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HomeMy WebLinkAboutNotice of Candidacy - Karen Thurman - 08/31/2009F TO: Superintendent of Elections of County/Municipality State of Georgia NOTICE OF CANDIDACY AND AFFIDAVIT (COUNTY/MUNICIPALITY) RECEIVED AVG 3 1 W CrrY CLERIC : 3q AWk Crit OF A mmm I, the undersigned, being first duly sworn on oath, do depose and say: that my name is Kafen that my residence address is 3 d �� kr-g CQ LL J (Street Number) (Street) �t-�\' Ory (City) (County) (Statel (Zip Code) that my post office address is that my telephone number is `A Q" - �:s I " 7 �S Z G (Business) \_(`Home) , that my profession, business, or occupation (if any ) is C� +t ��� (� It v�L kL aCC (,( C /1 Ta ; that the name of my precinct is1! 1 �C 1� / �-(� r ; 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 \ �j� f l C -�- 1 ; that my date of birth is / �>O; that I have been a legal resident (Furnish Circuit, District, or Post if Applicable) .he State of Georgia for ACI years; that I have been a legal resident of kO county for a S 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 years; that I am a citizen of the United States; thart�I am eligible to hold such office; that I am a G fir\ e -f Com` J { da of 1�i OUQ� ►,� candidate for such office in the to be held on the y �'` - (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. C-- +, (Signature of Candidate) Sworn to and subscribed before me this day of 120 (Notary Public) FEANM R MARC WAVA My Commission Expires N*y P^ PAM QL GA Required by Ga. Election Code, Sec. 21-2-132.) Form-NC-C&M-05 (over) 1. I desire that 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 [ y -K (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) [ t kl hereby tender cash/check in the amount of $ 13 9 o NAME OF BANK: Q) xU> CA M tft u" CHECK NUMBER: 1 -I `J (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) 4 IN 3