Form 48517 - Allen County / Vanderburgh County Superior Court Judge Declaration Of Candidacy - Indiana Election Commission

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(CAN-41)
ALLEN COUNTY / VANDERBURGH COUNTY
SUPERIOR COURT JUDGE
DECLARATION OF CANDIDACY
State Form 48517 (R / 10-99)
Indiana Election Commission (IC 33-5-5.1-29; 33-5-43.2-1)
INSTRUCTIONS: This form is used by an individual who is seeking election to the superior court in Allen or Vanderburgh County. A declaration
of candidacy must be filed with the Indiana Election Division no later than noon February 18, 2000 and no earlier than January 19, 2000.
)
STATE OF INDIANA
The candidate's name must be printed or typed, and must comply with the
SS:
)
requirements in Indiana Code 3-5-7. If a candidate's name does not comply with
COUNTY OF
ALLEN (CHECK ONE)
this state law, the declaration may be challenged under Indiana Code 3-8-1-2.
)
VANDERBURGH
)
I, ___________________________ the undersigned, certify the following:
(1) I am a registered voter of _________ precinct of the Township of ____________, (or of the _________________ ward of
the City or Town of _____________________,) County of __________________________________________, State of Indiana;
CONVENTION CANDIDATES ONLY
(2) I reside at__________________________________________________________________________________________
(Complete residence address must be inserted)
(3) If different from my residence address, my mailing address is: _________________________________________________
(Complete mailing address must be inserted; if same as residence address, print "SAME.")
4) I comply with all requirements under the laws of the State of Indiana to be a candidate for the following office (including any
(
applicable residency requirement). I am not ineligible to be a candidate due to a criminal conviction that would prohibit me from
serving in this office.
(5) I request that you place my name on the official general election ballot for the office of
Allen
Vanderburgh County
Superior Court Division, __________________ with the following individual currently serving as incumbent judge _________________
(Insert name or #)
(Insert name)
to be voted on at the general election to be held on the 7th day of November, 2000:
Signature of candidate
Date signed
Telephone number (include area code)
(
)
CAMPAIGN FINANCE INFORMATION
6) I have been a candidate for state or local office in Indiana in a previous primary election:
Yes
No (check one)
(
(if the answer to this question is no, skip paragraph 7.)
7) I have filed all reports required by IC 3-9-5-10 for all previous candidacies:
Yes
No (check one).)
(
8) I am aware of the provisions of IC 3-9 regarding campaign finance and the reporting of campaign contributions and
(
expenditures. I agree to comply with the provisions of IC 3-9.
Signature of candidate
Date signed
Telephone number (include area code)
(
)
(9) I have filed a campaign finance statement of organization for my principal committee with, the appropriate county election
board. I am aware that I may be required to file the campaign finance statement of organization not later than seven (7) days
after the final date to file this declaration of candidacy.
Please complete reverse of form

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