Applicant: Stanley R. Forbes, phase1-5926

Initial Application for Citizens Redistricting Commission

Submission Timestamp: 01/07/2010 18:49:38

Identification Information

Prefix (such as Mr., Mrs., Miss): Mr.
First Name: Stanley
Middle Name or Initial: R.
Last Name: Forbes
Suffix (Such as Jr., II, III, Esq.):
Physical Address
City: Esparto
State (if temporarily residing outside of California): CA
Zip/Postal Code: 95627
Country (if temporarily residing outside of the United States):
Mailing Address (if different than Physical Address)
City: Esparto
State (if temporarily residing outside of California): CA
Zip/Postal Code: 95627
Country (if temporarily residing outside of the United States):
County of Residence (if residing in California): Yolo

The Voters FIRST Act is designed to produce a Citizens Redistricting Commission that is reasonably representative of the state’s diversity. This information is required to help the Applicant Review Panel identify a diverse pool of most qualified applicants. Your age may be calculated from your date of birth and made public.

Gender


Racial or Ethnic Background

Select the circle that best describes your race/ethnicity:

: Persons having origins in any of the tribal peoples of North America, and who maintain cultural identification through tribal affliation or community recognition.

: Persons having origins in any of the original peoples of the Far East, Southeast Asia, or the Indian Subcontinent. This includes China, Japan, Korea, and the Philippine Islands.

: Persons having origins in any of the black racial groups of Africa.

: Persons of Mexican, Puerto Rican, Cuban, Central or South American, or other Spanish culture or origin, regardless of race.

: Persons having origins in the Pacific Islands, such as Samoa.

: Persons having origins in any of the original peoples of Europe, North Africa, or the Middle East.

: Specify:

Economic Status

What was your total household income during the past 12 months?

Eligibility Information

If you have any questions regarding your prior voting registration, voting record or party affiliation, we suggest that you contact the county clerk or voter registrar in the county in which you resided during the period of time in question. The contact information and address for California’s county elections offices can be found at http://www.sos.ca.gov/elections/elections_d.htm.

1. Have you been continuously registered to vote in the State of California since November 18, 2005?


2. With what party are you registered?

: Specify:

3. Has your voter affiliation remained the same since November 18, 2005?


4. Indicate in which of the last three statewide general elections you voted, check all that apply:

Conflicts of Interest

The Voters FIRST Act is designed to produce a Citizens Redistricting Commission that is independent from legislative influence, and therefore disqualifies from service any person having a “conflict of interest,” as defined by the Act. The information below is required to help the State Auditor and the Applicant Review Panel identify any conflicts of interest you may have.

5. Have you done any of the following within 10 years of the date you submit this application?

Yes No
a) Been appointed to, elected to, or a candidate for a California congressional or state office? (“Appointed” means appointed by the Governor, a member of the Legislature, or a member of the State Board of Equalization, or served at the pleasure of the Governor, a member of the Legislature, or a member of the State Board of Equalization.)
b) Served as an officer, employee, or paid consultant of a Calfornia political party or of the campaign committee of a candidate for a California congressional or elective state office?
c) Served as an elected or appointed member of a political party central committee in California?
d) Been a lobbyist registered with the State of California or a California local government?
e) Been a registered federal lobbyist?
f) Served as paid California congressional, legislative, or State Board of Equalization staff?
g) Contributed $2,000 or more to any California congressional, state or local candidate for elective public office in any calendar year?
6. Are you currently serving as staff, or as a consultant to the Governor of California, a member of the California Legislature, a California member of Congress, or a member of the State Board of Equalization?
7. Are you currently under contract with the Governor of California, a member of the California Legislature, a California member of Congress, or a member of the State Board of Equalization?

When answering questions 8 and 9, “immediate family” means your parents, spouse, registered domestic partner, children, siblings, parents in-law, siblings in-law, and sons and daughters in-law with whom you have:

Yes No
8. Do you have an immediate family relationship with the Governor of California, a member of the California Legislature, a California member of Congress, or a member of the State Board of Equalization?

9. Within the last ten years, has a member of your immediate family done any of the things asked about in questions (a) through (g) below?

Yes No
a) Been appointed to, elected to, or a candidate for a California congressional or state office? (“Appointed” means appointed by the Governor, a member of the Legislature, or a member of the State Board of Equalization, or served at the pleasure of the Governor, a member of the Legislature, or a member of the State Board of Equalization.)
b) Served as an officer, employee, or paid consultant of a Calfornia political party or of the campaign committee of a candidate for a California congressional or elective state office?
c) Served as an elected or appointed member of a political party central committee in California?
d) Been a lobbyist registered with the State of California or a California local government?
e) Been a registered federal lobbyist?
f) Served as paid California congressional, legislative, or State Board of Equalization staff?
g) Contributed $2,000 or more to any California congressional, state or local candidate for elective public office in any calendar year?

PRIVACY NOTIFICATION AND WAIVER

LEGAL AUTHORITY AND REASON FOR COLLECTION OF PERSONAL INFORMATION

The Voters FIRST Act (the Act) and the regulations implementing the Act require that the selection of Commissioners on the Citizens Redistricting Commission (Commission) be open to public scrutiny and the press (see subd. (d), Sec. 2, Voters FIRST Act; subd. (b), Sec. 2, Art. XXI, Cal. Const.; subd. (c), Secs. 8252, 11120, 11121, and 11125.1 Cal. Gov. Code; 2 CCR 60835, 60836, 60842, and 60846). The Act also requires that the Bureau of State Audits (bureau) select 60 of the most qualified applicants based upon their voter affiliation, the absence of any conflicts of interest, their qualifications to serve pursuant to Article XXI of the California Constitution, their relevant analytical skills, ability to be impartial, appreciation for California’s diverse demographics and geography, and their racial, ethnic, geographic, gender and economic diversity. To assess each applicant’s identity and qualifications to serve on the commission, and to track the demographic information of the applicant pool, this application seeks personal information about applicants that will be provided to the Applicant Review Panel, bureau staff, the public, including members of the press, the Legislature, and the commission.

CONSEQUENCE OF NOT PROVIDING ALL REQUESTED INFORMATION

Failure to provide all of the requested information will result in your disqualification and the removal of your name from the applicant pool. Thus, if you wish to serve on the commission, for each item of information requested, it is mandatory that you submit a response.

PERMISSION TO USE AND RELEASE PERSONAL INFORMATION

By submitting this application, you acknowledge that the application, all documents submitted in support of your application, including a Statement of Economic Interests (FPPC Form 700), if you are asked to submit one, letters of recommendation, materials generated as a result of any bureau and Applicant Review Panel investigation of you, and all comments about and responses to comments about your application are public records. You agree that the bureau shall provide copies of these materials to members of the public and the press, members and staff of the Applicant Review Panel, bureau staff, the Legislature, the commission, and as otherwise compelled by law. You authorize the bureau to use the information submitted by and about you as the bureau deems necessary to select commissioners and replacement commissioners or otherwise comply with its legal duties, and you also authorize the bureau to post all materials related to your application to serve on the commission on its website and any website authorized by the bureau.

VOLUNTARY WAIVER OF PRIVACY RIGHTS AND BUREAU LIABILITY

By applying to be a commissioner, you are waiving your privacy rights under various state and federal laws, including, but not limited to, the Information Practices Act (Cal. Civil Code § 1798 et seq.). Accordingly, by waiving your privacy rights, you are agreeing to permit the bureau to release any and all information submitted by or about you, EXCEPT that the bureau will not post on the Internet your date of birth, current physical, mailing, and email addresses (excluding the city and county), and telephone numbers, or the addresses and telephone numbers of your immediate family members. At this point in the process, the bureau will not collect, and please do not voluntarily submit to the bureau, your social security number, driver’s license number, financial account numbers, or health information. By submitting your application, you acknowledge and consent to the release of the information you and others are providing related to you, and except as specifically provided above, you are waiving your right to privacy regarding all information relating to you and your application to serve as a commissioner. This waiver authorizes the bureau to make public information submitted by or about you for a period of twelve (12) years from the date of your application, even if you are not selected as a commissioner, and you are providing this waiver voluntarily, understanding that the bureau shall not be legally liable as a result of the release of information submitted by or about you.

WHO TO CONTACT

You have a right to review personal information the bureau maintains about you and verify its accuracy. Please contact the bureau’s Privacy Officer at (916) 445-0255, 555 Capitol Mall, Sacramento, California, 95814 if you would like to view or obtain information about the location of your records and the categories of persons who use the information in your records.

Affirmation

I affirm, by entering my initials in the box, that the statements contained in this application are true and correct to the best of my knowledge, and that I have read and understand the Privacy Notification and Waiver.

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