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Municipal Offices Application for Nomination by Primary State of Wyoming ) ) ss. W.S. 22-23-302 County of ) I, the undersigned, swear or affirm that I was born on that I have been a resident of the state of Wyoming since (month/year), and that I am a registered voter of Election District No. Precinct No. in Ward No. in the city of and the state of Wyoming, residing at as of the closing of the municipal clerk’s office on the day this petition is filed, do hereby petition and request that my name be printed upon the official municipal primary ballot at the next primary election as a candidate for the office of I hereby declare that if nominated and elected, I will qualify for the office. DATED the day of , Print or type your name exactly as you wish it to appear on the ballot. (W.S. 22-6-111 states that professional titles and degrees shall not appear on the ballot. Per Rules, Ch. 18, fictitious or pseudo names will not be allowed.) Gender: In order to meet federal requirements for audio ballots and to accommodate individuals with disabilities, please print your name phonetically on the line above Kyle Balcaen Wudson would be Ky-ill Ball-Kin Wood-Sin). Signature Mailing Address (if different from residential) Mailing City/Town, Zip Code Campaign Telephone (will be published) Telephone Number (will not be published) E-Mail Address (will be published) Qualifications for Holding Office • Please ensure that: o You are not holding an office which may conflict, or be incompatible, with the office for which you are filing. o Your employment is compatible with the office you are seeking. • Candidates for municipal office must be a registered voter and a resident of the municipality and ward which he seeks to represent (W.S. 22-23-301) and will have resided in said ward for at least one year next preceding his election if so elected. (W.S. 22-23-103(b)). In a General Election year in which city wards are redrawn due to redistricting, a person may be a candidate if they are a resident of the city on the day they file their application for nomination, and have been a resident of the city for at least one year preceding their election. (W.S. 22-23-103(c)). • Pursuant to W.S. 6-10-106, a person convicted of a felony is incompetent to hold any office of honor, unless he has had a complete and full restoration of rights, not just voting rights. If you have any questions regarding your ability to hold office, please ask the County Clerk for clarification. 3/2022 Filing Period: May 12 through May 27, 2022 at 5:00 PM Filing Office: City or Town Clerk Filing Fee: $25 Office use only: Candidate Packet Male Female