Appointment to Serve As the Council Member to Represent the Chuckatuck Borough

Appointment to serve as the Council member to represent the Chuckatuck Borough

Pursuant to the City Charter of the City of Suffolk §3.04, the Suffolk City Council will appoint, by majority vote, a citizen of Suffolk who lives in the Chuckatuck Borough to serve in the vacancy of a Council Member to represent the Chuckatuck Borough. The appointed citizen will serve as the Council Member for Chuckatuck Borough until December 31, 2022. An election for the City Council seat of the Chuckatuck Borough will take place during the November 2022 General Election.

Eligibility for consideration and appointment requires the following:  Must be a resident and registered voter of the Chuckatuck Borough (Click here for map)  Must be at least the age of 18  Must not be a convicted felon or have been convicted of any crime that would preclude the right to hold office  Must complete and submit the notice of interest document  Must meet all other qualifications to hold office, pursuant to the Code of Virginia The City of Suffolk – City Clerk’s Office must be in receipt of all notices of interest no later than January 15, 2021, by close of business, which is 5:00 p.m., in all submission formats; electronic submission, United States Post, or electronic mail, at the following addresses: Office of the City Clerk, P.O. Box 1858, Suffolk, Virginia 23439 or [email protected]. NOTICE OF INTEREST COUNCIL MEMBER representing CHUCKATUCK BOROUGH

The resume and notice of interest must be received by the Suffolk City Clerk by 5:00 p.m. on January 15, 2021 via form submission, United States Post, or Electronic Mail at either of the following: Suffolk City Council, P.O. Box 1858, Suffolk, Virginia 23439 or [email protected].

First Name: Middle Initial: Last Name:

Date of Birth:

Telephone number:

Do you live in the Chuckatuck Borough? Yes No

Are you a registered voter in the Chuckatuck Borough? Yes No

Resident Address:

Length of time at current residence:

Years Lived in Suffolk, Virginia:

Current Occupation, Employer and Title:

Previous Employment:

1 NOTICE: This appointment is open exclusively to individuals who reside in the Chuckatuck Borough. Click here for a map of the Chuckatuck Borough.

Are you currently serving as appointee of the Suffolk City Council on any Boards, Commissions, Authorities, or Committees? List date of appointment and which currently held:

Have you ever previously served on any Boards, Commissions, Authorities, or Committees for the City of Suffolk? List the appointment term(s) length and title(s) while serving:

Have you served on any Boards, Commission, Authorities, or Committees outside of the City of Suffolk? List and provide dates served, office held while serving, and the locality served:

Have you participated with any civic or charitable organizations? List and provide dates of service(s) and any office(s) held while serving:

Are you or an immediate family member a party to a contract with the City for goods or services or do you have an interest in a company that does business with the City? If so, please name the party.

Have you been previously convicted of a felony?

Yes

2 Statement of Interest: Please provide a brief narrative advising the City Council as to why you would like to serve as a Council Member for the Chuckatuck Borough.

______A resume is attached

______I certify, based on information and belief formed after reasonable inquiry, the statements and information contained in these documents are true, accurate and complete.

Date: Printed Name: Signature

3 Chuckatuck Borough Precincts

Legend Approved: 10/05/2011 ^_ Polling Stations Street Centerlines / Chuckatuck Borough

Precincts

DISCLAIMER: THE CITY OF SUFFOLK MAKES NO WARRANTY, REPRESENTATION, OR GUARANTEE OF ANY KIND REGARDING EITHER ANY MAPS OR OTHER INFORMATION PROVIDED HEREIN OR THE SOURCES OF SUCH MAPS OR OTHER INFORMATION. THE CITY OF SUFFOLK SPECIFICALLY DISCLAIMS ALL REPRESENTATIONS OR WARRANTIES, EXPRESS OR IMPLIED, INCLUDING, WITHOUT LIMITATION, THE IMPLIED WARRANTIES OF MERCHANTABILITY AND FITNESS FOR A PARTICULAR PURPOSE.

The City of Suffolk assumes no liability either for errors, omissions, or inaccuracies in the information provided regardless of the cause. The City further assumes no liability for any decision made, action taken, or action not taken by the user in reliance upon any maps or information provided herein.

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