HomeMy WebLinkAboutRuiz, Arnold - Supporting DocumentsCITY OF SAN LUIS OBISPO
CAMPAIGN STATEMENT DISCLOSURE LOG
Date of Election: November 4, 2008 Office Sought: Council Member
Candidate:
Arnold Ruiz
San Luis Obispo, CA 93401
Committee Name: Arnold Ruiz For City Council
I.D. Number:
Treasurer:
Donald Hedrick
San Luis Obispo, CA 93401
G: \702 -01 Elections \Election 2008 \2008 Candidate Campaign Disclosure Logs \Ruiz \Ruiz Campaign Statement
Disclosure Log.doc
Form #/ Name
Date Due
Date Filed
Period Covered
Amendment
Filed
501
8 -6 -08
410
8 -27 -08
460
1016/08
10/6/08
1/1/08 — 9/30/08
Amend #1 10/23/08
460
10/23/08
10/23/08
10/1/08 — 10/18/08
460
2/2/09
2/2/09
10/19/08 —12/31 /08
Termination
410
2/2/09
2/2/09
Termination
G
City Supp.
10/28/08
10/28108
Formation —
10/27/08
a
G: \702 -01 Elections \Election 2008 \2008 Candidate Campaign Disclosure Logs \Ruiz \Ruiz Campaign Statement
Disclosure Log.doc
City of San Luis Obispo
PAYMENT VOUCHER
VENDOR
ADDRESS
ARNOLD RUIZ
I
I SAN LUIS OBISPO CA 93401 1
Date Vendor #
12/23/08
SPECIAL HANDLING/DELIVERY INSTRUCTION
Is a separate check required? Lj
Hold check for:
Invoice
Account #
Description
Amount
Number
Date
12 -23 -2008
RUIZ
12/23/08
GL # 100 - 47040
refund for deposit of Candidate's Statement
$183.53
TOTAL
$183.53
Requesting Departmentt
Pre ared By
Candidate Statement Charges by Candidate
Candidate
Sample Ballot
run charges
Set up
charge
Spanish
Translation_
Total
Mayor
_.
Dave Romero ✓
$200.25
$45.00
N/A
$ 245.25
Terry Mohan ,�
$503.82
$45.00
$104.6 1 ��r %')
$ 653.50
City Counsel
...Arnold Ruiz
$221.47
$45.00
N/A
$ 266.47
Jan Marx ✓
$221.47
$45.00
N/A � `�'
$ 266.47
John Ashbaugh
$221.47
$45.00
N/A tfu
$ 266.47
Dan Carpenter
$221.47
$45.00
N/A y3 U
$ 266.47
Marcia Nelson
$221.47
$45.00
N/A VS-O
$ 266.47
Paul Brown V,
$447.24
$45.00
104.61'9 I,obe`
$ 596.92
Page 2 of 2
P
Page 1 of 1
Hooper, Audrey
From: Hooper, Audrey
Sent: Thursday, December 18, 2008 4:07 PM
To: 'Candidate Arnold Ruiz'; 'Candidate Dan Carpenter'; 'Candidate Dave Romero'; 'Candidate Jan Howell
Marx'; 'Candidate John Ashbaugh'; 'Candidate Marcia Nelson'; 'Candidate Paul Brown'; 'Candidate Terry
Mohan'
Cc: Assistant Treasurer Kyle Goetz; Assistant Treasurer Pam Ruggles; Assistant Treasurer Roberta Soules;
Treasurer Ali Semon; Treasurer Anna Drabinski; Treasurer Dominic Perello; Treasurer Don Hedrick;
Treasurer George Sabo; Treasurer Jesse Norris; Treasurer Mike Radakovich
Subject: Cost for Printing of Candidates' Statements
I have received the charges from the Registrar of Voters for the costs of candidates statements. Each of you will be
receiving a refund. There is an error in these charges and so I will not provide you with the exact amount until I receive
clarification from the Registrar of Voters.
The amount will vary a bit.
If you requested an English only printing, you will be receiving approximately $180 - $200.
If you requested a Spanish translation as well, you will be receiving approximately $340.
Please let me know as soon as Dossible how you want, y_our checks_rnade_ payable (i.e., to you personally or to a
campaign bank account).
If I hear from you by the first of next week and can process your refund before Wednesday, the checks should be in the
mail on December 31st
I will be sending you an e-mail letting you know the exact amount you will be receiving as soon as I receive the correction
from the Registrar of Voters.
will also be advising you of your next/last filing requirement sometime next week if you haven't filed your termination
statement by that time.
For those of you who were unsuccessful candidates and still have campaign bank accounts open, please do not forget
that you must dispose of surplus funds by December 31 St. I'll cover that further in my e-mail.
Audrey
a
12/23/2008
Page 1 of 1
Hooper, Audrey
From: Hooper, Audrey
Sent: Tuesday, November 25, 2008 10:06 AM
To: 'Donald E. Hedrick'
Subject: Unequal Access to the Airwaves
Don,
I do not want you to think that I have been ignoring the following inquiry. I simply have been trying to give it some thought
and see if I could provide you with an accurate answer. But I fear I'm not going to be very helpful.
My suggestion would be to research the Federal Communications Commission website. This may be a good place to
start, although I suspect that after eight years of the current administration, the rules and regulations may not be
particularly sympathetic to your concerns. Unfortunately, I do not have the time or staff resources to assist you.
While it is also unfortunate that your and Arnold's requests did not receive an affirmative response, whatever the outcome
of you research will not change the outcome of this past election.
I'll be in touch in December to assist you and Arnold in filing the remaining required paperwork between then and
February 2nd.
Take care, Don.
Audrey
From: Donald E. Hedrick [ mailto :donhedrick @sbcglobal.net]
Sent: Wednesday, November 05, 2008 10:33 AM
To: Hooper, Audrey
Subject: Unequal Access to the Airwaves
Audrey,
How do we go about filing a complaint of being denied equal time on the radio. Arnold and
made multiple requests to be included on KVEC's talk radio and were shuned. I think that is a
violation of federal election law and we wish to proceed with a complaint. Do you have any
suggestions in this matter. We had an interesting campaign platform and would have liked to
participate with the other candidates on the radio yet we could not get on their schedule although we
made multiple requests via e-mail and personal visits to the station.
Yours, don Treasurer of The Committee to Elect Arnold Ruiz for City Council
Page 1 of 1
Hooper, Audrey
From: Hooper, Audrey
Sent: Wednesday, October 22, 2008 9:10 AM
To: 'Arnold Ruiz'; 'Donald E. Hedrick'
Subject: Form 460 Due Tomorrow (Need Amendment to the last one, too)
Importance: High
Arnold and Don,
I will be out of the office tomorrow and Friday. You have a form 460 that is due, which I'm sure you remember, by 5 p.m.
tomorrow. Because I will be gone tomorrow, you will either need to come in late today or make an appointment to meet
with Elaina tomorrow afternoon so she can carefully review your forms. Either one of us can help you.
Please try to have the form 460 completed before you come in and try to bring one copy as well as an original. If you
need help, though, we'll certainly be as accommodating as we can.
You will also need to complete an amendment to the last form you filled out (for the period of January 1 - September
30,2008). This means you will need to fill out the cover page of a blank form 460 and check the box for "Amendment" (not
"Pre- election statement "). On the lines below the amendment box, you can indicate that you are resubmitting the
Summary Page to complete line 19 (outstanding debts).
You will then need to submit a revised Summary Page. It was brought to my attention that you forget to carry the
amounts down from lines 2 and 9. (Since line 9 is 0, you will just need to carry down the $100 in loans received for that
period.) If you do not want to fill out an entirely new Summary Page, you can make a copy of that page from your last
filing and line through the zero on line 19 and write in the correct amount. (If you don't have a copy, let us know when you
come in.)
As with the new form 460 that is due, we require an original and copy of the amendment
Don't forget that both the candidate and treasurer must file both forms.
Hope this information is helpful.
Audrey
10/22/2008
CWY of son Luis OBISPO
August 12, 2008
Fair Political Practices Commission
428 J Street, Suite 620
Sacramento, CA 95814
Dear Sir or Madam:
Pursuant to FPPC requirements, enclosed is the Statement of Economic Interests (Form 700), for
the following San Luis Obispo City Council candidate in the November 4, 2008 General Municipal
Election:
Arnold Ruiz, Candidate for City Council
If you have questions regarding this form, please let me know.
City Clerk
Enclosures
G: \702 -01 Elections \Election 2008 \FPPC Form 700 Transmittal Letter.DOC
The City of San Luis Obispo is committed to include the disabled in all of its services, programs and activities-
Telecommunications Device for the Deaf (805) 781 -7410.
Cano, Elaina
From: tgong @co.slo.ca.us
Sent: Wednesday, August 13, 2008 10:43 AM
To: Cano, Elaina
Subject: Re: Candidate's Statement - Arnold Ruiz
Attachments: Ruiz Candidate Statement.doc; Ruiz Candidate Statement.pdf
E
IM
Ruiz Candidate
Ruiz Candidate
Statement.doc (...
Statement.pdf (•••
Thanbs Elaina.
Tommy Gong
County of San Luis Obispo
Assistant County Clerks- Recorder
email: tgong @co.slo.ca.us
"Cano, Elaina"
<ecano @slocity.or
g>
<tgong @co.slo.ca.us>
To
08/13/200810:32 cc
AM "Hooper, Audrey"
<ahooper @slocity.org>
Subject
Candidate's Statement - Arnold Ruiz
Hi Tommy,
Attached are the following documents for Council Candidate Arnold Ruiz:
1. Word Version of the Candidate's Statement of Qualifications
2. Cover Sheet and PDF Version of the Candidate's Statement of Qualifications.
Please confirm receipt.
Thanbs, Tommy,
i
Elaina
(See attached file: Ruiz Candidate Statement.doc)(See attached file: Ruiz Candidate Statement.pdf)
Page 1 of 1
Cano, Elaina
From: Cano, Elaina
Sent: Wednesday, August 13, 2008 10:33 AM
To: 'tgong @co.slo.ca.us'
Cc: Hooper, Audrey
Subject: Candidate's Statement - Arnold Ruiz
Attachments: Ruiz Candidate Statement.doc; Ruiz Candidate Statement.pdf
Hi Tommy,
Attached are the following documents for Council Candidate Arnold Ruiz:
1. Word Version of the Candidate's Statement of Qualifications
2. Cover Sheet and PDF Version of the Candidate's Statement of Qualifications.
Please confirm receipt.
Thanks, Tommy,
Elaina
8/13/2008
NOMINATION
PAPER
Hooper, Audrey
From: Hooper, Audrey
Sent: Friday, August 08, 2008 5:25 PM
To: 'tgong @co.slo.ca.us'
Cc: 'dgraton @co.slo.ca.us'; 'abowers @co.slo.ca.us'; Cano, Elaina
Subject: Signature Checks
Tommy,
Two more potential c ndidates returned papers this afternoon
Marcia's:
Arnold Ruiz
Council Member
2 Seats are up for Election
Nomination Paper contains 30 signatures
Nomination Paper submitted today, August 8, 2008.
Donald E. Hedrick
Mayor
1 Seat is are up for Election
Nomination Paper contains 22 signatures
Nomination Paper submitted today, August 8, 2008.
Page 1 of 1
Elaina will check on these at the same time she checks on
Let me know if you have questions. I will provide you with these and Marcia' Nelson's statements once we know they are
viable candidates.
Audrey
8/8/2008
Arnold Ruiz
Occupation: Retired Barber
Education and Qualifications: My goal is restore Laguna Lake.
1 a S `1
Wi your sup�rt, I am runru:
3 1 s a plan that wi be very
Yo a rest r i
on prcjc t 4ii
age,ption
4j Wih w r
p 1
worthy pr[iect. T�trou ut ti
poor Wien Laguna L e � `r
to enn c y,'A enfAcedrn tumoral i
B� hie i 4 �a�tch, r�ve 4�
14 aM giVe & eg ?ern lijkt
Age: 73
-7 Q! ICi r ly /S i)� /�7
for i Go A oal to rest Lake.
it ef2ttive.�i Ct o San Luis be ate to`�
,al fi�i�'ds. I( in e id gib s pro'e t W41 ti�4
(e�le o` San Luis Obis o get ac uknted w0imh tbfs�
Laa una e �pyc�e a i t`f1i e , odcYirqu
ored, i wzf l be me e a natural re itepo of 'r citizens
I.rve S' b In greater w�ter co ervation to tfi�e are a.
etition e or A!:doid sch tnegger 6 cut the reds
__ _ __ --
Jo mein this'w( by cause and I appreciate ydur vo� for me, Arnold Ruiz, on
November 4, 2008.
�S1?
CITY OF SAN LUIS OBISPG 1
FINANCE DFPARTMENT
990 PALM STREET
SAN LUIS OBISPO, CA 93401
CASHIER
(805)781 -7124
MISCELLANEOUS REVENUE
Please mark one:
iscellaneous Revenue
❑ Voucher Refund
Complete the information below:
Date: hk
Issuing Dept:
Vendor Name:
Voucher No.: Date:
Refund Description:
G.L. Acct:
Amount:
Please prepare a duplicate if you want a
receipt.
Return to.
CROUPS/AR/MISC. REVENUE VOUCHER
CANDIDATE'S STATEMENT OF �, ALIFICATIONS
(Elections Code Sections 13307, 13308, 13309, 13311)
Candidate for _ �La 0 C. ( V k4 VVI L �1— Pi
Of the City of San Luis Obispo at the November 4, 2008,
Municipal Election
/cy Date Statement Received from Candidate b
(File with CD or diskette attached) /�
INSTWICTIONS TO CANDIDATE
1. Cal ;ly read the information below
2. Complete the Name, Age & Occupation
portion of this statement.
3. Attach your statement to this form.
4. Return this form, the statement and an
electronic version of the statement to the City
Clerk's Office. The statement must be
submitted with your nomination papers, or if
none, no later than 88 days before the election.
It has been determined that the cost of the
statement is the responsibility of the
candidate. The estimated cost of printing
the statement is:
English $450' `t Spanish $550
NOTICE TO CANDIDATE: This statement may include your age, -occupation and a description of
your education and qualifications not to exceed 200 words. The statement must be written in the
first person singular. All statements will be printed in uniform style and type size. Please type
your statement in upper and lower case. Check the statement carefully for errors in spelling,
punctuation and grammar before filing as your statement will be printed exactly as submitted by
you.
I submit the following statement:
NAME: I-
OCCUPATION: K E _(_ ( L< F 1 )
Optional. (Maybe more descriptive than what will appear on ballot)
AGE:
Optional
EDUCATION AND QUALIFICATIONS - Statement and word count start here. Statement should be
printed on a separate page attached to this form. Statement must also be submitted in electronic format
C�►NDIDATE: PLEASE READ BELOW BEFORE SIGNING.
PURSUANT TO ELECTIONS CODE SECTIONS 13307 & 13308, 1 state that I prepared the attached statement which
is to be printed in the Voter's pamphlet and mailed to each registered voter in my district. I understand the deposit
amount is only an estimate of the actual cost that may be significantly more or les than the estimate, depending on the
number of candidates electing to file statements. Accordingly, the election official will bill me for any additional
expense or refund any excess amount paid depending on the final actual cost. I further state that I will pay for my
prorated cost of the statement at such time as required by the elections official
❑ I am indigent and unable to pay for my prorated costs in advance. Attached is a financial disclosure statement
pursuant to Elections Code Section 13309 and a release authorizing you to obtain a copy of my most recent federal tax
form. I certify under penalty of perjury under the laws of the State of California that the financial statement is true and
correct.
CHECK THE APPROPRIATE BOXES FOR PRINTING OPTIONS
❑ SPANISH - San Luis Obispo is not a language requirement county under the Federal Voting Rights Act. If you check
this box it indicates that you wish to have your statement translated and printed in Spanish in addition to English. The
cost of the Spanish statement is in addition to the cost of the English statement.
❑ WITHDRAWAL OF STATEMENT- If no other candidate has filed for election for the same office as of the close of
nominations, I authorize withdrawal of my statement of qualifications.
❑ WITHDRAWAL OF STATEMENT -If no other candidate for the same office has filed a statement of qualifications, I
authorize withdrawal of my statement of qualifications.
411 1-1� A Z " I -
(Print name as signed)
(Address of Candidate)
(
,C?/&
0
(Date of Signing)
G: \702 -01 Elections \Election 2008 \131ank Form Candidate's Statement.doc 8/8/2008
Arnold Ruiz Age: 73
Occupation: Retired Barber
Education and Qualifications: My goal is restore Laguna Lake.
With your support, I am running for City Council with a goal to restore our Laguna Lake.
I have a plan that will be very cost effective. The City of San Luis Obispo will be able to
do the restoration project with local funds. I intend to give this project my full time
attention. I will work to help the people of San Luis Obispo get acquainted with this
worthy project. Throughout the years, Laguna Lake has become a silt filled, odorous
pond. When Laguna Lake is restored, it will become be a natural respite for our citizens
to enjoy, an enhanced natural reserve, and bring greater water conservation to the area.
But here is the catch, we need to petition Governor Arnold Schwarzenegger to cut the red
tap and give us the green light to do a good deed for our community.
Join me in this worthy cause and I appreciate your vote for me, Arnold Ruiz, on
November 4, 2008.
Required to be given to candidate
Required to be signed and returned
BALLOT DESIGNATION WORKSHEET
This worksheet is int9nd9d tq�*sist in the prompt evaluation of requested ballot designations.
Name of Candidate: 7- O_D (a & r) / Z--
Office
(Including d r141. or division number, if applicable)
Home Address:
(area
0 CA. , � j� � j Evening Telephone Number:
(City, State and Zip Code) (area code)
Fax Telephone Number: `-
Business Address: (area code)
(Number and street address) E -mail:
(City, State and Zip Code) Name of Attorney or Other Person Authorized to Act in
Your Behalf:
Mailing Address:
(If different from above) His /Her Fax Number:
(City, State and Zip Code)
:2 :1610114
Telephone Number:.
E -mail Add
(area code)
(area code)
(Note: Designation must be your principal profession, vocation or occupation and may be no more than three words;
however, you may use the full title of the elective office you currently hold.)
(optional)
If above not accepted, 151 alternative:
2nd alternative:
Describe whatyou do and whyyou be/ieveyou are entitled to use the requested ballot designation. /fusing the title of an elective office,
you may submit a copy ofyour certificate of election or appointment.
Your Job
Dates You Held the Position: l % 1227
Name of Your Employer or Business: S.. c' d
Contact Person(s) Who Can Verify this Information:
Name(s): Z-
(area code) /
To the best of my knowledge and belief, the above - requested ballot designation(s) represent my true principal profession(s), vocation(s)
and /or occupation(s) which I am entitled to use as my ballot designations pursuant to §13107 and 13107.5: f the Elections Code.
Signed and dated this ay of in !rte r
(foeatio� �
Signature '
You may attach whatever supporting documentation or exhibits you wish that you believe support your proposed ballo stgnation.
These documents will not be returned to you, so do not submit original versions.
O \Forms \Nomination Documents \Ballot Designation Worksheet
2008 / Revised 10/07 MC Elections
Required to be given to candidate
Required to be signed and returned
BALLOT DESIGNATION REQUIREMENTS
For your reference, the relevant provisions of Elections Code 13107 and 13107.5 are reproduced below:
13107. BALLOT DESIGNATION REQUIREMENTS
(a) With the exception of candidates for Justice of the State Supreme Court or Court of Appeal, immediately under the name of each candidate,
and not separated from the name by any line, may appear at the option of the candidate only one of the following designations:
(1) Words designating the elective city, county, district, state, or federal office which the candidate holds at the time of filing the nomination
documents to which he or she was elected by vote of the people, or to which he or she was appointed, in the case of a superior court
judge.
(2) The word "incumbent" if the candidate is a candidate for the same office which he or she holds at the time of filing the nomination papers,
and was elected to that office by a vote of the people, or, in the case of a superior courtjudge, was appointed to that office.
(3) No more than three words designating either the current principal professions, vocations, or occupations of the candidate, or the principal
professions, vocations, or occupations of the candidate during the calendar year immediately preceding the filing of nomination
documents. For purposes of this section, all California geographical names shall be considered to be one word. Hyphenated words that
appear in any generally available standard reference dictionary, published in the United States at any time within the 10 calendar years
immediately preceding the election for which the words are counted, shall be considered as one word. Each part of all other hyphenated
words shall be counted as a separate word.
(4) The phrase "appointed incumbent" if the candidate holds an office other than ajudicial office by virtue of appointment, and the candidate
is a candidate for election to the same office, or, if the candidate is a candidate for election to the same office or to some other office, the
word "appointed" and the title of the office. In either instance, the candidate may not use the unmodified word "incumbent" or any words
designating the office unmodified by the word "appointed." However, the phrase "appointed incumbent" shall not be required of a
candidate who seeks reelection to an office which he or she holds and to which he or she was appointed, as a nominated candidate, in
lieu of an election, pursuant to Sections 5326 and 5328 of the Education Code or Section 7228, 7423, 7673, 10229, or 10515 of this
code.
(b) Neither the Secretary of State nor any other election official shall accept a designation of which any of the following would be true:
(1) It would mislead the voter.
(2) It would suggest an evaluation of a candidate, such as Outstanding, leading, expert, virtuous, or eminent.
(3) It abbreviates the word "retired" or places it following any word or words which It modifies.
(4) It uses a word or prefix, such as "former" or "ex-," which means a prior status. The only exception is the use of the word "retired."
(5) It uses the name of any political party, whether or not it has qualified for the ballot.
(6) It uses a word or words referring to a racial, religious, or ethnic group.
(7) It refers to any activity prohibited by law.
(c) If, upon checking the nomination documents and the ballot designation worksheet described in Section 13107.3, the election official finds the
designation to be in violation of any of the restrictions set forth in this section, the elections official shall notify the candidate by registered or
certified mail return receipt requested, addressed to the mailing address provided on the candidate's ballot designation worksheet.
(1) The candidate shall, within three days, excluding Saturday, Sunday, and state holidays, from the date he or she receives notice by
registered or certified mail, or from the date the candidate receives actual notice of [lie violation, whichever occurs first, appear before the
elections official or, in the case of the Secretary of State, notify the Secretary of State by telephone, and provide a designation that
complies with subdivision (a).
(2) In the event the candidate fails to provide a designation that complies with subdivision (a) within the three -day period specified in
paragraph (1), no designation shalt appear after the candidate's name.
(d) No designation given by a candidate shall be changed by the candidate after the final date for filing nomination documents, except as
specifically requested by the elections official as specified in subdivision (c) or as provided in subdivision (e). The elections official shall
maintain a copy of the ballot designation worksheet for each candidate that appears on the ballot in the county for the same period of time as
applied to nomination documents pursuant to Section 17100.
(e) The designation shall remain the same for all purposes of both priiTiary and general elections, unless the candidate, at least 98 days prior to
the general election, requests in writing a different designation which the candidate is entitled to use at the time of the request.
(f) In all cases, words so used shall be printed in 8 -point roman uppercase and lowercase type except that, if the designation selected is so long
that it would conflict with the space requirements of Sections 13207 and 13211, the elections official shall use a type size for the designation
for each candidate for that office sufficiently smaller to meet these requirements.
(g) Whenever a foreign language translation of a candidate's designation is required under the Voting Rights Act of 1965 (42 U.S.C. Sec. 1971),
as amended, to appear on the ballot in addition to the English language version, it shall be as short as possible, as consistent as is
practicable with this section, and shall employ abbreviations and initials wherever possible in order to avoid undue length.
(Amended by Stats, 2003, c. 62, §84.)
13107.5 USE OF "COMMUNITY VOLUNTEER"
(a) A candidate's ballot designation as "community volunteer" shall constitute a valid principal vocation or occupation for purposes of subdivision
(a) of Section 13107, if not otherwise in violation of any of the restrictions set forth in that section, and subject to the following conditions:
(1) A candidate's community volunteer activities constitute his or her principal profession, vocation, or occupation.
(2) A candidate is not engaged concurrently in another principal profession, vocation, or occupation.
(3) A candidate may not use the designation of "community volunteer" in combination with any other principal profession, vocation, or
occupation designation.
(b) The Secretary of State shall by regulation define what constitutes a community volunteer for purposes of this section.
O \Forms \Nomination Documents\Ballot Designation Worksheet
2008 / Revised 10/07 MC Elections
.A
GENERAL MUNICIPAL ELECTION - NOVEMBER 4, 2008
ACKNOWLEDGMENT FORM
7 p Id O / , hereby acknowledge receipt of nomination
documents and the candidate's packet on behalf T—M se or
as a candidate for Mayor r--- -- or Council Member in the General Municipal
Election to be held in the City of San Luis Obispo on Tuesday, November 4, 2008.
I am a registered voter and a qualified elector of the City of San Luis Obispo.
Date: y 7 Signature:
Name of Candidate:
Address:
Telephone Number:
E -Mail address:
Name of Treasurer:
Address:
Telephone Number:
E -Mail address:
Registration verified by: Date:'
C&LA C P� _011� __ - 6�e ,
GA702 -01 ElectionsTlection 20081Candidate's Acknowledgement.doc