Are you CANDIDATE?
YEAR OF CANDIDATE:
FOR OFFICE IN
CITY
COUNTY
STATE
( If you are a candidate,
complete this section and see last page of instructions.)
I am a candidate for the () () or ()
FOR OFFICE OF
Are you in LAW ENFORCEMENT?
Judge - Any Level
District Attorney/Asst or Deputy DA/DA Investigator
Attorney General/AG Attorney, Special Agent/Investigator
Post Certified Law Enforcement Officers
02. |
Last year, I was an ()
() () with the
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() () () and the name and address of my
()
() () () ()
() () () was
Name:
Address:
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02.1 |
As an
/
/
last year, my job title/position was
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02.2 |
Last year, the name(s) of the () () ()
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,
,
, ,
,
of which I was a Member was(were)
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02.3 |
Last year in the above public position(s) in 02. thru 02.2 I earned:
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