City of Manassas Park Treasurer Or Commissioner of the Revenue

DECLARATION OF CANDIDACY FOR NOMINATION

CITY OF MANASSAS PARK TREASURER OR COMMISSIONER OF THE REVENUE

I, ______declare myself a candidate to be the nominee of the Manassas &

(Print name as it is to appear on the ballot)

Manassas Park Cities Democratic Committee in the General Election for the ______, on November 7th, 2017. (fill in seat you are seeking)

In making this declaration, I certify as follows that:

·  I am a Democrat and not a member of any other political party.

·  I meet all requirements of state law to be placed on the ballot for the General Election.

·  I am eligible to be the Treasurer or the Commissioner of the Revenue under the laws of the Commonwealth of Virginia.

·  I do not intend to support, endorse, or assist any candidate who is opposed to the Democratic nominee in this General Election.

·  I will not run as an independent or with any other political affiliation against any Democrat in this General Election.

·  I will not participate in the nominating process of any other political party for this General Election.

·  I agree to abide by the Caucus Rules, the Virginia Democratic Party Plan, and all laws applicable to this nominating process and the General Election.

My permanent address is:

______

My mailing address is:

______

My telephone numbers and email address are:

(H)______(W) ______

(C)______Email address______

My campaign account is located at (bank): ______

Completed by (2) witnesses or notary

SIGNATURE: ______DATE: ______

Witness: ______Witness: ______

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Declaration, filling fee of $250 is received by: ______

Date: ______Time: ______

Authorized by the Manassas & Manassas Park Cities Democratic Committee, a Democratic Party of Virginia committee,

not affiliated with any candidate or candidate committee.