StateOfAlaskaOfficialElectionPamphlet

CandidateChecklist

Send Electronically To:
(call with credit card information) / E-Mail:
Phone:(907)465-4611
TollFree:(866)952-8683
or Mail To: / DivisionofElections
P.O.Box110017
Juneau, AK 99811-0017

DivisionofElections:

Ihaveenclosedthefollowinginformationregardingmycandidacyforinclusioninthe2016OfficialElectionPamphlet:

1.Abiographicalstatementof150wordsorless.AS15.58.030(e)

2.Apositionstatementof250wordsorless.AS15.58.030(e)

3.A5"x7"photograph(fiveincheswidebysevenincheshigh)taken within the last five years and limited to the head, neck and shoulders of the candidate. All photographs will be printed in black and white. AS 15.58.030(f)

4.Cash,check,moneyorder,orcreditcard(seecreditcardauthorizationformattached)fortheappropriateamountmadepayabletotheStateofAlaska,DivisionofElections.AS15.58.060(a)

$300.00–PresidentorVicePresidentoftheUnitedStates(each)

Irequestthattheaboveinformationbeprintedinthe2016StateofAlaskaOfficialElectionPamphletandcertifythatIamsubmittingmymaterialsbythestatutoryduedateofTuesday,August30,2016.AS15.58.030(a).

NameofCandidateDate

Director’s Office

PO Box 110017

Juneau,Alaska99811-0017

Phone: (907) 465-4611

Toll Free: (866) 952-8683

STATE OFALASKA

Division ofElections

Officeofthe Lieutenant Governor

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CREDITCARD PAYMENTAUTHORIZATION

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  • Submitting materials by mail or at one of the division offices: Complete this form and include with your materials.

Completionofthisformisnotproofofpaymentuntil the divisionprocessesthe informationcontainedherein.Ifanyofthe informationon thisformisillegible,the formwillbe rejected.Pleaseprint.

Iwish to make paymentbycreditcard forthe following:

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Thebottomsectionofthis formwillbedestroyeduponprocessingofthepayment.

StateOfAlaskaOfficialElectionPamphlet

CandidateForElectedOffice-BiographicalStatement

NOTE: All written materialmust betypewrittenperAS15.58.030(e). Electronicsubmissionofstatements viae-mail attachment or CDispreferred. USBThumbDriveswill not beaccepted.

RevisionsarenotallowedafterTuesday,August30,2016.AS15.58.030(a).

Pleasefollowthebelowformat whensubmitting your biographical information, althoughyoudonot havetousethisparticular page. Omittedcategorieswill not appear inthepamphlet. Biographical statements arelimitedto150words or less.Anywordsincludedbeyondtheallottedwordcount will not bepublished.

Pleasereviewyour pagecarefullybeforesubmitting andcheck for spelling andgrammaticalerrors. The wordcount must followstatutoryguidelines. Thewordcount does not includecategoryheadings. Pleasewriteout completenames ratherthanusing acronyms or abbreviations. Weattempt tomakethebiographicalsectionofthecandidatepageas uniformas possible.

Name:

(The candidate'snamewillbeprintedon the OEP page asitappearson the ballot.)

Officefiled for:

(example:President,VicePresident.)

PoliticalParty:

(Ifrunningasanominatingpetitioncandidate,pleaserefertohowyourpoliticaldesignationappearson the sampleballot,example:Non-partisan,Independent,etc.)

ResidenceAddress:

MailingAddress:

E-MailAddress:

Web SiteAddress:

WORD COUNTBEGINSHERE-150WORDSOR LESS

Anywordsincludedbeyondtheallottedwordcount will not bepublished.

Age:

(Atthe dateofthe election)

Placeof Birth:

Spouse’sName:

Children’sNames:

Occupation:

Lengthof Residencyin Alaska, if applicable:

(Howmanyyearsyouhavelivedin the state.)

List theAlaskancommunitiesthat youhavelived in andthedates, if applicable:

(Example:Anchorage1984-1986)

Education(HighSchool,Technical/Vocational,College/University,PostGraduate):

(Pleaselistthe schoolsname,datesattendedanddegreesorcertificatesobtained.)

MilitaryService:

(Pleaselistthe branch,length ofservice,rankandawards/medalsearned.)

PoliticalandGovernment Positions:

BusinessandProfessionalPositions:

ServiceOrganization(s) Membership:SpecialInterests:

Other(BiographicalInformationOnly):

StateOfAlaskaOfficialElectionPamphlet

CandidateForElectedOffice-PositionStatement

Candidate’sName:

NOTE: All written materialmust betypewrittenperAS15.58.030(e). Electronicsubmissionofstatements viae-mail attachment or CDispreferred. USBThumbDriveswill not beaccepted.

RevisionsarenotallowedafterTuesday,August30,2016.AS15.58.030(a).

Positionstatements arelimitedto250words or less. Articles suchas “a” “an” and“the”eachcount as oneword. Anywordsincludedbeyondtheallottedwordcount willnot bepublished. Pleaselistskills,positions onissues,politicalphilosophy, andothermatters as appropriatetoadvocatethecandidacy. Negativecampaignmaterial is notsuitablefor inclusionintheelectionpamphlet.