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TOWN OF VERNON WAUKESHA COUNTY WISCONSIN 2018 Candidate Infrmatin Packet (Fr additinal resurces and infrmatin please visit the Wiscnsin Electins and Ethics Cmmissin website [frmerly the Gvernment Accuntability Bard] at www.gab.wi.gv)

BALLOT ACCESS CHECKLIST FOR 2018 MUNICIPAL CANDIDATES WHERE NOMINATION PAPERS ARE USED Each f the fllwing frms must be cmpleted and filed n time by candidates fr municipal ffice in rder fr the candidate's name t be placed n the ballt at the February 20, 2018 Spring Primary and the April 3, 2018 Spring Electin. In the City f Milwaukee, the filing fficer is the Milwaukee City Electin Cmmissin. In all ther municipalities, the filing fficer is the municipal clerk. Candidates shuld cntact their filing fficer fr further infrmatin r t btain any f the necessary frms. Cmplete and submit a Campaign Registratin Statement (Frm ETHCF-1) t the filing fficer n later than 5 p.m. n Tuesday, January 2, 2018, r the candidate s name will nt be placed n the ballt. If the frm is faxed r emailed, the riginal dcument must fllw pstmarked n later than January 2, 2018. Wis. Stat. 8.10(5), 8.30(4), Wis. Admin. Cde EL 6.04 New candidates file a campaign registratin statement befre funds are cllected r spent r befre nminatin papers are submitted. Wis. Stat. 11.0202(1)(a), 11.0202(2)(a). Cntinuing candidates file an amended campaign registratin statement indicating the ffice sught and the new primary and electin dates befre funds are cllected r spent r befre nminatin papers are submitted. Wis. Stat. 11.0202(1)(a), 11.0202(2)(a). Cmplete and submit a Declaratin f Candidacy (EL-162) t the filing fficer n later than 5 p.m. n Tuesday, January 2, 2018 r the candidate s name will nt be placed n the ballt. If the frm is faxed r emailed, the riginal dcument must fllw, pstmarked n later than January 2, 2018. Wis. Stat. 8.10(5), 8.21, 8.30(4), Wis. Admin. Cde EL 6.04. Circulate and submit Nminatin Paper fr Nnpartisan Office (EL-169) t the filing fficer n later than 5 p.m. n Tuesday, January 2, 2018 r the candidate s name will nt be placed n the ballt. Only riginal nminatin papers (n phtcpies, faxes, r emailed dcuments) will be accepted. Nminatin papers may nt be circulated befre December 1, 2017. Wis. Stat. 8.10(2),(3), Wis. Admin. Cde EL 6.04(2). The number f signatures required is as fllws: All village and twn ffices: 20-100 1 st Class Cities: Citywide ffices 1,500-3,000 Alderpersn elected t district 200-400 2 nd and 3 rd Class Cities: Citywide ffices 200-400 Alderpersn elected at large 100-200 Alderpersn elected t district 20-40 4 th Class Cities: Citywide ffices 50-100 Alderpersn elected t district 20-40 Municipal judge candidates: Cmplete and submit a Statement f Ecnmic Interests (SEI) t the Wiscnsin Ethics Cmmissin. The SEI must be received in the Wiscnsin Ethics Cmmissin ffice n later than 4:30 p.m. n Friday, January 5, 2018 r the candidate s name will nt appear n the ballt. Wis. Stat. 8.10(5), 8.30(3), 19.43(4). Faxed frms are acceptable. Befre December 1, 2017, the Wiscnsin Ethics Cmmissin will mail Statement f Ecnmic Interests frms t each incumbent whse ffice is up fr electin. After December 1, 2017, a candidate may print the Statement f Ecnmic Interests frm and instructins frm the agency website. http://ethics.wi.gv. IMPORTANT NOTE REGARDING STATEMENTS OF ECONOMIC INTERESTS: A municipality may enact an rdinance establishing a cde f ethics fr public fficials that may require a candidate fr municipal ffice, in additin t the ffice f Municipal Judge, t file a Statement f Ecnmic Interests (SEI). The rdinance may als prvide that failure t timely file a Statement f Ecnmic Interests will prevent the candidate s name frm being placed n the ballt. Wis. Stat. 19.59(1m),(3)(b). Please cntact the filing fficer t learn if this requirement applies t yu. ELIS-7 Rev 2017-04 Wiscnsin Electins Cmmissin, 212 E. Washingtn Ave., 3 rd Flr, P.O. Bx 7984, Madisn, WI 53707-7984 608-261-2028 web: electins.wi.gv email: electins@wi.gv

CAMPAIGN REGISTRATION STATEMENT STATE OF WISCONSIN ETHCF-1 FOR OFFICE USE ONLY IF A CANDIDATE DOES NOT FILE THIS STATEMENT BY THE DEADLINE FOR FILING NOMINATION PAPERS, THE CANDIDATE S NAME WILL NOT BE PLACED ON THE BALLOT. NOTICE: ANY CHANGE OF INFORMATION ON THIS REGISTRATION STATEMENT MUST BE FILED WITHIN 10 DAYS. IS THIS AN AMENDMENT? Yes N 1. CANDIDATE AND CANDIDATE COMMITTEE INFORMATION Name f Candidate Party Affiliatin Office Sught (include district r branch number) Residence Address (number and street) Primary Date Candidate Telephne Number (residence) City, State and Zip Cde Electin Date Candidate Telephne Number (emplyment) Campaign Cmmittee Name (if any) Check One: Candidate Cmmittee Candidate Email Address Campaign Cmmittee Address (if different than abve) - Number, Street, City, State and Zip Cde Cmmittee Email Address Telephne Number (if different than abve) Cmmittee PIN Number (fur digits - REQUIRED fr all cmmittees registered with the G.A.B.) 2. POLITICAL COMMITTEE INFORMATION (Fr use Party Cmmittees, Legislative Campaign Cmmittees, PACs, Independent Expenditure Cmmittees, Referendum Cmmittees, Recall Cmmittees) Name f Cmmittee Cmmittee PIN Number (fur digits - REQUIRED fr all cmmittees registered with the G.A.B.) Address - Number, Street, City, State and Zip Cde Telephne Number Cmmittee Email Address Spnsring Organizatin - Name and Cmplete Address Type f Cmmittee: A. Plitical Party Cmmittee Natinal State Cunty Other B. Legislative Campaign Cmmittee Attach Statement Required by s.11.0403(d), Stats. Plitical Party and Legislative Campaign Cmmittees Only: This Cmmittee has a Segregated Fund Please prvide name f fund, and name and address f financial institutin: C. Plitical Actin Cmmittee Resident Cmmittee Nnresident Cmmittee D. Independent Expenditure Cmmittee Resident Cmmittee Nnresident Cmmittee E. Referendum Cmmittee Supprt Oppse Name f Referendum F. Recall Cmmittee Supprt Recall Oppse Recall Name f Official Subject t Recall - Attach Statement Required by s.9.10(2)(d) ETHCF-1 (Rev. 1/2016) THIS FORM IS PRESCRIBED BY: WISCONSIN GOVERNMENT ACCOUNTABILITY BOARD P.O. Bx 7984, Madisn, WI 53707-7984 Phne: 608-261-2028 Fax: 608-264-9319 web: https://cfis.wi.gv email: GABCFIS@wi.gv

3. COMMITTEE TREASURER (Campaign finance crrespndence is mailed t this address.) Treasurer s Name Telephne Number (residence) Address (number and street) Telephne Number (emplyment) City, State and Zip Cde Treasurer Email Address 4. PRINCIPAL OFFICERS OF COMMITTEE AND OTHER CUSTODIANS OF BOOKS AND ACCOUNTS Attach additinal listing if necessary. FOR INDEPENDENT AND LOCAL NONPARTISAN CANDIDATES ONLY: Indicate which fficers r cmmittee members are authrized t fill a vacancy in nminatin due t death f candidate by an asterisk(*). See Wis. Stats. 8.35. NAME MAILING ADDRESS Email Address Phne # POSITION 5. DEPOSITORY INFORMATION Name f Financial Institutin Address (number and street) City, State and Zip Cde CERTIFICATION MAJOR PURPOSE (Fr PACs, Independent Expenditure Cmmittees, and Referendum Cmmittees ONLY) We certify that we are an entity required t file under WIS. STAT. 11 (See: statutry definitins, 11.0101 r instructins belw fr details). TREASURER I, (print full name) certify the infrmatin in this statement is true, crrect and cmplete. Signature, Treasurer. CANDIDATE (r recall petitiner) Date I, (print full name) certify the infrmatin in this statement is true, crrect and cmplete. Signature, Candidate/Petitiner. Date + + + EXEMPTION FROM FILING CAMPAIGN FINANCE REPORTS 11.0104 Wis. Stats. + + + Yu may be eligible fr an exemptin frm filing campaign finance reprts. Cnsult the Campaign Finance Overview fr yur type f cmmittee t determine if yur cmmittee qualifies fr exemptin. This registrant is eligible fr exemptin. This registrant will nt accept cntributins, make disbursements r incur bligatins in an aggregate amunt f mre than $2,000 in a calendar year. I am aware that per statute 11.0104(2), exempt status is effective nly fr the calendar year it is granted, and must be renewed each year if the cmmittee wishes t remain exempt frm filing reprts. This registrant is n lnger eligible t claim exemptin. Signature f Candidate r Treasurer Date THE INFORMATION ON THIS FORM IS REQUIRED BY 9.10(2)(d), 11.0203, 11.0303, 11.0403, 11.0503, 11.0603, 11.0803, 11.0903, WIS. STATS. FAILURE TO PROVIDE REQUIRED INFORMATION MAY SUBJECT YOU TO THE PENALTIES OF 8.30(2), 11.1400, 11.1401, WIS. STATS.

CAMPAIGN REGISTRATION STATEMENT (ETHCF-1) INSTRUCTIONS Wh Must Register When Where Candidates ReferendaɎ cmmittees Recall cmmittees n later than filing nminatin papers r when they raise r spend any mney n electin, except thse needed t pen a bank accunt Befre spending r taking in mre than $10,000 Befre spending r taking in mre than $2,000 Lcal ffice r referenda- with the lcal clerk (twn, village, city, schl) State ffice r statewide referenda with the Wiscnsin Gvernment Accuntability Bard Fr a mix f state and lcal ffices with the Wiscnsin Gvernment Accuntability Bard Party Cmmittees Plitical Actin* Cmmittees (PACs) Independent Expenditure Cmmittees (IECs) Party cmmittees must register upn their inceptin and prir t raising r spending any funds. Befre spending r taking in mre than $2,500 Befre spending r taking in mre than $2,500 All Party Cmmittees, PACs, and IECs active in either state r lcal cntests must register at the state level, with the Wiscnsin Gvernment Accuntability Bard. * A PAC is nly required t register if it has the majr purpse f express advcacy, r spends mre than 50% f its ttal spending in a 12-mnth perid n express advcacy, referendum activity, r cntributins t candidates, legislative campaign cmmittees, and parties. An IEC is nly required t register if it has the majr purpse f independent expenditures, r spends ver 50% f its ttal spending in a 12-mnth perid n independent expenditures and referendum activity. Ɏ A Referendum Cmmittee is nly required t file if it has the majr purpse f making expenditures t supprt r defeat a referendum OR mre than 50% f its ttal spending in a 12-mnth perid is n expenditures made t supprt r defeat a referendum. Cmpleting a Registratin Statement Sectin 1: Candidate and Candidate Cmmittee Infrmatin - Sectin 1 shuld be cmpleted by candidate cmmittees nly. Campaign Cmmittee Name Any candidate that accepts a dnatin must have a cmmittee. Any cmmunicatin (flyers, newspaper ads, website) requires a disclaimer Paid fr by Cmmittee name. If yu are seeking multiple ffices (twn, cunty, schl bard), r plan t seek anther ffice in the future, yu may want t cnsider a generic cmmittee name withut the name f the ffice sught such as Friends f, r Cmmittee t Elect.. This will allw yu t keep the same cmmittee name fr varius ffices. Yur cmmittee name des nt have t include yur last name, but including yur last name makes searching fr yur cmmittee easier. Cmmittee PIN Number: is any cmbinatin f numerical digits selected by the cmmittee and is used fr electrnic signature purpses. Sectin 2: Nn-Candidate Cmmittee Infrmatin - Sectin 2 shuld be cmpleted by nn-candidate cmmittees nly. Cmmittee PIN Number: is any cmbinatin f numerical digits selected by the cmmittee and is used fr electrnic signature purpses. A. Plitical Party Cmmittee T use the name f ne f the recgnized plitical parties in Wiscnsin Cnstitutin, Demcratic, Libertarian, r Republican, yu must have permissin frm the state party.

C. Plitical Actin Cmmittee (PAC) PACs may receive mney frm individuals r ther PACs, and cntribute mney directly t candidates. PACs may nt accept mney frm crpratins. Cmmittees intending t make nly independent expenditures, withut cntributing t r crdinating with candidate cmmittees, shuld register as an Independent Expenditure Cmmittee - see letter D belw. A resident cmmittee is based in Wiscnsin and must reprt all receipts and expenses. A nn-resident cmmittee is based utside f Wiscnsin and must reprt nly expenses in Wiscnsin fr either lcal and state-level cntests. D. Independent Expenditure Cmmittee Cmmittees making nly independent expenditures may nt cntribute t candidate cmmittees directly. They als cannt crdinate with candidate cmmittees n express advcacy cmmunicatins that explicitly urge recipients t vte fr r against a candidate. These cmmittees may accept unlimited cntributins frm individuals and frm crpratins. Sectin 3. Campaign Treasurer - Sectin 3 shuld be cmpleted by all cmmittees. All cmmittees must name a treasurer. A candidate may designate any adult t serve as the cmmittee s treasurer, r the candidate may server as his/her wn treasurer. It is imprtant that the treasurer s name, cmplete address, telephne number and email address be prvided n the registratin statement and be kept current. All ntices and frms fr campaign finance reprts will be sent t this persn at the address given in this sectin. Failure t receive ntice f the filing requirement des nt exempt a candidate frm the requirement t file the reprts. Item 4. Principal Officers f the Cmmittee and Other Custdians f Bks and Accunts (Optinal) If the cmmittee has fficers r ther cntacts besides the treasurer, they shuld be listed in Item 4. Fr a recall cmmittee, the recall petitiner must be included here. The Ethics Cmmissin recmmends that yu prvide mre than ne persn s cntact infrmatin. Item 5. Depsitry Infrmatin (MANDATORY) In sme cases, banks may require a cmpleted ETHCF-1 registratin frm t pen a bank accunt. Yur cmmittee may register withut a bank accunt, but the ETHCF-1 frm must be amended within 10 days t reprt any change, including new bank accunt infrmatin. In general, all cmmittees must have a campaign depsitry accunt. Please list the infrmatin fr ne f these tw ptins: 1. Separate campaign accunt This accunt may be used nly fr campaign funds The bank may require an Emplyer Identificatin Number (EIN) frm the IRS t pen a cmmittee accunt 2. Only Candidates may use a persnal bank accunt This is allwed nly if the candidate is claiming the exemptin frm filing finance reprts (under $2,000 f receipts, under $2,000 expenses in a calendar year) Candidates running fr mre than ne elected ffice may have mre than ne cmmittee and mre than ne campaign depsitry accunt.

Certificatin The candidate and cmmittee treasurer must sign the riginal registratin statement f a candidate cmmittee certifying that the infrmatin is true, crrect, and cmplete. Fr a recall cmmittee, the recall petitiner and the treasurer must bth sign. A candidate serving as his/her wn treasurer nly needs t sign nce. Nn-candidate cmmittees require nly the treasurer s signature. Amendments t the registratin may be signed by either the candidate r treasurer. If there is a change in treasurer, the new treasurer shuld sign. Exemptin Frm Filing Campaign Finance Reprts All cmmittees must file campaign finance reprts, unless they check the bx t claim exemptin and remain within thse limits. A cmmittee nt cllecting r spending mre than $2,000 ttal in a calendar year. Candidate cmmittees and Party Cmmittees must register befre cllecting r spending any mney, but thse cmmittees may nt have t file reprts if they claim exemptin. PACs and IECs d nt have t register until they cllect r spend mre than $2,500 in a calendar year. A PAC r IEC that is already registered, but will have limited activity fr a calendar year, may claim exemptin and wuld nt have t file reprts fr that year. A referendum cmmittee that des nt cllect r spend mre than $10,000 is nt required t register. Because a referendum cmmittee is unlikely t be active fr multiple years, it wuld be rare fr this type f cmmittee t claim exemptin. A recall cmmittee that des nt cllect r spend mre than $2,000 is nt required t register. A recall cmmittee des nt have t file reprts unless it succeeds in frcing a recall electin. If a cmmittee n exempt status exceeds any f the limits listed abve: The cmmittee must immediately file an amended ETHCF-1 with the apprpriate filing fficer, revking the exempt status. The cmmittee must reprt all campaign finance activity back t the beginning f the calendar year. If a cmmittee filed reprts fr the previus calendar year, and wishes t g n exempt status fr the upcming year, the cmmittee must file a January Cntinuing reprt cvering all activity thrugh December 31 st. Include an updated ETHCF-1 requesting exempt status fr the upcming year. Renewing Exemptin Statute 11.0104(2) states that exemptin is effective nly fr the calendar year it is granted. If a cmmittee wishes t renew its exempt status, it must file the (ETHCF-14) r a new ETHCF-1 after 12/31 and befre the clsing date fr the first reprting perid fr which it wuld be required t file a reprt. Candidates n the ballt that calendar year may claim exemptin when they first register, r renew their exemptin frm the previus calendar year, but a candidate n the ballt that calendar year may nt claim exemptin befre the date f her/his electin if he/she has nt been n exempt status previusly. See statute 11.0104(1) (b). Amending a Registratin Statement When any f the infrmatin reprted n the registratin statement changes, the statement must be amended by filing a new ETHCF-1. The candidate r treasurer must file the new ETHCF-1 within 10 days f the change, checking the yes bx at the tp f the frm t indicate that it is an amendment.

Candidate's name (required); n titles may be used. Candidate s mailing address, including municipality fr mailing purpses (required if different than residential address r vting municipality) Title f ffice (required) NOMINATION PAPER FOR NONPARTISAN OFFICE Candidate s residential address (required) N P.O. bx addresses Street, fire, r rural rute number; bx number (if rural rute); and name f street r rad State (required) WI Zip cde Branch, district r seat number (required if applicable) Branch District Seat Type f electin (required) spring special Candidate s municipality fr vting purpses (required) Twn (name f municipality) Electin date (required) D nt use primary date. M/Day/Year Name f jurisdictin r district in which candidate seeks ffice (required) I, the undersigned, request that the candidate, whse name and residential address are listed abve, be placed n the ballt at the electin described abve as a candidate s that vters will have the pprtunity t vte fr him r her fr the ffice listed abve. I am eligible t vte in the jurisdictin r district in which the candidate named abve seeks ffice. I have nt signed the nminatin paper f any ther candidate fr the same ffice at this electin. The municipality used fr mailing purpses, when different than municipality f residence, is nt sufficient. The name f the municipality f residence must always be listed. Signatures f Electrs Printed Name f Electrs Residential Address (N P.O. Bx Addresses) Street and Number r Rural Rute (Rural address must als include bx r fire n.) 1. Twn 2. Twn 3. Twn 4. Twn 5. Twn 6. Twn 7. Twn 8. Twn 9. Twn 10. Twn Municipality f Residence Check the type and write the name f yur municipality fr vting purpses. Date f Signing M/Day/Year CERTIFICATION OF CIRCULATOR I, certify: I reside at. (Name f circulatr) (Circulatr's residential address - Include number, street, and municipality.) I further certify I am either a qualified electr f Wiscnsin, r a U.S. citizen, age 18 r lder wh, if I were a resident f this state, wuld nt be disqualified frm vting under Wis. Stat. 6.03. I persnally circulated this nminatin paper and persnally btained each f the signatures n this paper. I knw that the signers are electrs f the jurisdictin r district the candidate seeks t represent. I knw that each persn signed the paper with full knwledge f its cntent n the date indicated ppsite his r her name. I knw their respective residences given. I intend t supprt this candidate. I am aware that falsifying this certificatin is punishable under Wis. Stat. 12.13(3)(a). (Date) (Signature f circulatr) EL-169 Rev. 2016-07 Wiscnsin Electins Cmmissin, P.O. Bx 7984, Madisn, WI 53707-7984 608-261-2028 web: electins.wi.gv email: electins@wi.gv Page N.

INSTRUCTIONS FOR PREPARING NOMINATION PAPERS FOR NONPARTISAN OFFICE This is a sample nminatin paper frm. It cnfrms t the statutry requirements fr nminatin papers fr nnpartisan ffice. All infrmatin cncerning the candidate must be cmpleted in full befre circulating this frm t btain signatures f electrs. All infrmatin cncerning the signing electrs and the circulatr must be cmpleted in full befre filing with the apprpriate filing fficer. This frm may be reprduced in any way. A candidate's picture and bigraphical data may als be added t this frm. The Wiscnsin Electins Cmmissin has determined that n disclaimer r ther attributin statement is required n nminatin papers. Candidates are advised t send a sample f their cmpleted frm the filing fficer fr review befre circulatin. Page Numbers Number each page cnsecutively, beginning with 1, befre submitting t the filing fficer. A space fr page numbers has been prvided in the lwer right-hand crner f the frm. Candidate's Name - Insert the candidate's name. A candidate may use his r her full legal name, r any cmbinatin f first name, middle name, and initials r nickname with last name. The Wiscnsin Electins Cmmissin has determined that, absent any evidence f an attempt t manipulate the electral prcess, candidates are permitted t chse any frm f their name, including nicknames, by which they want t appear n the ballt. N titles are permitted. In additin, names such as Red r Skip are permitted, but names which have an apparent electral purpse r benefit, such as Lwer taxes, Nne f the abve r Lwer Spending are nt permitted. It is als nt permissible t add nicknames in qutes r parentheses between first and last names. Fr example, Jhn Jack Jnes r Jhn (Jack) Jnes are nt acceptable, but Jhn Jnes, Jack Jnes r Jhn Jack Jnes are acceptable. Candidate's Address Insert the candidate s residential address (n P.O. Bx addresses) and the municipality fr vting purpses. Indicate if the municipality f residence is a twn, village, r city. If a candidate's mailing address is different frm the residential address r vting municipality, a cmplete mailing address must als be given. Date f Electin - Insert the date f the electin. If the nminatin paper is being circulated fr a spring electin, the date is the first Tuesday in April. If the electin is a special nnpartisan electin, the date f the special electin must be listed. Title f Office - The name f the ffice must be listed alng with any branch, district, r seat number (if applicable) that clearly identifies the ffice the candidate is seeking. If necessary, the name f the jurisdictin that identifies the ffice, such as Dane Cunty Circuit Curt Judge, Branch 3, must als be listed. Name f Jurisdictin - The nminatin papers must als indicate the municipality r jurisdictin in which the signing electrs are qualified t vte, as it relates t the ffice sught by the candidate named n the nminatin paper. Fr example, fr a statewide ffice the jurisdictin is the State f Wiscnsin. Others may be the cunty, twn, village, city, aldermanic district, schl district, r twn sanitary district, as required. Signatures and Printed Name f Electrs - Only qualified electrs f the jurisdictin r the district the candidate seeks t represent may sign the nminatin papers. Each signer must als legibly print their name. Each electr must prvide their residential address (n P.O. Bx addresses), including any street, fire r rural rute number, bx number (if rural rute) and street r rad name, and municipality f residence. A pst ffice bx number alne des nt shw where the electr actually resides. The name f the Municipality f Residence must be listed fr each signing electr and must clearly identify the twn, village r city where the electr's vting residence is lcated. The date the electr signed the nminatin paper, including mnth, day and year, must be indicated. Ditt marks that fllw crrect and cmplete address r date infrmatin are acceptable. The circulatr may add any missing r illegible address r date infrmatin befre the papers are filed with the filing fficer. Signature f Circulatr - The circulatr shuld carefully read the language f the Certificatin f Circulatr. THE CIRCULATOR MUST PERSONALLY PRESENT THE NOMINATION PAPER TO EACH SIGNER. THE NOMINATION PAPER MAY NOT BE LEFT UNATTENDED ON COUNTERS OR POSTED ON BULLETIN BOARDS. The circulatr's cmplete residential address including municipality f residence must be listed in the certificatin. After btaining signatures f electrs, the circulatr must sign and date the certificatin. Other Instructins - Candidates and circulatrs shuld review Ch. GAB 2.05, 2.07, Wis. Adm. Cde. Original nminatin papers must be in the physical custdy f the apprpriate filing fficer by the filing deadline. A pstmark n the filing deadline is NOT sufficient. Nminatin papers CANNOT be faxed t the filing fficer. Ch. GAB 6.04(2), Wis. Adm. Cde. Nminatin papers with the required number f signatures must be filed with the apprpriate filing fficer n later than 5:00 p.m. n the first Tuesday in January (r the next day if the first Tuesday is a hliday) befre the spring electin. Special electins may have different filing deadlines. Check with the filing fficer. In rder fr a candidate's name t be placed n the ballt, a candidate must file a Campaign Registratin Statement (ETHCF-1), a Declaratin f Candidacy (EL-162), and Nminatin Papers (EL- 169) cntaining the apprpriate number f signatures fr the ffice sught n later than the filing deadline. Wis. Stat. 8.10(3). Candidates fr state ffice and municipal judge must als file a statement f ecnmic interests with the Wiscnsin Ethics Cmmissin by the third business day after the nminatin paper filing deadline. Wis. Stat. 19.43. If any ne f these required frms is nt filed by the deadline, the candidate's name will nt be placed n the ballt. Wis. Stat. 8.30. If a candidate r circulatr has any questins, he r she shuld cntact the filing fficer.

Declaratin f Candidacy (See instructins fr preparatin n back) FOR OFFICE USE ONLY Is this an amendment? Yes (if yu have already filed a DOC fr this electin) N (if this is the first DOC yu have filed fr this electin) I,, being duly swrn, state that Candidate's name I am a candidate fr the ffice f Official name f ffice - Include district, branch r seat number representing If partisan electin, name f plitical party r statement f principle - five wrds r less (Candidates fr nnpartisan ffice may leave blank.) and I meet r will meet at the time I assume ffice the applicable age, citizenship, residency and vting qualificatin requirements, if any, prescribed by the cnstitutins and laws f the United States and the State f Wiscnsin, and that I will therwise qualify fr ffice, if nminated and elected. I have nt been cnvicted f a felny in any curt within the United States fr which I have nt been pardned. 1 My present address, including my municipality f residence fr vting purpses is: Twn f Village f City f Huse r fire n. Street Name Mailing Municipality and State Zip cde Municipality f Residence fr Vting My name as I wish it t appear n the fficial ballt is as fllws: (Any cmbinatin f first name, middle name r initials with surname. A nickname may replace a legal name.) STATE OF WISCONSIN Cunty f (Cunty f ntarizatin) } ss. (Signature f candidate) Subscribed and swrn t befre me this day f,. (Signature f persn authrized t administer aths) NOTARY SEAL NOT REQUIRED My cmmissin expires r is permanent. Ntary Public r (Official title, if nt a ntary) The infrmatin n this frm is required by Wis. Stat. 8.21, Art. XIII, Sec. 3, Wis. Cnst., and must be filed with the filing fficer in rder t have a candidate's name placed n the ballt. Wis. Stats. 8.05 (1)(j), 8.10 (5), 8.15 (4)(b), 8.17 (2), 8.20 (6), 120.06 (6)(b). EL-162 Rev. 2016-07 Wiscnsin Electins Cmmissin, P.O. Bx 7984, Madisn, WI 53707-7984 608-266-8005 web: electins.wi.gv email: electins@wi.gv 1 A 1996 cnstitutinal amendment bars any candidate cnvicted f a misdemeanr which vilates the public trust frm running fr r hlding a public ffice. Hwever, the legislature has nt defined which misdemeanrs vilate the public trust. A candidate cnvicted f any misdemeanr is nt barred frm running fr r hlding a public ffice until the legislature defines which misdemeanrs apply.

Instructins fr Cmpleting the Declaratin f Candidacy All candidates seeking ballt status fr electin t any ffice in the State f Wiscnsin must prperly cmplete and file a Declaratin f Candidacy. This frm must be ON FILE with the prper filing fficer n later than the deadline fr filing nminatin papers r the candidate's name will nt appear n the ballt. A facsimile will be accepted if the FAX cpy is received by the filing fficer n later than the filing deadline and the signed riginal declaratin is received by the filing fficer with a pstmark n later than the filing deadline. Infrmatin t be prvided by the candidate: Type r print yur name n the first line. The title f the ffice and any district, branch, r seat number fr which yu are seeking electin must be inserted n the secnd line. Fr legislative ffices insert the title and district number, fr district attrneys insert the title and the cunty, fr circuit curt ffices insert the title, cunty and branch number, and fr municipal and schl bard ffices insert the title and any district r seat number. Type r print the plitical party affiliatin r principle supprted by yu in five wrds r less n the third line. Nnpartisan candidates may leave this line blank. Felny cnvictins: Yur name cannt appear n the ballt if yu have been cnvicted f a felny in any curt in the United States fr which yu have nt been pardned. Please see ftnte n page 1 fr further infrmatin with respect t cnvictins fr misdemeanrs invlving a vilatin f public trust. These restrictins nly apply t candidates fr state and lcal ffice. Yur current address, including yur municipality f residence fr vting purpses, must be inserted n the furth line. This must include yur entire mailing address (street and number, municipality where yu receive mail) and the name f the municipality in which yu reside and vte (twn, village, r city f ). If yur address changes befre the electin, an amended Declaratin f Candidacy must be filed with the filing fficer. Wis. Stat. 8.21. Federal candidates are nt required t prvide this infrmatin, hwever an address fr cntact purpses is helpful. Type r print yur name n the fifth line as yu want it t be printed n the fficial ballt. Yu may use yur full legal name, r any cmbinatin f first name, middle name, and initials, r nickname with last name. Nte: The Wiscnsin Electins Cmmissin has determined that, absent any evidence f an attempt t manipulate the electral prcess, candidates are permitted t chse any frm f their name, including nicknames, by which they want t appear n the ballt. N titles are permitted. In additin, names such as Red r Skip are permitted, but names which have an apparent electral purpse r benefit, such as Lwer taxes, Nne f the abve r Lwer Spending are nt permitted. It is als nt permissible t add nicknames in qutes r parentheses. Fr example, Jhn Jack Jnes r Jhn (Jack) Jnes are nt acceptable, but Jhn Jnes, Jack Jnes r Jhn Jack Jnes are acceptable. This frm must be swrn t and signed in the presence f a ntary public r ther persn authrized t administer aths, such as a cunty r municipal clerk. Wis. Stat. 8.21(2). Infrmatin t be prvided by the persn administering the ath: The cunty f ntarizatin. The date the Declaratin f Candidacy was signed and the ath administered. The signature and title f the persn administering the ath. If signed by a ntary public, the date the ntary s cmmissin expires must be listed. The ntary seal is nt required. All candidates fr ffices using the nminatin paper prcess and all schl district candidates must file this frm with the apprpriate filing fficer n later than the deadline fr filing nminatin papers. Wis. Stats. 8.10 (5), 8.15 (4)(b), 8.17 (2), 8.20 (6), 8.50 (3)(a), 120.06 (6)(b). Candidates nminated fr lcal ffice at a caucus must file this frm with their municipal clerk within 5 days f receiving ntice f nminatin. Wis. Stat. 8.05 (l)(j).

Pst Office Bx 2973 17 West Main Street, Suite 310 Madisn, WI 53701-2973 Vice (608) 266-8005 Fax (608) 267-0500 E-mail: seb@seb.state.wi.us http://electins.state.wi.us State f Wiscnsin \ Electins Bard KEVIN J. KENNEDY Executive Directr MEMORANDUM TO: FROM: Cunty and Municipal Clerks Kevin J. Kennedy, Executive Directr State Electins Bard DATE: July 1, 1997 SUBJECT: Effect f Cnstitutinal Amendment Barring Cnvicted Felns frm Running fr r Hlding Elective Office in Wiscnsin In Nvember 1996, the electrs f the State f Wiscnsin ratified a cnstitutinal amendment which bars any persn, wh has been cnvicted f a felny fr which they have nt been pardned, r wh has been cnvicted f a misdemeanr invlving a vilatin f public trust fr which they have nt been pardned, frm hlding a state r lcal ffice. As a result f the adptin f this cnstitutinal amendment, which tk effect n Nvember 5, 1996, lcal electin fficials will have t address a number f questins relating t cnvicted felns wh seek t run fr ffice r wh are elected t ffice. The cnstitutinal amendment deals with tw different types f crimes. The first invlves felny cnvictins. Any persn cnvicted f a felny in any federal r state curt in the United States is barred frm running fr state r lcal ffice in Wiscnsin, unless that persn has been pardned. The secnd invlves misdemeanr cnvictins invlving a vilatin f public trust. The term, misdemeanr invlving a vilatin f public trust, has nt been defined by state law. Filing fficers d nt have t wrry abut individuals cnvicted f that categry f crime until the term has been defined. At the present time, there is n such thing as a misdemeanr invlving a vilatin f public trust. The State Electins Bard staff has revised the Declaratin f Candidacy frm (EB-162) t reflect this cnstitutinal change. Any persn seeking t be a candidate fr state r lcal ffice must file a Declaratin f Candidacy. That declaratin cntains a swrn statement that the persn has nt been cnvicted f any felny fr which they have nt been pardned, r any misdemeanr invlving a vilatin f public trust fr which they have nt been pardned. Any persn wh falsely signs this statement culd be cnvicted f a vilatin f S. 12.13(3)(a), (am), Wis. Stats. If a persn seeking t becme a candidate advises yu that they have been cnvicted f a felny, yur best apprach is t advise them that they cannt be a candidate and discurage them frm filing ballt access dcuments, including nminatin papers, a Declaratin f Candidacy and Campaign Registratin Statement.

COUNTY AND MUNICIPAL CLERKS July 1, 1997 Page 2 If it is brught t yur attentin that a persn wh is a cnvicted feln has filed ballt access dcuments, the matter needs t be reslved in cnsultatin with yur municipal r cunty attrney. It is the psitin f the State Electins Bard that yu shuld nly act n infrmatin that has been presented t yu, in the frm f a swrn cmplaint, alleging that a persn has been cnvicted f a felny and evidence is prvided in supprt f that allegatin. Yur municipal attrney can assist yu in verifying the basis f the cmplaint. Once it has been determined that a candidate r an elected fficial has been cnvicted f a felny, the municipal attrney can assist yu in remving the persn s name frm the ballt r take apprpriate steps t have the persn remved frm ffice. A frmal ntice shuld be sent t the candidate r elected fficial infrming that persn f the filing fficer s decisin t remve his r her name frm the ballt. This change t Wiscnsin law regarding candidate qualificatins and the qualificatins f elected public fficials des nt require the municipal clerk t verify that every elected fficial r candidate fr elected public ffice has nt been cnvicted f a felny fr which they have nt been pardned. The clerk shuld rely n the swrn statement f the candidate n the Declaratin f Candidacy. N actin shuld be taken unless there is evidence, in the frm f a swrn cmplaint, setting frth allegatins which establish that a candidate r elected fficial has been cnvicted a felny fr which they have nt been pardned. G:\Lwe\EB Frms\EB-162 Mem