INSTRUCTIONS FOR QUALIFYING State offices qualify with the Alabama Democratic Party in Montgomery. County offices qualify with the Democratic County Chair. 1) Fill out the Statement of Economic Interests. Keep a copy for your files. Submit a copy the county chair or the Alabama Democratic Party simultaneously with your qualifying papers. Within five days of the date your Declaration of Candidacy form is notarized, file a copy directly with the Alabama Ethics Commission. Alabama Ethics Commission http://ethics.alabama.gov RSA Union PO Box 302300 100 North Union Street Ste 104 OR Montgomery, AL 36103 Montgomery, AL 36104 (Certified Mail) Judicial candidates must also file a copy of the Statement of Economic Interests with the Clerk of the Supreme Court, 300 Dexter Avenue, Montgomery, AL 36104, within 10 days of qualifying as a candidate. 2) Fill out the Appointment of Principle Campaign Committee and file with the Office of the Secretary of State for state offices, State Capil, Room E-204, or mail certified P.O. Box 5616, Montgomery, AL 36103, or with the Probate Judge for county offices, within 5 calendar days of the date your Declaration of Candidacy is notarized. U.S. Senate and U.S. House of Representatives candidates must file financial disclosure forms and reports with the Federal Elections Commission (FEC). 3) Make out a personal/campaign/certified check or money order payable the Alabama Democratic Party in the amount specific the office in which you will qualify according the Qualifying Fee Schedule. Candidates running for county office should contact your county chair for qualifying fees. 4) Fill out the Alabama Democratic Party Declaration of Candidacy completely and have notarized. 5) File with the Alabama Democratic Party at 501 Adams Ave., Montgomery, AL 36104, or mail certified P.O. Box 950, Montgomery, AL 36101 for state offices or the County Chair for county offices: 1. Statement of Economic Interests 2. Appointment of Principle Campaign Committee 3. Qualifying Fee 4. Declaration of Candidacy Please note: qualifying forms received after the qualifying deadline, regardless of postmark, will not be accepted. 6) It is recommended that you call the IRS at 800-829-4933 obtain a Federal Tax ID number (EIN) for your campaign s bank account. You are advised seek professional advice if you need additional information. 7) Keep other Pre-Election Report forms on file and file with the Office of the Secretary of State or Probate Judge on time according the FCPA Filing Calendar. In addition, familiarize yourself with the Candidate Filing Guidelines and Campaign Advertising Disclaimer Guidelines. Alabama Democrats Phone: (334) 262-2221 Toll Free: (800) 995-3386 Fax: (334) 262-6474 www.aladems.org
FAIR CAMPAIGN PRACTICES ACT STATE OF ALABAMA THIS AREA FOR OFFICIAL USE ONLY Appointment of Principal Campaign Committee Please print in ink or type. Full Name of Candidate Offi ce Sought (include district or circuit number, if applicable) Political Party / Ballot Affi liation Address of the Committee (street or post offi ce box) City State ZIP Code Telephone Number This form is due within five (5) calendar days of reaching the threshold amount, or within five (5) calendar days of qualifying with a political party, or within five (5) calendar days of fi ling a petition as an independent or third party candidate. Type of Committee (check one) I appoint myself as the sole member of my principal campaign committee. I hereby appoint the individuals listed below act as my principal campaign committee. If you are appointing others serve as your committee, you must select at least two members. You may appoint up fi ve members. One member should be designated as the chairperson of the committee. A second member should be designated as the treasurer. Please clearly print their names and addresses in the spaces below. Each appointee must sign his or her name. Full Name Chairperson Full Name Committee Treasurer Member Address (street or post offi ce box) Address (street or post offi ce box) City State ZIP Code City State ZIP Code Signature of Appointee Signature of Appointee Full Name Committee Member Full Name Committee Member Address (street or post offi ce box) Address (street or post offi ce box) City State ZIP Code City State ZIP Code Signature of Appointee Signature of Appointee Full Name Committee Member Filing Threshold Amounts for Public Offices under the Fair Campaign Practices Act Address (street or post offi ce box) City State ZIP Code $25,000 Statewide offi ce $10,000 State Senate seat $5,000 State House seat $5,000 Circuit or district offi ce County or municipal offi ce Signature of Appointee Where file this form... State candidates fi le with the Offi ce of the Secretary of State, located in the Alabama State Capil, Room E-210. The mailing address is P.O. Box 5616, Montgomery, Alabama 36103-5616. As required by the Alabama Fair Campaign Practices Act, I hereby swear or affi rm the best of my knowledge and belief that the information contained herein is true and correct. County and municipal candidates fi le with their county's judge of probate. Signature of elected offi cial or candidate Date FORM REVISED 9.2.2011
This Form May Be Completed On-line at www.ethics.alabama.gov CANDIDATE YES NO (Year) FOR OFFICE IN CITY COUNTY STATE If you are a candidate, complete this section and see last page of instructions. If you are not a candidate, check no and continue. STATEMENT OF ECONOMIC INTERESTS FOR 2010 CALENDAR YEAR - TO BE FILED NO LATER THAN MAY 2, 2011, EXCEPT FOR CANDIDATES, who must file simultaneously with their qualifying forms as required by Section 36-25-15, Code of Alabama 1975. Alabama Ethics Commission Street Address 100 North Union Street, Suite 104 Mailing Address (RSA Union Building) P. O. Box 302300 Telephone Montgomery, Alabama 36104 Montgomery, AL 36130-2300 334-242-2997 PLEASE READ INSTRUCTIONS BEFORE ATTEMPTING TO COMPLETE FORM. 01. Full Name, Home Address, and Telephone Number(s) of Filing Person: (Last) (First) (Middle) (Suffix) (Nickname) (Street) (Route) (P.O. Box) (City) (Zip) (County) (Home & Business Phones) IF name changed within past year, please indicate former name: NAME: (Last) (First) (Middle) PLEASE FILL IN THE BLANKS OR CIRCLE THE CORRECT WORD(S) OR NUMBER(S) AS APPROPRIATE 02. Last year, I was an (elected official) (appointed official) (employee) with the (Municipality) (County) (State) and the name and address of my(department)(office)(agency)(board)(college)(county)(municipality)(commission)was 02.1 As an elected/appointed official/employee last year, my job title/position was 02.2 Last year, the name(s) of the (State) (County) (Municipal) Board(s), Commission(s), Committee(s), Authority(ies), Council(s), etc. of which I was a Member was(were) 02.3 Last year in the above public position(s) in 02. thru 02.2 I earned: ($0-) (-$10,000) (More $10,000). 03. I am a candidate for the (State) (County) or (Municipal) Office of 1
04. Other my public position(s) in 02. thru 02.2, my and/or my spouse s occupation(s) or business(es) last year which 1/3 or more of working time was spent (including self-employment) was (were) 04.1 The name and address of my employer, listed in 04. above, last year was 04.2 I was self-employed last year and the name and address of my business last year was 04.3 Information on Family Members: SPOUSE S Name, address, and business or employer DEPENDENT CHILDREN Name, address, and any employment Names Only of LIVING ADULT CHILDREN Names Only of LIVING PARENTS Names Only of LIVING SISTERS/BROTHERS Names Only of LIVING PARENTS OF SPOUSE 05. Last year, from the occupations or businesses listed in 04., I, my spouse and dependents earned an aggregate of: ($0-) (-$10,000) (More $10,000). 05.1. Last year, (I) (My spouse) (dependents) owned 5% or more of the sck in the firm(s) listed in 04.1, 04.2 05.2 Last year, (I) (My spouse) was a consultant and earned more from each firm listed in 04.1, 04.2 05.3 Last year, (I) (My spouse) served as an (Officer) (Direcr) (Trustee) of the firm(s) listed in 04.1, 04.2 2
06. OTHER INCOME INFORMATION ON YOU, YOUR SPOUSE AND DEPENDENT CHILDREN List tal combined household income, in addition what is listed in 02.3 thru 05., the names of each business income is derived from, and the income from each business. Write in type of Income Received: Salaries, Fees, Dividends, Profits, Commissions, Other Compensation (including interest on bank accounts) Less $10,000 Check Appropriate Box $10,000 More 06.1 06.2 06.3 06.4 Last year did you earn more $5,000 as an: Officer Direcr Trustee Consultant N/A (Circle the applicable one and explain, if necessary.) 06.5 Last year did you earn more but less $5,000 as an: Officer Direcr Trustee Consultant N/A (Circle the applicable one and explain, if necessary.) 06.6 Last year, did YOU, YOUR SPOUSE or DEPENDENTS serve as: Officer Direcr Trustee Consultant N/A (Circle the applicable one and explain, if necessary.) 06.7 Name any business or subsidiary thereof in which you, your spouse, or dependents, jointly or severally, owned 5% or more of the sck or in which you, your spouse or dependents served as an officer, direcr, trustee, or consultant where the service provides income of at least and less $5,000; or at least $5,000 or more for the reporting period. 3
07. REAL ESTATE HOLDINGS (Exclude your Homestead) (TO BE COMPLETED ONLY BY ELECTED OFFICIALS, APPOINTED OFFICIALS or CANDIDATES for State, County or Municipal Offices.) 07.1 Did YOU, YOUR SPOUSE OR DEPENDENTS own real estate for investment or revenue production last year? No Yes If yes, list each piece of real estate WHEREVER SITUATED separately below and provide the requested information. 07.2 Did YOU, YOUR SPOUSE, DEPENDENTS or A BUSINESS WITH WHICH YOU ARE ASSOCIATED receive any rent or lease income from any governmental agency in Alabama last year? No Yes If yes, specific details of the lease or rent agreement shall be filed with the Ethics Commission. (CHECK APPROPRIATE BOXES and ADD ADDITIONAL SHEETS AS NECESSARY.) What is the fair market value? What is the annual gross rent or lease income? Location of Real Estate (City, County and State) Less More Less $10,000 $10,000 but less or more 4
08. INDEBTEDNESS INFORMATION: Report debts owed all businesses operating in Alabama*as of December 31 last year, EXCEPT indebtedness associated with the (homestead) home in which you live. Include debts of YOUR SPOUSE and DEPENDENT CHILDREN. (*Doing business in Alabama, regardless of where their home office is located or where you mail your payment.) Provide actual NUMBER and CHECK APPROPRIATE CATEGORY it is not necessary include name of card(s), business(es), account number(s), or actual amount owed. Check appropriate boxes below. TYPE 08.1 Banks (include Credit Cards) 08.2 Credit Unions and Savings and Loan Associations (include Credit Cards) 08.3 Insurance Companies How many do you OWE? NUMBER Less $25,000 How much do you OWE? (Check box that relates the combined tal in each category) $25,000 More 08.4 Mortgage Firms 08.5 Sckbrokers or Bond Firms 08.6 Individuals or other businesses (include sre cards) 5
09. PROFESSIONAL OR CONSULTING SERVICES (To be completed if YOU or YOUR SPOUSE received income last year in return for professional or consulting activities, i.e. legal, accounting, medical or health-related, real estate, banking, insurance, educational, farming, engineering, architectural management, or other professional services or consultations, etc. State the number of clients and check appropriate boxes.) Check if no income was received for Professional or Consulting Services for the categories of Clients shown below. Categories of Clients Number of Clients Less $10,000 Annual Gross Income During Reporting Year $10,000 $25,000 $25,000 More Anticipated Annual Retainer Income Less $5,000 More $5,000 09.1 UTILITIES Electric Gas Telephone Water Cable Television Companies 09.2 TRANSPORTATION Intrastate Companies Pipeline Companies 6
Categories of Clients Number of Clients Less $10,000 Annual Gross Income During Reporting Year $10,000 $25,000 $25,000 More Anticipated Annual Retainer Income Less $5,000 More $5,000 Oil Exploration Gas Exploration Oil and Gas Retailers 09.3 FINANCE & INSURANCE Banks Savings & Loan Associations Loan and/or Finance Companies Manufacturing Firms Mining Companies Life Insurance Companies Casualty Insurance Companies Other Insurance Companies 7
Categories of Clients Number of Clients Less $10,000 Annual Gross Income During Reporting Year $10,000 $25,000 $25,000 More Anticipated Annual Retainer Income Less $5,000 More $5,000 Retail Companies Beer Companies Wine Companies Liquor Companies Beverage Distriburs 09.4 ASSOCIATIONS Trade Professional Governmental Public Employee Public Official 09.5 GOVERNMENT State County Municipal Other Government Corp. Or Authorities 09.6 MISCELLANEOUS 8
10. DECLARATION OF REPORTING PERSON I have read and completed this Statement of Economic Interests, Form ASEC-1(Revised), and do swear (or affirm) that the information contained in said Statement of Economic Interests is true and correct. I fully understand that anyone who violates the disclosure provision of this Act shall be subject a fine of $10.00 a day not exceed annually. I also understand that any attachments that I place with this form become a part of this public record. SIGNED (Signature of Reporting Person) Date PLEASE PRINT/TYPE NAME OF PERSON SIGNING FORM ***(Please do not mail the instructions with your form as they may increase your postage and should be destroyed or retained with your copy of your form.)*** RETURN COMPLETED ORIGINAL SIGNED FORM TO: Alabama Ethics Commission STREET ADDRESS MAILING ADDRESS RSA Union, Suite 104 P.O. Box 302300 100 North Union Street Montgomery, AL 36130-2300 Montgomery, AL 36104 9
Presidential Preference Primary Election: Tuesday, March 13, 2012 Statewide Primary Election: Tuesday, March 13, 2012 Primary Runoff Election: Tuesday, April 24, 2012 General Election: Tuesday, November 6, 2012 Purple lines indicate deadlines involving monthly reports. Monthly reports are due on the last day of each month beginning 12 months prior the election date. Blue lines indicate deadlines involving weekly reports. Weekly reports are due on the Friday of each week beginning on the month prior the election date. Red lines indicate deadlines involving daily reports. Beginning on the 8th day prior the election, daily reports are due for principal campaign committees and PACs that receive or spend $5,000 or more on any day with a view ward influencing the election. Once a principal campaign committee or PAC meets this daily amount, it must file daily reports up until the election date. elections involving county and city offices. This does not apply Date March 13, 2011 September 28, 2011 September 28, 2011 September 30, 2011 Ocber 29, 2011 Ocber 29, 2011 Ocber 31, 2011 November 6, 2011 November 28, 2011 November 28, 2011 November 30, 2011 December 26, 2011 December 31, 2011 December 31, 2011 January 2, 2012 January 3, 2012 January 13, 2012 January 27, 2012 Activity Candidates intending participate in the 2012 primary election may begin soliciting and accepting contributions Deadline close books for the monthly report for the primary election Certified mail deadline for the monthly report for the primary election Deadline file the monthly report for the primary election Deadline close books for the monthly report for the primary election Certified mail deadline for the monthly report for the primary election Deadline file the monthly report for the primary election Candidates intending participate in the 2012 general election, but not in the primary election, may begin soliciting and accepting contributions Deadline close books for the monthly report for the primary election Certified mail deadline for the monthly report for the primary election Deadline file the monthly report for the primary election State Holiday (Christmas) Deadline close books for the monthly pre-election report for the primary election Certified mail deadline for the monthly pre-election report for the primary election State Holiday (New Year's) Deadline file the monthly report for the primary election Last day candidates may qualify with political parties participate in primary election Certified mail deadline for the annual report
January 27, 2012 January 28, 2012 January 31, 2012 January 31, 2012 February 1, 2012 February 1, 2012 February 3, 2012 February 7, 2012 February 8, 2012 February 8, 2012 February 10, 2012 February 15, 2012 February 15, 2012 February 17, 2012 February 22, 2012 February 22, 2012 February 24, 2012 February 27, 2012 February 27, 2012 February 28, 2012 February 29, 2012 February 29, 2012 February 29, 2012 March 2, 2012 March 2, 2012 March 5, 2012 March 6, 2012 Certified mail deadline for the monthly report for the primary election Deadline close books for the monthly report for the primary election (falls on a Sunday) Deadline for candidates and political committees file annual report Deadline file the monthly report for the primary election Deadline close books for the weekly report for the primary election Certified mail deadline for the weekly report for the primary election Deadline file the weekly report for the primary election Regular legislative session begins. Deadline close books for the weekly report for the primary election Certified mail deadline for the weekly report for the primary election Deadline file the weekly report for the primary election Deadline close books for the weekly report for the primary election Certified mail deadline for the weekly report for the primary election Deadline file the weekly report for the primary election Deadline close books for the weekly report for the primary election Certified mail deadline for the weekly report for the primary election Deadline file the weekly report for the primary election Deadline close books for the monthly report for the primary election Certified mail deadline for the monthly report for the primary election Mardi Gras - Observed in Baldwin and Mobile County Deadline file the monthly report for the primary election Deadline close books for the weekly report for the primary election Certified mail deadline for the weekly report for the primary election Deadline file the weekly report for the primary election Last day register vote for the primary election Daily report due. Please refer the instructions on the p of the calendar page. ( Does not apply Daily report due. Please refer the instructions on the p of the calendar page. ( Does not apply
March 7, 2012 March 7, 2012 March 7, 2012 March 8, 2012 March 9, 2012 March 9, 2012 March 12, 2012 March 12, 2012 March 13, 2012 March 14, 2011 March 14, 2012 March 16, 2012 March 21, 2012 March 21, 2012 March 23, 2012 March 28, 2012 March 28, 2012 March 30, 2012 March 31, 2012 March 31, 2012 April 2, 2012 April 4, 2012 April 4, 2012 April 6, 2012 April 11, 2012 April 11, 2012 April 13, 2012 Daily report due. Please refer the instructions on the p of the calendar page. ( Does not apply Deadline close books for the weekly report for the primary election Certified mail deadline for the weekly report for the primary election Daily report due. Please refer the instructions on the p of the calendar page. ( Does not apply Daily report due. Please refer the instructions on the p of the calendar page. ( Does not apply Deadline file the weekly pre-election report for the primary election Daily report due. Please refer the instructions on the p of the calendar page. ( Does not apply Pre-election report due for principal campaign committees and PACs receiving or spending an aggregate of $5,000 or more on any day with a view wards influencing the election's result no later 12:01 am Primary Elections Deadline close books for the weekly report for the primary election Certified mail deadline for the weeklyreport for the primary runoff election Deadline file the weekly report for the primary runoff election Deadline close books for the weekly report for the primary election Certified mail deadline for the weekly report for the primary runoff election Deadline file the weekly report for the primary runoff election Deadline close books for the weekly report for the primary election Certified mail deadline for the weekly report for the primary runoff election Deadline file the weekly report for the primary runoff election Deadline close books for the monthly report for the primary election Certified mail deadline for the monthly report for the primary runoff election Deadline file the monthly report for the primary runoff election Deadline close books for the weekly report for the primary election Certified mail deadline for the weekly report for the primary runoff election Deadline file the weekly report for the primary runoff election Deadline close books for the weekly report for the primary election Certified mail deadline for the weekly report for the primary runoff election Deadline file the weekly report for the primary runoff election
April 13, 2012 April 16, 2012 April 17, 2012 April 18, 2012 April 18, 2012 April 18, 2012 April 19, 2012 April 20, 2012 April 20, 2012 April 23, 2012 April 23, 2012 April 24, 2012 April 28, 2012 April 28, 2012 April 30, 2012 May 28, 2012 May 29, 2012 May 29, 2012 May 31, 2012 June 4, 2012 June 30, 2012 June 30, 2012 July 2, 2012 July 4, 2012 July 11, 2012 July 28, 2012 July 28, 2012 Last day register vote for the primary runoff election Daily report due. Please refer the instructions on the p of the calendar page. ( Does not apply Daily report due. Please refer the instructions on the p of the calendar page. ( Does not apply Daily report due. Please refer the instructions on the p of the calendar page. ( Does not apply Deadline close books for the weekly report for the primary election Certified mail deadline for the weekly report for the primary runoff election Daily report due. Please refer the instructions on the p of the calendar page. ( Does not apply Pre-election report due for principal campaign committees and PACs receiving or spending an aggregate of $5,000 or more on any day with a view wards influencing the election's result on the 4th day Deadline file the weekly report for the primary runoff election Daily report due. Please refer the instructions on the p of the calendar page. ( Does not apply Pre-election report due for principal campaign committees and PACs receiving or spending an aggregate of $5,000 or more on any day with a view wards influencing the election's result no later 12:01 am Primary Runoff Election Deadline close books for the monthly report for the primary election Certified mail deadline for the monthly report for the general election Deadline file the monthly report for the general election State Holiday Deadline close books for the monthly report for the primary election Certified mail deadline for the monthly report for the general election Deadline file the monthly pre-election report for the general election State Holiday ( Jefferson Davis' Birthday) Deadline close books for the monthly report for the primary election Certified mail deadline for the monthly report for the general election Deadline file the monthly report for the general election State Holiday - Independence Day Last day candidates in primary election can accept contributions retire a campaign debt Deadline close books for the monthly report for the primary election Certified mail deadline for the monthly report for the general election
July 31, 2012 August 22, 2012 August 29, 2012 August 29, 2012 August 31, 2012 September 3, 2012 September 29, 2012 September 29, 2012 Ocber 1, 2012 Ocber 3, 2012 Ocber 3, 2012 Ocber 5, 2012 Ocber 8, 2012 Ocber 10, 2012 Ocber 10, 2012 Ocber 12, 2012 Ocber 17, 2012 Ocber 17, 2012 Ocber 19, 2012 Ocber 24, 2012 Ocber 24, 2012 Ocber 26, 2012 Ocber 26, 2012 Ocber 29, 2012 Ocber 29, 2012 Ocber 29, 2012 Ocber 30, 2012 Deadline file the monthly report for the general election Last day candidates in primary runoff election can accept contributions retire a campaign debt Deadline close books for the monthly report for the primary election Certified mail deadline for the monthly report for the general election Deadline file the monthly report for the general election State Holiday (Labor Day) Deadline close books for the monthly report for the primary election Certified mail deadline for the monthly report for the general election Deadline file the monthly report for the general election Deadline close books for the weekly report for the primary election Certified mail deadline for the weekly report for the general election Deadline file the weekly report for the general election State Holiday (Columbus Day) Deadline close books for the weekly report for the primary election Certified mail deadline for the weekly report for the general election Deadline file the weekly report for the general election Deadline close books for the weekly report for the primary election Certified mail deadline for the weekly report for the general election Deadline file the weekly report for the general election Deadline close books for the weekly report for the primary election Certified mail deadline for the weekly report for the general election Deadline file the weekly report for the general election Last day register vote for general election Daily report due. Please refer the instructions on the p of the calendar page. ( Does not apply Deadline close books for the monthly report for the primary election Certified mail deadline for the monthly report for the general election Daily report due. Please refer the instructions on the p of the calendar page. ( Does not apply
Ocber 31, 2012 Ocber 31, 2012 Ocber 31, 2012 Ocber 31, 2012 November 1, 2012 November 2, 2012 November 2, 2012 November 5, 2012 November 5, 2012 November 6, 2012 January 29, 2013 January 31, 2013 March 6, 2013 Deadline file the monthly report for the general election Daily report due. Please refer the instructions on the p of the calendar page. ( Does not apply Deadline close books for the weekly report for the primary election Certified mail deadline for the weekly report for the general election Daily report due. Please refer the instructions on the p of the calendar page. ( Does not apply Daily report due. Please refer the instructions on the p of the calendar page. ( Does not apply Deadline file the weekly report for the general election Daily report due. Please refer the instructions on the p of the calendar page. ( Does not apply Pre-election report due for principal campaign committees and PACs receiving or spending an aggregate of $5,000 or more on any day with a view wards influencing the election's result no later 12:01 am General Election Certified mail deadline for annual report 2011 annual report due (on or before January 31 of the succeeding year) next after general election Last day candidates in general election can accept contributions retire a campaign debt