2024 Jeffco GOP Qualifying

DECLARATION OF CANDIDACY

I hereby declare that I am a candidate for 2024 Republican nomination for election to the office of:
Name of the office and, if applicable, the place number: *
I certify that:

(1) I possess the qualifications fixed by law for said office and will in no way be disqualified from the same,

(2) I am not subject to disqualification from registering and voting under the laws or the Constitution of the State of Alabama,

(3) I have not been convicted of a felony under the lawss of the United States or of another State and,

(4) I am a Republican and I endorse and will actively support the principles and policies of the Republican Party.
Check boxes if applicable:

Filed principal campaign committeeFiled statement of economic interests
On this date*

MonthDayYear
Date
Name*

First NameLast Name
Residence Address (No P.O. Boxes)*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Home Phone*
Please enter a valid phone number.
Work Phone
Please enter a valid phone number.
Cell Phone
Please enter a valid phone number.
Email*
example@example.com
NAME AS YOU WISH IT TO APPEAR ON BALLOT- NO TITLES *
Signature*

Clear
Should be Empty:

DECLARATION OF CANDIDACY