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DOUGLAS COUNTY BOARD OF EQUALIZATION APPLICATION APPLICANT INFORMATION Last Name First M.I. Date Street Address Apartment/Unit # City State ZIP Phone E-mail Address EDUCATION High School Address From To Did you graduate? YES NO Degree College Address From To Did you graduate? YES NO Degree Other Address From To Did you graduate? YES NO Degree OTHER QUALIFICATIONS List property owned by applicant Address / Legal Description Address / Legal Description Elected posts held with terms of office Have you ever been convicted of a felony? YES NO PREVIOUS EMPLOYMENT / EXPERIENCE Company Phone Address Years Company Phone Address Years Other Relevant Experience DISCLAIMER AND SIGNATURE After reviewing the qualifications and training requirements, please sign below indicating that you meet the qualifications and that you agree to comply with the training requirements: Signature Print Date Council of Superior Court Clerks of Georgia This form created pursuant to OCGA §48-5-311(b)(2)(A)