United States Coast Guard Auxiliary

UNITED STATES COAST GUARD AUXILIARY FIRST DISTRICT SOUTHERN REGION CERTIFICATION OF ELECTION (Rev. 06-12)

Ref: (a) Auxiliary Manual, COMDTINST M 16790.1G (b) Flotilla/Division Standardized Standing Rules

Date of Election:______Election for Office of: Certifying Officer:______( )DCDR and VCDR of Division______Title of Certifying.Officer:______( )FC and VFC of Flotilla______

CANDIDATES APPROVED BY SCREENING COMMITTEE: If more than one – use reverse side of this form/ additional page

( )DCDR ( )FC ______( )VCDR ( )VFC ______

NOMINATIONS FROM THE FLOOR-If more than one-use reverse side of this form/ additional page

( ) Yes ( ) No - Nominations from the floor called for by member of electing body ( ) Yes ( ) No – Nominee present, qualified to run, accepts nomination and agrees to serve if elected

( ) DCDR ( ) FC ______( )VCDR ( ) VFC______

YES NO ( ) ( ) A quorum of the membership was present (check unit’s Standing Rules). ( ) ( ) All candidates holding any elected office for the first time passed the APC or Flotilla Leadership course, ICS 100 & 700, ( ) ( ) All candidates designated in AUXDATA as being CURRENT for year in which election is held in any one of the following categories: VE, IT, or OPS or served as staff or elected officer for 2 years, or have minimum of 25 hrs of participation in a mission area (7029 time does not count) in previous year ( ) ( ) Were all previsions of units standing rules met? ( ) ( ) Were candidates for DCDR or VCDR past members of the Division Board? (12 month minimum regular term at lower level required) ( ) ( ) Has candidate for FC or VFC been a member for at least 12 months? ( ) ( ) Candidate is NO LONGER in AP status must be in IQ status?

RESULTS OF ELECTION ( ) DCDR ( )FC ______( ) VCDR ( ) VFC______I, the undersigned, hereby certify, as a duly elected officer of the Auxiliary, or designated presiding officer, that I have conducted this election according to the Auxiliary Manual and unit standing rules and that the above named individuals have been duly elected and I not aware of any challenge to the election. ______Signature Name Date Addendum to Certificate of Election (reverse side)

ADDITIONAL NOMINATIONS FOR FLOTILLA OFFICES

Flotilla Commander:

______

Flotilla Vice Commander:

______

Division Commander:

______

Division Vice Commander:

______