HomeMy WebLinkAboutSpecht, Jeffery Ballot DesignationCity of: San Luis Obispo PAGE 3 - r
entoca'dateElection Date: November 3, 2020 R�ff
ed and r umed.
EXPIRES: December31, 2020 BALLOT DESIGNATION WORKSHEE AUG l
Pursuant to California Elections Code Section 13107,13107.3,13107.5; California Code of Regulations Section 20711. Thi entire fg �1 s •C QQ� t00: or it will
not be accepted and you will not be entitled to a ballot designation. DO NOT LEAVE ANY RESPONSE SPACES BLANK. f in raqueStecT is nol 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:
Office of:
Home Address:
Mailing Address:
Business Address:
Business Phone:
Fax Number:
Home/Mobile Phone: 2
E-Mail: � � �1s f — om
Other Person Authorized to Act in Your Behalf or Not Applicable:
Attorney Name: Office:
Home Address:
Business Address:
Mailing Address:
Business Phone:
Fax Number:
PROPOSED BALLOT DESIGNATION:
1st Alternative: &_ YNeo r
Home/Mobile Phone:
E-Mail :
2nd Alternative: 'r"rievrenc CJ � —. -,e4DV0
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 "/"].
(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 (T') 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. Do not submit originals.
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_NominalionDocumentslBallot Designation Worksheet, Rev. 1012019 MCADirect
City of: San Luis Obispo PAGE 4 Required to be given to candidate.
Election Date: +: +=rf+ner T. ?c?a Required to be signed and returned.
EXPIRES: December J1, 2020 REMEMBER, IT IS YOUR RESPONSIBILITY TO JUSTIFY
YOUR PROPOSED BALLOT DESIGNATION AND PROVIDE ALL REQUESTED DETAILS.
For your reference, 191ir�winmc mo 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):
-Te b&6V\ 56 5- 10&N plo,Yc9r/ 5 Ve-a •4Cdc
Current or Most Recent Job Title: 3 . Start Date:
Employer Name or
Business:
Person(s) Who Can Verify this Information:
Name(s):
�5— 45fe h
Name(s): _finqny� S re�a
Justification for use of proposed ballot designation (2nd PV%
Current or Most Recent Job Title:
Employer Name or
Business:
Name(s):
70,
End Date:
Phone Number: I - 90T 7? C'lCt `! M
E-Mail: LtM
IC
Phone Number: —3?05 —,) I5 —62_4S,-
E-Mail An5nT SiPtm_ckiT 0_1rmli �.Ca))
Start Date:
Person(s) Who Can Verify this Information:
Phone Number:
E-Mail:
Phone Number:
Name(s):
E-Mail:
End Date:
Forms_ NominationDocuments0allotDesignation Worksheet, 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, 2010
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? 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
-Refer to any activity prohibited by law?
Yes
❑ No
If the answer is to any of these questions is "Yes,"
"
your proposed Ballot Designation is likely to be rejected.
Candidate's Signature: 2Q, Date: pi
iV V_ C__7 lor_�
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Forms_ NominationDocuments0allot Designation Worksheet, Rev. 1012019 MCADirect