DECLARATION FOR NOMINATION
NEIGHBORHOOD COUNCIL MEMBER

To the Election Administrator and Electors of the City of Great Falls, County of Cascade, and State of Montana.

I, the undersigned citizen of the United States of America and resident of the District herein named in the said City, declare pursuant to Charter of the City of Great Falls, Article VII, Section 4, that I am a candidate for the election for the office of Neighborhood Council Member in District No. ________ in the above named City, at the election to be held in said City on November 6, 2007 and for such purpose do affirm that I possess the qualifications prescribed by the City of Great Falls, and that:

1. My name as it is to appear on the ballot is:

   _____________________________________________________________________________

2. My complete mailing address, and phone number, is:

   _____________________________________________________________________________

   Number & Street name
   PO Box

   ________________________________________________________________________________

   City, State and Zip Code
   Phone:    home             work

(Candidate must sign and acknowledge his/her Declaration for Nomination before a Notary Public if mailed, or before the Election Administrator or Deputy if delivered in person.)

On this ______________ day of _______________________________, 20_______, before me

______________________________________________________________________________

personally appeared _____________________________, known to me (or proved to me on the oath of ____________________), to be the person whose name is subscribed to the foregoing Declaration for Acceptance, and acknowledge to me that __he executed the same.

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