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STATE OF
Village of
DECLARATION OF CANDIDACY
I, ______________________, being first duly sworn upon my oath do hereby state for my affidavit that:
I, ______________________, hereby declare that I am a candidate for the
office of for a ________ (four) year term to be elected at the regular
municipal election to be held on
I affirm that I currently reside at ___________________________________
(Street Address)
I affirm that my name and resident address as stated in this Declaration
of Candidacy are identical to my name and resident address as stated in my
affidavit of registration on file with the
I affirm that I am eligible and legally qualified to hold the office for which I have declared my candidacy.
I affirm that I have not been convicted of a felony.
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I affirm that I have been convicted of a felony and that my elective franchise has been restored.
I affirm that I, or my authorized representative, shall personally appear
at the office of the Village Clerk during normal business hours on
I affirm that I, or my authorized representative, can be reached at the following telephone number(s) for purposes receiving telephone notice _________________________ or ___________________________.
I affirm that this declaration of candidacy is an affidavit under oath
and that any false statement knowingly made herein constitutes a fourth degree
felony under laws of
___________________________________________
Signature of Candidate
Subscribed and sworn to before me this ______ day of _____________, 20_____.
My Commission Expires:
_______________________________ _________________________________________
Notary Public
Received in the office of the Village Clerk at ________ (A.M./P.M.) on the ________ day of
_____________, 20______.
____________________________________, Village Clerk