STATE OF ALASKA - DIVISION OF ELECTIONS

DECLARATION OF CANDIDACY
REGIONAL EDUCATIONAL ATTENDANCE AREA SCHOOL BOARD MEMBER
ELECTION DATE: OCTOBER 1, 2013

GENERAL INSTRUCTIONS:

  1. Who May File: If you are registered to vote within the boundaries of the Regional Educational Attendance Area (REAA), you may file for the office of REAA board member. You must also be registered to vote within the section of the seat for which you are filing.

  2. When To File: You may file now, the sooner the better. Hand delivered and faxed candidacy filings must be received no later than 5:00 pm, Friday, August 2, 2013. Mailed forms must be postmarked no later than August 2, 2013, and received by the Division of Elections no later than August 12, 2013.

  3. How and Where To File: Print this page and complete the candidate information below, sign and date the certification, and hand-deliver, mail or fax it to any Division of Elections office (addresses below).
CANDIDATE INFORMATION:
Please Print Clearly or Type Your Information


I, ____________________________________, request that my name be placed on the ballot for the election on

October 1, 2013, for the following REAA : ______________________________________, Seat ___________

My RESIDENCE address is: _________________________________________________________, Alaska _________

My MAILING address is: ___________________________________________________________, Alaska _________

Telephone: (Home)_________________; (Work)_________________; (Message)__________________

I request my name be placed on the ballot as follows:

Last Name:_________________________________, First Name:________________________________ M.I._______

Nickname and/or Suffix:_________________
* The Director of Elections may not include on the ballot as part of the candidate's name, any honorary or assumed title or prefix but may include in the candidate's name any nickname or familiar form of a proper name of the candidate. [AS 15.15.030(4)]

Mailing address and phone number to be displayed on the Division of Elections' web site listing:

Official Candidate Mailing Address:____________________________, City:________________________

State:_______ Zip:_____________ Phone_________________
OATH: I certify that the information on this form is true and correct, that I am a registered voter in the State of Alaska and that I reside within the boundary and section of the REAA board seat for which I am seeking election.

SIGNATURE:_________________________________________ DATE:______________________

VOTER # SSN or ADL#:______________________

Privacy Disclaimer

Unless otherwise made confidential or protected from disclosure by law, information provided on this form may be subject to disclosure under the
Alaska Public Records Act (AS 40.25.100—40.25.295). Failure to provide requested personal information may result in the Division’s inability to
process relevant portions of this form. Requested information will be used only for purposes directly associated with the processing of this form. For
information on how to challenge the accuracy or completeness of personal information maintained by the Division, please send the Division a written
request that the personal information be changed. The request must comply with AS 40.25.310 and be sent to the Division of Elections at the following address: Division of Elections, Director’s Office, PO Box 110017, Juneau, AK 99811-0017.

Mail or Fax your completed filing to the regional elections office nearest you:

Director's Office
PO Box 110017
Juneau AK 99811-0017
Phone: (907) 465-4611
Fax: (907) 465-3203

Region I Elections Office
PO Box 110018,
Juneau, AK 99811-0018
Phone: (907) 465-3021
Fax: (907) 465-2289

Region III Elections Office
675 7th Ave., Suite H3
Fairbanks, AK 99701-4594
Phone: (907) 451-2835
Fax: (907) 451-2832

Region IV Elections Office
PO Box 577,
Nome, AK 99762-0577
Phone: (907) 443-5285
Fax: (907) 443-2973