CANDIDATE AFFIDAVIT [Art. XXVIII, Sec. 2(2) & (1), C.R.S.]

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1 Space Below For Office Use Only Municipal Candidates file with the Municipal Clerk CANDIDATE AFFIDAVIT [Art. XXVIII, Sec. 2(2) & (1), C.R.S.] This affidavit shall certify that I,, am a candidate for the (Year) election, [Art. XXVIII, Sec. 2(2)] for the office of, (Office) District # (if applicable), County. (District or at large ) (County) I understand that campaign finance activities in Colorado are governed by Article XXVIII of the Colorado Constitution, Article 45, Title 1 of the Colorado Revised Statutes (C.R.S.) (also known as the Fair Campaign Practices Act (FCPA)), and the Littleton Municipal Code I further certify that I am familiar with the provisions of the Colorado Fair Campaign Practices Act (FCPA) as required in of the Colorado Revised Statutes. Signature of Candidate Date: Physical Address of Candidate: Mailing address: (Street/City/St/Zip) Business Phone: Residence Phone: Fax: Web Address: * Address: The notary section below must be completed in full. STATE OF COLORADO COUNTY OF Before me,, a notary/officer duly authorized to administer oaths, in and for said State, personally appeared, whose name is subscribed to the foregoing Candidate Affidavit, and who affirms, that said statements are true and that the candidate acknowledges the execution of said instrument to be of their own free act and voluntary deed for the uses and purposes therein set forth. Subscribed and affirmed to before me this day of, 20. (Seal) (Notary/Official Signature) (Commission Expires)

2 CANDIDATE AFFIDAVIT INSTRUCTIONS Colorado Constitution Reference: Section 2(2), article XXVIII Colorado Revised Statutes: (1), C.R.S. Who uses this form? All candidates for public office. Purpose of form: This form is to be used by all candidates seeking an elected office. Is this form required for all candidates? YES When should this form be filed? Form must be filed with the Littleton City Clerk s Office within ten (10) days of becoming a candidate. When does an individual become a candidate? When the individual publicly announces an intent to seek public office and thereafter receives a contribution or makes an expenditure in support of the candidacy. What is the definition of Public announcement? Campaign and Political Finance Rule 1.20 states: Publicly announced an intention to seek election to public office or retention of a judicial office means that a person has made a statement signifying an interest in the office by means of a speech, advertisement, or other communication reported or appearing in public media or in any place accessible to the public. Such statement includes a stated intention to explore the possibility of seeking an office. The registration of a candidate committee shall also constitute a public announcement of an intention to seek election or retention. 1. Print or type the name of candidate on the first line. COMPLETING THE FORM 2. Print or type the year the office is up for election and the office being sought. 3. Indicate the district number or at large of the office being sought. 4. The candidate must sign and date the form. Signature must be notarized. 5. Print or type the physical address of the candidate. 6. Print or type the mailing address of the candidate if different from physical address. 7. Print or type the candidate s business or residential telephone number. 8. *Print or type the candidate s address. The city clerk s office will use this address to send notices and correspondences. 9. The remainder of the form must be completed by a Notary Public. Please note that this form and the information contained within are considered public information. All information is required.

3 Below Space For Office Use Only NEW COMMITTEE REGISTRATION FORM ( , C.R.S.) Please use this form if you are registering a new committee for Colorado campaign finance purposes. Select Only One Committee Type: Candidate Committee Political Party Small Donor Committee Political Committee Issue Committee 527 Political Organization Federal PAC Committee Name: Committee Address (Physical): Committee Address (Mailing): Phone Number: Fax Number: Name should be descriptive. Include office, organization name, etc. Note: CO does not have PACs, only political committees. Alternate Phone Number: Web Address: Check Only One Jurisdiction: Federal State County Municipal Multi-County Other: Purpose/Office Sought (include office, district & election year, if applicable): Financial Institution Information: Institution Name: Institution Address: Agent / Contact Information: Name of Person Acting As Registered Agent: Under Colorado law, only the registered agent (or the candidate in the case of candidate committees) may file the committee reports. Phone Number: Alternate 1: Authorization Registered Agent Registered Agent s Signature: Print Candidate Name: (if different from candidate) Date: Candidate Address (include mailing): Candidate Signature: Date:

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5 DO NOT REMOVE STAPLES PETITION WILL BECOME INVALD CITY OF LITTLETON, COLORADO NOMINATION PETITION MUST CONTAIN 50 VALID SIGNATURES FOR NOMINATION WARNING: IT IS AGAINST THE LAW: For anyone to sign this petition with any name other than one s own or to knowingly sign one s name more than once for the same candidate or to knowingly sign the petition when not a registered elector. Do no sign this petition unless you are an eligible elector of the City of Littleton. To be an eligible elector you must be registered to vote and eligible to vote in City of Littleton elections. Do not sign this petition unless you have read or have had read to you the proposed nomination petition in its entirety and understand its meaning. (C.R.S ) NOMINATION PETITION of for the office of COUNCIL MEMBER. (Candidates Name) To the Honorable, Wendy Heffner, City Clerk of the City of Littleton We, the undersigned REGISTERED electors of the City of Littleton, Colorado, in District *, hereby petition that (*leave blank if Candidate at Large) who resides at in the (Candidates full name) (Candidates full address) City of Littleton and State of Colorado, shall be a candidate for the office of COUNCIL MEMBER - ** to (**District # or At-Large) be voted for at the Coordinated Election to be held on the 3 rd day of November, We designate the following named person or persons as a Committee to fill any vacancy which may occur in said nomination. Name(s) of Vacancy Committee Address Phone # 1 2

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7 AFFIDAVIT OF CIRCULATOR I, hereby certify that I circulated this petition from (Print Name of Circulator) (Date) to for the nomination of for the office of (Date) (Print Name of Candidate) ; that each signature of the person signing said petition and to which the signer added his or her address and that each signer has stated to me that he or she is a registered elector within the City of Littleton, to which this petition refers. Date, 2015 State of Colorado County of Signature of Circulator Subscribed and sworn to before me this day of, (SEAL) Notary Public or Other Officer ACCEPTANCE OF NOMINATION (Candidate must complete this section) I,, hereby accept the nomination tendered me by the foregoing petitioners for the office of. (Candidate s signature) YOUR NAME WILL APPEAR ON THE BALLOT THE WAY YOU PRINT IT HERE. (NO DEGREE OR TITLE ALLOWED) (Print your name here) Mailing Address Physical Address Date, 2015 State of Colorado County of Subscribed and sworn to before me this day of, (SEAL) Notary Public