7> J;fAw
that my residence address is
V/v
(City)
T -rva"01t f w
(Street Number)
FV P
(County)
(State)
(Street)
;Oce
(zip Cod
that my post office address is
that my telephone number is 7 701 C23 - YYYQ 720 36 0 - OO Y_3 ;
(Business) (Home)
that my profession, business, or occupation (if any ) is f #?
that the name of my precinct is AIL- OdA ; that I am an elector of the county/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
C/j' y 4110vNCIL — RXIWAra ; that my date of birth is 7-31-4A ; that I have been a legal resident
(Furnis Circuit, District, or Post if Applicable)
the State of Georgia for ears; that I have been a legal resident of f AA/V county for 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 wears; 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 iL�N " (,�f AJf It d to be held on the b -M day of OW*AYt , 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 use such election as
a candidate for the office I am seeking.
( nature of Candidate)
i
Sworn to and subscribed before me this 1 � day of , 200
Y�a AJ
(Notary Public)
JEANETTE R MARCHIAFAVA
My Commission Expires
Notary Public, Fulton Co., GA
My Commission Expires August 29, 2009
(Required by Ga. Election Code, Sec. 21-2-132.)
,
Form-NC-C&M-05 (over)
,hat my name appear on the ballot as follows:
(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 KA
(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) X I am not required to submit a nomination petition, because I am:
[XJ Specify [Code § 21-2-132]:
4. (a) [ ] I hereby tender cash/check in the amount of $ 3L
NAME OF BANK: OANt of 'PA//T /&x(o
CHECK NUMBER: W
(b) A] 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 SHOULPREVIEW 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)