Example Supplemental Application

Congratulations on moving forward to the supplemental application for the Citizens Redistricting Commission (Commission). You must provide an answer to all questions that apply to you. If you miss a question, you will be prompted to answer missing responses before you can submit the application.

You do not have to complete the entire application at one time. At any point, you can save your application using the "Save Application" button. After the application has been saved, you can use your email address and password to return to this site to complete the application. Be sure to submit your supplemental application on or before September 20, 2019.

All fields with * are required to submit the application.

Part 1: Essay Questions:

The response to each of the following essay questions is limited to no more than 3200 characters including spaces (approximately 500 words). The response fields below will allow you to cut and paste text from any word processing program such as Microsoft Word.

Part 2: General Information

Secondary Education
Did you graduate from high school?*
If not, do you possess a GED or equivalent?

University or College, Business, Correspondence, Trade, or Service School(s) Attended

Post-Secondary Education

Employment History

Employment History

Activities

Former Names, Nicknames or Aliases

Have you used or been known by any other names, nicknames, or aliases since you became an adult?*

Criminal History

Have you ever been convicted of a felony by any court?*
Criminal History

* If known, include the reference to the statute under which you were convicted (i.e. Penal Code section 424).

Voting Information

When you voted in any of the last three statewide general elections (i.e. the elections in November 2014, November 2016, and November 2018), did you vote using a different name or address than those you used on the initial application?*

Former Residences

List all of the places you have lived for 30 days or more at one time during the last 10 years (do not include information for where you lived prior to your 18th birthday). This does not include your current residence. If you lived in temporary housing while permanently residing somewhere else, note that with an * in the street address line:

Former Residence

Financial Contributions

List all of the monetary and non-monetary contributions valued at a total of $250 or more that you have made in any single calendar year during the past two years to any professional, social, political, volunteer, and/or community organization or cause. Begin with your most recent contribution:

Financial Contribution

Part 3: Family Information

You must provide information about each living family member described in this paragraph. Information about each of your family members is necessary to determine whether you have a conflict of interest that would prohibit you from serving on the Citizens Redistricting Commission. In this part of the application, you must provide information about your living parents, spouse, registered domestic partner (RDP), children, siblings, parents-in-law, siblings-in-law, sons-and daughters-in-law. Step-parents, step-children, and step-siblings count as parents, children, and siblings.

Do you have any immediate family members as described?*
Family Member
For this family member, you must state whether within the past 10 years this person has engaged in any of the activities that could cause you to have a conflict of interest under the Voters FIRST Act. The following is a list of those activities:
  • 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.)
  • Served as an officer, employee, or paid consultant of a California political party or the campaign committee of a candidate for a California congressional or elective state office.
  • Served as an elected or appointed member of a political party central committee operating in California.
  • Been a lobbyist registered with the State of California or a California local government.
  • Been a registered federal lobbyist.
  • Served as paid California congressional, legislative, or State Board of Equalization staff.
  • Contributed $2,500 or more during a calendar year to any California congressional, state, or local candidate for elective public office.
Within the past 10 years, has the family member engaged in any of these activities that could cause you to have a conflict of interest?*

For each family member you must indicate whether you have a special (bona fide) relationship with that person. You have a special (bona fide) relationship with a family member if during the past 12 months you have (Guidance for determining Conflicts of Interest):

  1. Cohabitated with that person for a period or periods totaling 30 days or more.
  2. Shared with that person ownership of any real or personal property having a total value of $1,000 or more.
  3. Provided to or received from that person a financial benefit totaling $1,000 or more.
Do you have a special relationship with this person based on any of the three factors described?*

Other Relevant Material

Part 4: Letters of Recommendation

An applicant must submit, or arrange for the submission of, three letters of recommendation from individuals or organizations. A letter of recommendation may be no longer than three pages. Guidance for letters of recommendation. (Note: Any additional recommendations may be submitted as a public comment and public comments are considered by the Applicant Review Panel. However, a public comment submitted about you will not count as a letter of recommendation.)

An applicant's letters of recommendation must be submitted to the California State Auditor's Office (State Auditor's Office) on or before September 20, 2019. All three letters of recommendation must include your applicant identification number, which is 999999. This identification number is unique to your application and ensures that all of your letters of recommendation are correctly attached to your application file before they are reviewed by the Applicant Review Panel.

Online Submission of Letters of Recommendation

We have provided three links for you to provide to the individuals who will be submitting letters of recommendation on your behalf. Each link may be used for only one letter and will expire upon that letter's submission. Remember to communicate to the individuals writing your letters of recommendation that their letters must include your applicant identification number, as provided above.

Submission of Letters of Recommendation via E-mail, Facsimile, Mail, or Common Carrier

Online submission of letters of recommendation is preferred. You may also submit letters of recommendation via email to shapecaliforniasfuture@auditor.ca.gov, by facsimile to (888) 694-5288, or by U.S. Mail or other common carrier mailed to the address provided below. All letters of recommendation submitted via email, facsimile, U.S. Mail, or other common carrier must include both your application identification number (999999) and the letter of recommendation number (1, 2, or 3). Letters of recommendation sent to the State Auditor's Office that are not received or postmarked by September 20, 2019, will not be considered, and the applicant will not continue on in the application process.

The letters of recommendation must be addressed to the Applicant Review Panel and can be mailed to:

Applicant Review Panel
c/o California State Auditor's Office
621 Capitol Mall, Suite 1200
Sacramento, California, 95814

Part 5: Financial Disclosure Form

If likely to be selected for an interview, you will be required to submit FPPC Form 700, Statement of Economic Interests. The Fair Political Practices Commission's website has more information about the FPPC Form 700. You do not need to submit that form now. You will receive an email at a later date if you will be required to submit this form.

Part 6: PRIVACY NOTIFICATION AND WAIVER

LEGAL AUTHORITY AND REASON FOR COLLECTION OF PERSONAL INFORMATION

The Voters FIRST Act (Act) and the regulations implementing the Act require that the selection of commissioners for the Citizens Redistricting Commission (Commission) be open to public scrutiny and the press (California Constitution, Article XXI, section 2, subdivision (c); Government Code sections 8252, 11120, 11121, and 11125.1; California Code of Regulations, title 2, sections 60835, 60836, 60842, and 60846). The Act also requires the California State Auditor's Office (State Auditor's Office) to select 60 of the most qualified applicants based upon their voter affiliation; eligibility to serve pursuant to Article XXI of the California Constitution; the absence of any conflicts of interest; relevant analytical skills; ability to be impartial; appreciation for California's diverse demographics and geography; and racial, ethnic, geographic, gender, and economic diversity. To determine 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, State Auditor's Office staff, and 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, it is mandatory that you submit a response for each item of information requested.

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 State Auditor's Office or Applicant Review Panel investigation of you, and all public comments and responses to public comments about your application are public records. You agree that the State Auditor's Office shall provide copies of these materials to members of the public and the press, members and staff of the Applicant Review Panel, State Auditor's Office staff, the Legislature, the Commission, and as otherwise compelled by law. You understand that members of the Applicant Review Panel and the public may make public statements about you. You authorize the State Auditor's Office to use the information submitted by and about you as the State Auditor's Office deems necessary to select commissioners, replacement commissioners, or otherwise comply with its legal duties. You also authorize the State Auditor's Office to post all materials related to your application to serve on the Commission on its website and any website authorized by the State Auditor's Office.

VOLUNTARY WAIVER OF PRIVACY RIGHTS AND STATE AUDITOR'S OFFICE LIABILITY

By applying to be a commissioner, you are waiving your privacy and other rights under various state and federal laws including, but not limited to, the Information Practices Act (Cal. Civil Code section 1798 et seq.), and any defamation, invasion of privacy, and negligence claim you may have against the State Auditor's Office and those acting on its behalf. Accordingly, by waiving your privacy rights, you are agreeing to permit the State Auditor's Office to release any and all information submitted by or about you, EXCEPT that the State Auditor's Office will not post on the Internet your date of birth; physical, mailing, and email addresses (excluding the city and county); telephone numbers; the addresses and telephone numbers of your immediate family members; or any materials that the State Auditor's Office deems offensive. At this point in the process, the State Auditor's Office will not collect, and you should not voluntarily submit to the State Auditor's Office, 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 State Auditor's Office to make public information submitted by or about you for a period of 12 years from the date of your application, even if you are not selected as a commissioner. You are providing this waiver voluntarily, understanding that the State Auditor's Office shall not be legally liable as a result of the release of information submitted by or about you or as the result of comments made about you by others, and that the State Auditor's Office will post on its website or otherwise release publicly. This includes claims of defamation, invasion of privacy, negligence, and any other statutory or common law claims.

WHOM TO CONTACT

You have a right to review personal information the State Auditor's Office maintains about you and to verify its accuracy. Please contact the State Auditor's Office's Information Privacy Officer at (916) 445-0255; 621 Capitol Mall, Suite 1200, 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.