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Declaration for Nomination and Oath of Candidacy For City-County Butte-Silver Bow FOR FILING OFFICE ONLY Filed this______day of Document # Deputy or Filing Officer DECLARATION AND OATH FOR PRIMARY ELECTION TO BE FILED WITH SECRETARY OF STATE COUNTY ELECTION ADMINISTRATOR Filing for office of: Nonpartisan Full name of office including district and/or department numbers if applicable Name of Political Party Candidate Name (printed exactly as it should appear on the Mailing Address: Street or PO Box City Zip Residence Address: Street City Zip County of Residence: Home Phone: Work Phone: Email Address: Website Address: IF THIS DECLARATION IS FOR ANY ELECTED OFFICIAL OFFICE FOR BUTTE-SILVER COUNTY, YOU MUST MEET THE CHARTER’S REQUIREMENTS: I hereby certify that I am a qualified elector and resident of the City-County for at least one year before filing a Nomination and Oath of Candidacy for City-County Butte-Silver Bow. IF THIS DECLARATION IS FOR COUNTY COMMISSIONER FOR BUTTE-SILVER COUNTY, YOU MUST MEET THE CHARTER’S REQUIREMENTS: I hereby certify that I have been a resident of the district for six months. FILING FEE – FEE MUST BE PAID BEFORE FILING IS VALID: Candidate Filing Fee, if applicable, in the amount of $ is hereby submitted with this Declaration and Oath of Candidacy. OATH OF CANDIDACY - CANDIDATE MUST SIGN IN THE PRESENCE OF A NOTARY PUBLIC OR AN OFFICER OF THE OFFICE WHERE THIS FORM IS FILED: I hereby affirm that I possess, or will possess within constitutional and statutory deadlines, the qualifications prescribed by the Constitution and laws of the United States and the State of Montana. Signature of Candidate Date NOTARY OR AUTHORIZED OFFICER State of Montana County of Signed and sworn to before me this of by Printed Name of Candidate Where to file for Federal, Statewide, State District and Legislative offices: Montana Secretary of State State Capitol, 2nd Floor, Room 260 PO Box 202801 Helena, MT 59620-2801 Online: candidates.mt.gov By Fax: [PHONE REDACTED] Where to file for County, City and most Local District offices: County Election Administrator's Office A list of county election offices may be found at: sos.mt.gov/elections [SEAL/STAMP] Signature of Notary or Public Official [Montana notaries must complete the following if not part of stamp at left] Printed Name of Notary Public Notary Public for the State Residing My commission Updated January 9, 2012