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Home My WebLink AboutPease, Andrea (Andy) Ballot Designation Worksheet.s_EvEIV ED .... City of: San Luis Obispo PAGE 3 }}�von to c ndidate. Election Date: November 3, 2020 Bquir dF & rred and eturnod. EXPIRES: December 31, 2020 BALLOT DESIGNATION WORKSHEE SI.�,�. _ � K Pursuant to California Elections Code Section 13107,13107.3, 13107.5; California Code of Regulations Section 20711. This entire form must be completed, or it will not be accepted and you will not be entitled to a ballot designation. DO NOT LEAVE ANY RESPONSE SPACES BLANK. If information requested is not applicable, please write N/A in the space provided. Otherwise the information MUST be provided. UPON FILING, THIS WORKSHEET WILL BE PUBLIC RECORD. Candidate Name: &Y,S re-0- ( .kvtAm ) Pe -a s e, Office of: l . o V Yl C i � "'e,r— Home Address: 2 g I n C� L � $ �]ca Lk q 3 qo i Mailing Address: Ste, Business Address: 1015 N r eoyYio bu 200 SeL vk L Jc3 06cs )o C Q q 3 qO Business Phone: � (Xns Z 3,- _6 3.5 5- Home/Mobile Phone: S a Fax Number: Other Person Authorized to Act in Your Behalf or Not Applicable: ❑ E-Mail . Q-YL 0 i Vl L'*L (a R Ce Q t? h • Co W\, Attorney Name: Office. Home Address: Business Address Mailing Address: Business Phone: Fax Number: Home/Mobile Phone: E-Mail : PROPOSED BALLOT DESIGNATION: d a e V M6 V\+ 1st Alternative: re_" bo T �� rn a c-� t teA 2nd Alternative: You may select as your ballot designation one of the following: (a) Your current principal profession(s), vocation(s), or occupation(s) [maximum total of three words, separated by a "P']. (b) The full title of the public office you currently occupy and to which you were elected. (c) "Appointed [full title of public office]" if you currently serve by appointment in an elective public office and are seeking election to a different office. (d) "Incumbent' if you were elected (or, if you are a Superior Court Judge, appointed you are a candidate for the same office that you hold) to your current public office and seek election to a new term, (e) "Appointed Incumbent' if you were appointed to your current elective public office (other than Superior Court Judge) and seek election to a new term, In the space provided on the next page or on an attachment sheet, describe why you believe you are entitled to use the proposed ballot designation. If your proposed ballot designation contains one or more slashes (" /") separating words in your ballot designation for separate principal profession(s), vocation(s), or occupation(s) (collectively known as "PVOs"), complete a justification section for each separate PVO. Attach any documents or exhibits that you believe support your proposed ballot designation. If using the title of an elective office, attach a copy of your certificate of election or appointment. These documents will not be returned to you. 00 not submitrl i Is. If your proposed ballot designation includes the word "volunteer," indicate the title of your volunteer position and the name of the entity for which you volunteer along with a brief description of the type of volunteer work you do and the approximate amount of time involved. You may only use the ballot designation "community volunteer" if you volunteer for a 501(c)(3) charitable, educational, or religious organization, a governmental agency or an educational institution. You may not use "community volunteer" together with another designation. Forms_ NominationDocumentsWallot Designation Worksheet, Rev. 1012019 MCADirect City of: San Luis Obispo PAGE 4 Required to be given to candidate. Election Dare; .Vovemnnr J. 2020 Required to be signed and returned. EXPIRES: December 31. 2020 REMEMBER, IT IS YOUR RESPONSIBILITY TO JUSTIFY YOUR PROPOSED BALLOT DESIGNATION AND PROVIDE ALL REQUESTED DETAILS. For your reference, t41i�Nt-i% oaae . are Elections Code Sections 13107-13107,5 and California Code of Regulations (CCR) Section 20711. You may also wish to consult Elections Code Section 13107.5 ("community volunteer') and CCR Sections 20712 - 20719 (found at www.sos.ca.gov). If your proposed ballot designation contains one or more slashes "I" separating multiple principal profession(s), vocation(s), or occupation(s) (collectively known as "PVOs"), complete a justification section for each separate PVO. Justification for use of proposed ballot designation (1st PVO): S e c tte— a-S Cv o vLCJ VVV " e, S e(e.C, -eS 2dI6 " 0-M Current or Most Recent Job Title: Coo 1n U � Start Date: ( Z f Zo �. End Date: 7 pre s e,vt, Employer Name or Business: lit o S &-n L<< C 0 Person(s) Who Can Verify this Information: Name(s): Tfie. 5 a.. V I Phone Number: �09 -7 — 7 ( O z I ��+hAI E-Mail: Name(s): D er-e,K- -IL t(l VcrY� Justification for use of proposed ballot designation (2nd PVO): T a to - & ( { cW s eA a.2 ( V, ih ba�aytc.e Greem Covxgo kv\�1 Phone Number: .7 yy 7 C E-Mail: 1 �y` S ( o c-� �a . b e t «� l� w Current or Most Recent Job Title:�Start Date: jc,L,�e_e End Date: Employer Name or Business: ( h �>,~ lace. �;f-ee-v� CoyI su I Lyn Person(s) Who Can Verify this Information: Phone Number: qL 3 - 6 3 Name(s): 3�lr -kh n I r " t1 t E Mail: ,d j r ►�ba la 0Ce ee.n . c� Name(s): C�n W U r Phone Number: b-U 6 cf -5— E-Mail: �a-fl C-e ffk3�l -C �lVVL Forms_ NominationDocuments0allotDesignallonWorksheet Rev. 1012019 MCADirect City of San Luis Obispo PAGE 5 Required to be given to candidate. Election Date: November 3, 2020 Required to be signed and returned. EXPIRES: December 31, 2020 Before signing below, answer the following questions: Does your proposed ballot designation: -Use only a portion of the title of your current elected office? Yes ❑ No -Use only the word "Incumbent" for an elective office (other than Superior Court Judge) to which you were appointed? �Q Yes No -Use more than three total words for your principal professions, vocations or occupations? Yes ❑ No -Suggest an evaluation of you, such as outstanding, leading, expert, virtuous, or eminent? Yes ❑ No [ -Refer to a status (Veteran, Activist, Founder, Scholar), rather than a profession, vocation or occupation? Yes ❑ No �] -Abbreviate the word "retired"? Yes ❑ No -Place the word "retired" after the words it modifies? Example: Accountant, retired Yes ❑ No -Use any word or prefix (except "retired") such as "former" or "ex-" to refer to a former profession, vocation Yes ❑ No or occupation? -Use the word "retired" along with a current profession, vocation or occupation? Yes ❑ No Example: Retired Firefighter/Teacher -Use the name of a political party or political body? Yes ❑ No -Refer to a racial, religious, or ethnic group? Yes ❑ No F]v -Refer to any activity prohibited by law? Yes ❑ No [f If the answer is to any of these questions is "Yes," your proposed Ballot Designati ra is likely to be rejected. Candidate's Signature: PW Date: bl 20 Lo Forms_NominationDocuments0allot Designation Worksheet, Rev. 1012019 MCADirect