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Revised 12/20/2022 CITY OFFICE DECLARATION OF CANDIDACY CANDIDATE FILING PERIOD (I.C. 50-410) OFFICE INFORMATION Opens: August 28, 2023 (8:00 am) Closes: September 8, 2023 (5:00 pm) Filing for the Office of: CANDIDATE WITHDRAWAL DEADLINES (I.C. 34-1405A) City Name: September 22, 2023 (5:00 pm) CERTIFICATION I, the undersigned, being a resident of the State of Idaho and of the city listed above, do hereby declare myself a candidate for the office entered above to be voted on at the Election to be held on the day of 2023 and I certify that the information on this Declaration is true and accurate. I further certify that I possess the legal qualifications to hold said office. I submit herewith the filing fee of ($40.00), or in lieu of the filing fee the nominating petition containing the five signatures of qualified electors as statutorily required. Dated: Candidate Signature: Subscribed and sworn to before me this day of Signature: Notary Public in and for the State of Idaho, residing at My Commission Expires: NOTARY SEAL HERE EC-3A - Declaration of Candidacy for City Offices – Approved by the Idaho Secretary of State CAMPAIGN FINANCE INFORMATION I do hereby certify that I am a registered elector of the State of Idaho and appoint myself as treasurer for my campaign. If any campaign finance contributions or expenditures reach or exceed $500, I will create a Campaign Finance account with the Secretary of State, and may at that time, appoint another person as Treasurer or remain as my own Treasurer. Idaho Code 34-701(2) now requires phone numbers to be provided. Idaho Code 34-704(4) states that all information in declarations of candidacy shall be made publicly available upon request. BALLOT NAME Write your name exactly as you would like it to appear on the ballot CANDIDATE INFORMATION Candidate Name (As it appears on your voter registration record.) Candidate Phone First MI Last Suffix Mailing Address Street Address City State Zip Code County HOMESTEAD EXEMPTION (I.C. 34-107[2], 34-701[3]) Have you, or your spouse, claimed a homestead exemption? Yes No If Yes, Please List the Address Street Address City State Zip Code County