TO: Superintendent ofl Elections of_ State of Georgia  County/Municipality  NOTICE OF CANDIDACY. AND AFFIDAVIT COUNTYMUNICIFALT,  I,thet undersigned, being first dulys swom on oath, do depose and say: my namei is_  myr residence: address is (City) my post officea addressi is_ my telephone numberi is_ my profession, business, or occupation (ifa any) )is_ ther name ofr my precincti is_ (Circuit, District, orF Posti ifApplicable)  (Street)  (Street Number) (County) (Business)  (State)  (ZipCode)  (Home)  ;Iama ane elector oft the county/municipality ofmy  residence eligible to votei int the election inv whichI Iama ac candidate; thei name oft the officel Ia ams seekingis is Iwilll havel been a legalr resident oft the State of Georgia for consecutives years; a legalr resident of consecutive: years; al legal resident ofn my district (ifa applicable) for_ Iam eligible tol hold such office;t thatI ama a candidate fors such officei int the  my date ofbirthi is  asoft thes general electon fort this office, consecutive: years; and  county for  al legalr resident ofn my circuit (ifa applicable) for  consecutive: years;I Iam: ac citizen oft thel Uniteds States;  tobeh held ont the  (Election)  day of  20  Ihave never been convicted ands sentencedi in any court ofc competent jurisdiction forf fraudulent violation ofp primary or election laws, malfeasancei inc office, orf felonyi involving moralt turpitude or conviction of domestic violence under thel laws ofthis State, any other State, ord ofthe United States, or, ifsoc convicted that my civil rights! have! been restored; anda at leastt teny years have elapsed from thec date of completion oft thes sentence withouts subsequent conviction ofa another felonyi involving moralt turpitude; Iami notad defaulter for any federal, state, county, municipal, ors school systemt taxes required ofs such officeholder ord candidate ifsuchp person! has been finally adjudicatedl bya a court ofo competent jurisdiction to owet thoset taxes, buts suchi ineligibility may ber removed at any time by full payment thereof, orb by making payments to the tax authority pursuantt toa apayment plan, or under such other conditions ast the General. Assembly may provide! by generall law (pursuant to Ga. Const.. Art. I, Sec. I, paragraph m;Iwillr notl knowingly violatea any provisions ofthe Iunderstand that any false statement! knowingly madel by mei int thisl Notice of Candidacy and Affidavit will subject me toc criminal penalties as provided! byl law andl hereby request you toc cause myi name tob bep placed ont the ballots tob be used ins such election as  Georgia Election Code (O.C.G.A. $21-2)o or ofther rules orr regulations adopted thereunder.  acandidate fort thec officel Iams seeking. Sworn toa ands subscribed before met this  (Signature ofCandidate)  dayo of_  20  (Notary Public)  My Commission: Expires_  (Required! by Ga. Election Code O.C.G.A.S $21.2.132.) Idesire that my name appear ont thel ballota as follows (thes surname oft the candidate shall bea asi ita appears ont the candidate's voter registration card):  ShouldI Ibe elected, Idesiret that my namea appear on official  documents: asf follows:  (Please Print)  (Please Print)  (over)    Check only one  1. oI amr runningi ina special election fora aj partisan officea and my party: affiliation is  ol amr running asa a1 nonpartisan candidate. pI: ami running asa ani independent candidate. oI am running tob bet ther nominee ofthe_ Convention;  Party (Body): nominated by:  Other (Specify method ofnomination: ands statute and party rule governing and allowing such method ofr nomination):  2.JIamr required to filet thea abovel Noticef followed bya ai nomination petition containing atl least_ Iami notr required tos submit a nomination petition pursuant to O.C.G.A.S $21-2-132, becausel Iam:  valid: signatures due.  Running asa ar nonpartisan candidate. Running asa ani incumbent. Running ina a special election.  Running fora a state-wide office nominated bya duly constituted political body convention.  3. Ihereby tender check/money order int the amount ofs_  NAME OF BANK:_ CHECKI NUMBER:  Int thee event that: a candidate pays his ork her qualifying fee with a check thati iss subsequently retumed fori insufficient: funds, the superintendent shall automatically find that such candidate has not met the qualifications for holding the office beings sought, unlesst the bank, credit union, ord other financiali institution returning the checko certifiesi in writing by and officer's or director's oatht that the bank, creditu union, orf financial institution erredi inr returning thec check asp prescribedi in O.C.G.A. $21-2-6(d). Ihereby filea al Pauper's Affidavit, accompanied byac qualifying petition as prescribedi in O.C.G.A. $21-2-132(g),in  lieu ofp paying thec qualifying fee.  NOTE: CANDIDATES FOR1 THEI FOLLOWING OFFICES MUSTI FILE AN ADDITIONAL, AFFIDAVITIN ACCORDANCE WITH THEI LISTED CODE SECTION. ANDI MAYHAVE OTHER! REQUIREMENTS) IN ORDER TO BE QUALIFIED TO SEEK OFFICE. CANDIDATES: SHOULD! REVIEWTHE QUALIFICATIONS) FOR1 THE  OFFICE FOR WHICH THEY OFFER: FORI ELECTION CAREFULLY.  CLERK OF SUPERIOR COURT JUDGE OF THE PROBATE COURT SHERIFF CORONER TAXRECEIVER TAXCOLLECTOR TAX COMMISSIONER  O.CGA-5156S00)O) O.C.G.A. $1 15-9-2(a)(2) O.CGASI5-1600) 0.CGA-545-610)0) OCGA.4852100)0) OCGA48521000) 0CG.A.54852100)0)  Form-NC-C&M-20