oklahoma declaration of candidacy 601 … candidate...this or any other state or of the united...

OKLAHOMA DECLARATION OF CANDIDACY Candidate Information and Oath

NOTICE: All information provided on this form will be made publicly available.

PLEASE TYPE OR PRINT

CANDIDATE INFORMATION

Date of birth:

Title of Office Sought: (include district office or ward number if applicable) S Candidate's Residence Address: (Street, City, State, lip)

Candidate's Mailing Address: (Street, City, State, lip) 3

J am a registered voter in preCinct U Optional Information: Phone number:

D Candidate for the'

Email Address: Website:

______ Party !ltlndependent Candidate D Nonpartisan Judicial Candidate

This Declaration is accompanied by a (check one): t:&.Cashier's/certified Check 0 Petition CRIMINAL HISTORY DISCLOSURE AND OATH

CRIMINAL DISCLOSURE: Have you been convicted, pled guilty or nolo contendere, or otherwise been determined by a court of proper authority in Oklahoma or in another state to be guilty of a misdemeanor involving embezzlement or of a felony under the laws of this state or of the United States? DYES ~o Have you been named in an outstanding warrant for arrest for a misdemeanor involving embezzlement or a felony in this or any other state or of the United States? []yES ~o If you answer YES to either of these questions, you are required to fill out and sign the Criminal History Disclosure form and include it in your Declaration of Candidacy.

PUblic or Other Ofl'lCer)

2018 State of Oklahoma Filing Packet Candidate Information and Oath / 12

601




Candidate's full legal name;

Title of Office (include district office or ward number if applicable)

i Residence (Street, City, State, Zip)

Candidate's Mailing Address: (Street, City, State, Zip)

I am a Optional Phone n Email Address; rrw'

Date of birth;

602

\1 Candidate forthe !?efuhl,ca f' Party o Nonpartisan Judicial Candidate This Declaration is accompanied by a (check one): Check Petition

CRIMINAL HISTORY DISCLOSURE AND OATH CRIMINAL DISCLOSURE: Have you been convicted, pled guilty or nolo contendere, or otherwise been determined by a court of proper authority in Oklahoma or in another state to be guilty of il misdemeanor involving embezzlement or of a felony under the laws of this state or of the United States? DYES ~o Have you been named in an outstanding warrant for ar~for a misdemeanor involving embezzlement or a felony in this or any other state or of the United States? DVES po If you answer YES to either of these questions, you are required to fill out and sign the Criminal History Disclosure form and include it in your Declaration of Candidacy.

I, the swear or affirm that the information provided in this Declaration of Candidacy is true and correct, that I have read and signed the Candidate Qualifications for the office that I seek, that I am fully qualified to become a candidate for said office, and that I will be fully qualified to hold said if elected,

..'-':..Ll-""-"'-== County of .---NOTARY PUBLIC.STATE OF OKLAHOril:1scrlbed end swom to before me -O>.L!.L."!,....-'''"'"''''-''''-'-L..l'''-''-'-'.-'-'='----

My Commission expires Ie}" CYl - )0 \'1 Commlss n JOY DAWN MILLER

CQMM. EXP. COMMISSION ~ 15009352 10072019 PONTOTOC COUNTY

2018 State of Oklahoma Filing Packet

Oklc,

Candidate Information and Oath / 12


603



CANDIDATE INFORMATION Candidate's name as It will appear on ballot;

CAl{ L fJ /1 ~ $'&;V Candidate's full legal name;

PA j(

(~jt:~'~):~:?,\ OKLAHOMA DECLARATION OF CANDIDACY ~E~(} _______ C_a_n_d_id_a_t_e_l_n_fO_r_m_a_t_io_n_a_n_d_o_a_t_h ________ 604

'C.',,"'/ NOTICE: All information provided on this form will be made publicly available.



Candidate's name as it will appear on ballot: Donald Chasteen

Candidate's lull legal name: Donald Wayne Chasteen Date 01 birth: (Month, Date, Year): 02 -16-1965

Title 01 Office Sought: , (include district office or ward number il applicable) Ins u ra n ce Com m ISS lone r Candidate's Residen:eAddress: 18996 E 590 Rd I I Ok 74036 (Street, City, State, ZIp) no a, Candidate's Mailing Address: PO B (Street, City, State, Zip) OX 201 Inola, Ok 74036

I am a registered voter in precinct # 660026 in the County 01 Rogers Optional Information:

Phone number: 918-638-4214 Email Address: [email protected] Website:

~ Candidate for the ~Rcpublic~n Party D Independent Candidate D Nonpartisan Judicial Candidate

This Declaration is accompanied by a (check one): ~ Cashier's/Certilied Check o Petition CRIMINAL HISTORY DISCLOSURE AND OATH

CRIMINAL DISCLOSURE: Have you been convicted, pled guilty or nolo contendere, or otherwise been determined by a court of proper authority in Oklahoma or in another state to be guilty of a misdemeanor involving embezzlement or of a felony under the laws ofthis state or of the United States? DYES [ZjNO Have you been named in an outstanding warrant for arrest for a misdemeanor involving embezzlement or a felony in this or any other state or of the United States? []yES [ZjNO If you answer YES to either of these questions, you are required to fill out and sign the Criminal History Disclosure form and include it in your Declaration of Candidacy.

I, the undersigned, swear or affirm that the information provided in this Declaration of Candidacy is true and correct, that I have read and signed the Candidate Qualifications for the office that I seek, that I am fully qualified to become a candidate for said office, and that I will be fully qualified to hold said office, if elected.

I Signatu re of Ca ndidate --tQ)".L-"~",="",M=~----,v.!--""--"-"""""",,,""""+,~

ft of signatures ____ _

2018 State of Oklahoma Filing Packet Candidate Information and Oath I 12





Candidate's name as it will appear on ballot: David Sm ith

Date of birth:

605

Candidate's full legal name: David Anthony Smith (Month, Date, Year): 12,01,1968

Title of Office Sought: (include district office or ward number if applicable) State Representative, District 18 Candidate/s Residence Address:

(Street, Cit y,State, Zip) 3360 Cabiness rd. Mcalester OK. 74501 Candidate's Mailing Address: 3 . (Street, City, State, Zip) 360 Cabl ness rd. Mcalester OK. 74501

I am a registered voter in precinct # 610021 in the County of Pittsburg Optionailnformation:

Phone number: 918 429 5334 Email Address:[email protected] Website:

~ Candidate for the xRepub~'can Party o Independent candidate o Nonpartisan Judicial Candidate This Declaration is accompanied by a (check one): [kf Cashier's/Certified Check D Petition

CRIMINAL HISTORY DISCLOSURE AND OATH

CRIMINAL DISCLOSURE: Have you been convicted, pled guilty or nolo contendere, or otherwise been determined by a court of proper authority in Oklahoma or in another state to be guilty of a misdemeanor involving embezzlement or of a felony under the laws of this state or of the United States? DYES ~O Have you been named in an outstanding warrant for arrest for a misdemeanor involving embezzlement or a felony in this or any other state or of the United States? []yES ~O If you answer YES to either of these questions, you are required to fill out and sign the Criminal History Disclosure form and include it in your Declaration of Candidacy.

I, the undersigned, swear or affirm that the information provided in this Declaration of Candidacy is true and correct, that I have read and Signed the Candidate Qualifications for the office that I seek, that I am fully qualified to become a candidate for said office, and that I will be fully qualified to hold said office, if elected.

Signature of candidateO~ ~ NOTARY

State of D~ County of ' \\\\e,'o\.AY3 Subscribed and sworn to before me __ l\--'---L/.1.1.L1 _!'--\c:g=-_________ _ My Commission expires 01-//-22 Commission Number I 'bDbb3'=f1

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OKLAHOMA DEClARATION OF CANDIDACY Candidate Information and Oath



Candidate's name as it will appear on ballot: Jeffrey Cartmell

606

Candidate's full legal name: Jeffrey Colin Cartmell Date of birth: (Month, Date, Year): 07/13/1986

Title of Office Sought: . (include district office or ward number if applic~ble) State Senator - District 30 Candidate's Residence Address: (Street, City, State, Zip) 9604 Mahler Place, The Village, OK 73120 Candidate's Mailing Address: PO B (Street, City,State, Zip) OX 21252, Oklahoma City, OK 73156

I am a registered voter in precinct ff 5501 05 in the County of Oklahoma

Optional Information:

Phone number: (405) 202-1309 Email Address: [email protected]:www.JeffreyCartmell.com

[i] Candidate for the _"-c'P'_"'_""'_" ________ Party 0 Independent Candidate D Nonpartisan Judicial Candidate

This Declaration is accompanied by a (check one): ~ Cashiers/Certified Check D Petition , , CRIMINAL HISTORY DISCLOSURE AND OATH

CRIMINAL DISCLOSURE: Have you been convicted, pled guilty or nolo contendere, or otherwise been determined by a court of proper authority in Oklahoma or in another state to be guilty of a misdemeanor involving embezzlement or of a felony under the laws ofthis state or ofthe United States? DYES !Z]NO Have you been named in an outstanding warrant for arrest for a misdemeanor involving embezzlement or a felony in this or any other state or of the United States? []yES [{jNO If you answer YES to either of these questions, you are required to fill out and sign the Criminal History Disclosure form and include it in your Declaration of Candidacy.

I, the swear or i that the information provided in this Declaration of Candidacy is true and correct, that I have read and signed the Candidate Qualifications forthe office that I seek, that I am fully qualified to become a candidate for said office, and that I will be fully qualified to hold sai if el

Signature of Candidate 4'+'Y'b6Z~L:.---_--------

My CommIssion expIres


~ ______ O __ K_lA __ H_~a_~_:_id_~_~_;_~_~_~_~_:_I~_i:_n_~_:_dC_:_a_~h_D_ID_A __ CY _______ 6_07 NOTICE: All information provided on this form will be made publicly available.



Candidate's name as it will appear on ballot: Nikki G. Leach

Candidate's full legal name: Nikki Gene Leach Date of birth: (Month, Date, Year): 07/23/1959

Title of Office Sought: (include district office or ward number if applicable) AssocIate District Judge - Noble County Candidate's Residence Address: 1320 N (Street, City, State, Zip) 9th Street, Perry, OK 73077 Candidate's Mailing Address: (Street, City, State, Zip) P.O. Box 1006, Perry, OK 73077

1 am a registered voter in precinct 1:1 520101 in the County of Nobl.,

Optional Information: Phone number: 580-336-2433 Email Address: Website:

o Candidate for the ' Party o Independent Candidate [!J Nonpartisan Judicial Candidate This Declaration is accompanied by a (check one): ~ Cashiers/Certified Check o Petition


CRIMINAL DISCLOSURE: Have you been convicted, pled guilty or nolo contendere, or otherwise been determined by a court of proper authority in Oklahoma or in another state to be guilty of a misdemeanor involving embezzlement or of a felony under the laws of this state or ofthe United States? DYES [{]NO Have you been named in an outstanding warrant for arrest for a misdemeanor involving embezzlement or a felony in this or any other state or of the United States? DYES 0NO If you answer YES to either of these questions, you are required to fill out and sign the Criminal History Disclosure form and include it in your Declaration of Candidacy.

I, the undersigned, swear or that the information prOVided in this D ration of Candidacvsjrue and correct, that I have read and signed the Candidate Qualifications for the office that I seek, th3-Y am .E1I y'~tlaJjfild to become a candidate for said office, and that I will be fully qualified to hold said offic ,i I cfed:.

Slate of

Subscribed and sworn to before me _~:::.,,",,'-.L-L_-/-,_2Uc:L-!!'-___ _

/( Ie:? /"'1 \ },~ ),;" .,(o,r (1 1/'1 My Commission expires ,/,/6 ,/{~0f7: comm;SSlon N/,j' ,rcr . J L L (

Cf /. I/d (0'--Slgn~tur of Notary Public or Officer Authprlzed to Administer Oath

J /t-;-

Title of Officer (Notary Pub!! or Other Officer)

# of signatures ____ _

2018 state of Oklahoma Filing Packet Candidate Information and Oath I 12

608 q1::c~.t~~~ OKLAHOMA DECLARATION OF CANDIDACY ~;.::' ,.'f.:} Candidate Information and Oath -,';;:'" --------:----------------------------."." 'mri ,r.-NOTICE: All information provided on this form will be made publicly available.


CANDIDATE INFORMATION Candidate's name as it will appear on ballot; Bob D. Buchanan

Candidate's full legal name; Bob Don Buchanan Date of birth: (Month, Date, Year):03/15/1960

Title of Office Sought: D t . t A tt D 1 0 (include district office or ward number if applicable) IS riC orney, IStriCt Candidate's Residence Address: 350651 (Street, City, State, Zip) E 5100 Rd, Pawnee, OK 74058 Candidate's Mailing Address: 0 (Street, City, State, Zip) P Box 445, Pawnee, OK 74058

I am a registered voter in precinct #5901 04 in the County of Pawnee Optional Information: Phone number: Email Address: Website:

D Candidate for the' Party Iillndependent Candidate o Nonpartisan Judicial Candidate This Declaration is accompanied by a (check one): ~ Cashier's/Certified Check D Petition

CRIMINAL HISTORY DISCLOSURE AND OATH CRIMINAL DISCLOSURE: Have you been convicted, pled guilty or nolo contendere, or otherwise been determined by a court of proper authority in Oklahoma or in another state to be guilty of a misdemeanor involving embezzlement or of a felony under the laws of this state or of the United States? DYES 0NO Have you been named in an outstanding warrant for arrest for a misdemeanor involving embezzlement or a felony in this or any other state or of the United States? []yES 0NO If you answer YES to either of these questions, you are required to fill out and sign the Criminal History Disclosure form and include it in your Declaration of Candidacy.

I, the undersigned, swear or affirm that the information provided in this Declaration of Candidacy is true and correct, that I have read and signed the Candidate Qualifications forthe office that I seek, that I am fully qualified to become a

candidate for said office, and that I will be fully qualified to hold SK?/dy

SignatureofcandidateF's~4j~~e:-~~====::::::::.--------.. 1~' n!1 r: ;, NOTARY

SEAL

State of O/

OKLAHOI'VIA DECARLI. 1l0N OF CANDIDACf candidate Information and Oath

NOTICE: .oJ1 information provided on this form will be made publidy available,

PLEA::E1YPE OR PRINT

() k "l.j-33i 'Itt33.:L

Have you been convicted, pled guilty or nolo contendere, or otherwise been determined by a court of proper authority in O


610 NOTICE: All information provided on this form will be made publicly available.



Candidate's name as it will appear on ballot: LaVelle C. Compton

Candidate's full legal name: LaVelle Christopher Compton Date of birth: (Month, Date, Year): September 12, 1990 Title of Office Sought: . .. (include district office or ward number if applicable) Oklahoma State Representative, District 90 Candidate's Residence Address: (Street, Cit y,State, Zip) 5616 Clearwater Drive OKC, OK 73179 Candidate's Mailing Address: (Street,City,State, Zip) 5616 Clearwater Drive OKC, OK 73179

I am a registered voter in precinct # 550165 in the County of OKLAHOMA


Phone number: 405-514-8297 Email Address: Website:

111 Candidate for the xOemocraUc Party o Independent Candidate o Nonpartisan Judicial Candidate This Declaration is accompanied by a (check one): Jj] Cashiers/Certified Check D Petition


CRIMINAL DISCLOSURE: Have you been convicted, pled guilty or nolo contendere, or otherwise been determined by a court of proper authority in Oklahoma or in another state to be guilty of a misdemeanor involving embezzlement or of a felony under the laws of this state or of the United States? []yES [{jNO Have you been named In an outstanding warrant for arrest for a misdemeanor involving embezzlement or a felony in this or any other state or of the United States? []yES [ZjNO If you answer YES to either of these questions, you are required to fill out and sign the Criminal History Disclosure form and include it in your Declaration of Candidacy.

I, the undersigned, swear or affirm that the information provided in this Declaration of Candidacy is true a correct, that I have read and signed the Candidate Qualifications for the office that I seek, that I am fully qualified to be':0J'ue-a candidate for said office, and that I will be fully qualified to hold said offi~,-if-1!1E!cfi!Cl).~

--=~'lP":;'J---~

Stale of r2'h.,;&.~~~

Subscribed and sworn to before me O~ I ~i :LC I fl 't"'"'"'!II!!'I'~"'-"''''''''''-W>.f My Commission expires Q ~ is.:Z~ ;it Commission Number t2,7 pc::; 6 ;39/

")~"'oIANAJ.HOllADAY r / / Notary Public - State of Oklahoma Commission Number 05006391

My Commission Expires Ju113, 2021







Candidate's name as it will appear on ballot: Bryan Vinyard

611

Candidate's full legal name: Bryan Douglas Vinyard Date of birth: (Month, Date, Year): 09/07/1968

Title of Office Sought: (include district office or ward number if applicable) Oklahoma House District 46 Candidate's Residence Address: (Street, City, State, Zip) 3813 Danfleld Lane, Norman, OK 73072 Candidate's Mailing Address: (Street, City, State, Zip) 3813 Danfleld Lane, Norman, OK 73072

I am a registered voter in precinct # 140027 in the County of Cleveland

Optional Information: Phone number: 405-615-7788 Email Address: [email protected] Website:

II Candidate forthe xReplJblican Party D Independent Candidate D Nonpartisan Judicial Candidate This Declaration is accompanied by a (check one): ~ Cashier's/Certified Check D Petition


CRIMINAL DISCLOSURE: Have you been convicted, pled guilty or nolo contendere, or otherwise been determined by a court of proper authority in Oklahoma or in another state to be guilty of a misdemeanor involving embezzlement or of a felony under the laws of this state or of the United States? DYES 0-Jo Have you been named in an outstanding warrant for arrest for a misdemeanor involving embezzlement or a felony in this or any other state or of the United States? []yES [{)Iro If you answer YES to either of these questions, you are required to fill out and sign the Criminal History Disclosure form and include it in your Declaration of Candidacy.

I, the undersigned, swear or affirm information provided in this Declaration of Candidacy is true and correct, that 1 have read and signed the Candidate Qualifications for the office that 1 seek, that 1 am fully qualified to become a

candidate for said office, and that 1 will be fully qualified to hold said of~ if elected. I ~

Signature of Candidate o...~ ~

State of County of

r - - - - - - - - - - - - - --Su!lfcribed and sworn to before me {;;::.rrv1[ tJ!lAqer I ""~' GARRETTKRUGE~yJ;ommlssioneXPlres (W~-t1 commlsslonNumb~r l So{OY'Y5 I SEAL Notary Public in and for I ~~ 1 State of Oklahoma I :et "~~ I

"'UBC ," 15010735 I --=----''---'-----:7''--''-------Sign:tureofNOtarYPublic ~ to AdmInister Oath

~X ~o~~~.s.:!~ ~x~r~s ~e~. ~3~2~~ Un;ve'I~ Ba"1Kcq

Title of Officer (Notary Public or Other Officer)

2018 State of Oklahoma Filing Packet Candidate information and Oath / 12

(I ___ O_K~LA~H_c_Oa_~_:_id_~_;e_C_I~A_fO_R:_m_:_~~_oN_n_~_:d_C_oA_a~_~_ID_A_C_Y ___ 6_' 1_2 NOTICE: All information provided on this form will be made publicly available.


CANDIDATE INFORMATION Candidate's name as it will appear on ballot:

S h6\a tonclfen Date of (Month, Date, Year):

Title of Office (include district office or ward number if applicable)

Candidate's Residence (Street, City, State, Zip) D (,0dS-SO 0 k 04055 Candidate's Mailing AOfICOSS: (Street, City, State, Zip) 1)S'S1 N. 1151; t. Me.., () {DlSS'Oj 6k '14065 I am a voter in Optional Information: I I Phone number: q~~-loq5'211J)'r Email Address:.Sc..ordren~eox..neiwebsite:

D Candidate for the .::' __________ Party 0 Independent Candidate ~ Nonpartisan Judicial Candidate

CRIMINAL DISCLOSURE: Have you been convicted, pled guilty or nolo contendere, or otherwise been determined by a court of proper authority in Oklahoma or in another state to be guilty of a misdemeanor involving embezzlement or of a felony under the laws of this state or olthe United States? DYES l:ZINo Have you been named in an outstanding warrant for arres~ for a misdemeanor involving embezzlement or a felony in this or any other state or of the United States? DYES ~NO If you answer YES to either of these questions, you are required to fill out and sign the Criminal History Disclosure form and include it in your Declaration of Candidacy.

I, the undersigned, swear or rm that i I Candi is true correct, that I have read and signed the Candidate Qualifications for the office that I seek, that I am fully qualified to become a candidate for said office, and that I will be fully qualified to hold said offiT)f elected.!!

Signature of Candidate I?o/I tI /IJL; ~

State of flj~'gd~'11J'& county of

SEAL






(include district office or ward number if applicable)

Candidate's Residence (Street, City, State, Zip)

Candidate's Mailing (Street, City, State, Zip)

I am a I voter in Optional I Phone number:

Date of (Month, Date, Year):

613

~ Candidate for the '::'_.LL.'l.Ll.l.l..1.

_~ OKLAHOMA DECLARATION OF CANDIDACY ~) Candidate Information and Oath 614 ~~i~ -------------------------------------------------------------------------NOTICE: All information provided on this form will be made publicly available.



Candidate's name as it will appear on ballot: E k W riC . Harris

Candidate's full legal name:Erick W. Harris Date of birth: (Month, Date, Year):May 6, 1987

Title of Office Sought: (include district office or ward number if applicablel State Senate, District 30 Candidate's Residence Address: 1 0201 (Street, City, State, Zip) Major Avenue, The Village, OK 73120 Candidate's Mailing Address: 1 0201 (Street, City, State, Zip) Major Avenue, The Village, OK 73120

I am a registered voter in precinct #5501 06 in the County of Oklahoma Optional Information: Phone number: Email Address:[email protected] Website:www.ErickHarrisOK.com

il Candidate for the Republican Party o Independent Candidate o Nonpartisan Judicial Candidate This Declaration is accompanied by a (check one): iii Cashier's/Certified Check o Petition


CRIMINAL DISCLOSURE: Have you been convicted, pled guilty or nolo contendere, or otherwise been determined by;i court of proper authority in Oklahoma or in another state to b~uilty of a misdemeanor involving embezzlement or of a felony under the laws of this state or of the United States? UVES ~O Have you been named in an outstanding warrant for arrest for a misdemeanor involving embezzlement or a felony in this or any other state or of the United States? []yES 0NO If you answer YES to either of these questions, you are required to fill out and sign the Criminal History Disclosure form and include it in your Declaration of Candidacy.

I, the undersigned, swear or affirm that the information provided in this Declaration of Candidacy is true and correct, that I have read and signed the Candidate Qualifications for the office that I seek, that I am fully qualified to become a candidate for said office, and that I will be fully qualified to hold said o~;:,ectehU .4

Signature of Candidate ~ C::/, ~

State oma Tammy J Rasmussen OKLAHOMA COUNTY

NOTARY

State of O\

,


NOTICE: All information provided on this form will be made publicly available,



Candidate's name as it wmAP~~o; br!t: 8 D IA.J (1.1 e.... Date of birth:

616

Candidate's fUlllerrameR

Qr rJ~ 00-1.1 ~ f!) 'vlJ N .L (Month, Date, Year): 11- " .J .- J ?s-< . Title of Office Sought: -- I (include district office or ward number if applicable) CJ I< 0.. sQs~,J"'~ UJ ~> \-- (0 Candidate's Residence Address:

~ "'-l'Q ",4 0 k (Street, City, State, Zip) ,.1t ;l..( &, j-\ vJLj '/0 /Cf70 I Candidate's Mailing Address:

g, O~ ,

(Street, City, State, Zip) ~. O. 261 ~ IJ--\"l.


CRIMINAL DISCLOSURE: Have you been convicted, pled guilty or nolo contendere, or otherwise been determined by a court of proper authority in Oklahoma or in another state to b~uilty of a misdemeanor involving embezzlement or of a felony under the laws of this state or of the United States? U\'ES ~O Have you been named in an outstanding warrant for arrest for a misdemeanor involving embezzlement or a felony in this or any other state or of the United States? OvES ~O If you answer YES to either of these questions, you are required to fill out and sign the Criminal History Disclosure form and include it in your Declaration of Candidacy.

I, the undersigned, swear or affirm that the information provided in this Declaration of Candidacy is true and correct, that I have read and signed the Candidate Qualifications for the office th I seek, that I am fully qualified to become a candidate for said office, and that I will be fully qualified to hold said 0 ice if ect .

LINDSAY ROBERTS Notary PublICI Inandllrtha

Slate of Okllhoma Commlillon #1100018f Comm".lon~1'U$ U24120fil

#

St.te of O)(l9",hQr(l.O. County of

Subscribed and sworn to before me O-pn d., ;to f ff My Commission expires 0 I J. 411 C) CommisSion Numb~ 2r I

Signature ot Notary PUblic or Officer Authorized to Administer Oath

Y\.O LA. b\ " c..

2018 state of Oklahoma Filing Packet Candidate Information and Oath /12

NIP



Candidate's Residence (Street, City, State, Zip)


lama


617

o Nonpartisan Judicial Candidate This Declaration is accompanied by a (check one): s/Certified Check Petition

CRIMINAL HISTORY DISCLOSURE AND OATH CRIMINAL DISCLOSURE: Have you been convicted, pled guilty or nolo contendere, or otherwise been determined by a court of proper authority in Oklahoma or in another state to b~uilty of a JDiWemeanor involving embezzlement or of a felony under the laws of this state or of the United States? uYES 1QIII6 Have you been named in an outstanding warrant for arrest fo~isdemeanor involving embezzlement or a felony in this or any other state or of the United States? []yES lONo If you answer YES to either of these questions, you are required to fill out and sign the Criminal History Disclosure form and include it in your Declaration of Candidacy.

I, the undersigned, swear or affirm that the information provided in this that I have read and signed the Candidate Qualifications for the candidate for said office, and that I will be fully qualified to hold said

.J..LJ>....C====- County of

arrifD1lVntJ,aiified to become a

Subscrlbadand swom to before me A~r; \ CI-n,) ,,)0\0 My Commission expire. Sf e 1. )deOI Commission Number '-1\)t)l\ ,1

~~\:.\::~!?";\ OKLAHOMA DECLARATION OF CANDIDACY ~~}.::~~it~}) Candidate Information and Oath 618 ~~~i~ --------~----~~~----------~~----------~---------------------------NOTICE: All information provided on this form will be made publicly available.


CANDIDATE INFORMATION Candidate's name as it will appear on ballot: Frankie Robbins

Candidate's full legal name: Frankie lee Robbins I Date of birth: 12/07/1945 (Month, Date, Year):

Title of Office Sought:

(include district office or ward number if applicable) United States Representative -- OK District 3

Candidate's Residence Address: 118 Fir Dr., Medford, OK 73759 (Street, City, State, Zip)

Candidate's Mailing Address: 118 Fir Dr., Medford, OK 73759 (Street, City, State, Zip)

--_. .-

I am a registered voter in precinct # 27 in the County of Grant

Optionallnrormat{on: Phone number: 580-741-1347 Email Add ress: [email protected] Website: robbinsforoklahoma.com

Irl Candidate for the Democratic Party D Independent Candidate o Nonpartisan Judicial Candidate This Declaration is accompanied by a (check one): Irl Cashiers/Certified Check DPeUtion

CRIMINAL HIS.TQ~Y DISCLOSURE~!\lD~ ___ CRIMINAL DISCLOSURE: Have you been convicted, pled guilty or nolo contendere, or otherwise been determined by a court of proper authority in Oklahoma or in another state to b~uilty of a misdemeanor involving embezzlement or of a felony under the laws of this state or ofthe United States? lJYES 0NO Have you been named in an outstanding warrant for arrest for a misdemeanor involving embezzlement or a felony in this or any other state or of the United States? []yES 0Jo If you answer YES to either ofthese questions, you are required to fill out and sign the Criminal History Disclosure form and include it in your Declaration of Candidacy.

I, the undersigned, swear or affirm that the information proVided in Declaration of Candidacy is true and correct, that I have read and signed the Candidate Qualifications for the office that I seek, that I am fully qualified to become a candidate for said office, and that I will be fully qualified to hold said office, if ::e~

Slgnatur.otCandidat. C ~~M

County of

SubScribed and sv.'Orn10 before me /t1eche/1 B l




Title of Office Sought: (include district office or ward number if applicable)

(Street, City, State, Zip)


Optional Information: Phone number: Email

Date of birth: (Month, Date, Year):

620

D Candidate for the ' Party o Nonpartisan Judicial Candidate This Declaration is accompanied by a (check one): Cashier's/Certified Check Petition

CRIMINAL HISTORY DISClOSURE AND OATH

CRIMINAL DISCLOSURE: Have you been convicted, pled guilty or nolo contendere, or otherwise been determined by a court of proper authority in Oklahoma or in another state to be guilty $)' misdemeanor involving embezzlement or of a felony under the laws of this state or of the United States? DYES I.!aIIO Have you been named in an outstanding warrant for ar~t for a misdemeanor involving embezzlement or a felony in this or any other state or of the United States? []yES lYJIIO If you answer YES to either of these questions, you are required to fill out and sign the Criminal History Disclosure form and include it in your Declaration of Candidacy.

I, the undersigned, swear or affirm that the information provided in this Declaration of Candidacy is true and correct, that I have read and signed the Candidate Qualifications for the office that I seek, that I am fully qualified to become a candidate for said office, and that I will be fully qualified to hold sailtGrffk~~I'Octed.

cH~fs'f6PHER E. BARNES Notary PubliC - State 01 Oklahoma Commission Number 0400B447

My Commission Expires Sep 16, 2020

#

2018 State of Oklahoma Filing Packet

Subscribed and sworn to before me ~~C!LJl!::l!

My Commission expires .)t::~'-'-"'-'7i7i"::

Signature of Notary Public or Officer Authorized to Administer Oath

Br ...... J.. 1Y"v4-*lAB*V Title of Officer (Notary Public or Other Officer)

Candidale Information and Oath I 12

I/~~~ OKLAHOMA DECLARATION OF CANDIDACY \~@~:~I __ -:-:-:-=:--::"::-:-:-C_a_n-:d_id_a_te---:-:ln:-f-:-o_rm--:-:a-:ti:-o-;-n_a-:n::-d:-O_a_t-:h_-:--:--:-----:----:-: __ 6_21


PLEASE 1YPE OR PRINT


Candidate's name as it will appear on ballot: Brandon T. Phillips

Candidate's full legal name: Brandon Tyler Ph illips Date of birth: (Month, Date, Year):07/04/1978

Title of Office Sought: (include district office or ward number if applicable) State Representative, District 33 Candidate's Residence Address: 5011 (Street, City, State, Zip) w 1st Ave., Stillwater OK, 74074 Candidate's Mailing Address: 5011 (Street, City, State, Zip) w 1st Ave., Stillwater OK, 74074

I am a registered voter in precinct #600401 in the County of Payne Optional Information:

Phone number: 405-338-5480 Email Address:[email protected] Website:

I!I Candidate for the Democrat Party o Independent Candidate o Nonpartisan Judicial Candidate This Declaration is accompanied by a {check one}: ijJ Cashiers/Certified Check o Petition

CRIMINAL HISTORY DISCLOSURE AND OATH CRIMINAL DISCLOSURE: Have you been convicted, pled guilty or nolo contendere, or otherwise been determined by a court of proper authority in Oklahoma or in another state to b~uilty of a misdemeanor involving embezzlement or of a felony under the laws of this state or of the United States? UVES ~O Have you been named in an outstanding warrant for arrest for a misdemeanor involving embezzlement or a felony in this or any other state or of the United States? []yES [!2JNo If you answer YES to either of these questions, you are required to fill out and sign the Criminal History Disclosure form and include it in your Declaration of Candidacy.

I, the undersigned, swear or affirm that the information provided in this Declaration of Candidacy is true and correct, that I have read and signed the Candidate Qualifications for the office that I seek, that I am fully qualified to become a candidate for said office, and that I will be fully qualified to hold said offZ3;i ,f!e. ct?; rn!~

Signature of Candidate __ ~ ___ L ~ " V'

NOTARY

Stateof roV.l ~ County of c)1l1~lL SUbscribed and sworn to before me Su8::L.o \ l.d,~ lEt-My Commission expire, to ~ammlSSlon Number \ t.o 9.:f::! I G3 -. .

"pO PETO # of signatures ____ _

:018 state of Oklahoma Filina Packet Candidate Information and Oath I 12



Candidate's name as it will appear on ballot: -----o



Date of birth: (Month. Date, Year):

Title of Office Sought: Le.a '\ ,,:>\o...~ ...... ~ - ~a..'t

>':ak\ OKLAHOMA DECLARATION OF CANDIDACY 623 \:1fjf} Candidate Information and Oath

",," ---N-O-T-IC-E-: -A~I:-I i-n-:"fo-r-m-a-t-io-n-p-r-o-v-id-e-d-o-n-t-h-is-fo-r-m-w-ii-I b-e-m-a-d-e-p-u-b-li-c-Iy-a-v-a-il-ab-I-e-. ---



Candidate's name as it will appear on ballot: C H R I S HARRI SON

Candidate's full legal name: Christopher John Harrison, Sr. Date of birth: (Month, Date, Year): 12/17/1974

Title of Office Sought: (include district office or ward number if applicable) Oklahoma State House of Representatives District 99 Candidate's Residence Address: (Street, City, State, Zip) 1819 N.E. 11TH STREET Oklahoma City, Oklahoma 73117 Candidate's Mailing Address: 1300 N (Street, City, State, Zip) Lottie Oklahoma City, Oklahoma 73117

I am a registered voter in precinct # 550245 in the County of Oklahoma



Ii] Candidate for the xDcmoc .. 1! Party D Independent Candidate D Nonpartisan Judicial Candidate

This Declaration is accompanied by a (check one): ijJ Cashiers/Certified Check o Petition CRIMINAL HISTORY DISCLOSURE AND OATH

CRIMINAL DISCLOSURE:

Have you been convicted, pled guilty or nolo contendere, or otherwise been determined by a court of proper

authority in Oklahoma or in another state to be guilty of a misdemeanor involving embezzlement or of a felony under

the laws ofthis state or of the United States? DYES [{INO

Have you been named in an outstanding warrant for arrest for a misdemeanor involving embezzlement or a felony in

this or any other state or of the United States? DYES [{jNO

If you answer YES to either of these questions, you are required to fill out and sign the Criminal History Disclosure

form and include it in your Declaration of Candidacy.

I, the undersigned, swear or rm that the information provided in this Declaration of is true and correct,

that I have read and signed the Candidate Qualifications for the I seek, ,..-1-:;;;~,"'" qualified to become a

candidate for said office, and that I will be fully qualified to hold

state of

Subscribed and sworn to before me _-'='''-'-L.I..l._.---'--'-'-='-'-''''=------

My Commission expires

Offi(;er/\u'ho(;z"d to Administer Oath


e_---::-:-:-::o:-=-K_:_LA~H:_~-a~-:':'""id-~-:-ec__:I~-~:_:r-~_:_:-~O_:_ioN-n-~-::-d C_t_a_~h_D_ID_A_C_Y ___ _ NOTICE: All information provided on this form will be made publicly available.

Candidatels (Street, City, State, Zip)

Candidate's Mailing Address: '-,_.--, (Street, City, State, Zip)

I am a voter in

Phone


Date of birth: (Month, Date, Yearl:

~candidate for the -"----\"-'--'\'"""-l.L.:'-'-'''''-''''---__ Party 0 Independent Candidate

This Declaration is accompanied by a (check one): Check Petition

CRIMINAL HISTORY DISCLOSURE AND OATH CRIMINAL DISCLOSURE:

624

Have you been convicted, pled guilty or nolo contendere, or otherwise been determined by a court of proper authority in Oklahoma or in another state to b~uilty ~misdemeanor involving embezzlement or of a felony under the laws of this state or of the United States? UVES t:)\IO Have you been named in an outstanding warrant for arrest for a misdemeanor involving embezzlement or a felony in this or any other state or of the United States? []yES E:J'Jo If you answer YES to either of these questions, you are required to fill out and sign the Criminal History Disclosure form and include it in your Declaration of Candidacy_

swear or affirm that the information provided in this Declaration of Candidacy is true and correct, that I have read and signed the Candidate Qualifications for the office that I am fully qualified to become a candidate for said office, and that I will be fully qualified to hold said

ntle of Officer

signatures ____ _





CANDIDATE INFORMATION Candidate's name as it will appear on ballot: A

ND'{ COI-E\J\AN

625

Candidate's full legal name: :::rA.0~5 CO LEI--\AN. I Date of birth: ~ l"-lOREW (Month, Date, Year): 2/:;"0/1"11'1

Title of Office Sought: (include district office or ward number if applicable) U c' , ~) I K6PIZE5E::l--ITAT I \lE (OK -

1/!t'J;\ OKLAHOMA DECLARATION OF CANDIDACY ~~ _____________ C_a_n_d_i_da_t_e_l_n_fO_r_m_a_t_io_n __ a~n_d_O_a_t_h ______________ _


626



10M .5 t-.fe.s Candidate's full legal name:

~ .(; '.\-J5 1 Date of birth:

'" O\) ~) tq\S ~TO\'-N -r 10,,0 >l".a s .!If (Month, Date, Year):

Title of Office Sought: :s~..,e: (include district office or ward number if applicable) Z A .i 6LSt-flJ:~~ 0(' ~PAM....{dd Candidate's Residence Address: ~(P3tf7z.. (3. ~ ~ S~l\tS'au:l D~l&~ (Street, City, State, Zip) 7tfEjs-S" /e>K5,..-L_ .. _" _____________ _

NOTARY

NIPD PETD # of signatures ____ _


OKLAHOMA DECLARAT!ON OF CANDIDACY Candidate Information and Oath


Title of Office Sought: 0 r~ "" InIl'r' (include district office or ward n

Candidate's Residence Address: (Street, City, State, Zip)

Mailing Address: (Street, City, State, Zip)

I am a voter in Optional Information: Phone number: 91 t(, -)7) - 6' '})


in the Cou


627

~ Candidate for the .c:'_-=----'-"'-''-'-'='''--____ Party o Nonpartisan Judicial Candidate

CRIMINAL DISCLOSURE: Have you been convicted, pled guilty or nolo contendere, or otherwise been determined by a court of proper authority in Oklahoma or in another state to be guilty of a misdemeanor involving embezzlement or of a felony under the laws of this state or of the United States? []yES ~NO Have you been named in an outstanding warrant for arrest for a misdemeanor involving embezzlement or a felony in

this or any other state or of the United States? DYES ~NO If you answer YES to either of these questions, you are required to fill out and sign the Criminal History Disclosure form and include it in your Declaratipn of Candidacy.

I, the undersigned, swear or affirm that the information provided in this Declaration of that I have read and signed the Candidate Qualifications for the office that I seek, that I am fully candidate for said office, and that I will be fully qualified to hold said ellect~. ~:"-:>'::-::J>

State of

Subscribed and sworn to before me '!I~, J 77::; d4J My Commission expires a/tr,b / Commission Number #- J 3 tf II ( 3 d







Candidate's name as it will appear on ballot: MARK EDWARD KOSINSKI

628

Candidate's full legal name: MARK EDWARD KOSINSKI Date of birth: (Month, Date, Year): 5/17/1963

Title of Office Sought: (include district office or ward number if applicable) STATE HOUSE D I STRICT #71

~~:~~,a~~;~,~~:~~:;~;tddress: 1 055 E. 60TH STREET #921, TU LSA, OK 74105 Candidate's Mailing Address: 1 055 E (Street, City, State, Zip) 60TH STREET #921, TULSA, OK 74105

I am a registered voter in precinct # 109 in the County of TULSA

Optional Information: Phone number: 918-949-3720 Email Address: [email protected] Website:

[iJ Candidate for the ~REPUBLICAN Party D Independent Candidate D Nonpartisan Judicial Candidate

This Declaration is accompanied by a (check one): ~ Cashier's/Certified Check D Petition CRIMINAL HISTORY DISCLOSURE AND OATH

CRIMINAL DISCLOSURE: Have you been convicted, pled guilty or nolo contendere, or otherwise been determined by a court of proper authority in Oklahoma or in another state to b,!:Jluilty of a misdemeanor involving embezzlement or of a felony under the laws of this state or of the United States? UVES 0NO Have you been named in an outstanding warrant for arrest for a misdemeanor involving embezzlement or a felony in this or any other state or of the United States? DYES IZiNO If you answer YES to either of these questions, you are required to fill out and sign the Criminal History Disclosure form and include it in your Declaration of Candidacy.

I, the undersigned, swear or affirm that the information provided in this Declaration of Candidacy is true and correct, that I have read and signed the Candidate Qualifications for the office that I seek, that I am fully qualifie to become a candidate for said office, and that I will be fully qualified to hold said ff' e, if el cte \

HOLLY H. RYAN Not~)(ebllc - State of Oklahoma

Commission Number 11003210 My Commlssion Expires Apr 7, 2019

Signature of Candidate -=--""=I-"--I,;,I-=--I,IL--.::-""""--"----

NOTARY

State of 0 K County of _:=\...L>\..)\-'-S"'""--_tA..-'-___ -,-__ _

Subscribed and sworn to before me Y -\ Ir\ b (Y'\{il1' IL. JL OS'i" 5)L \ MyCommlsslonexplres Lj ._~r[ q Commission Number \ \ {)03Z--1 b

+WQJ-




(Street, City, State, Zip)

lama voter in Optional Information: Phone number:


in the of

Email Address: Website:

629

~candidate for the .:--'''-'''1''o




CANDIDATE INFORMATION Candidate's name as it will appear on ballot: G. BRENT RUSSELL

630

Candidate's full legal name: Gaylon Brent Russell Date of birth: (Month, Date, Year): 03/11 /1959

Title of Office Sought: . . (include district office or ward number if applicable)AsSOClate District Judge, Stephens County, OK Candidate's Residence Address: (Street, Cit y,State, Zip) 3313 Jacquelyn Terrace, Duncan, OK 73533 Candidate's Mailing Address:

3313 Jacquelyn Terrace, Duncan, OK 73533 (Street, City, State, Zip)

I am a registered voter in precinct # 1 in the County of Stephens

Optional Information: Phone number: 580-467-3574 Email Address: [email protected]:

o Candidate for the' Party o Independent Candidate [!I Nonpartisan Judicial Candidate This Declaration is accompanied by a (check one): ~ Cashier's/Certified Check o Petition , ., CRIMINAL HISTORY DISCLOSURE AND OATH CRIMINAL DISCLOSURE: Have you been convicted, pled guilty or nolo contendere, or otherwise been determined by a court of proper authority in Oklahoma or in another state to be guilty of a misdemeanor involving embezzlement or of a felony under the laws ofthis state or of the United States? DYES iZlNO Have you been named in an outstanding warrant for arrest for a misdemeanor involving embezzlement or a felony in this or any other state or of the United States? DYES [ZiNO If you answer YES to either of these questions, you are required to fill out and sign the Criminal History Disclosure


State of

Subscribed and sworn to before me ---1-----IL~'if-~1-..lL1ir--'""""-_r_='-'--'''----

My Comm!sslon expIres

Oath

#


I) _~:-:-:-::O:-=-K-:,lA-::--H:-~_a~_:-:-id_~_:_eC-:-:I~_~:-:r_~-:-:-:-I~-:-i:_n_~-:-::-d C_t_a_~h-:-D_ID-:-A-:--:-CY_::-:-: __ 6 31 NOTICE: All information provided on this form will be made publicly available.


CANDIDATE INFORMATION Candidate's name as it will appear on ballot: Mike Duffy

Candidate's full legal name: Michael Kent Duffy Date of birth: (Month, Date, Year): 1 0/23/1964

Title of Office Sought: (include district office orward number if applicable) District Judge, District 3 Candidate'$ Residence Address: 321 (Street, City, State, Zip) Paseo De Vida / ~t'lJJ o/,,- 7SJJ.-./ r\~~ . Candidate's Mailing Address: 321 (Street, City, State, Zip) Paseo De Vida IfL'IJ,f J K- 7jJ'2-/ t" \1.-1

I am a registered voter in precinct # 2 in the County of Jackson Optional Information: Phone number: Email Address: Website:

o Candidate for the' Party D Independent Candidate I!I Nonpartisan Judicial Candidate This Declaration is accompanied by a (check one): ~ Cashier's/Certified Check o Petition

CRIMINAL HISTORY DISCLOSURE AND OATH CRIMINAL DISCLOSURE: Have you been convicted, pled guilty or nolo contendere, or otherwise been determined by a court of proper authority in Oklahoma or in another state to be guilty of a misdemeanor involving embezzlement or of a felony under the laws of this state or of the United States? DYES ~NO Have you been named in an outstanding warrant for arrest for a misdemeanor involving embezzlement or a felony in this or any other state or of the United States? []yES 0NO If you answer YES to either of these questions, you are required to fill out and sign the Criminal History Disclosure form and include it in your Declaration of Candidacy.

I, the undersigned, swear or affirm that the information provided in this that I have read and signed the Candidate Qualifications for the office candidate for said office, and that I will be fully qualified to hold said



20 \ 8 state of Oklahoma Filing Packet

Candidacy is true and correct, I am fully qualified to become a

Oath

Candidate Information and Oath / 12

NIP

OKLAHOMA DECLARATION OF CANDIDACY Candidate Information and Oath 632

-----=~~~------~~~--~--------------~ NOTICE: All information provided on this form will be made publicly available. PLEASE TYPE OR PRINT

CANDIDATE INFORMATION Candidate's name as it will appear on ballot: J a na Wa lIace

Candidate's full legal name: Jana Kay Wallace Date of (Month, Date, Year): July 6 1962

Title of Office Sought: (include district office or ward number if applicable) Pushmataha ASSOCiate District J UClq,e Candidate's i Address: (Street, City, State, Zip) 410318 E 1900 Rd, Antlers OK 74523 Candidate's Mailing Address: P 0 (Street, City, State, Zip) "

I am Optional Information: Phone number: 580-298-2553

Box 432, Antlers OK 74523 Pushmataha

Email Address: [email protected]:

~[:ar,diclate for the -"' __________ Party 0 Independent Candidate 1]1 Nonpartisan Judicial Candidate

CRIMINAL DISCLOSURE: Have you been convicted, pled guilty or nolo contendere, or otherwise been determined by a court of proper authority in Oklahoma or in another state to be guilty of a misdemeanor involving embezzlement or of a felony under the laws of this state or ofthe United States? DYES [{jNO Have you been named in an outstanding warrant for arrest for a misdemeanor involving embezzlement or a felony in this or any other state or ofthe United States? []yES !ZINO If you answer YES to either of these questions, you are required to fill out and sign the Criminal History Disclosure form and include it in your Declaration of Candidacy.

I, the undersigned, swear or affirm that the prOVided in this Declaration of Candidacy is true and correct, that I have read and signed the Candidate Qualifications for the office that I seek, that I am fully qualified to become a candidate for said office, and that I will be fully qualified to hold said office, if~ __________

Signature of Candidate ___ ---

633 e OKLAHOMA DEClARATION OF CANDIDACY :,': ',:,: Candidate Information and Oath ;",,:,,~ ------------------------------------



CANDIDATE INFORMATION Candidate's name as it will appear on

legailldlll"o . ....-

Title of Office Sought: (include district office or ward nurllbl"')}~"lpU.;II~il!j"'1'

Candidate's Residence Address: II \ (Street, City, State, Zip) "t-t

Address: (Street, City, State, Zip)

I am a voter in Optional Information: Phone number:

\ IX.

Email Address:

Date I (Month, Date, Year): l .1

1-3\\0

Website:

C",riiriIMp for the """~"-,......,.",,-,,,,,-,-,,=-__ Party D Independent Candidate D Nonpartisan Judicial Candidate

CRIMINAL DISCLOSURE: Have you been convicted, pled guilty or nolo contendere, or otherwise been determined by a court of proper authority in Oklahoma or in another state to b~uiltyct a misdemeanor involving embezzlement or of a felony under the laws of this state or of the United States? uYES l:fJIIO Have you been named in an outstanding warrant for arrest for a misdemeanor involving embezzlement or a felony in this or any other state or of the United States? DYES ~O If you answer YES to either of these questions, you are required to fill out and sign the Criminal History Disclosure form and include it in your Declaration of Candidacy,

I, the swear or affirm the i provided in this Declaration of Candidacy is true and correct, that I have read and signed the Candidate Qualifications for the office that I seek, that I am fully qualified to become a candidate for said office, and that I will be fully qualified to hold saic:j"{lffic:j\,

SubscrIbed and sworn to b~~e ~~e:::~::7';~!LL ___ -:--=;-:--;-:~=;r=7=

My CommissIon expires ':::~0:10~~ ccf'nnl~~n

to AdmInister Oath






634-

o Nonpartisan Judicial Candidate Dedaration is accompanied by a (check one): Check Petition

CRIMINAL HISTORY DISCLOSURE AND OATH :,; I ' , CRIMINAL DISCLOSURE: H'ave you been convicted, pled guilty or nolo contendere, or otherwise been determined by a court of proper authority in Oklahoma or in another state to be guilty ~. misdemeanor involving embezzlement or of a felony u. nder the laws of this state or of the United States? DYES t:jNO .... ~.a)le you been named in an outstanding warrant for ar~for a misdemeanor involving embezzlement or a fel(j'~YJn+.( tMis'or any other state or of the United States? []yES E]NO':": If you answer YES to either of these questions, you are required to fill out and sign the Criminal History Disclosure form and include it in your Declaration of Candidacy,

I, the undersigned, swear or rm that the provided In this Declaration of Candidacy is true and COIIIi',

_ OKLAHOMA DECLARATION OF CANDIDACY 635 'l~j _______ C_an_d_i_d_at_e_l_n_fo_r_m_a_t_io_n_a_n_d_o_a_th ______ _




Candidate's name as it will appear on ballot: JJ BURNAM

candidate'sfUlllegalname:JOSEPH JESS BURNAM Date of birth: (Month, Date, Year):05/26/197 4

Title of Office Sought: 0 0 MA C (include district office or ward number if applicable) KLAH HOUSE OISTRI T 70

candidate'sResiden~eAddress:2419 E 24TH ST TULSA OK 74114 (Street, City, State, ZIp) "

candidat~'sMailingAddress:2419 E 24TH ST TULSA OK 74114 (Street, City, State, Zip) "

I am a registered voter in precinct # 720071 In the County of TULSA Optional Information : Phone number: Email Address: Website:

l!l Candidate for the ,DEMOCRATIC Party o Independent Candidate o Nonpartisan Judicial Candidate This Declaration is accompanied by a (check one): l!lCashler's!Certlfied Check o Petition

CRIMINAL HISTORY DISCLOSURE AND OATH CRIMINAL DISCLOSURE: Have you been convicted, pled guilty or nolo contendere, or otherwise been determined by a court of proper authority in Oklahoma or in another state to b~uilty of a misdemeanor involving embezzlement or of a felony under the laws of this state or of the United States? UVES ~O Have you been named in an outstanding warrant for arrest for a misdemeanor involving embezzlement or a felony in this or any other state or of the United States? []yES 010 If you answer YES to either of these questions, you are required to fill out and sign the Criminal History Disclosure form and include it in your Declaration of Candidacy.

I, the underSigned, swear or information provided in this Declaration is true and correct, that I have read and signed the Candidate Qualifications for the office that I seek, that I am fully qualified to become a candidate for said office, and that I will be fully qualified to hold said offi~r:Jf:~lj:ptetr.7

Sta.eo! Q\(\(JhCtnCl Counlyo! __ lll..1

ii~t:;;"':::':?~O\ OKLAHOMA DECLARATION OF CANDIDACY 636 %~:~rJ Candidate Information and Oath

"'~,~~,'_,;,~,;;:;:: / ----=::-:-:--:-::--:---:---:-:-:--:---::----::-:----:---:-:-:----:-:-----NOTICE: All information provided on this form will be made publicly available.



Ben Croff Date of birth: Candidate's full legal name:

Benjamin James Croff (Month, Date, Year): 12,07,1979

Title of Office Sought: (include district office or ward number if applicable) State House of Representatives District71

Candidate's Residence Address: (Street, City, State, Zip) 2657 South Boston Place !v~"- I OK 7 LillY /Vv-' Candidate's Mailing Address: (Street, City, State, Zip) 2657 South Boston Place !;fA./Ylt- 11~

I am a registered voter in precinct 11720062 in the County of Tulsa Optional Information: Phone number: Email Address: Website:

00 Candidate for the Reoublican Party o Independent Candidate o Nonpartisan Judicial Candidate This Declaration Is accompanied by a (check one): OOCashier's/Certified Check D Petition


CRIMINAL DISCLOSURE: Have you been convicted, pled guilty or nolo contendere, or otherwise been determined by a court of proper authority in Oklahoma or in another state to be guilty of a misdemeanor involving embezzlement or of a felony under the laws ofthis state or of the United States? []vES IL]NO Have you been named in an outstanding warrant for arrest for a misdemeanor involving embezzlement or a felony in this or any other state or of the United States? []yES [LINO If you answer YES to either of these questions, you are required to fill out and sign the Criminal History Disclosure form and include it in your Declaration of Candidacy.

I swear or the in this is true correct, that I have read and signed the Candidate Qualifications for the office that I seek, that I fully qualified to become a candidate for said office, and that I will be fully qualified to hold said

State of

Subscribed and sworn to betore me ---I-4!."-...l....





Candidate's name as it will appear on ballot: Barbara Crisp

637

Candidate'sfUlllegalname:Barbara Bernice Crisp Date of birth: (Month, Date, Year): 11/26/1967

Title of Office Sought: (include district office or ward number if applicable) State Senate, District 2 Candidate's Residence Address: E (Street, City, State, Zip) 16802. 380 Rd. Claremore, OK 74017 Candidate's Mailing Address: 16802 (Street, City, State, Zip) E. 380 Rd. Claremore, OK 74017

I am a registered voter in precinct # 11 in the County of Rogers Optional Information: Phone number: 918-344-0126 Email Address:[email protected] Website:

~ Candidate for the xRepublican Party o Independent Candidate o Nonpartisan Judicial Candidate This Declaration is accompanied by a (check one): ~ Cashier's/Certified Check D Petition

CRIMINAL HISTORY DISCLOSURE AND OATH CRIMINAL DISCLOSURE: Have you been convicted, pled guilty or nolo contendere, or otherwise been determined by a court of proper authority in Oklahoma or in another state to be guilty of a misdemeanor involving embezzlement or of a felony under the laws of this state orofthe United States? DYES 0NO Have you been named in an outstanding warrant for arrest for a misdemeanor involving embezzlement or a felony in this or any other state or of the United States? DYES 0NO If you answer YES to either of these questions, you are required to fill out and sign the Criminal History Disclosure form and include it in your Declaration of Candidacy.

I, the undersigned, swear or affirm that the information provided in this Declaration of Candidacy is true and correct, that I have read and signed the Candidate Qualifications for the office that I seek, that I am fully qualified to become a candidate for said office, and that I will be fully qualified to hold said

State of Q Ie 10, 'vlOMCi.. County of Subscribed and sworn to before me ---.JruC::W'-L~_1.::::~e:L--.LLL ___ _

SEAL My Commission expires

Signature of Notary Public or Officer Authorized to Administer Oath

NDtcvry PUblic" Tille of Officer (Notary Public or Other Officer)



NIP





Candidate's name as it will appear on ballot: Erik Motsinger

638

candidate'sfulllegalname:Erik Carl Motsinger Date of birth: (Month, Date, Year):07105/1980

Title of Office Sought: (include district office or ward number if applicable) District J uge, District 7, Office 5 Candidate's Residence Address: (Street, City, State, Zip) 200 N Harvey Ave, APT 1609, Oklahoma City, OK 73102 Candidate's Mailing Address: (Street, City, State, Zip) 200 N Harvey Ave, APT 1609, Oklahoma City, OK 73102

I am a registered voter in precinct #550205 in the County of Oklahoma Optional Information: Phone number: (405)210-6074 Email Address:[email protected] Website:www.erikmotsinger.cOm

D Candidate for the Party o Independent Candidate [!J Nonpartisan Judicial Candidate This Declaration is accompanied by a (check onef:"'lii:l Cashier'slCertified Check D Petition

CRIMINAL HISTORY DISCLOSURE AND OATH CRIMINAL DISCLOSURE: Have you been convicted, pled guilty or nolo contendere, or otherwise been determined by a court of proper authority in Oklahoma or in another state to be guilty of a misdemeanor involving embezzlement or of a felony under the laws of this state or of the United States? DYES ~O Have you been named in an outstanding warrant for arrest for a misdemeanor involving embezzlement or a felony in this or any other state or of the United States? DYES 0No If you answer YES to either of these questions, you are required to fill out and sign the Criminal History Disclosure form and include it in your Declaration of Candidacy.

I, the swear or i the information provided in this Declaration of Candidacy is true and correct, that I have read and signed the Candidate Qualifications for the office that I seek, that I am fully qualified to become a candidate for said office, and that I will be fully qualified to hold said office, if elected.

~' ........ . "~\O 1 '. \~s.a .'-...\0.., (? '

_~.

I) ___ O_K_LA:---:H~~a_~_:_id_~_~e_C--:-I~~~O~~_~_:_I~_oN_n_~--:-:~d C_oA_a N_th_D_1 D_A_C_Y ___ 6_3_9 NOTICE: All information provided on this form will be made publicly available.



M: c"-o-e.l A \1...a.Ft- tv\. ~+-,'; ~ Candidate's full legal name: Date of birth:

M ~C\tcG\

OKLAHOMA DECLARATION OF CANDIDACY 640 ~t~ Candidate Information and Oath

~;;6">/':~ --------:------------------------------NOTICE: All information provided on this form will be made publicly available.



Candidate's name as it will appear on ballot: Ed Trumbull

candidate'sfUlllegalname:Edward Jude Trumbull Jr. Date of birth: (Month, Date, Year): 09/06/62

Title of Office Sought: (include district office or ward number if applicable) State House of Representatives District 5 Candidate's Residence Address: (Street,CitY,State,Zip) 714 Apple Drive, Grove, Okla. 74344 Candidate's Mailing Address: 714 A I (Street, City, State, Zip) pp e Drive, Grove, Okla. 74344 I am a registered voter in precinct #21 0005 in the County of Delaware Optional Information: Phone number: 918-791-8256 Email Address:[email protected] Website:

~ Candidate for the xOemocmUc Party o Independent Candidate o Nonpartisan Judicial Candidate This Declaration is accompanied by a (check one): l!I Cashiers/Certified Check D Petition


CRIMINAL DISCLOSURE: Have you been convicted, pled guilty or nolo contendere, or otherwise been determined by a court of proper authority in Oklahoma or in another state to be guilty of a misdemeanor involving embezzlement or of a felony under the laws of this state or of the United States? DYES ~O Have you been named in an outstanding warrant for arrest for a misdemeanor involving embezzlement or a felony in this or any other state or of the United States? DYES ~o If you answer YES to either of these questions, you are required to fill out and sign the Criminal History Disclosure form and include it in your Declaration of Candidacy.

I, the undersigned, swear or affirm that the information provided in this Declaration of Candidacy is true and correct, that I have read and signed the Candidate Qualifications for the office that I seek, that I am fully qualified ,t#come a candidate for said office, and that I will be fully qualified to hold said office, ~~ected. ~ 7/

Signature of Candidate ~ ,k~,rn -~~ NOTARY

state of OkL~r0d County of ..1oeJS~l=-f\~Lv~AA=~..,=-_____ _

~~MEUSSAT-;O~iY~~~j~ ubscrlbed and sworn to before me Apr)) ) 2.. I 20 \ '8' OFFl{;JI.)~ SEAL - NOTARY PUBLIC y Commission expires 3/),& /;).'U Commission Number 110 OD 3;;)0'-(

"'51l'ITE OF OKLAHOMA COMMISSION Ifyl>tC2883

~~---~--""""--i-Q-& \..

NIPD PETD # of signatures ____ _

2018 Slale of Oklahoma Filing Packel Candidale Informalion and Oalh I 12




Candidate's Mailing Address: (Street, City, State, Zip) 5




641

Have you been convicted, pled guilty or nolo contendere, or otherwise been determined by a court of proper authority in Oklahoma or in another state to be guilty ~isdemeanor involving embezzlement or of a felony under the laws of this state or of the United States? DYES Lt::fNO Have you been named in an outstanding warrant for ar~tJPr a misdemeanor involving embezzlement or a felony in this or any other state or of the United States? []yES l.eI1IJo If you answer YES to either of these questions, you are required to fill out and sign the Criminal History Disclosure form and include it in your Declaration of Candidacy.

I, the I swear or I provided in this Declaration of Candidacy is true and correct, that I have read and signed the Candidate Qualifications for the office that I seek, that I am fully qualified to become a candidate for said office, and that I will be fully qualified to hold

State of C?

h(a~\ OKLAHOMA DECLARATION OF CANDIDACY ~l~~ _____________ c_a_n_d_id_a_t_e_'_n_fo_r_m_a_t_io_n_a_n_d __ o_a_th _______________ 642




Date of birth: (Month, Date, Year): \:;).

Title of Office ~ouem: (include district office or ward number if applicable)

Candidate's Address: (Street, City, State, Zip)

Candidate's Address:

AJ" o (Street, City, State, Zip) \

Website:

643

D Nonpartisan Judicial Candidate

CRIMINAL DISCLOSURE: Have you been convicted, pled guilty or nolo contendere, or otherwise been determined by a court of proper authority in Oklahoma or in another state to be guilty~. misdemeanor involving embezzlement or of a felony under the laws of this state or ofthe United States? DYES MO Have you been named in an outstanding warrant for ar~. s. for a misdemeanor involving embezzlement or a felony in this or any other state or of the United States? []yES RO If you answer YES to either of these questions, you are required to fill out and sign the Criminal History Disclosure form and Include it in your Declaration of Candidacy.

I, the undersigned, swear or affirm that the information in this Declaration I is true correct, that I have read and signed the Candidate Qualifications for the office that I seek, that I am fully qualified to become a candidate for said office, and that I will be fully qualified to hold

Kimberly Arrington NOTARY PUBUC

PONTOTOC COUNTY STATE OF OKLAHOMA

COMMISSION NO. 03009295 EXPIRES 06/24/2019



2018 State of Oklahoma Filing Packet Condidote Information and Oath / 12

~fI:'t):.~'J~ OKLAHOMA DECLARATION OF CANDIDACY 'If: . ",:,: Candidate Information and Oath ~~/l:;' ----:-:-:==---:-::-:-:---:----:-:--:--:----::----:---:--------NOTICE: All information provided on this form will be made publicly available,


CANDIDATE INFORMATION Candidate's name as It will appear on ballot,

Title of Sought:

a _----:-:-:=O-:-:-KL--.A~H_:_~-a-~__.;-dD-at-EeC-I~_:_~__.:-r~__.:-I~_:_iO-~-~-:-d C_oA_a N--.th_D_1 D_A_C_Y ____ 6 4 5 NOTICE: All information provided on this form will be made publicly available,



i (include district office or ward number if applicable)

Candidate's (Street, City, State, Zip)

Candidate's Mailing Address: (Street, City, State, Zip)

I am a voter in Optional Information:

Ca ndidate for the -"-'--.tS.L1~12.t.2t..Cl-nL_



Have you been convicted, pled guilty or nolo contendere, or otherwise been determined by a court of proper authority in Oklahoma or in another state to be guilty of a misdemeanor involving embezzlement or of a felony under the laws ofthis state or of the United States? DYES !)(lNO Have you been named in an outstanding warrant for arrest for a misdemeanor involving embezzlement or a felony in this or any other state or of the United States? []yES J)?JNO If you answer YES to either of these questions, you are required to fill out and sign the Criminal History Disclosure form and include it in your Declaration of Candidacy,

I, the u i swear or I that the information provided in this Declaration of Candidacy is that I have read and signed the Candidate Qualifications for the office that I seek, that I am candidate for said office, and that I will be fully qualified to hold said

Subscribed and sworn to ceTC>re,'n. ,----'--""'-'-'-""'--'-'--'--'--'='-'=_'--'--'--'--=,

SEAL My CommissIon expires --------------_.. ,

, .~ ~"~~':----C"ON-NIE CLEMENS 1 , '+.,.. .~ .: \ nAL Notary PublIC t t M( State of Oklahoma t ! ".",V 1116009964 Explre'!.~~!!!~~ : I Commission __ .... --- .. - .. -----, --_ .... ---_ .. --







Candidate's name as it will appear on ballot: 0 AVE C RUT C H FIE L 0

646

Candidate's full legal name: DAVID LEROY CRUTCHFIELD

Date of birth: (Month, Date, Year): 11 121 11948

Title of Office Sought: (include district office or ward number if applicable)ASSOCIATE DISTRICT JUDGE, DELAWARE COUNTY, 13TH JUDICIAL DISTRICT

Candidate's Residence Address: 56351 (Street, Citv, State, Zip) E. 307 RD., AFTON, OKLAHOMA 74331 Candidate's Mailing Address: 56351 (Street, CitV, State, Zip) E. 307 RD., AFTON, OKLAHOMA 74331

I am a registered voter in precinct 1# 3 in the Countv of DELAWARE Optional Information:

Phone number: 918-542-8400 Email Address:ocRUTCHFIElO@CRUTCHFIELDLAw,NETWebsite:

o Candidate for the' Party o Independent Candidate [!] Nonpartisan Judicial Candidate This Declaration is accompanied bva (check one): III Cashier's/Certified Check o Pelilion


CRIMINAL DISCLOSURE: Have vou been convicted, pled guilty or nolo contendere, or otherwise been determined by a court of proper authority in Oklahoma or in another state to b~uilty of a misdemeanor involving embezzlement or of a felony under the laws of this state or ofthe United States? UVES !!:INO Have you been named in an outstanding warrant for arrest for a misdemeanor involving embezzlement or a felony in this or any other state or of the United States? []yES [!jNO If you answer YES to either of these questions, you are required to fill out and sign the Criminal History Disclosure form and include it in your Declaration of Candidacy.

I, the swear or i the information provided in that I have read and signed the Candidate Qualifications for the offirpA'h~t candidate for said office, and that I will be fully qualified to hold sai,'I1offike,

#I of signatures ___ _

2018 State of Oklahoma Filing Pocket Candidate Information and Oath I 12

I I


NOTICE: All information provided on this form will be made pUblicly available.



Title of Office 'OIJErlI: (include district office or ward number if applicable)

Ca i Residence MOrE"S: (Street, City, State, Zip)

Candidate's Mailing Address: (Street, City. State, Zip)

1 am a voter in ~.n.n'~n'

Optional Information: Phone number: 5"~

5Dll

Email

G2!'Candidate for the .::.-l,...eML DIANA J. HOLLADAY r=t Notary Public - State of Oklahoma

Commission Number 05006391 My Commission Expires )1,11 13, 2021 SI9P

NIPD # of signatures ____ _






Candidate's name as it will appear on ballot: La u ra Stee I e Date of birth:

648

Candidate's full legal name: La u ra Danyel Steele (Month, Date, Year): 11/06/1970

Title of Office Sought: (include district office orward number if applicable) House of Representatives Dist. 98 Candidate's Residence Address: (Street,City,State,Zip) 1700 E. Laredo st. Broken Arrow, OK 74012 Candidate's Mailing Address: 1700 E (Street, City, State, Zip) Laredo st. Broken Arrow, OK 74012 I am a registered voter in precinct # 476 in the County of Tulsa Optional Information:

Phone number: 918-527-4720 Email Address: [email protected] Website:

Candidate for the Republican Party o Independent Candidate o Nonpartisan Judicial Candidate .<

This Declaration is accompanied by a (check one): [;J'Cashier's/Certified Check o Petition CRIMINAL HISTORY DISCLOSURE AND OATH

CRIMINAL DISCLOSURE: Have you been convicted, pled guilty or nolo contendere, or otherwise been determined by a court of proper authority in Oklahoma or in another state to be guilty of a misdemeanor involving embezzlement or of a felony under the laws of this state or of the United States? 0 YES. NO Have you been named in an outstanding warrant for arrest for a misdemeanor involving embezzlement or a felony in this or any other state or of the United States? DYES .NO If you answer YES to either of these questions, you are required to fill out and sign the Criminal History Disclosure form and include it in your Declaration of Candidacy.

I, the undersigned, swear or affirm that the information provided in this Declaration of Candidacy is true and correct, that I have read and signed the Candidate Qualifications for the office I seek, that I am fully qualified to become a candidate for said office, and that I will be fully qualified to hold said o(fic~~~~Q.....'i\ __

Slaleof OK/"ham"" County of T Ci Is Q., Subscribed and sworn to before me ---=[",o",u




CANDIDATE INFORMATION Candidate's name as it will appear on ballot: G R L h

ary ,. an am

649

Candidate's full legal name:Gary Ronald Lanham Date of birth: 1 0 19 195 (Month, Date, Year): - - .

ntle of Office Sought: SSt D' . 1 0 (include district office or ward number if applicable) enate ea Istnct

Candidat~'s Reslden~eAddress:PO B 999 CR2595 H . OK 74035 (Street, City, State, ZIp) ox . omlnY

Candidate's Mailing Address: PO (Street, City, State, Zip) - Box 387 Skiatook, OK 74070

I am a registered voter in precinct # 5' 1

CRIMINAL HISTORY DISCLOSURE AND OATH CRIMINAL DISCLOSURE: Have you been convicted, pled guilty or nolo contendere, or otherwise been determined by a court of proper authority in Oklahoma or in another state to b!liuilty of a misdemeanor involving embezzlement or of a felony under the laws ofthis state or of the United States? UV'ES 0110 Have you been named in an outstanding warrant for arrest for a misdemeanor involving embezzlement or a felony in this or any other state or of the United States? DYES 0110 If you answer YES to either of these questions, you are required to fill out and sign the Criminal History Disclosure form and include it in your Declaration of Candidacy.

I, the undersigned, swear or affirm that the information provided in this Declaration of Candidacy Is true and correct, that I have read and signed the Candidate Qualifications for the office that I seek, that I am fully qualified to become a candidate for said office, and that I will be fully qualified to hold said office, if ~ected.

stoia of

~"I!.ertl!.~ ao~ .wom to PofOfa ma ----l..LLl-_.I::....lJLI....I.--'-='-=LL"-"_

MyComml"IQooxplfaS l.l-:t-yr\3 Comml"'QoN"ml!'f \tbOD3'3 \ s= , u Dt'~b~Q b ~- -~

SlgoaMo 01 Notary puolle or om .. f Allthort .. d to Mmlol.'ar Oath

2.-

2018 state of Oklahoma Filing Packet Candidate Information and Oath I 12





Candidate's name as it will appear on ballot: J Paul Ganzel

650

Candidate's full legal name: James Paul Ganzel I Date of birth: 08/04/1968 (Month, Date, Year):

Title of Office Sought: S R " , (include district office or ward number if applicable) tate epresentatlve District 36

Candidate's Residence Address: 115 Count Rd 2603 Hominy OK 74035 (Street, City, State, ZIp) y ,

Candidate's Mailing Address: 115 County Rd 2603 Hominy OK 74035 (Street, City, State, Zip) ,

I am a registered voter in precinct # 570112 . Osage In the County of Optional Information: Phone number: 918-698-7979 Email Address: [email protected] Website:

~ Candidate for the Republican Party o Independent candidate o Nonpartisan Judicial Candidate This Declaration is accompanied by a (check one): ~ Cashiers/Certified Check o Petition


CRIMINAL DISCLOSURE: Have you been convicted, pled guilty or nolo contendere, or otherwise been determined by a court of proper authority in Oklahoma or in another state to be guilty of a misdemeanor involving embezzlement or of a felony under the laws of this state or of the United States? DYES 0Jo ' Have you been named in an outstanding warrant for arrest for a misdemeanor involving embezzlement or a felony in this or any other state or of the United States? []yES 0110 If you answer YES to either of these questions, you are required to fill out and sign the Criminal History Disclosure form and include it in your Declaration of Candidacy.

I, the undersigned, swear or affirm that the information provided in this that I have read and signed the Candidate Qualifications for the office candidate for said office, and that I will be fully qualified to hold said

of Candidacy is true and correct, that I am fully qualified to become a

State of MtLU/,LJ!!'J.'J2,t},~ county of

r--:-----;.-.-----"""ubscrlbed and sworn to before me /(/ IN! ( If I (( b '1 .p'l'A/(/, Oli'FICIAL SI';AL I! cl g 7 i'lll!iHAL KIM E, KIRBY __ yCommlsslonexplres DC)p [~I"commissionNumber 6(poo ")0

o ":,::!:',~'" CllllllrllHHIOri II 06009087 I ~ < --if' ~ . J . 'f>/AHrJ" !rlll""; [)1:pIOmIJflr 15, 2018 ~ 'kYAlflj;[/~

Signature of Notary Public or Officer Authorized to Adm!n!M Oath

(IIoiR0/) ~V\ tb'c. . Tille of Officer (Notary PubUc or Other Officer)


2018 state of Oklahoma Filing Packet Candidate Information and Oath / 12





Candidate's name as it will appear on ballot: J d B B k or an . UC

Date of birth:

651

Candidate's full legal name: Jordan Blake Buck (Month, Date, Year): August 9, 1989

Title of Office Sought: ., (indude district office or ward number if applicable) State House of Representatives District 48 Candidate's Residence Address:. (Street,City,State,Zip) 3270 Clmmaron Rd. Wilson, OK 73463 Candidate's Mailing Address: (Street, City, State, Zip) 3270 Clmmaron Rd. Wilson, OK 73463

I am a registered voter in precinct # 100r)71 in the County of Carter



~ Candidate for the Domocrat Party D Independent Candidate D Nonpartisan Judicial Candidate

This Dedaration is accompanied by a (check one): ~ Cashier's/Certified Check D Petition CRIMINAL HISTORY DISCLOSURE AND OATH

CRIMINAL DISCLOSURE: Have you been convicted, pled guilty or nolo contendere, or otherwise been determined by a court of proper authority in Oklahoma or in another state to be guilty of a misdemeanor involving embezzlement or of a felony under the laws of this state or ofthe United States? DYES [{jNO Have you been named in an outstanding warrant for arrest for a misdemeanor involving embezzlement or a felony in this or any other state or of the United States? DYES [ZjNO If you answer YES to either of these questions, you are required to fill out and sign the Criminal History Disclosure form and include it in your Declaration of Candidacy.

I, the undersigned, swear or information provided in this Declaration of Candidacy is true and correct, that I have read and signed the Candidate Qualifications for the office that I seek, that I am fully qualified to become a candidate for said office, and that I will be fully qualified to hold said office, ifAleqtec\...""

AL OFFICIAL SEAL 1 BRENDA J. ALEXANDER NOTARY PUBLIC OKLAHOMA

CARTER COUNTY COMM. NO. 00000638 EXP. 03-0820

State of ()mA- County of Subscribed and sworn to before me .:!J5r",-,e.n",-",d""~J'''----LA.!.I,,,e",J(y,.,c f)C/.d=ef''---____ _ My Commission expires -,3o:.:lU\8,1>VotlL __ commISSion Number _-,,&'~3=8 ____ _

gnature of Notary Public or Officer Authorized to AdmInister Oath

signatures ____ _

2018 State of Oklahoma Filing Packet Candidate Information ond Oath / 12




(include district office or ward number if applicable)


Mailing (Street, City, State, Zip)

I am a voter in Optional Information: Phone number:

li

Email Address:

652

I3il Candidate for the .::._C-l""",~=>..\..l'-"'''''''--_ Party 0 Independent Candidate 0 Nonpartisan Judicial Candidate This Declaration is accompanied by a (check one): Cashier's/Certified Check Petition

CRIMINAL HISTORY DISCLOSURE AND OATH CRIMINAL DISCLOSURE: Have you been convicted, pled guilty or nolo contendere, or otherwise been determined by a court of proper authority in Oklahoma or in another state to be guilty of a misdemeanor involving embezzlement or of a felony under

the laws of this state or of the United States? QyES ~O Have you been named in an outstanding warrant for arrest for a misdemeanor involving embezzlement or a felony in this or any other state or of the United States? []yES [lNO If you answer YES to either of these questions, you are required to fill out and sign the Criminal History Disclosure


I, the undersigned, swear or affirm that the information provided in this Declaration of Candidacy is true and correct, that I have read and signed the Candidate Qualifications for the office that I seek, that I am fully qualified to become a

candidate for said office, and that I will be fully qualified to hold said ~~~~:

oklahoma declaration of candidacy 601 … candidate...this or any other state or of the united...

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