Declaration of Candidacy

This form is needed to “declare” yourself as a candidate for a particular office. The candidate’s name will appear on the ballot as it appears on the Declaration of Candidacy. The Declaration must be signed by the candidate. It may not be signed by anyone else. All candidates for public and party offices must file a Declaration of Candidacy.

(To retrieve this document for printing, complete the form, hit the “Submit” button below, and then the “Download” button that appears on the next screen.)

For the office of:*

Advisory Neighborhood Commissioner (ANC), Single-Member District (SMD)

Required for ANC/SMD offices

Candidate’s Name*

Email Address*

Daytime Phone*

Voter Registration Number

Date/Type of Election*

Party Affiliation (if applicable)*

List your residence address(es), including zip code(s), for the last three (3) years (the various office residency requirements can be found on www.dcboe.org and in the candidate packet):

Current Residence Address*

From (to present)*

Previous Residence Address

From

to

Second Previous Residence Address

From

to

INDICATE IN THE SPACE BELOW HOW YOUR NAME SHOULD BE LISTED ON THE BALLOT. Please complete this section carefully. If there are any periods or commas in your name, write them clearly. Do NOT include prefixes or titles, such as Miss, Mr., Dr., Rev., or degrees. Note that when listing your name, the Board will not permit a candidate to specify a modified form of their given name that confuses or misleads the voters and is otherwise not legally acceptable. For example, James Smith could be Jim Smith but not Jim "The Best" Smith*

Indicate here how your name is pronounced

After the form is completed, click SUBMIT. Then, in the next screen, you must print the PDF and:

DO NOT SIGN IT YET. You must either:

1) have this Declaration notarized by a public notary, or

2): appear at the Board’s office with the form completed, except for your signature, and sign the document in the presence of Board staff. The Declaration must be filed no later than the nominating petition filing deadline.

ANY PERSON WHO MAKES ANY FALSE REPRESENTATIONS AS TO HIS OR HER QUALIFICATIONS FOR HOLDING ELECTIVE OFFICE SHALL UPON CONVICTION BE FINED NOT MORE THAN $10,000, OR BE IMPRISONED NOT MORE THAN FIVE YEARS, OR BOTH.